Medicolegal Issues: Perception, Awareness, and Behavioral Changes Among Italian Neurosurgical Community: Survey-Based Analysis

Background: Despite the rising trend of medicolegal challenges in Italy, there is a significant lack of literature on this topic. To provide better understanding of awareness toward medicolegal aspects, defensive behavior, consent-taking practice, and general perceptions of Italian neurosurgeons on this issue, a cross-sectional survey was conducted. Methods: A questionnaire covering various aspects of medicolegal issues, in an anonymous online form, was sent to neurosurgeons practicing in Italy via e-mail-through a national mailing list-and social media platforms. The data collection period was November 1, 2020 to December 31, 2020. Results: A total of 64 single responses were included. We assessed 1) awareness of Italian neurosurgeons about a legal framework: a low level of knowledge has been reported-87.5% were unaware of the terms and conditions outlined by the contract with the institution, 75.6% of respondents stated they didn't know the main body of law that governed the medical community; and 2) perception toward defensive medicine: 92.2% believed that they were not trained to face possible medicolegal issues, but only a few tried to acquire more knowledge about medical legal issues, such as learning how to obtain a proper informed consent for a surgical procedure (34.4%). Conclusions: This study marks the first survey to identify the perceptions among Italian neurosurgeons of medical legal issues and related "defensive medicine" practices: This is of relevance given its exorbitant cost in terms of public expenditure, psychologic burden, and its relevant impact on health care delivery.