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Parkinson’s Disease and the Law: Motor and Non-Motor Determinants in Medical Courts Cases

P. Amami, D. Ziemele, A. Albanese (Rozzano, Italy)

Meeting: MDS Virtual Congress 2020

Abstract Number: 307

Keywords: Environmental toxins, Neurobehavioral disorders, Paraquat

Category: Other

Objective: We reviewed the legal issues involving PD patients in Italy and United Kingdom and correlated these findings with the clinical condition of the involved PD patients.

Background: Parkinson’s disease (PD) is associated with a significant occurrence of legal issues, related to either civil or to criminal aspects. There is evidence that PD patients may be involved in a variety of lawsuits, but a comprehensive review is lacking. PD is one of the most frequent neurodegenerative disorders, affecting at least 6 million people worldwide.

Method: The DeJure Italian and the Westlaw UK repositories were searched for legal cases concerning PD patients from inception to May 2019. Only cases where PD or PD symptoms were directly involved in the dispute or in the final ruling were selected. This search allowed to retrieved detailed information on the trials and served to identify the clinical conditions related to the judiciary PD cases on record. A further search was performed on PubMed and Google by combining the identified clinical conditions and PD. The motor and non-motor features relevant for trial and the final ruling were identified in each legal case.

Results: A total of 56 cases directly related to PD were found: 35 in Italy and 21 in the UK. Eight issues were involved in the reviewed cases: causes of parkinsonism, impulse control behaviours, mental status, handwriting, disability, falls, applicability of detention, and discrimination or stigma. We found that two conditions were related frequently to controversial in the trial: causes of parkinsonism and impulse control behaviours. In these two conditions, the witnesses’ specialized opinions were central for the resolution of the trial. By contrast, there was adequate knowledge leading to consistent ruling on the other conditions, namely mental status, handwriting, disability, falls, applicability of detention, and discrimination or stigma.

Conclusion: PD patients may be implicated in several legal issues, far beyond cases of clinical malpractice. In some cases, PD clinical conditions represent the main bulk of lawsuits. This is particularly evident for impulse control disorders and for cases of supposedly acquired parkinsonism related to pollutants.

To cite this abstract in AMA style:

P. Amami, D. Ziemele, A. Albanese. Parkinson’s Disease and the Law: Motor and Non-Motor Determinants in Medical Courts Cases [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/parkinsons-disease-and-the-law-motor-and-non-motor-determinants-in-medical-courts-cases/. Accessed June 15, 2025.
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