Beyond Individual Fault: A Context-Sensitive Framework for Assessing Medical Liability in Obstetrics and Gynaecology

Previous obstetric and gynaecological malpractice reviews identify recurring concerns but do not specify a sequence for examining conduct before deviation, causation and attribution. We developed a context-sensitive conceptual framework.

A structured critical narrative review of PubMed/MEDLINE, Scopus and Web of Science Core Collection was combined with analysis of Romanian legal and professional sources. The broad searches yielded 1785 database records before deduplication. The team's legal specialist manually screened the overlapping thematic searches 2A-2D using her subject expertise; duplicates were removed and 223 unique publications were retained. The 347 records reported for thematic search 2A alone are not the input denominator for that corpus. She extracted the information for 40 selected anchor publications, mapping them to eight broad themes. The thirteen-domain Context-Sensitive Liability Assessment Framework for Obstetrics and Gynaecology (CSLAF-OG) was illustrated using three principal Romanian judicial cases and one additional case.

The framework orders context, professional standards, autonomy, communication, documentation and organisational conditions before harm, deviation, causation and attribution.

CSLAF-OG is a conceptual aid for retrospective analysis, not a validated instrument or legal test. Independent evaluation remains necessary.