Clinical practice guidelines; legal aspects

In many countries, practice guidelines are considered an important means to make medical decisions more effective and rational. The growing use of such standards raises a number of legal questions: What is the legal status of practice guidelines? What are the responsibilities of the makers? To what extent do guidelines allow for clinical discretion or for patient preferences? How are they applied by the courts? This paper briefly discusses these questions in the context of Dutch law and medicine. It also addresses the issue, to what extent cost-benefit considerations may be taken into account in developing clinical guidelines.