Urgent Reforms Needed to Address Cosmetic Surgery Malpractice in Jordan

Dear Editor-in-Chief, In recent years, there has been a notable increase in demand for cosmetic surgery in Jordan.[1] However, this expansion has coincided with a startling rise in malpractice lawsuits, which are frequently brought on by legal ambiguities, regulatory gaps, and the pervasiveness of unlicensed practitioners.[2-4] To improve patient safety and guarantee responsibility in this field, these problems necessitate immediate adjustments. The practice of performing cosmetic operations by unlicensed individuals is a significant concern. Even though there are not many board-certified plastic surgeons in Jordan, thousands of unlicensed practitioners nonetheless practice it,[4] frequently resulting in seriously harming patients [Table 1].[5] Even if Jordanian Medical and Health Liability Law No. 25 was created to control medical illegal behavior, it is still not strictly enforced, especially in the field of cosmetic surgery.[6] Stricter licensing regulations and more serious penalties for unlicensed practice are all examples of the stronger monitoring that is required. Campaigns to raise public awareness should also teach people how to validate a surgeon’s credentials before having any surgery done. Legal inefficiencies further exacerbate the problem, as Jordan lacks a complete legal framework that specifies the duties of cosmetic surgeons.[7] The Jordanian legal system also has a shortage of expert legal practitioners – judges and lawyers – who can effectively handle medical malpractice cases. This shortfall is complemented by the Jordanian Bar Association’s law that prohibits members of other professional associations, such as the Jordanian Medical Association, from practicing law.[8] This prohibition hinders the development of a sector of legal professionals who have learned to address the unique complexities of medical malpractice within the special field of cosmetology.Table 1: Reported cases of unlicensed cosmetic procedures and complications (extracted from Qistas Legal Database)Another fundamental problem is the legal classification of cosmetic surgery obligations. Certain cases classify cosmetic procedures as an obligation of means, whereby the surgeon must provide competent care but not a guarantee of outcomes. Other cases employ an obligation to achieve a result, holding surgeons liable for producing an assured esthetic outcome. For instance, in Decision No. 1112/2013, the Court of Cassation ruled against a surgeon for failing to achieve the desired cosmetic outcome, applying the obligation to achieve a result. However, in Decision No. 2213/2021, the Court of Cassation ruled that the surgeon only had to exercise reasonable medical skill, which is evidence of an obligation of means. The Jordanian Medical and Health Liability Law No. 25 attempted to codify medical responsibilities but remained ambiguous, with its consequences leading to contradictory judicial rulings.[7] The differentiation has to be clearer to administer justice to malpractice claims. Addressing these challenges requires a collaborative effort between the government, medical institutions, and legal bodies. By strengthening enforcement of the Jordanian Medical and Health Liability Law No. 25, improving legal processes, and ensuring greater transparency in the cosmetic surgery industry, Jordan can better protect patients from the risks of malpractice. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.