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Liability · Three tracks · 2026-05-24

Three legal tracks

In the Netherlands a physician can be held to account via three separate tracks. They stand on their own and can be pursued simultaneously.

1. Civil law — the Wgbo and the good-clinician standard

The Medical Treatment Contracts Act (Wet op de geneeskundige behandelingsovereenkomst, Wgbo, art. 7:446 et seq. of the Dutch Civil Code) is the core of Dutch medical civil law. The physician must act as a good clinician (art. 7:453 BW). The standard: what would a reasonably competent and reasonably acting colleague do in the same circumstances?1

If the physician breaches that norm and damage results, compensation can be claimed under art. 6:74 BW, typically through the hospital, which under art. 7:462 BW carries central liability. The individual physician is rarely the named defendant — the claim runs through the institution and its liability insurer (MediRisk or Centramed).

Alongside the duty of care stands the duty of disclosure (art. 7:448 BW). The physician must inform the patient comprehensibly about the nature and purpose of the treatment, anticipated effects and risks, alternatives, and health status. Only then can valid consent be given (art. 7:450 BW). Incomplete information makes consent challengeable — and in extreme cases the intervention can even be qualified as battery. See informed consent as the strongest route.

2. Disciplinary law — the BIG Act

Every BIG-registered healthcare provider is subject to disciplinary law. A complaint can be filed with the Regional Disciplinary Board for Healthcare (Regionaal Tuchtcollege voor de Gezondheidszorg). The standards of review are broad:2

  • First disciplinary norm — acts or omissions contrary to the care the practitioner owes the patient.
  • Second disciplinary norm — acts contrary to the interest of the proper exercise of individual healthcare.

Sanctions range from warning, reprimand, fine and suspension to removal from the BIG register. A disciplinary complaint is free for the complainant and legal representation is not mandatory, though advisable in complex cases.

Disciplinary law has a lower threshold than civil law: no damages, but an authoritative public ruling on norm violation. For a later civil case, a disciplinary ruling is often decisive evidence. Since 2019 the disciplinary limitation period is ten years from the event, with an exception when the public health interest requires later proceedings.3

3. Criminal law — the exceptional track

In cases of gross negligence or intent, criminal law may come into play: battery (art. 300 Dutch Criminal Code), aggravated battery (art. 302), or death or serious bodily harm by negligence (art. 307/308). This track is rare in a medical context — but not excluded.

Irreversible bodily interventions on minors without sound scientific underpinning could, in a future policy or cultural shift, be reconsidered in this light. The Public Prosecution Service decides on prosecution after a criminal complaint.

The special problem of the minor patient

The Wgbo provides a tiered system of competence and consent (art. 7:450 BW): up to age 12 parents decide, from 12 to 16 parents and child jointly, from 16 the child alone. This works reasonably for ordinary medical decisions. It strains for decisions with lifelong, irreversible consequences.

The law requires that the minor be capable of a reasonable appraisal of their own interests. For interventions affecting fertility, sexual function, brain development, and the body for decades, that reasonable appraisal is highly doubtful in a 12-, 13-, or 14-year-old. The British High Court held in Bell v Tavistock that this is in practice nearly impossible.4 Although that ruling was reversed on procedural grounds, the developmental-psychological reasoning remains unrebutted. The UN Convention on the Rights of the Child adds an external framework: article 3 makes the best interest of the child a primary consideration; article 24 guarantees the right to the highest attainable standard of health.

Limitation — a long shadow

The civil limitation period is five years from discovery of the damage, with an absolute cap of twenty years from the event (art. 3:310 BW). For minors, the period does not run while the patient is still a minor (art. 3:321 lid 1 sub b BW). A 13-year-old who receives puberty blockers in 2026 can bring a civil action up to 2046 — if awareness of the damage comes later.

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Notes

  1. Wet op de geneeskundige behandelingsovereenkomst, codified in title 7 book 7 of the Dutch Civil Code; art. 7:453 BW codifies the good-clinician standard.
  2. Wet op de beroepen in de individuele gezondheidszorg (BIG Act), art. 47 — the two disciplinary norms.
  3. Amendment to the BIG Act 2019: introduction of a ten-year limitation period for disciplinary complaints (previously unlimited).
  4. Bell v Tavistock [2020] EWHC 3274 (Admin); reversed in [2021] EWCA Civ 1363 on procedural grounds, not on the developmental-psychological reasoning.