For years, lawyers and insurers have counseled doctors and hospitals to "deny and defend" during malpractice cases. Many still warn clients that any admission of fault, or an expression of regret, could invite litigation and imperil careers. But now that healthcare providers are choking on malpractice costs and consumers are demanding action against medical errors, a handful of prominent academic medical centers are trying a different approach. By promptly disclosing medical errors and offering apologies and fair compensation, they hope to restore integrity to dealings with patients, make it easier to learn from mistakes, and dilute anger that often fuels malpractice lawsuits.