Introduction

Medicolegal issues are increasingly relevant to practice in critical care, and might lead to various processes within a variety of organizations. The law is complex and variable, and although some familiarity with relevant aspects of legislation is important, the details are probably beyond the grasp of most health care professionals. However, an understanding of the underlying medicolegal issues is usually a good guide to doing the right thing.

But in the end, the best legal defense in medicine is the appropriate care of one's patients.

Ethics, morality and the law

The complexity and variability of the law

Legislation varies between countries. In some countries the law, or a substantial part of it, is codified, or written down. In others, common law pertains, under which the legal position on most issues is not specified, but is determined from case law, on the basis of precedence. Even with codified law, interpretation and precedence are important. Furthermore, policy may have greater practical importance than the law itself.

The law and doing the right thing

Decisions involving life and death are commonplace in critical care and it can be difficult to know exactly how the law applies in the particular circumstances of each individual case. For example, euthanasia is illegal (and amounts to murder) in many countries, and legislation mandating the provision of ‘the necessities of life’ is common, yet the withdrawal of life-sustaining treatment (e.g. mechanical ventilation, intravenous fluids) occurs regularly.