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New Emirates Medical Journal

Volume 2, 2 Issues, 2021
ISSN: 0250-6882 (Online)
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Open Access Article

Medicolegal Aspects of Disclosure of Side Effects of Biologic Drugs in Rheumatology: A Pilot Study

Ryan Basheer1, *, Souheil Moufarrej2, Humeira Badsha3
1 Department of Law, University of Birmingham, Birmingham, UK
2 University of Southern California, Los Angeles, USA
3 Dr. Humeira Badsha Medical Center, Dubai, UAE



Management of rheumatoid arthritis is complicated due to different disease presentations and the multiplicity of drugs. Although most patients are informed about the risks of treatment, there remain possible side-effects, which patients are not informed about to avoid the 'information dump.’ Rheumatologists have to balance what they believe is essential to tell patients versus what reasonable patients believe they need to know to make an informed consent.


To determine differences in information that the physicians give, regarding the possible side effects of treatment options for rheumatoid arthritis, and what the patients actually want to know.


To conduct this pilot study, a questionnaire was devised to assess what patients and prescribing rheumatologists, from the Gulf Cooperative Council, consider important for being informed about, including the possible adverse events with biologic drugs in rheumatoid arthritis.


A total of 20 patients and 13 physicians completed the questionnaire. Physicians routinely discussed the increased risk of infections (100%), skin rashes at injection sites (92%),falling white blood cell counts, and alterations in liver enzymes (84%). Patients were less interested in learning about infections (72%) and more interested in learning about rare complications, such as an increased risk of heart failure and cancer (81%), which doctors were less likely to discuss.


There is a discordance between what doctors inform patients about and what patients want to know regarding the risks of biologic therapy in rheumatoid arthritis. This information gap can have a significant legal implications in routine practice if a patient develops a rare side effect of which they have not been informed. We propose a solution of both verbal and signed informed consent to bridge the gap.

Keywords: Side effects, Biologics, Rheumatoid arthritis, Disclosure, Informed consent, Medicolegal.

Article Information

Identifiers and Pagination:

Year: 2021
Volume: 2
Issue: 1
First Page: 25
Last Page: 30
Publisher Id: nemj-2-25
DOI: 10.2174/0250688201999200421153704

Article History:

Received Date: 23/12/2019
Revision Received Date: 09/04/2020
Acceptance Date: 09/04/2020
Electronic publication date: 12/02/2021
Collection year: 2021

© 2021 Basheer et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Law, University of Birmingham, Birmingham, UK; Tel: +971506409533; E-mail:


Abdullah Shehab
Emirates Cardiac Society
Emirates Medical Association
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Acceptance rate = 40%

Average review speed: 45 days average

18 days from acceptance to publication