Article Text

Download PDFPDF
When is the practice of pathology malpractice?
  1. Raimond W M Giard1,2
  1. 1Department of Clinical Pathology, Maasstad Ziekenhuis, Rotterdam, The Netherlands
  2. 2Rotterdam Institute of Private Law, Erasmus School of Law, Erasmus University Rotterdam, The Netherlands
  1. Correspondence to Dr Raimond W M Giard, Department of Clinical Pathology, Maasstad Ziekenhuis, PO Box 9119, 3007 AC Rotterdam, the Netherlands; rwm.giard{at}


Because of its complex nature, surgical pathology diagnosis has an appreciable degree of fallibility and is increasingly subject to legal scrutiny. In litigation, the first practical step is to explain why and how this adversity could happen, and the second is the question of apportionment of responsibility and its legal consequences. As pathologists, we have to provide a methodology of investigation allowing a clear distinction between reasonable and unacceptable pathology practice without the twist of hindsight. For that we need to examine the different steps from test ordering to the final report. The most critical aspect of the enquiry is the act of diagnosis itself. What can reasonably be expected and what precautions have normally to be taken? Experts are often requested to re-examine the slides. For that we need a well-devised protocol enabling blinded review. Tort law has two important interconnected goals: compensation for damages and prevention of the same slip ever being made again. We can only properly learn from our mistakes if we carry out an unbiased investigation. Poor normative judgement of diagnostic failures will backfire on the profession.

  • Pathology
  • medico-legal aspects
  • professional misconduct
  • negligence
  • professional
  • insurance
  • liability
  • diagnosis
  • medical law

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.