LEGAL AND POLICY CONSIDERATIONS IN USING CLINICAL-PRACTICE GUIDELINES

The increased use of clinical practice guidelines has implications for both public policy and for litigation, Physicians are concerned that the introduction of practice guidelines will reduce their clinical dec ision-making authority and that the failure to follow clinical practic e guidelines will lead to medical liability, Although practice guideli nes are an increasing part of medical pract ice, there has been only l imited litigation to determine the extent to which guidelines will be used to set the applicable standard of cure, This article discusses th e potential legal and public policy issues raised by the introduction and use of clinical practice guidelines. From a legal perspective, the primary issue is whether guidelines will be used to set the ''standar d of care'' or will be one piece of evidence that a jury would use to determine the outcome of medical liability litigation. Based on an ass essment of the applicable legal and policy considerations, the article concludes that courts should admit guidelines into evidence, but that they should not be used as the sole determinant of the standard of ca re, instead, guidelines should be treated as one piece of evidence to be weighed by the jury, This approach will facilitate physician accept ance of guidelines by not imposing liability for the failure to follow guidelines without additional evidence to determine the standard of c are, (C) 1993 by Excerpta Medica, Inc.