title: A proposal for limited criminal liability in high-accuracy endoscopic sinus surgery.
abstract: The aim of the present study is to propose legal reform limiting surgeons' criminal liability in high-accuracy and high-risk surgery such as endoscopic sinus surgery (ESS). The study includes a review of the medical literature, focusing on identifying and examining reasons why ESS carries a very high risk of serious complications related to inaccurate surgical manoeuvers and reviewing British and Italian legal theory and case-law on medical negligence, especially with regard to Italian Law 189/2012 (so called "Balduzzi" Law). It was found that serious complications due to inaccurate surgical manoeuvers may occur in ESS regardless of the skill, experience and prudence/diligence of the surgeon. Subjectivity should be essential to medical negligence, especially regarding high-accuracy surgery. Italian Law 189/2012 represents a good basis for the limitation of criminal liability resulting from inaccurate manoeuvres in high-accuracy surgery such as ESS. It is concluded that ESS surgeons should be relieved of criminal liability in cases of simple/ordinary negligence where guidelines have been observed.
authors.affiliation: Laboratory of Forensic Medicine & Toxicology, School of Medicine, Aristotle University of Thessaloniki, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Voultsos
authors.affiliation: Institute of Bioethics & Medical Humanities, School of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Casini
authors.affiliation: School of Law, University of Camerino, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ricci
authors.affiliation: Institute of Philosophy of Scientific and Technological Activity, Campus Bio-Medico University of Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Tambone
authors.affiliation: Institute of Bioethics & Medical Humanities, School of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Midolo
authors.affiliation: Institute of Bioethics & Medical Humanities, School of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: A G
authors.initials: AG
authors.lastname: Spagnolo
mesh_terms: D004724:Endoscopy / Q000592:standards; D006801:Humans; D007558:Italy; D016365:Liability, Legal; D008318:Malpractice / Q000331:legislation & jurisprudence*; D010256:Paranasal Sinuses / Q000601:surgery*; D018570:Risk Assessment
keywords: Endoscopic sinus surgery; Gross negligence; Italian Law 189/2012; Malpractice; Medical liability