Current trends for medico-legal disputes related to functional nasal surgery in Italy

The problem of professional liability in case of adverse outcomes or failures secondary to surgery is very sensitive in many countries of the European Community. In Italy, a recent sentence of the Supreme Court concerning a patient who underwent septoplasty raised considerable doubts in relation to the guidance to be followed in disputes related to an alleged professional liability, further exacerbating the juridical orientation of recent years in this context. This ruling involves any surgery, as well as rhinologic surgery, and calls into question most regulatory and legal principles that have traditionally been adopted by the Italian Civil Law. The sentence states that the plaintiff is only required to document the failure of surgical treatment, but not the breach of the duty of care by the surgeon, thus shifting the burden of proof to the physician-debtor. It also considers that, in assessing the degree of negligence, reference should be made to the qualifications of the surgeon, according to principles that are not covered by current regulations, denying that in general surgery (i.e., not with aesthetic purposes) the surgeon must only to act with diligence and need not guarantee a favourable outcome. This series of statements, complementing one another and evolving more unfavourably towards physicians, facilitate legal disputes for speculative purposes through complainants, with obvious health and socio-economic implications.