Legal issues in allergy and clinical immunology

Clinical risk management for the allergist focuses primarily on concerns regarding adverse occurrences and the possibility of civil litigation as a result of negligence or professional liability. Risk is substantially reduced with an understanding of such predictable drug reactions as overdosage, side effects, secondary effects, and drug interactions. In addition, all clinicians who prescribe have a duty to disclose to their patients the possibility of unpredictable reactions, including intolerance, idiosyncrasy, and allergy or hypersensitivity. This disclosure should be part of a comprehensive discussion of the risks and benefits of, and alternatives to, therapeutic agents and procedures they recommend. The process of informed consent becomes even more critical with the increasing influence of hospital and managed care formularies on prescribing decisions. Although cost effectiveness is an important factor in prescribing decisions, the possibility of adverse effects, treatment failure, noncompliance, and other negative considerations must also be weighed.