Legal proceedings against doctors in the COVID-19 era: an Italian phenomenon

Editor – At the time of writing, more than 165,000 cases of SARS-CoV-2 infection have been confirmed in Italy. Although the number of new daily positives is decreasing, the situation is still severe, especially for healthcare workers who struggle every day, risking their own lives and that of their relatives. The situation is aggravated by the fact that in recent weeks in Italy, several law firms have taken advantage of the desperation of these days to advertise and bring lawsuits against doctors, making them the scapegoat for the global pandemics.

In Italy, more than 116 doctors died due to the SARS-CoV-2 infection since the beginning of the pandemic.¹ We collected data on each one of them, using local newspapers and obituaries as sources. We found out that 110 were male (95%) and only 6 were female (5%), the youngest was 49 years old, the oldest 94 years old and the average age was 70 years old. Five of these doctors had returned from retirement to help with the emergency, only 21 were retired. Eighty-two per cent of the deceased worked closely with patients at the time of the infection.

On 19 March 2020 and 26 March 2020 there were 8 deaths, the highest number in the whole month; 49 were family doctors, followed by dentists (10 deaths). Those most at risk were doctors who operate outside hospitals. General practitioners, since the emerging of more and more COVID-19 cases, have highlighted the problem of not having enough personal protective equipment or even just detergents. To cope with the problem, they have adopted various safety measures, including communications with the patients by telephone and prescriptions strictly made online. Moreover, given the shortage of medical specialists, healthcare workers had to drastically increase working hours to provide adequate assistance to the ill.

In addition to these dramatic circumstances, as the number of SARS-CoV-2 infected people grew, more and more physicians started being denounced by lawyers who wanted to speculate on this situation, requiring the intervention of the country's National Federation of Orders of Surgeons and Dentists (FNOMCeO).²

The moral question we would like to raise is: ‘To what extent one doctor, who fights in the front lines endangering his own life, and that of his relatives, should be held accountable for the death of a patient with COVID-19?’

It should be noted that, according to the current Italian law, if a doctor is an employee of a health facility, whether private or public, he will be protected by the health facility which can move in recourse if the doctor has acted with willful misconduct or gross negligence. The current system would already provide for guarantees that contemplate emergency situations. To put these guarantees in place, however, criminal investigations would still have to be carried out.

This phenomenon, if not curbed immediately, is likely to reduce the availability of healthcare professionals, thus aggravating the shortage of health specialists and giving way to long and expensive legal proceedings that would distract doctors from their work and increase the psychological pressure on them.

For this reason, we believe that during this unprecedented global health crisis, lawyers should not be allowed to sponsor lawsuits against doctors and new measures must be taken to safeguard health professionals, not only physically and financially, but legally too. However, these measures should at the same time prevent any ethically incorrect behavior from passing under a penal shield.