Medicolegal Issues in Healthcare and their Contributing Factors: A Scoping Review

Medicolegal Issues & Contributing Factors
Vol. 21 No. 1 : 2026 (93-110)

Surya Marsom Surya Marsom
Azimatun Noor Aizuddin Azimatun Noor Aizuddin

Abstract
Medicolegal issues in healthcare are rising globally, driven by growing patient awareness, heightened expectations and increased access to legal support. Understanding the root causes of these disputes is crucial for improving patient safety and minimising legal risks. This scoping review aimed to identify contributing factors to medicolegal issues in healthcare. The review followed Arksey and O’Malley’s five-stage scoping review framework and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Literature search was conducted in PubMed, EBSCOhost, Scopus and Web of Science, covering publications from January 2018 to April 2024. After applying inclusion and exclusion criteria, 45 out of 360 studies were included and analysed thematically. The most commonly reported causes of medicolegal claims were errors and delays in diagnostic testing (48.9%), communication failures (48.9%), procedural errors (40%), failure to make clinical decisions and judgments (31%) and treatment complications (24%). Other contributing factors included inadequate informed consent, system-level failures and patient-related factors such as noncompliance and comorbidities. Addressing these multifactorial issues requires a comprehensive approach, including enhanced clinical training, improved communication strategies, standardised documentation practices and systemic reforms. These findings offer valuable insights for healthcare leaders and policymakers to reduce medicolegal risks and strengthen the quality and safety of care.
Keywords : Contributing factors; healthcare litigation; medicolegal issues; scoping review,
Abstrak
Isu medikolegal dalam penjagaan kesihatan semakin meningkat di seluruh dunia. Ini didorong oleh peningkatan kesedaran dalam kalangan pesakit, harapan yang lebih tinggi kepada sistem perubatan serta akses yang lebih mudah kepada sokongan perundangan. Memahami punca utama masalah ini penting bagi meningkatkan keselamatan pesakit dan meminimumkan risiko perundangan. Kajian ini bertujuan untuk mengenal pasti faktor-faktor yang menyumbang kepada isu medikolegal dalam penjagaan kesihatan. Kajian ini dilaksanakan berdasarkan rangka kerja lima peringkat Arksey dan O’Malley serta mematuhi garis panduan "Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews". Carian literatur dijalankan melalui pangkalan data PubMed, EBSCOhost, Scopus dan Web of Science yang merangkumi penerbitan dari Januari 2018 hingga April 2024. Artikel disaring berdasarkan kriteria inklusi dan eksklusi yang ditetapkan. Data yang berkaitan diekstrak serta dianalisis secara tematik. Daripada 360 artikel yang diperolehi hanya 45 artikel memenuhi kriteria kelayakan. Faktor penyebab tuntutan medicolegal yang banyak dilaporkan ialah kesilapan dan kelewatan dalam membuat ujian diagnostik (48.9%), kegagalan komunikasi (48.9%), kesilapan prosedur (40%), kegagalan membuat keputusan dan pertimbangan klinikal (31%) serta komplikasi rawatan (24%). Faktor penyumbang lain termasuk persetujuan bermaklumat yang tidak mencukupi, kegagalan pada peringkat sistem serta ketidakpatuhan terhadap protokol serta faktor berkaitan pesakit sendiri. Menangani cabaran ini memerlukan pendekatan pelbagai dimensi dan peringkat yang merangkumi latihan klinikal, komunikasi berkesan, amalan dokumentasi yang piawai, penjagaan berfokuskan pesakit dan reformasi di peringkat sistem. Penemuan ini memberikan panduan penting dalam usaha mengurangkan risiko medikolegal dan meningkatkan kualiti serta keselamatan penjagaan kesihatan.
Kata Kunci : Faktor penyumbang; isu medikolegal; litigasi penjagaan kesihatan; salah laku perubatan,

Correspondance Address
Azimatun Noor binti Aizuddin. Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +6019 3750153 Email: azimatunnoor@hctm.ukm.edu.my


FIGURE 1: PRISMA flowchart of the study selection process; PRISMA: Preferred reporting items for systematic reviews and meta-analyses