Complications in Neurosurgery: General Ethical Principles for Minimizing Them and Subsequent Legal Action

Medicine and surgery carry inherent risks of inadvertent and unintended harm to the patient. Training, experience, and skill help ensure smooth recovery in most cases. However, there are circumstances beyond the control of the neurosurgeon that may predispose to complications. This review discusses steps that may help to diminish risks to the patient and can be taken before their admission to hospital, in the operating theater, and after surgery. When a complication does occur despite all care, it is essential to maintain total transparency with the patient and his or her family. It is important that they are active witnesses to the care and treatment being lavished on the individual to minimize the harm from the mishap. Should legal action follow despite such efforts, the neurosurgeon must be prepared to defend with the help of a wise, experienced lawyer and to provide evidence of his or her professional competence and the appropriateness of care offered to the patient. In any case, it is counterproductive to view every patient as a potential legal threat or indulge in defensive medical practice.