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Commentary on the Judgment of the Court of Cassation, Criminal Section No. 30051 of 2022: Medical Responsibility and Professional Negligence

The recent ruling by the Court of Cassation No. 30051 of July 29, 2022, provides significant insights regarding the responsibility of the doctor in case of complications during a procedure. In this specific case, M.V., an endoscopic surgeon, was convicted of professional negligence following the death of a ninety-year-old patient, N.M., after a colonoscopy. Let's analyze the key points of the ruling and the legal implications arising from it.

The Context of the Case

The Court of Appeal of Venice had upheld the conviction of M.V., considering that the procedure was carried out without following the guidelines and without the necessary thoroughness. The patient, affected by significant comorbidities, underwent an invasive examination that was not entirely justified by the symptoms presented.

The specialist doctor must necessarily proceed before performing the endoscopic examination with both the anamnesis and clinical assessment and the evaluation of the appropriateness of the requested examination.

The Reasons for the Conviction

V.M.'s appeal was based on several arguments, including the alleged insufficiency of evidence and the violation of legal principles. However, the Court confirmed that the surgeon should have evaluated not only the patient's conditions but also the indication of the examination diagnosed by the attending physician, as the risk of complications in elderly patients is significantly higher.

  • Failure to suspend the examination despite the patient's poor intestinal preparation.
  • Failure to consider less invasive diagnostic alternatives before proceeding with the colonoscopy.
  • An approach that demonstrated a lack of prudence and professional diligence.

Legal and Professional Implications

This ruling emphasizes the importance of professional responsibility of the physician, particularly in the endoscopic field. The Court reiterated that the surgeon is not merely an executor of orders but must always act according to the principles of prudence and diligence, taking into account the complete clinical picture of the patient.

Furthermore, it highlights how defensive medicine, often invoked in similar contexts, cannot justify choices that compromise patient safety. It is essential for doctors to have adequate training and to follow the guidelines, not only to protect themselves from potential legal liabilities but also to ensure the health and safety of patients.

Conclusions

The ruling of the Court of Cassation No. 30051 of 2022 represents an important precedent in the field of medical responsibility. It highlights the obligation of the physician to carefully evaluate every intervention and to choose the most appropriate diagnostic approach, always respecting the guidelines and taking into consideration the specific conditions of the patient. In this perspective, continuous education and professional updating play a crucial role.