The legal significance of clinical guidelines in The Netherlands.

In The Netherlands the use of clinical guidelines has increased rapidly. To a growing extent, judges also refer to them. Although they are not regarded as legal rules, clinical guidelines do play various roles in judicial decision making. In attaching importance to clinical guidelines, judges sometimes speak about the qualities they look for. Scientific credibility, the prestige of the developing organisation, the way they come about, positiveness, clarity, carefulness and cognizability are mentioned. However, the importance attached to clinical guidelines by the courts does not endanger clinical autonomy. Except for one very instructive incident, Dutch judges have shown respect for clinical autonomy.