Awareness of the medico-legal aspects of clinical practice among anesthesiologists: a knowledge, attitude, and practices survey

Abstract Background: The rise in medico-legal litigation and evolving legal frameworks has made medico-legal awareness essential for anesthesiologists. Identifying gaps in legal knowledge can support targeted educational interventions to improve compliance and patient safety. This study assessed medico-legal knowledge and awareness among anesthesiologists across different practice settings and experience levels. Methods: A structured questionnaire covering key medico-legal topics was distributed to 350 anesthesiologists working in corporate hospitals, medical colleges, and freelance practice. The survey evaluated the knowledge of informed consent, anesthesia documentation, legal liabilities, the Consumer Protection Act 2019, punitive damages, statutory limitations, and other relevant legislations. Responses were analyzed according to the practice type and years of professional experience. Results: Many participants demonstrated adequate knowledge regarding maintenance of anesthesia records (90.3%), management of intraoperative deaths (97.4%), legal liability (96.3%), and informed consent procedures (78%). In contrast, the awareness of punitive damages (6.9%) and statutory limitation periods for negligence claims (18.3%) was markedly low. Significant differences were observed in the awareness of the Epidemic Diseases (Amendment) Act, 2020, with a higher awareness among corporate and institutional practitioners compared to freelancers. Greater clinical experience was associated with improved foundational medico-legal knowledge. Although only 4.6% reported prior litigation, a majority (67.4%) acknowledged the importance of professional indemnity insurance. Conclusions: While anesthesiologists demonstrate strong basic medico-legal knowledge, important gaps persist in advanced legal concepts and recent legislative updates. Structured medico-legal education is needed to enhance legal preparedness and promote safer anesthesia practice.