Clinical practice guidelines; legal aspects

The number of clinical guidelines is rapidly increasing. The proliferation of guidelines and their growing use in medical practice make them also more conspicuous from a legal point of view. Legal questions relate first of all to guideline development: what are the responsibilities of the makers? when are they liable for 'defects' in their 'products'? Other questions concern the position of doctor and patient: to what extent do guidelines allow for clinical discretion or for patient preferences? How are they to be applied by the courts? The paper briefly discusses these issues, in particular the question to what extent cost-benefit considerations may be taken into account in developing clinical guidelines.