Medicolegal sidebar: the law and social values: conformity to norms.

T he last two articles published in the Medicolegal Sidebar addressed the complex interplay between the law and social values [1, 2]. Sometimes, court decisions may appear to be arbitrary and unfair to the medical profession, but a deeper examination of judicial rulings can show the practical tensions that courts sometimes face in adjudicating medical malpractice claims. We previously addressed the development of legal doctrines that are relevant to medical malpractice cases, such as ‘‘loss of chance’’ [1] and ‘‘res ipsa loquitor’’ [2]. In this article, we ask whether physician conformity to established and accepted treatment norms should always insulate the provider against medical malpractice claims. The question is relevant because of the prevailing assumption among physicians that compliance with the medical standard of care requires conformity to treatment norms that their peers would follow in comparable circumstances [14]. Indeed, a general assumption in medical malpractice litigation is that a physician or a surgeon who conforms to the prevailing norms of professional conduct, as described by an expert witness, should not be found liable for medical negligence [11]. However, as this article will illustrate, conformity to a medical norm as a measure of professional performance or medical negligence presents daunting challenges to American jurisprudence.