An exploratory study of the impact of the medico-legal environment on surgical practice in Ireland

Thumbnail Image
Defensive_Medicine_CORA.pdf(344.16 KB)
Accepted Version
Tumelty, Mary-Elizabeth
Cinnamond, Kaitlyn
Hannigan, Ailish
Tierney, Sean
Spain, Eimear
Journal Title
Journal ISSN
Volume Title
Brill Academic Publishers
Research Projects
Organizational Units
Journal Issue
Defensive medicine describes behaviours engaged in by physicians, for the purposes of averting the threat of medical negligence litigation and/or complaints. Defensive practice typically encompasses ‘assurance’ or ‘avoidance’ behaviours, or ‘positive’ or ‘negative’ defensive medicine. Assurance behaviours include, for example, meticulous notetaking and ordering further clinically unnecessary tests, whereas avoidance behaviours encompass actions such as refusing to engage with a patient perceived to be high-risk. Whilst such practices may be understandable, defensive medicine is problematic for a number of reasons: it may result in a lower standard of patient care, where for example, a patient is exposed to unnecessary risk(s); and it can increase healthcare costs, which in turn limits resources. Drawing on the findings of a survey of surgeons in Ireland, this study investigates the existence of defensive practices, and explores the impact of the civil and regulatory responses to patient safety incidents on surgical practice. Given the increasing emphasis on patient safety and cultivating a “no-blame” culture both nationally and internationally, the findings of this research illustrate the tension between the current medico-legal and regulatory environment and medical practice, with implications for quality and safety.
Defensive medicine , Liability , Litigation , Patient safety
Tumelty, M. E., Cinnamond, K., Hannigan, A., Tierney, S. and Spain, E. (2021) 'An exploratory study of the impact of the medico-legal environment on surgical practice in Ireland', European Journal of Health Law, 28. doi: 10.1163/15718093-bja10056
© 2021, Brill Academic Publishers. All rights reserved.