oa Current Allergy & Clinical Immunology - Severe allergies and the law - the case of anaphylaxis : ethics

Volume 25, Issue 3
  • ISSN : 1609-3607



Worldwide, anaphylaxis remains an important cause of sudden death. The crux of the management is immediate administration of adrenaline as part of competently administered cardiopulmonary resuscitation (CPR). The many pitfalls in identifying and avoiding the triggers and in managing the anaphylactic reactions increase the likelihood of mistakes, which place the patients' lives in danger and at the same time expose medical practitioners to the risk of malpractice litigation and even to criminal investigations in certain circumstances.

There are reports that indicate and predict a steep increase in the number of professional insurance claims in South Africa. Therefore, knowledge of the most important legal principles applicable in medical negligence cases empowers practitioners and allows them to formulate, predict and prevent the risks of a certain conduct.
It is important to be aware that civil liability may be incurred when practitioners fail to perform their duties at a reasonable standard of care in the given circumstances. The reasonableness of the standard of care when managing anaphylaxis is established through objective criteria provided by evidence-based research.
Anaphylaxis-related deaths following diagnostic or therapeutic procedures are deemed unnatural and will be investigated by a magistrate in inquest proceedings. If the inquest findings point to the practitioner's negligence, charges of culpable homicide may be brought against him or her. When things go wrong, it is important to express regrets for the suffering and loss, but apologies must be submitted only after seeking advice from the risk managers, insurers or legal representatives.

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