For a physician who has been named as a defendant in a medical malpractice lawsuit, the decision whether to settle has significant legal, practical, and ethical implications. The physician defendant typically has extremely strong feelings concerning such a decision. Emotions can range from relief and gratitude to extreme anger. Physicians sometimes oppose settlement because they believe that settling is tantamount to acknowledging that a claim has merit. This article will discuss the legal, practical, and ethical considerations of a medical malpractice settlement for the physician and the defense attorney. Hopefully, increased understanding of these important and often competing factors will lead to a more informed, and, therefore, better decision for the physician. The Defense Team