["Guidelines, codes of practice, standards". Risk or chance for physician and patient?]

As far as the law concerning liability is concerned, guidelines, codes of practice, and medical standards are not contrasting concepts, nor do they indicate material differences; instead, those terms describe more or less precisely the care that a physician is required to exercise when treating patients and that a judge is required to assess in a trial. Guidelines, codes of practice, and standards thus take effect not directly, but indirectly, in that both physician and judge retain a certain discretion in making decisions in a particular case. The current obsession with guideline--primarily based on economic considerations and present in all specialist areas--together with the increasingly detailed rules that are being issued, carries the risk that to medical profession may of its own doing become too restricted, that physicians will become limited in their choice of treatment, and that the criteria by which liability is assessed will become stricter, thus increasing the physician's risk of being held liable under civil or criminal law. We need to prevent a development taking place in which "medical standards" become "standardized medicine", leading to a situation in which only what is stipulated in the form of a guideline or a code of practice will be paid for (and hence only that can be done).