• Ismail Zaed, Grazia Menna, Anna Maria Auricchio, Franco Servadei, Diego Garbossa, Alessandro Olivi, and Giuseppe Maria Della Pepa.
• Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Neurosurgery, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy.
• World Neurosurg. 2021 Oct 1; 154: e774-e780.

BackgroundDespite 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.MethodsA 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.ResultsA 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%).ConclusionsThis 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.Copyright © 2021 Elsevier Inc. All rights reserved.

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