Introduction

The growing number of lawsuits against doctors seems to be related to poor personal communication, unrealistic expectations of performance, the high costs of medical attention, and better informed and more critical patients.1 2 A lucrative industry has developed around this phenomenon. In response, doctors buy expensive insurance, which seriously affects their medical practice, summarised in the concept of “defensive medicine.”3 The practice of defensive medicine includes ordering excessive diagnostic procedures and consultations to minimise the risks of being sued.4 Consequently, the cost of medical care increases, promoting resentment in patients, which in turn favours lawsuits, creating a vicious circle.5

Fear of being sued drives some doctors to additional detrimental actions, such as abandoning risky specialties; refusing to treat seriously ill patients; and using clinical records and informed consent forms as means of legal protection, rather than as medical tools.6^–8 Differentiation between complications (an unintentional or adverse reaction that aggravates the original disease) and negligence (failure to exercise a reasonable degree of care) is not always simple and may be interpreted differently by the doctor and the patient or their legal adviser.9

In lawsuits, the legal counsel is confidential, and medical opinion is in some cases given by professionals whose academic background, fairness, and expertise are inadequate.10^–12 Accusations are submitted through a penal court, because the sole requirement is the presumption, on the side of the claimant, that a misdeed might have been committed. Cases presented in court may take years to resolve; lawyers are hired for a long time with cumbersome financial investment for the patient and the doctor. Deplorably, …