This study examines the impact of the decision-to-incision interval (DII) in childbirth on physicians’ criminal liability and analyzes how this interval is interpreted within the scope of the duty of care under Turkish law. A descriptive and analytical methodology was employed through the examination of 38 obstetric malpractice decisions issued between 2015 and 2025 by the 12th Criminal Chamber of the Court of Cassation and the General Assembly of the Supreme Court. Cases involving emergency obstetric conditions were identified using keywords such as “decision-to-delivery time,” “delayed cesarean section,” “fetal distress,” “negligence,” and “physician liability.” Relevant legal regulations, including the Turkish Penal Code, Law No. 1219, the Medical Deontology Regulation, and the Patient Rights Regulation, were analyzed in comparison with the Ministry of Health’s 2022 Childbirth Services Guide. The decisions were evaluated using qualitative content analysis. The results show that approximately 71% of the cases exceeded the commonly referenced 30-minute decision-to-incision interval, which was generally interpreted unfavorably for physicians. However, in several decisions rendered after 2022, courts increasingly considered systemic factors such as staff shortages, operating room constraints, and delays in blood supply. This trend indicates a shift in judicial reasoning, in which the duration of the interval alone is no longer treated as the decisive factor in determining criminal liability. The findings suggest that the decision-to-incision interval should be regarded as a guideline-based clinical target rather than a strict legal deadline. Accordingly, physicians’ criminal liability should be assessed not solely on elapsed time alone.
Şanlıkan et al. (Fri,) studied this question.