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Observations Ethics Man

“How can I avoid being sued?”

BMJ 2011; 343 doi: (Published 14 December 2011) Cite this as: BMJ 2011;343:d7827
  1. Daniel K Sokol, honorary senior lecturer in medical ethics at Imperial College and barrister
  1. daniel.sokol{at}

Common sense is the key

“Doctors don’t care much about ethics,” an unusually frank junior doctor told me one day. “What they care about is law: they don’t want to get sued.” As an ethicist and, like all healthy people, a patient in waiting, I believe strongly that doctors should provide medical care to a high ethical standard.

Yet, as a lawyer, I am aware that many ethical violations have no consequence in law. A healthcare professional may wander through the hospital, exuding rudeness and disdain from every pore, leaving a trail of anxious patients and relatives in his wake, without any legal repercussions. A breach of the duty of care is, in itself, not enough. There must be an injury resulting from that breach; and, in the eyes of the law, grief, anger, and upset are not injuries.

The law, however, does try to keep up with ethics. In Chester v Afshar,1 a neurosurgeon failed to inform the patient of a 1-2% chance of developing cauda equina syndrome from spinal surgery. Sadly, despite being operated on competently, she developed the condition and sued …

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