From scribble to scrutiny: The legal risks of poor clinical handwriting

Abstract

Illegible handwritten patient records pose a significant threat to clinical accountability and legal integrity in South Africa’s healthcare system. Despite clear guidelines from the Health Professions Council of South Africa (HPCSA), poor documentation remains widespread, particularly in public sector facilities. A black-letter doctrinal analysis was conducted of South African law (Medicines and Related Substances Act General Regulations, HPCSA Booklet 9, and the National Health Act) and the evidentiary treatment of clinical records in case law. A focused comparative reference to a 2025 Punjab & Haryana High Court judgement was used to contextualise the normative stakes of legibility in another common-law system. South African primary law already requires legible prescriptions and legible, understandable clinical records; courts treat hospital notes as hearsay unless properly admitted, with clarity impacting the weight accorded to such documentation. The Indian judgement constitutionally frames legibility as part of the right to health and mandates interim capital-letter prescriptions pending digitisation. Clear documentation is essential for justice, safety and the dignity of patients. The article calls for curriculum reform, digitisation, policy enforcement and legal recognition of legibility as a component of the right to access healthcare. This article may assist legal and medical professionals in recognising legibility as a constitutional obligation, thereby strengthening medico-legal accountability and promoting patient-centred care.