Medical textbooks are not legal documents

Say you’re a defendant in a malpractice suit giving your deposition. Plaintiff’s attorney holds up your favorite medical textbook and asks “Doctor, would you consider this an authoritative source of information in your specialty?” Answer yes if you want to help send that attorney’s kids to college.

The correct answer, as your risk management folks will tell you, is that no textbook is authoritative and that treatment must be individualized, applying the best available evidence with judgment, tailored to the patient’s individual circumstances.

Recently the editors of several leading emergency medicine textbooks made this answer official in a position statement. It opens:

The editors of the textbooks listed below strongly believe that the complex practice of medicine, the vagaries of human diseases, the unpredictability of pathologic conditions, and the functions, dysfunctions, and responses of the human body cannot be defined, explained, or rigidly categorized by any written document. It is neither the purpose nor intent of our textbooks to serve as a final authoritative source on any medical condition, treatment plan, or clinical intervention, nor should our textbooks be used to rigorously define a rigid standard of care that should be practiced by all clinicians.