Background:

Italy is one of the few countries globally where physicians can be criminally prosecuted. Despite the pandemic emergency, the total of pending civil sector files in 2020 is rather stable compared to 2019, with a CR equal to 101%. However, erosion has stopped of the pathological backlog, which has suffered a net increase in the Supreme Court (+12%), an evident growth also in the Court (+3.1%) and more contained in the Court of Appeal (+1.1%). It is detected, in any case, a reduction of 7%, compared to 2019, of the pending proceedings before the courts ordinary in commercial matters and, albeit slight, in ordinary litigation. In general, they fell, as of December 31, 2020, the registrations of all civil proceedings. ISTAT has published the information reported by physicians in 4,942 death cards of subjects was analyzed microbiologically diagnosed with a positive SARS-CoV-2 test. During the 2020 COVID-19 pandemic no national effective guidelines/protocols were given so HPs have no official documents to refer to in order to properly treat the patients and this has led to a significant increase in cases evolving into criminal and civil proceedings for medical malpractice.

Results:

The aim of our review is to identify a way by which HPs and Health Institutions can avoid legal proceedings and legal complaints. Despite the pandemic emergency, the total of pending civil sector files in 2020 is rather stable compared to 2019, with a CR equal to 101%. However, erosion has stopped of the pathological backlog, which he has suffered a net increase in the Supreme Court (+ 12%), an evident growth also in the Court (+ 3.1%) and more contained in the Court of Appeal (+ 1.1%). It is detected, in any case, a reduction of 7%, compared to 2019, of the pending proceedings before the courts ordinary in commercial matters and, albeit slight, in ordinary litigation. In general, they fell, as of December 31, 2020, the registrations of all civil proceedings. ISTAT has published the information reported by physicians in 4,942 death cards of subjects was analyzed microbiologically diagnosed with a positive SARS-CoV-2 test (15.6% of the total deaths reported to the ISS Integrated Surveillance System until 25 May). In the cards of deaths are certified, in addition to COVID-19, those conditions and diseases that have played a role in determining death. Law No. 24/2017 states that an HP who commits an avoidable technical error can be considered not guilty if full compliance with proper national guidelines/protocols is proven and it is not a case of “gross negligence” (a term that is not explicitly defined by any law). During the 2020 COVID-19 pandemic no national effective guidelines/protocols were given so HPs have no official documents to refer to in order to properly treat the patients and this has led to a significant increase in cases evolving into criminal and civil proceedings for medical malpractice.

The aim of our review is to identify a way by which HPs and Health Instituions can avoid legal proceedings and legal complaints. Despite the pandemic emergency, the total of pending civil sector files in 2020 is rather stable compared to 2019, with a CR equal to 101%. However, erosion has stopped of the pathological backlog, which he has suffered a net increase in the Supreme Court (+ 12%), an evident growth also in the Court (+ 3.1%) and more contained in the Court of Appeal (+ 1.1%). It is detected, in any case, a reduction of 7%, compared to 2019, of the pending proceedings before the courts ordinary in commercial matters and, albeit slight, in ordinary litigation. In general, they fell, as of December 31, 2020, the registrations of all civil proceedings. ISTAT has published the information reported by physicians in 4,942 death cards of subjects was analyzed microbiologically diagnosed with a positive SARS-CoV-2 test (15.6% of the total deaths reported to the ISS Integrated Surveillance System until 25 May). In the cards of deaths are certified, in addition to COVID-19, those conditions and diseases that have played a role in determining death. Law No. 24/2017 states that an HP who commits an avoidable technical error can be considered not guilty if full compliance with proper national guidelines/protocols is proven and it is not a case of “gross negligence” (a term that is not explicitly defined by any law). During the 2020 COVID-19 pandemic no national effective guidelines/protocols were given so HPs have no official documents to refer to in order to properly treat the patients and this has led to a significant increase in cases evolving into criminal and civil proceedings for medical malpractice.

Conclusion: The crisis physician-patient has been going on for a while and has led to a fracture in the relationship, evident especially in the aggressions that everyday physician suffer and in the number of legal procedures. Doctors do not have the same respect from patients like decades ago.

 In the last few years patients have become more more suspicious against physicians and many of them believe that beyond a particular doctor’s behavior there is a business activity.

This had pushed physician to practice a sort of defensive medicine with higher costs for the NHS (estimated in 8-12 billions €)

 The professionals of health are often targets of attacks not only from those who has actually suffered a damage or a loss but also from people who are only trying to get money from them (i.e. relatives of very old and sick people suing doctors because the elderly died during the pandemic).