Publication date: May 09, 2025
Physicians’ liability is one of the key pillars of the healthcare system. It provides mechanisms for controlling the quality of medical services and protecting patients from errors and negligence. In the Polish legal system, this liability is multidimensional, encompassing disciplinary, civil and criminal liability. Each of these areas has a separate function, although their common goal is to ensure safety and maintain high standards of medical practice.
One of the most controversial and at the same time most serious misconducts in medical practice is failure to provide assistance to a patient. Article 30 of the Polish Act of 5 December 1996 on the professions of physician and dentist clearly imposes on the physician the obligation to provide medical assistance in every situation where delay in intervention may lead to the risk of loss of life or serious damage to health. The Code of Medical Ethics additionally strengthens this obligation by indicating that the overriding ethical imperative for a physician is the well-being of the patient, and that he cannot be guided by administrative, financial or social factors that could limit his willingness to provide assistance. Despite these unambiguous legal and ethical regulations, in practice there are situations in which physicians make decisions that result in a serious threat to the health and life of patients.
A medical error is an action or omission by a doctor that is inconsistent with the current state of medical knowledge and leads to harm to the patient. The most common errors include diagnostic, therapeutic and organizational errors. The Polish Supreme Court in its judgment of April 1, 1955 (IV CR 39/54) defined medical error as:
“an action or omission by a doctor in the scope of diagnosis and therapy, inconsistent with applicable medical knowledge.”
One of the most serious misdemeanours in the medical profession is failure to provide assistance to a patient. An analysis of court decisions confirms that diagnostic and therapeutic negligence can lead to serious legal consequences. An example is the Supreme Court judgment of 27 September 2010 (ref. V KK 34/10), which concerned a doctor who failed to undertake life-saving measures for an unborn child, despite the existence of grounds for performing a caesarean section. The Supreme Court overturned the judgment acquitting the doctor, finding that the doctor had an obligation to foresee the threat and take preventive measures.
The civil liability of a physician results mainly from the provisions of the Civil Code. In the event of harm to a patient due to a diagnostic or therapeutic error, the physician or medical facility may be required to pay compensation or damages if a causal relationship between the physician’s action and the patient’s harm is demonstrated.
Criminal liability applies to situations in which a doctor, through his or her actions or omissions, causes unintentional death, exposes a patient to the risk of losing their life or health, or fails to provide assistance. It has been repeatedly emphasized in court rulings that a doctor is also liable in situations where he or she fails to perform necessary diagnostic or therapeutic activities. An example is the judgment of the District Court in Konin of 16 December 2016 (II Ka 272/16), the doctor did not decide on a caesarean section, despite the alarming CTG results and the visible threat to the life of the fetus. The court found that the child’s death was unintentionally caused as a result of negligence.
In another case, the District Court in Świdnica in 2016 (ref. IV Ka 347/16) sentenced a surgeon who failed to hospitalize a patient with symptoms of complications after drug administration. Despite the patient’s visible symptoms of infection and fainting, the doctor did not order appropriate diagnostic tests, which exposed the patient to direct danger of loss of life or serious damage to health.
The court system in Poland includes both common courts and disciplinary courts. Common courts deal with civil and criminal cases, while medical courts assess professional misconduct. Cases concerning medical errors may be heard by district or regional courts, depending on the importance of the case, and in particularly complicated cases may go to the Supreme Court, which has the ability to overturn judgments and refer cases for retrial.
The professional liability of doctors is also considered in the framework of disciplinary courts, which operate within the structure of the medical self-government. In accordance with Articles 75 and 78 of the Act on Medical Chambers, in the event of professional misconduct, the doctor may be punished by the regional medical court, and in the event of an appeal – by the Supreme Medical Court. Proceedings before the medical court may be conducted independently of criminal and civil proceedings. However, in cases where the breach of professional duties has the characteristics of a crime, the doctor’s case may be examined by common courts. The Supreme Court in its judgment of 5 June 2019 (reference number III KK 212/18) emphasized that even in cases of a serious patient illness, the doctor is liable if his errors or omissions could have contributed to the deterioration of the patient’s health or death.
The local jurisdiction of common courts is regulated by Articles 31 and 32 of the Code of Criminal Procedure. The court competent for the place where the crime was committed decides, and in case of doubt, the court of the place where the crime was discovered or the residence of the accused. In the case of professional liability of doctors, according to Article 78 of the Act on Medical Chambers, the competent court is the regional medical court of the chamber to which the accused doctor belongs.
The Polish legal system is governed by the principle of legalism, as defined in Article 10 of the Code of Criminal Procedure. This means that law enforcement agencies are required to initiate proceedings in the event of a reasonable suspicion that a crime has been committed. Criminal proceedings are independent of disciplinary proceedings before a medical court, but the outcome of one may affect the other.
The professional liability of a doctor results from a breach of professional ethics and regulations governing the practice of the profession, as specified in Article 53 of the Act on Medical Chambers. Disciplinary proceedings are conducted independently of criminal or civil proceedings. It is possible to suspend disciplinary proceedings until the conclusion of criminal proceedings if their outcome may affect the decision of the medical court.
The proceedings before the Regional Medical Court are held in two instances. In the first instance, the regional medical court competent for the chamber to which the accused doctor belongs issues a ruling. In the second instance, the case is heard by the Supreme Medical Court. In accordance with the Constitution of the Republic of Poland, court proceedings have at least two instances.
The professional self-government of doctors acts as the prosecutor in disciplinary proceedings. The Advocate for Professional Liability, after conducting explanatory proceedings, files a motion for punishment with the medical court. The patient, as the injured party, has the right to participate in the proceedings as an auxiliary prosecutor.
The Medical Court is not part of the general justice system, but a disciplinary body operating within the professional self-government of doctors. Its task is to assess violations of professional ethics and standards of professional practice. These proceedings may be conducted in parallel with criminal or civil proceedings.
Patients who believe they have been victims of medical malpractice can pursue their rights in several ways:
Each of these paths enables the patient to seek justice and hold doctors accountable for their actions.
A motion to penalize a doctor is a key element of disciplinary proceedings conducted before the District Medical Court. According to Article 75 of the Act on Medical Chambers, this document must include the doctor’s name and surname, the number of the license to practice the profession, a detailed description of the professional misconduct, including time, place, manner of committing and effects, data of witnesses, other evidence and justification of the motion. This motion is a condition for initiating proceedings and plays a role analogous to an indictment in criminal proceedings.
Mediation proceedings are an alternative to disciplinary proceedings. Under Article 113 of the Act on Medical Chambers, the professional liability advocate or the medical court may refer the case to mediation if both parties agree. Mediation lasts a maximum of two months and is not included in the period of the explanatory proceedings.
In recent years, the issue of terminating pregnancy in situations where the mother’s health and life are at risk has become a major problem in the Polish legal system. The ruling of the Constitutional Tribunal of October 22, 2020 (K 1/20) tightened the regulations on legal abortion, eliminating the premise of severe fetal defects as a basis for terminating pregnancy. As a result, doctors increasingly find themselves in a situation in which they are afraid to make decisions about terminating a pregnancy, even if the patient’s health is at risk. The result is the so-called “chilling effect”, which causes doctors to delay therapeutic decisions, which can lead to serious health consequences and even death of patients.
The liability of doctors for failure to provide medical assistance is based on the principle of the guarantor, resulting from Article 2 of the Penal Code. The doctor, as a person with a special obligation to protect the patient’s health, is criminally liable for the consequences of diagnostic or therapeutic negligence.
The Hippocratic Oath, which is one of the ethical pillars of the medical profession, is not only a declaration of medical knowledge but also a commitment to act in accordance with high moral standards. Although its formula has changed over the years, it still contains fundamental principles that are essential for the proper practice of medicine. The key objective is to ensure that doctors act responsibly, with respect for patients and their dignity, maintaining full confidentiality and striving for the patient’s well-being.
The modern version of the oath, adapted to contemporary realities, also takes into account contemporary challenges in medicine, such as the need to care for patients’ mental health, access to modern therapies, and ethical considerations regarding new medical technologies. Despite these changes, the most important principles remain unchanged – the doctor still commits to treating in a responsible manner, striving for the good of the patient, regardless of their race, religion, or political beliefs.
In Poland, medical graduates take the Physician’s Oath, which is part of the Code of Medical Ethics. This Code, adopted in 1991 and amended twice (in 1993 and 2003), regulates the ethical principles that apply to physicians. According to the Act on Medical Chambers, the medical self-government is responsible for establishing ethical principles and supervising their observance.
The Physician’s Oath includes key principles such as respect for the patient’s dignity, professional secrecy, striving for the patient’s well-being, and conscientious practice of the profession. Physicians also undertake to avoid actions that could harm the patient.
Violation of these rules may lead to professional consequences, such as suspension of the right to practice or civil liability. The Code of Medical Ethics and the supervision of the medical self-government ensure high standards of medical care and public confidence in the medical profession.
In summary, the professional responsibility of doctors plays a key role in the healthcare system, ensuring compliance with medical and ethical standards. This responsibility is multidimensional – from disciplinary responsibility before medical courts, through civil liability, to criminal liability if the doctor’s negligence led to the death or serious damage to the patient’s health. Court decisions clearly indicate that doctors have an obligation not only to perform medical procedures, but also to anticipate potential threats and take preventive measures. At the same time, contemporary legal challenges, such as restrictions on termination of pregnancy, put doctors in a difficult situation, in which the fear of criminal liability can lead to dangerous omissions. Therefore, it is necessary to continue monitoring and adapting the system of doctors’ responsibility to the dynamically changing medical and legal realities, in order to ensure both the safety of patients and the possibility of doctors to practice their profession in accordance with current medical knowledge.