SPECIAL ARTICLE   

Minerva Medicolegale 2018 June;138(1-2):12-7

DOI: 10.23736/S0026-4849.18.01773-X

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

Classification of medicolegal risk in aesthetic medicine and plastic surgery

Antonino ARACO ✉

Medical Italian Defence Union (MIDU), Rome, Italy

In aesthetic medicine and in aesthetic plastic surgery, the outcomes are not always those expected by the surgeon and by the patient. This mismatch, between the expected and obtained result, may arise from the occurrence of damaging events. These events may result, either from a professional technical error, or from an expected and predictable complication which is not further preventable from good medical art. From the juridical point of view, two questions arise: is the doctor responsible for any aesthetic damage that occurs as a consequence of an expected and predictable complication, which was also known and accepted by the patient and not further preventable by good medical art?, and is there any medical or legal instruments to distinguish an aesthetic damage resulting from a technical error, from that resulting from any complication? With regard to the first point, it is known that even when a procedure of medicine and cosmetic surgery is performed to “rule of art,” a certain number of events can occur, foreseen and foreseeable, and not further preventable, which leads to the term “complications,” as related to the susceptibility of a specific patient to develop them. Among forensic medicine, if a complication occurs, the doctor cannot be blamed for the patient’s aesthetic damage. Regarding the second point, two juridical medical questions are open: Who can determine whether an event productive of aesthetic damage arise from a medical complication or is the consequence of medical misconduct. Are there any legal or medical scientific instruments to discern damages resulting from complications from damages resulting from medical fault? In order to better define the matter, I have personally analyzed and classified, in three distinct categories of legal medical risk, these events. Therefore, the occurrence of some of these events will presume the “medical complication,” while the occurrence of others will make presume the culpable event. These three categories of medico-legal risk have an exclusive value in the civil juridical field and therefore have no practical application in the criminal legal field.

KEY WORDS: Legal liability - Malpractice - Defensive medicine - Risk management