Clinical Anatomy and Medical Malpractice—A Narrative Review with Methodological Implications

Abstract

Anatomical issues are intrinsically included in medico-legal methodology, however, higher awareness would be needed about the relevance of anatomy in addressing medico–legal questions in clinical/surgical contexts. Forensic Clinical Anatomy has been defined as “the practical application of Clinical Anatomy to the ascertainment and evaluation of medico-legal problems”. The so-called individual anatomy (normal anatomy, anatomical variations, or anatomical modifications due to development, aging, para-physiological conditions, diseases, or surgery) may acquire specific relevance in medico–legal ascertainment and evaluation of cases of supposed medical malpractice. Here, we reviewed the literature on the relationships between anatomy, clinics/surgery, and legal medicine. Some methodological considerations were also proposed concerning the following issues: (1) relevant aspects of individual anatomy may arise from the application of methods of ascertainment, and they may be furtherly ascertained through specific anatomical methodology; (2) data about individual anatomy may help in the objective application of the criteria of evaluation (physio–pathological pathway, identification–evaluation of errors, causal value, damage estimation) and in final judgment about medical responsibility/liability. Awareness of the relevance of individual anatomy (risk of iatrogenic lesions, need for preoperative diagnostic procedures) should be one of the principles guiding the clinician; medico–legal analyses can also take advantage of its contribution in terms of ascertainment/evaluation.

Keywords

• medical malpractice
• anatomical variations
• iatrogenic lesions
• post-mortem imaging
• clinical anatomy
• forensic clinical anatomy