Respect for Patients' Rights in Hospital Practice: Associations with Physicians' Legal Knowledge, Defensive Medicine, and Patient-Centered Care.

Background/Objectives: This study examined associations of physicians' legal knowledge, defensive medicine, and patient-centered orientation with self-reported respect for patients' rights. Methods: A single-center cross-sectional study (February-June 2026) included 96 physicians. The primary outcome was the Patients' Rights Respect Score (PRRS, 0-100). The confirmatory analysis compared PRRS between legal-knowledge groups (adequate ≥70/100). Multivariable regression was secondary; mediation and prediction were exploratory. Results: Adequate legal knowledge (34/96, 35.4%) was associated with higher PRRS (76.8 ± 7.1 vs. 71.0 ± 8.4; difference 5.8, 95% CI 2.6-9.0, p < 0.001, d = 0.73) and lower Defensive Medicine Scale scores (44.5 ± 6.8 vs. 48.5 ± 9.3, p = 0.016). Patient-Practitioner Orientation Scale scores were independently associated with PRRS (B = 6.64 per point, p < 0.001; model R2 = 0.513); the adjusted legal-knowledge coefficient was not statistically significant (B = 1.09 per 10 points, p = 0.094). In exploratory parallel mediation models, 41.8% of the knowledge-PRRS association was statistically accounted for by indirect associations, mainly through patient-centered orientation; concurrent measurement precludes causal ordering. An exploratory model for PRRS < 70 had an optimism-corrected AUC of 0.789 (internal validation only). Conclusions: Legal knowledge was associated with greater self-reported respect in unadjusted comparisons. Indirect associations were hypothesis-generating, and predictive performance does not establish clinical utility. Confirmation requires multicenter, longitudinal studies with objective measures of practice.