Medical liability in Spain's Supreme Court: consolidated doctrine and 2024-2025 rulings
Analysis of Supreme Court case law on medical liability: informed consent, loss of chance, burden of proof and key 2024-2025 rulings.
# Medical Liability in Spain's Supreme Court
General Doctrine
The Supreme Court has established that doctors have obligations of means, not results: they must act in accordance with the lex artis ad hoc but do not guarantee cure. The Civil Chamber (Sala Primera) handles private medicine cases; the Administrative Chamber (Sala Tercera) handles NHS liability.
Informed Consent: Recent Case Law
STS (Civil) 15/3/2024: Lack of informed consent does not automatically generate liability for adverse outcomes. Causation requires proof that, if properly informed, the patient would have refused the intervention ("hypothetical consent" doctrine).
STS (Admin) 22/11/2023: In public medicine, failure to obtain informed consent for a materialized risk creates a rebuttable presumption of causation.
Loss of Chance in Late Diagnosis
The most innovative 2020-2025 case law focuses on late cancer diagnosis. The TS awards loss-of-chance compensation when a screening protocol existed, wasn't followed, and the late diagnosis reduced therapeutic options. Quantification is based on the percentage of survival probability lost (30-70% of total damage value per STS 14/5/2024).
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