Clinical Guidelines and Professional Liability: A Short Comment from the Legal Side

Abstract

The paper explores the relationship between clinical guidelines and medical liability. In order to ascertain the standard of care required for example in ear surgery, courts rely on expert opinions and on existing clinical guidelines from medical societies. They assume that clinical guidelines express the reasonable standard of care that, when followed, insulates surgeons from liability. But judges keep the right to find that a set of clinical guidelines does not sufficiently protect the patient’s health interests. If in contrast clinical guidelines are overly cautious (e.g. by requiring a scientifically questionable examination), there is no incentive stemming from the legal rules on medical liability to deter surgeons from following the guidelines. However, a growing concern about health costs may in the future influence professional behaviour as much as fear of a malpractice suit today.

Die Implementierung der Telemedizin im urologischen Alltag

“…Die Operateure müssen ihre Qualifikationen nachweisen und alle Standards der Patientenversorgung und operativen Tätigkeit sollten nachweislich eingehalten werden. Wünschenswert sind tele-medizinische Leitlinien der jeweiligen Berufsgesellschaft, an denen sich der Mediziner orientieren kann [32,33].…”

General Comments on This Issue: How Much Good Does It Take to Make a Real Difference?

“…Some obvious examples of non-relevant information include the molecular structure of a prescribed drug or the biochemical pathways of its metabolism. Here too, there is a threshold: patients should be given any and all information which a reasonable person would need in however, our disagreement on marginal cases is also a reason why guidelines should leave room for adaptation to individual cases, a point made by several contributors to this issue [1,2,5,6] . When benefits are on average marginal, individual circumstances will be very likely to make a relevant difference and push the benefits expected in an individual case over, or sometimes under, the threshold proposed in a guideline.…”