1. What can digital posts prove in a malpractice file?
In examining medical liability, the operation note, tests, discharge summary, patient file and expert reports keep their core importance. Even so, part of the dispute concerns how the patient's will was formed before the intervention: With what expectation did the patient apply? Which result did the physician describe? Was information given about a particular risk? How was the complaint received after the procedure?
Depending on the nature of the claim, a text on Instagram or a message sent to the patient can be explanatory data about the scope of the contract, disclosure, clinical guidance, management of complications or infringement of personality rights. However, inferring from an advertising sentence alone whether a medical procedure was negligent does not replace the separate inquiry into fault and causation. [1][2]
General advertising, a personal assurance and the real content of the contract are different things
The slogan "the best technology" on a clinic's account and a message from the physician after examining the patient saying "we will achieve this degree of improvement for you" do not have the same evidential value. The first may be assessed as general commercial language; the second may matter for the content of an individualized consultation. Even so, not every advertising promise by itself creates a legally valid guarantee of result. The date of publication, the addressee, how explicit it is, the consultations and the procedure the parties agreed on must be examined together.
2. How are screenshots, messages and internet records assessed under the HMK?
That electronic data is a document does not make it conclusive evidence
Article 199 of the Code of Civil Procedure No. 6100 places electronic data relevant to the dispute within the scope of "documents". A publicly available social media post, a physician's message, an earlier version of a website, and photo and video files can therefore be submitted to the court. Yet being a document does not mean that the content is indisputably true, that it belongs to the account concerned or that it is absolutely binding. [1]
The rule in Article 189/2 of the HMK that unlawfully obtained evidence is disregarded also applies. A conversation the patient took from his or her own phone and private messages obtained by unauthorized access to a third person's account are not on the same legal footing. Lawful acquisition, identifiability of the source and preservation of technical integrity of a record are related but different checks.
Factors that strengthen the reliability of a digital record
• The link to the original post, the account's username, the date of the post and, where possible, the post ID.
• Alongside the screenshot, an uninterrupted screen recording or, where possible, preservation of the source file.
• The full context of the conversation before and after, not only the selected line of the messaging.
• Records on the ownership of the number or account, and consistency between the dates of the procedure and the patient file.
• A file format, metadata and retention record suitable for examination by an IT expert in case of objection.
• Where there is a danger that the evidence will be lost or become harder to obtain, considering the need for preservation of evidence (delil tespiti) under Article 400 et seq. of the HMK.
A notarial record can help document that a screen existed at a given moment; but it does not in every case prove by itself whom the account belongs to, that an image shows the real treatment result, or that the content has not been altered. The subject of any technical objection must be specified concretely.
3. The effect of advertising on the promised-result debate in aesthetic surgery
A therapeutic medical relationship is distinguished from an aesthetic promise of result
In medical activities aimed at treatment, the legal relationship is in most cases assessed under the provisions on mandate and the duty of loyalty and care in Article 506 of the Turkish Code of Obligations (TBK). The physician does not undertake to achieve an absolute cure in every patient, but to provide medical service in line with knowledge and technical standards. A complication that occurs despite the course of the disease or a careful intervention is not in every case regarded as fault.
By contrast, in some interventions where the production of a particular aesthetic result is agreed purely or predominantly, the Court of Cassation applies the provisions on contracts for work in Article 470 et seq. of the TBK. The contractor's duty of care also continues under Article 471 of the TBK. The aesthetic/therapeutic aspect of the procedure, the promised appearance and the parties' agreement are assessed together; the mere use of the word "aesthetic" does not automatically place all medical interventions in the same category. [3][4]
Does a social media text alone change the nature of the contract?
No. It may constitute evidence of the existence of a specific promise of result, but the court determines the nature of the contract by assessing all the material facts. A physician saying "no scar will remain" in a post visible to everyone and promising a particular scar appearance to the patient at the consultation carry different legal weight. Conversely, the fact that the physician explained the personal risks clearly in an individual consultation is also important in assessing a single general promotional statement.
What matters is not an assumption that the advertisement alone formed a contract, but making visible the relationship between the social media claim, the individual consultation, the consent and the result of the intervention.
4. What do the relevant Court of Cassation decisions say?
12 March 2025: The claim of a surgery broadcast on Instagram was also in the file
Court of Cassation 6th Civil Chamber, 12.03.2025, E. 2024/2449, K. 2025/1005. In a case concerning a breast reduction and lift procedure, the patient claimed that her operation was broadcast live on Instagram and that she had not permitted this; the physician argued that there was a handwritten consent on the use of social media. The Court of Cassation assessed the dispute under a contract for work, found it erroneous that the court dismissed the case solely on the ground that there was no physician fault, and quashed the judgment. [3]
The scope of the decision must be separated carefully: the Instagram live broadcast and the consent issue appear in the decision among the parties' claims and defenses; the main ground for the quashing is that the promised aesthetic result and the claims for pecuniary and non-pecuniary damage based on it were not properly assessed. The decision does not say that every Instagram broadcast directly creates malpractice or liability for compensation. Permission and data protection law must be examined separately.
17 November 2025: A "no medical error" report may not be sufficient on its own for a contract for work
Court of Cassation 6th Civil Chamber, 17.11.2025, E. 2024/3670, K. 2025/3903. It was accepted that there was a contract for work between the parties covering the aesthetic procedure. In the file the patient also relied on WhatsApp correspondence; the Court of Cassation concluded that an assessment should be made essentially of whether the agreed result had occurred and of the heads of loss. The appeal review, which did not find the first-instance dismissal appropriate, ended with quashing. [4]
These two decisions show that digital communication can be discussed in the case file; but claiming that the digital posts were the sole decisive evidence in both goes beyond the scope of the decisions.
5 December 2023: Promised result and expert examination in a rhinoplasty
Court of Cassation 6th Civil Chamber, 05.12.2023, E. 2022/3416, K. 2023/4080. It was emphasized that the court must not remain at the level of fault or complication, but must separately examine whether the agreed result was obtained in an aesthetic procedure. For a contract for work, the examination of the result may require the technical report to be supplemented with concrete questions. [5]
27 April 2026: Assessment under mandate in functional treatment and a procedural limit
Court of Cassation 3rd Civil Chamber, 27.04.2026, E. 2025/5356, K. 2026/2466. In a case brought over operations in which nasal obstruction and an aesthetic expectation coexisted, the Chamber dealt with the specific dispute under the duty of care arising from a contract of mandate; it affirmed the dismissal, which relied on the assessment that the medical procedure was in line with the indication and that no fault had been found. The decision also stated that, in the simplified procedure, raising later an informed-consent claim not put forward in the statement of claim amounts to an expansion of the claim. This decision shows that a contract for work cannot be accepted in every file involving an aesthetic-appearance claim, and the importance of framing the litigation strategy coherently in the first petition. [13]
13 February 2025: An anaesthesia form does not prove disclosure for another operation
Court of Cassation 3rd Civil Chamber, 13.02.2025, E. 2024/1848, K. 2025/836. The file discussed that the consent form for the operation concerned lacked the patient's signature, whereas another form relating to anaesthesia was signed. The decision is important for an approach that does not reduce proof of procedure-specific informed consent to a general signature or another procedural document. [6]
5. What happens if informed consent and a digital promise conflict?
The duty of disclosure serves to enable the patient to form his or her decision freely as to the diagnosis, the nature of the proposed intervention, reasonable alternatives, foreseeable risks, expected benefit and the likely consequences of not intervening. Articles 15, 18 and 24 in particular of the Patient Rights Regulation (Hasta Hakları Yönetmeliği) and related provisions, and Article 5 of the Convention on Human Rights and Biomedicine, matter in this assessment. [7]
If a physician presents a procedure as "risk-free and guaranteed" on a social media account while obtaining from the same patient a consent that lists different risks, this may raise the questions of the consistency of the information given and whether the patient was genuinely informed. The legal consequence of this conflict, however, cannot be decided without examining whether the content reached the patient, the individualized information, the timing and the type of intervention.
The decision of the 13th Civil Chamber of the Court of Cassation dated 22.05.2019, E. 2017/8664, K. 2019/6410 contains the assessment that a signed standard consent may be found insufficient if it does not explain the concrete risks and alternatives of the procedure, and that the burden of proving disclosure lies with the physician or hospital. [8]
Although it may seem justified from the patient's side, the claim that "it said something different on Instagram" does not by itself secure compensation for all losses. From the physician's side too, the defense that "the form had been signed" does not render unnecessary the examination of the scope and timing of the consent.
6. Before-and-after images raise three separate legal issues
Description of the clinical result and personalized expectation
Showing aesthetic results in photographs does not mean the same outcome will occur for everyone who sees the post. But adding categorical statements such as "you too will achieve the same result" over the image changes the scope of the presentation. The selection of comparison photos, the date of the procedure, the follow-up period and its description must be assessed.
Misleading photography and the prohibition on alteration
Article 7 of the Regulation on Promotion and Information Activities in Health Services dated 12 November 2025 allows patient images under certain conditions. These include that the before and after shots are taken in the same setting and under the same technical conditions, that the dates of the procedure and the shots are stated, and that no technological correction is applied afterwards. Filters, manipulated lighting, artificial changes to the face or body, or misleading make-up may affect both the promotional assessment and the possible judicial assessment of the image. [9]
Personal data and permission to use images
Consent to treatment is not permission for social media promotion. The visual-content consent in Annex 1 of the Regulation is the specific provision sought for sharing content; the patient must be able to see the image to be published in advance, be able to withdraw consent, and must not be treated differently in fees or treatment because he or she did not give permission to share. The provisions on closing the visual content to interactions such as comments, likes and reposts, and on images of the moment of intervention, apply separately. [9]
7. The distinction between a physician's personal account and the hospital account in KVKK decisions
KVKK decision of 29 June 2022: consent given to the hospital did not cover the physician's account
Personal Data Protection Board, 29.06.2022, 2022/630. Patient images taken during a rhinoplasty were shared on the physician's personal social media account. The Board did not accept covering a certain part of the face as sufficient anonymization and held that the image permission obtained by the hospital did not automatically cover the post on the physician's personal account. A sanction was imposed on the institution for its data security measures. [10]
This decision shows that, in a post on a personal account, it is necessary to look not only at whether the image appears anonymous but also at who gave consent, to whom the consent was addressed, and its purpose and medium of use.
KVKK decision of 11 May 2023: explicit consent did not remove the sectoral advertising ban
Personal Data Protection Board, 11.05.2023, 2023/787. In a case where health data was used for promotional purposes, the Board concluded that, even where explicit consent had been obtained from patients, data processing contrary to the advertising restrictions in the health sector is not legitimized automatically. [11]
A warning as to timing: Both Board decisions relate to the former legislative period, and decision 2023/787 relates to the text of Article 6 of Law No. 6698 before its 2024 amendment. The conditions of data processing applicable to an event in 2026 should be determined by considering current Article 6 of the KVKK, the 2025 promotion Regulation and the nature of the procedure together. These decisions are used to explain concrete past events and continuing legal principles. [9][10][11][12]
8. Can a WhatsApp message be regarded as a clinical assurance given to a patient?
The use of the telephone and messaging tools in physician-patient communication is not in itself a sign of unlawfulness or malpractice. The issue is whether the message amounts to stating a definitive medical opinion without an examination, making light of serious complaints or giving a personal guarantee.
The following three examples show general risk types:
• "No trace will remain after this procedure." — A question of assurance of a specific result.
• "Your complaint will go away; you don't need to come for a check-up." — A problem of monitoring the complication and of medical assessment.
• "This image is normal; no further examination is needed." — The risk of a definitive assessment without sufficient clinical information.
However, a firm finding of fault cannot be made without the conditions under which the message was written, the earlier examination, the images the patient sent, the timing, the phone traffic, the check-ups called for and the medical records. If the correspondence is forged or only selected lines are submitted, the reliability of the evidence is discussed separately.
In practice, it matters that clinics have a messaging policy under which appointment and administrative communication does not replace a medical assessment, that in applications involving urgency the person is directed to an appropriate health assessment, and that the necessary records are kept in the patient file.
9. The legal and technical position of a deleted post
Removal of a post does not automatically invalidate a screenshot, record of findings (tespit tutanağı) or records previously obtained lawfully. Nevertheless, the possibility of objection as to the date, the genuine account and the integrity of the file remains. That 24-hour stories later become inaccessible also does not make it impossible to rely, as evidence, on a file saved in the past.
For a physician or clinic, stopping the offending post must be distinguished from destroying evidence relating to an existing dispute. While unlawful public content containing health data is removed as required, appropriate internal records should be preserved with regard to statutory retention obligations, pending proceedings, the relevant court orders and data minimization. Medical records must not be altered retroactively. [1][9][10]
10. The limit on responding publicly to patient comments
Even if a person has stated on social media that he or she is a patient, a physician or clinic does not acquire, on that basis, the authority to describe in a public space that person's medical history, prescriptions, check-up records, complaints or date of application.
Replies such as "you did not take your medication regularly" or "you did not come to the check-ups we recommended" can raise, independently of the clinical assessment, the issue of disclosure of personal data and patient confidentiality. Hasty sentences may also be relied on later as party statements in a subsequent case. The safer practice is to direct the correspondence to an authorized and secure patient communication channel without confirming the person's health information in a public space.
11. The physician's personal account, the clinic account and posts by an agency
Publishing content through a personal profile does not automatically exclude the provisions on professional promotion and data protection. Whether consent given to the hospital's account covers the physician's private account, which data the agency processes, who decides on posting and which user audience is targeted must be examined separately. [10]
The institution's contract with the agency should regulate the following expressly: pre-publication review; the limit on sources that may be used; recording of image consent; restriction of access to health data; post and comment settings; removal of incorrect content; and internal breach notification and the allocation of duties. That responsibility has been transferred to the agency in the contract does not automatically remove the hospital's own public-law or data protection obligations.
12. In a concrete case, which record is linked to which claim?
| Record or document | Legal issue that can be raised | Additional examination required |
|---|---|---|
| Instagram post and advertising statement | General promise, promotional language, provision of information | Date, publishing account, addressee, context |
| Patient-specific WhatsApp conversation | Individual assurance, guidance after a complication | The entire exchange, ownership of account/number, medical file |
| Before-and-after photograph | Example result presented and expected appearance | Whether it belongs to a real patient, shooting conditions, comparability |
| Informed consent and physician's note | Risk information, scope of the procedure, timing | Signatures, specificity to the procedure, date of explanation, evidence of oral information |
| Discharge summary, operation note, follow-up records | Medical practice and management of complications | Specialist expert, causation, alternative medical explanations |
| Consent to image sharing | Data processing and authority to publish | Annex 1, which account/medium is covered, withdrawal |
The core issue for the court is not to place one record above the others but to weigh all the evidence together, determining for the proof of which concrete fact each claim is used. Furthermore, a breach of advertising legislation does not by itself prove that the intervention was medically erroneous or causally linked to the loss.
13. How should risky statements be corrected before publication?
| Risky statement | Information-focused alternative | Legal note |
|---|---|---|
| "100% success is achieved in this operation." | "The result may vary depending on personal medical characteristics and the healing process." | An alternative sentence alone does not make the content lawful if other visuals or sales language contradict it. |
| "No scar remains." | "Scar formation and healing may differ from person to person." | Individual assessment and disclosure are required. |
| "Zero-risk treatment." | "Depending on the characteristics of each interventional procedure, there may be risks." | Downplaying risk can give rise to a disclosure issue. |
| "The result in the photo will be exactly the same for you." | "Sample images do not guarantee the same clinical result for every patient." | The conditions of Article 7 of the Regulation for sharing images are also sought separately. |
| "Your complaint will definitely pass; no check-up is needed." | "Whether an appropriate medical check is needed to assess your complaint must be determined." | Do not substitute a ready-made text for a real clinical assessment. |
Important distinction: These alternatives are not formulaic statements that provide freedom to advertise. The content as a whole, the images used, the referral to the health service, sponsored publication and patient data must be examined separately.
14. Managing evidence before a dispute, for patients and physicians
Points for the patient to note
• Preserve the full link of the relevant social media content, the visible date and a screenshot.
• Keep the conversations to which he or she is a party, together with the earlier and later conversation context.
• Request the existing copies of the contract, payment, patient file, consent, images and check-up records.
• Not resort to unlawful access, unauthorized entry into a third person's device or seizure of private accounts.
• For records at risk of deletion, consider preservation of evidence and an appropriate procedural application with a lawyer.
• When filing the case, identify and substantiate separately the claims based on inadequate disclosure, promised result, fault in technical performance and management of complications; avoid omissions that could lead to the prohibition on later expansion. [13]
Points for the physician and the health institution to note
• Keep it auditable which responsible person published the content, when and with what approval.
• Keep the consent, operation and follow-up file unaltered afterwards and in line with the retention conditions of the legislation.
• Treat removal of unlawful posts, retention and access-authority issues as separate legal steps.
• Not disclose health data in public discussions with patients; direct medical questions to the recorded consultation process.
• When a case or complaint arises, not confuse the headings of administrative sanction, data protection, disciplinary and private-law liability.
15. A 15-point digital publication check for physicians and clinics
- Does the post contain a definitive clinical result, a claim of no risk, a guarantee or superiority over other physicians?
- Does the content give protective health information, or does it generate demand for a particular service?
- From which account, to which target audience and by which method will the post be published?
- Is the patient photograph or video used genuinely necessary?
- Is there valid permission for the patient image under Annex 1 of the 2025 Regulation?
- Did the patient see the final content to be published in advance?
- Is there a filter, retouching, AI alteration or misleading lighting correction on the image?
- Are the before-and-after images comparable; are the necessary dates correct?
- Have the interaction and sponsored-publication restrictions been applied to the image?
- Does it contain patient imagery from the moment of the intervention or operation?
- Might the person be thought anonymous merely because only the face has been covered?
- Does the social media account contradict the oral and written disclosure given to the person?
- Do the WhatsApp replies contain a definitive medical judgment without an examination?
- Does a public reply to the patient confirm or disclose private health information?
- When this post enters a case file, will its source, context and legal purpose be clearly explainable?
These questions are an internal pre-review tool; they do not replace legal advice or medical assessment.
Conclusion
In malpractice disputes, digital communication is no longer merely a matter of advertising or public relations. The legal value of a digital record depends on which fact it is submitted to prove, how it was obtained, whom it belongs to and how far it coincides with the operation note, the consent and the clinical follow-up documents. The Court of Cassation's decisions examining promised results in aesthetic procedures show that the result promised by the physician must be distinguished from fault in medical practice alone.
For physicians and health institutions, the workable approach is not to prohibit all posts but to establish a predictable publication and record-keeping order that separates information from promise of result, medical consent from permission to share images, and public statement from patient privacy. For the patient, the essential point is to rely not on a single screenshot but on a concrete claim supported by lawfully obtained and complete records.
Frequently Asked Questions
Can an Instagram post alone win a malpractice case?
No. A post can be a document under Article 199 of the HMK; but which claim it supports as to medical fault, promise, causation, loss or disclosure is examined separately. Its ownership and lawful acquisition may also be disputed.
If the result of an aesthetic operation is disliked, is the physician necessarily liable?
No. Even though aesthetic interventions may be assessed as contracts for work, it is first determined what the agreed result was and how it was performed. The medical records, the patient's characteristics, the complication and the claims for compensation are assessed separately.
Can a WhatsApp message be submitted to the court without a notary?
Yes. Messages can be submitted as documents; but neither the absence nor the presence of a notarial record by itself determines the accuracy of the message. Account ownership, date, integrity of the conversation and, where necessary, technical examination are important.
Is consent to the operation sufficient for a patient image?
No. Consent to a medical intervention and consent to image sharing on social media are different. Form Annex 1 of the 2025 Regulation and the other conditions in Article 7 are assessed separately.
Can a deleted Instagram story still be evidence?
It can. Data and records previously saved lawfully can be examined. Deletion does not automatically invalidate them, nor does it make verification of the original account and date unnecessary.
If the patient's name does not appear on the physician's personal account, does the KVKK not apply?
No. Features of the photograph other than the face, the voice, the clinical context and other information can make a person identifiable. KVKK decision 2022/630 is important for this distinction; that the account is personal does not by itself remove liability.
If the patient has made the complaint public on social media, may the physician reply in detail?
A person's own post does not give the physician authority to disclose all medical secrets. An appropriate and confidential communication method should be used, without discussing patient file information in a public channel.
Can a clinic transfer all responsibility to an advertising agency?
A contract can be made with an agency; but this does not automatically remove the health institution's own legislative and personal data obligations. Data access, publication approval and the control process must be supervised.
Sources
1. Code of Civil Procedure No. 6100, in particular Articles 189, 190, 199 and 400 et seq. Ministry of Justice UYAP Legislation and Case Law: link
2. Turkish Code of Obligations No. 6098, in particular Articles 470, 471, 475, 502 and 506. Legislation Information System: link
3. Court of Cassation 6th Civil Chamber, 12.03.2025, E. 2024/2449, K. 2025/1005; aesthetic procedure, claim of an Instagram broadcast and promised result. Full text of the decision: link
4. Court of Cassation 6th Civil Chamber, 17.11.2025, E. 2024/3670, K. 2025/3903; promised aesthetic result, expert report and compensation. Full text of the decision: link
5. Court of Cassation 6th Civil Chamber, 05.12.2023, E. 2022/3416, K. 2023/4080; contract for work in rhinoplasty. Full text of the decision: link
6. Court of Cassation 3rd Civil Chamber, 13.02.2025, E. 2024/1848, K. 2025/836; procedure-specific informed consent. Full text of the decision: link
7. Patient Rights Regulation, Articles 15, 18, 24 and related provisions. Ministry of Health of the Republic of Türkiye: link
8. Court of Cassation 13th Civil Chamber, 22.05.2019, E. 2017/8664, K. 2019/6410; scope and proof of informed consent. Full text of the decision: link
9. Regulation on Promotion and Information Activities in Health Services, 12.11.2025, Official Gazette no. 33075, in particular Articles 5–7 and Annex 1. Ministry of Health of the Republic of Türkiye, Antalya Provincial Health Directorate: link
10. Personal Data Protection Board, decision no. 2022/630 of 29.06.2022. Personal Data Protection Authority: link
11. Personal Data Protection Board, decision no. 2023/787 of 11.05.2023. Personal Data Protection Authority: link
12. Personal Data Protection Authority, announcement on the 2024 amendments to Articles 6 and 9 of Law No. 6698: link
13. Court of Cassation 3rd Civil Chamber, 27.04.2026, E. 2025/5356, K. 2026/2466; mandate, fault and expansion of the claim in a functional/aesthetic nasal operation. Full text of the decision: link