The two should not be confused, although some legal cases may involve both, for example, when a physician is called as an expert witness in a malpractice case against another health care provider. Caring for patients who travel when they become ill abroad and for travellers who have returned ill are another source of medico-legal risk. While travel physicians commit to consulting with a traveller by phone or email, there is always a duty of care. The travelling physician should be aware of the limitations associated with a consultation that does not allow for an in-person interview and physical examination. Caution should be exercised during remote telemedical consultations. Referral to a local health care provider may be the preferred option if possible. Most clinical negligence litigation involves either non-diagnosis or delay in diagnosis. This is particularly relevant for the care of the returning traveler. Depending on the itinerary, it may be important to ensure that the patient is notified prior to travel to see a physician in case they become ill upon return.21 Medico-legal risk awareness helps promote high standards of clinical practice. A prudent approach to informed consent, rigorous clinical notes, and ongoing professional development are important recommendations to mitigate the risk of clinical neglect. The adoption of these medico-legal recommendations will improve patient safety and optimize standards of care. Forensic principles underpin every movement of a clinician.

In a climate where physicians must increasingly justify their actions to patients, colleagues and the Medical Association, knowledge of medical law and your practice guidelines is essential. Good doctors apply clinical knowledge in a way that is legally and ethically correct. They also know when to consult older colleagues and avoid working in silos. Simple things like writing concise and accurate records, getting valid consent from patients, and knowing when to seek advice can help you practice safely. Kieran M. Kennedy, Gerard T. Flaherty, Medico-Legal Risk, Clinical Negligence and Travel Medicine Practice, Journal of Travel Medicine, Volume 23, Number 5, September 2016, taw048, doi.org/10.1093/jtm/taw048 15. Mokhtar M, Azab SMS, Hassan S, Ez-Elarab HS.

Study on the treatment of forensic cases in Cairo`s public hospitals. J Forensic Leg Med. 2018;60:15–24. doi:10.1016/j.jflm.2018.09.001 Medico-legal issues are those dealing with medical law, the rights and obligations of physicians and patients in law. For an allegation of negligence to be proven, four essential facts must be established individually.4 First and foremost, the travelling physician must have a duty of care to the patient. On the other hand, it is not necessary for that professional to have attained a recognized level of practice in the provision of such care. Third, the patient must have suffered physical, financial, psychological and/or other loss. Finally, the loss must have been legally caused by the absence of an accepted standard of care. It is the responsibility of the applicant (i.e. the patient) to prove negligence, and if the evidence for all four aspects is not accepted by the court, the charge of negligence is not upheld.

Such evidence also raises the question of whether there are limits to the health improvements that can be achieved through medical care alone. Understanding the intersection of legal and health inequalities can provide space for innovative solutions and highlights the need to put service users at the heart of any reform. Instead of expecting patients or physicians to navigate complex structures, evidence-based policies and user-centred service models can improve health and equity outcomes. 22. Cohen IG, Gerke S, Kramer DB. Ethical and legal implications of remote monitoring of medical devices. Milbank Q. (2020) 98:1257-89. doi: 10.1111/1468-0009.12481 Some clinicians may have received requests for advice on other aspects of the law. One in five Australians has three or more legal problems in a year, according to a 2012 survey.

Legal issues include accidents, family breakdown, debt and crime. In the study, 30% of respondents sought legal advice from a lawyer and 18.9% sought legal advice from a physician. People with chronic illness or disability were more likely to have legal problems. 16. Hassan Q, Bashir MZ, Shah MM. Physical trauma – a major cause of medical legal cases at DHQ Abbottabad Hospital. J Ayub Med Coll Abbottabad. 2010;22(2):156–159. The present study has potential limitations. This is a single-centre study and may not be generalizable. Further studies are expected to include several centres in the country.

In addition, all reports have been translated into Arabic and English. In addition, the duration of the examination is only six months, which may not be the complete nature of the medico-legal cases that occur in the aforementioned hospital. 8. Chaudhary B, Shukla PK, Bastia BK. Role of the Department of Clinical Forensic Medicine in the quality and standardization of forensic reports. J Forensic Leg Med. 2020;74:102007. doi:10.1016/j.jflm.2020.102007 9. Malik R, Atif I, Rashid F, Abbas M. An analysis of 3105 forensic cases in Rawalpindi tertiary hospital. Pak J Med Sci. 2017;33(4):926–930.

doi:10.12669/pjms.334.11696 Good doctors apply clinical knowledge legally and ethically – but all doctors can slip. Here are survival tips for the top five medico-legal risks for young doctors. The administration of travel vaccines involves many medico-legal risks. The travel physician should have a well-formulated consent procedure to promote informed consent. It may be necessary to complement the discussion about the risks and benefits of vaccination by providing reading materials and time for the patient to make an informed decision. In some cases, it may be necessary to postpone vaccination to a later consultation to give the patient sufficient time to consider available options. While the use of informed consent is recommended, a signed informed consent form does not automatically mean that informed consent has been obtained.8 Careful documentation of the patient`s decision-making process is recommended. This is especially important if a patient refuses vaccinations or other treatments that the travel physician deems necessary. The extent to which pre-existing conditions are taken into account in light of vaccination decisions is of concern. Ignoring an immunosuppressive disease, for example before yellow fever vaccination, could have serious consequences and, after weighing the probability, would likely be considered negligent practice if an adverse patient outcome occurs. If in doubt, the pregnancy status should be questioned and/or effectively verified in the travellers prior to administration of the vaccine.

Management of breastfed travellers also poses a potential medico-legal risk, particularly with respect to failure to vaccinate due to concerns about vaccine safety for the breastfed child. It is generally accepted that breastfeeding is not a contraindication to vaccination, except in the case of smallpox vaccines.9 Standard guidelines and principles of good practice should be followed when drafting the MPR. In addition to the responsibility for patient care, the physician may be required to draft the MLR accurately, in a standardized manner and to report the results of the MLCs to the relevant judicial authorities.