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A Supreme Court verdict last month significantly reduced doctors' responsibility for follow-up care, ruling that it is the patient's responsibility to obey the doctor's instructions.

The ruling was handed down on an appeal in the case of Z., a 65-year-old woman from the Jerusalem area. Z. sued the Leumit health maintenance organization after she had to have a kidney removed in 1998, saying her doctors' negligence was responsible for the kidney failure.

In 2006, the Jerusalem District Court ruled sweepingly in her favor. Z.'s family doctor was negligent, it said, because she did not send Z. for all the appropriate tests; Leumit was negligent both in failing to ensure that information was adequately shared among Z.'s doctors and in delaying approval for a CT scan; and Z.'s urologist was negligent because, after sending her for an IVP test, he did not make sure that she had taken it - which in fact, she did not. Leumit and the doctors then appealed.

In their ruling, Justices Hanan Melcer, Eliezer Rivlin and Salim Joubran overturned the lower court's finding of negligence against the urologist. "Imposing a sweeping follow-up obligation, even when the patient has been given a reasonable explanation and made an informed decision about whether to follow the doctor's recommendation, would impose an unreasonable burden on physicians," they wrote, in a sharp reversal of the approach the courts have taken over the last few years.

The justices noted that failure to take almost any test recommended by a doctor can result in harm to the patient. Therefore, "as a matter of legal policy, there is no justification for imposing a sweeping obligation on every physician to perform ongoing follow-up to ensure that the patient acts in accordance with his medical advice."

Finally, they overturned the judgment of negligence against Leumit for the way information was shared among Z.'s doctors, though not for delaying approval of the CT scan. The finding of negligence against the family doctor was also upheld.

The Family Doctors Association welcomed the verdict's decision to make patients bear some responsibility for their own care.

"It's inconceivable that the medical system should have to follow up on every instruction it gives a patient," said Prof. Shlomo Vinker, the association's chairman, who also heads the family medicine department at Tel Aviv University's medical school. "The verdict doesn't remove all responsibility from doctors, heaven forbid, but it does put this responsibility into proportion.