Abstract
Emergency Departments (EDs) are high-risk environments characterized by diagnostic uncertainty, driving physicians toward defensive medicine—ordering unnecessary tests primarily to mitigate litigation risk rather than improve patient outcomes. This practice exceeds the legal standard of care, escalating healthcare costs, prolonging ED stays, and increasing patient anxiety and radiation exposure. This paper explores the boundary between defensive medicine and legal standards through a multidisciplinary lens of legal medicine, healthcare ethics, and malpractice jurisprudence. Presenting a conceptual framework and hypothetical scenarios, it proposes that evidence-based protocols, medico-legal education, shared decision-making, and AI decision support can effectively reduce over-testing while maintaining patient safety.
