Medical Crimes and the Civil Liability of Physicians
Medicine is a discipline dedicated to preserving and improving health, treating diseases and injuries, and it plays a vital role worldwide. The history of this science dates back to prehistoric times, when human beings sought new methods of treatment by applying available tools and knowledge. As this process continued, medical science became increasingly modernized. Alongside the development of new and diverse treatment methods that have facilitated medical care, practitioners of this profession have also faced growing challenges, including heightened responsibility in the treatment process and increased legal sensitivity.
A substantial number of cases brought before judicial authorities concern allegations of medical errors, professional negligence, and adverse treatment outcomes. As a result, the issue of physicians’ civil liability has become particularly important.
In Iran, medical activities were, for the first time, explicitly subject to statutory regulation through the enactment of laws governing medical crimes. Under these laws, any negligence or error in the performance of professional medical duties may give rise to legal investigation and prosecution.
What Is the Civil Liability of a Physician Toward a Patient?
Medical Error and Medical Negligence From a Legal Perspective
From a legal standpoint, medical error and medical negligence are distinct concepts. A medical error refers to an unintentional act that results in an undesirable treatment outcome. Criminal medical negligence arises when such conduct causes injury or harm due to the physician’s failure to observe professional standards or due care.
Civil Liability of Physicians
The Islamic Penal Code contains specific provisions addressing medical crimes, whereas the Civil Code and the Civil Liability Act are largely silent on this issue. Articles 59 and 60 of the Islamic Penal Code provide that lawful medical and surgical procedures performed with the consent of the patient, or of the patient’s legal guardians or representatives, and in accordance with scientific and technical standards, do not constitute a criminal offense. In urgent cases, obtaining consent is not required. Accordingly, a release obtained by the physician from the patient’s family may exempt the physician from liability for bodily or financial harm resulting from treatment.
As a general principle, the law presumes physician liability unless the absence of fault is proven. Under the fault-based theory, a physician’s obligation is considered an obligation of means rather than an obligation of result. This means that the physician is required to apply all professional skill, care, and effort during treatment, but is not responsible for guaranteeing a cure. A physician is therefore considered liable only when negligence or fault is established.
Article 489 of the new Islamic Penal Code states that if a physician causes death or bodily injury in the course of treatment, the physician is liable to pay blood money unless the treatment was carried out in accordance with accepted medical standards, a release was obtained, and no fault was committed. In such circumstances, obtaining a release eliminates both civil and criminal liability. Mere consent, however, removes only the criminal aspect of liability, while civil liability may still remain.
When Is a Nurse Liable for Harm Caused to a Patient?
When a physician instructs a patient or a nurse to perform certain treatments and bodily injury or death occurs, liability generally rests with the physician unless the physician acted in accordance with professional standards, obtained a valid release, and committed no fault. However, if a nurse becomes aware of an incorrect prescription or instruction and fails to prevent its execution, the resulting harm may be attributed to the nurse or, in some cases, to the patient.
Filing a Complaint or Lawsuit Against Physicians
To file a complaint against a physician, the complainant must first register the complaint through the judicial electronic service offices. After registration, a case file is formed and referred to the specialized prosecutor’s office for medical crimes. Following preliminary investigations by an investigating judge or assistant prosecutor, and upon issuance of an indictment with the prosecutor’s approval, the criminal case is referred to Criminal Court Two, which has jurisdiction to hear the merits of the case and issue a judgment.
What Penalties Apply if a Physician Commits Negligence During Surgery?
If a patient dies as a result of surgery, a complaint may be brought against the physician for medical negligence. The extent of each party’s fault is examined during the criminal proceedings. Pursuant to Article 616 of the Islamic Penal Code, if a physician causes death through negligence, including lack of care, recklessness, or insufficient skill, the act constitutes involuntary manslaughter and is punishable by imprisonment from one to three years. In addition, payment of blood money may be ordered as part of the sentence.
Frequently Asked Questions About Medical Crimes and Civil Liability of Physicians
A physician must apply all professional skill, care, and effort to the treatment process. A physician is held liable only when fault or negligence is proven. In cases where medical negligence results in injury or bodily harm, the physician is responsible for paying blood money or compensating damages.
Medical error refers to an unintentional act that leads to an unsatisfactory treatment outcome. Medical negligence involves conduct such as carelessness, recklessness, or lack of professional skill that causes harm and gives rise to both civil and criminal liability.
If the physician’s actions comply with accepted medical standards, valid consent or release is obtained from the patient or legal representative, and no fault is established, the physician is exempt from civil and criminal liability. Consent alone removes criminal liability, but civil liability may still apply.
If a nurse becomes aware of an incorrect medical instruction and fails to take preventive action, the resulting harm may be attributed to the nurse or, in certain cases, to the patient. Otherwise, primary liability generally rests with the physician.
If medical negligence leads to a patient’s death, the physician may be convicted of involuntary manslaughter under Article 616 of the Islamic Penal Code and sentenced to imprisonment from one to three years, along with the obligation to pay blood money. What is a physician’s civil liability toward a patient?
What is the difference between medical error and medical negligence?
Under what circumstances is a physician exempt from liability?
When is a nurse liable for harm to a patient?
What is the penalty for medical negligence resulting in death?
