Practicing Healthcare Professions in Saudi Arabia

Practicing Healthcare Profession in Saudi Arabia

According to the Law of Practicing Healthcare Professions issued under the Royal Decree and its implementing regulations, the general duties of the Health practitioner is to practice his profession in the interest of the individual and the society within the scope of respecting the human right to life, safety, and dignity, taking into consideration the customs and traditions prevailing in the Kingdom.

What are the Patient Rights in Saudi Arabia?

Patients and their families have the right to health care: Receiving health services according to (evidence-based medicine) that are appropriate, continuous, organized, and specialized at every level of care, whether preventive or therapeutic, and promptly. 

• Providing Health Care and Services Based on Respect and Appreciation: Providing adequate health care at all times and under all circumstances in a manner, that preserves their dignity without prejudice to their religious, doctrinal, and spiritual beliefs and their cultural and social background.


• Privacy and Confidentiality: Preventing disclosure, misuse, circulation, or access to patient information, whether in (the medical file or medical information related to the diagnosis, analysis, and treatment of any party or person without the consent of the patient or their legal guardian (except as required by the judicial authorities).

• Healthcare Plan Engagement: Enabling patients and their families to communicate with the treatment team to obtain complete and up-to-date information regarding the diagnosis, the proposed treatment, its expected benefits and results, the suggested medical alternatives - if any, complications, risks, and the treatment success rate using the terms that they understand and comprehend.

• Clarity and Comprehensiveness of Forms and Reports: Introducing patients to the information contained in the medical authorization in a clear manner and understandable terms, with an explanation of the expected negative and positive results as a consequence of the approval or refusal; besides, providing a list of interventions that require a separate my medical authorization and keeping the medical authorization in the patient’s file.

Medical Errors & Patient Safety

Medical errors are defined as the failure of a management plan to be completed as planned or the use of a wrong management plan. Potential medical errors can be litigated to establish clinical negligence.

There is some advice on how to avoid medical error, based on the actual pitfalls observed in investigating cases and forming the ground of lawsuits.

How to Avoid Medical Errors?

- Assess your patient thoroughly and ask for consultations of different specialties, to properly prepare your patient for the stress of any intervention.

- Estimate accurately the patient risk and discuss it in detail with the patient or family members, to be implemented on patient consent before any intervention.

- Clear documentation of every detail (with date and time) is the cornerstone that backs you up in case of incidents.

- Follow up with your patient closely in the postoperative period, especially in risky patients or those situations where Intra-operative events have been encountered.

- Update your professional knowledge which is to be considered the best way to gain confidence and respect among medical staff, as well as when dealing with well-informed patients or their family members.

- Support Continuing Medical Education, Audits, Clinical incident reporting, Case discussions, and Morbidity and Mortality meetings in different medical facilities.

- In case you had been encountered in an incident and called for interrogation, review the whole case beforehand, and write down specific and important events meanwhile, you could also refresh your memory with the patient filing and records during the interview session. Further, quote relevant literature which could strengthen your position in practical and professional matters, lastly, it is permissible to provide your testimony in writing thus to be recorded as such.

Eventually, the consequences of an error are disastrous and prophylaxis is by far much easier than dealing with litigations. The patient's or relatives’ claim may lead to a verdict that can affect the practitioner's professional life or exert a financial burden.According to the Saudi Journal of Anesthesia, ensuring a safe and effective method of medical practice is the prime duty of the practitioner.

The Responsibilities of Professional Doctors

Professional liabilities consist of 3 different aspects:

1- Civil liability: This is the responsibility of a physician towards the patient when harm is inflicted as a result of direct action against medical rules from the physician or proven negligence.

2- Punitive liability: This deals with physicians who violate the rules and regulations of medical practice, even with no subsequent harm resulting to the patient.

3- Disciplinary liability: Where a physician fails to meet the professional standards, requirements, and ethics.

The correct identification of the requirements and limitations regarding the legal liability of medical personnel and the prevention and management methods for this risk is the key to aligning medical practice to the applicable legal requirements and quality standards.

Medical Malpractice 

Professional liability of medical personnel may be rooted in both the scientific/technical side and the ethical side of medical and pharmaceutical practice. Any breach of good medical/ pharmaceutical practices or legal regulations resulting from the relationship between the medical personnel and the patient can be sanctioned through professional liability (malpractice).

Saudi Arabia's Healthcare system 

There is growing attention toward patient safety worldwide, as the reduction of incidence and cost of adverse events (AE) has become a priority.

Even though medical care in Saudi Arabia has shown a remarkable improvement over the past years, based upon international standards in the setting up of medical facilities in addition to a well-organized training system for medical practitioners with tracing and authentication of qualifications throughout the Saudi Commission for Health Specialities, but the adverse events of medical practice are inevitable.

The increasing population, together with an increased awareness of health matters, has resulted in a trend toward increasing medical practice litigations. The increased litigation could also stem from people becoming more aware of standard medical care and demanding it as well.This is reflected by the number of complaints and claims against health care providers (whether generally as a facility or individually against physicians).

However, according to the Journal of Family and Community Medicine, the possible reasons for the increased number of litigations against healthcare professionals could be attributed to the ever-increasing media focus on medical errors and the prevailing blame culture. It was difficult, therefore, for the investigators to estimate the size of the problem. Following international standards could restrict the magnitude of medical errors which had been classified by the Agency for Health Research and Quality as diagnostic error, equipment error, misinterpretation of medical orders or data, and finally mismanagement with resultant morbidity as postoperative infections or mismatched blood transfusion.

What is Healthcare Litigation?

Litigation systems are the compensation of patients who are injured because of the negligence of healthcare professionals.

The Saudi Medical Journal emphasizes that any efficient process of litigation of medical errors involves a series of steps taken to resolve a matter, through negotiations toward an out-of-court settlement, or a full-court trial. 

How to File a Complaint Against a Healthcare Practitioner?

• The process of medical litigation starts once a patient or a member of his/her relatives complains of medical malpractice from their point of view which ends with morbidity or mortality. 


• The complaint is directed either to the Ministry of Health or the City Government according to the medical facility indulged in the complaint. 


• A process of investigation and interrogation follows within the medical facility with the presumed accused medical staff members either sharing the responsibility or attending the event. 


• The Medico-Legal Committee (MLC) is then assigned to follow a process of a thorough review of all documents and medical filing together with interviewing both sides of the claim- the plaintiff and defendant(s), to reach a final decision of accusation or clearance from the claim according to the “Regulations of Medical Practice “, which is based on professional aspects and governed by “Islamic Sharia law”.

Types of Patient Compensations 

1. Issuing an administrative warning

2. Financial compensation, to the patient or his dependents, according to Islamic Sharia law,

3. Prohibiting the physician from medical practice and withdrawal of his medical license, or Imprisonment in some cases.

Medical Liability Case in Saudi Arabia

An example of a legal action that was taken against anesthesiologists according to Medico-legal liabilities of anesthesia practice in Saudi Arabia paper: Maternal Mortality due to bleeding during Cesarean section.

A breech presentation case was presented for the emergency cesarian section in a P 11+1 patient. During the procedure intractable hemorrhage started. The attendants found no available blood and mortality followed six hours postoperatively.

The result: The anesthetist was accused of negligence for two reasons. First, for not making sure of the availability of blood before induction of anesthesia, and second, which is more interesting. that no anesthesia record existed and that the anesthetist only filled up progress notes in the patient chart so, there was no documentation of his intraoperative management. This was considered by the MLC Committee as a case of negligence and decided that the anesthetist should share the financial compensation with the obstetrician. Obstetrical practice and surgical specialties are the leading specialties of all the clinical specialties implicated in litigations, followed by anesthesia which is considered also a high-risk specialty.

According to the World Health Organization (WHO), risk management bodies have settled some recommendations to help avoid being subjected to malpractice lawsuits.

Risk Management Approach

• Communicate with patients and colleagues: Clear and complete communication with patients, staff, and colleagues is a must if errors and misunderstandings are to be avoided. It has been shown that patients are reluctant to sue a doctor who takes the time to explain medical issues and answer all of their questions.


• When in doubt, get a second opinion: Risk management specialists say that one of the major causes of malpractice litigation is a misdiagnosis. A second opinion should be sought from a respected colleague who has wider experience in the type of case being evaluated.


• Obtain a thorough detailed and informed patient consent that explains the definite diagnosis reached, the management plan, and the expected complications, that might be encountered.


• Document all medical decisions, communications, and even recommendations related to any case in a detailed, timely manner.