Bolam v Friern Hospital Management Committee [1957]
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Bolam v Friern Hospital Management Committee [1957] 1 WLR 582 is a pivotal English tort law case that introduced the Bolam test, a standard for evaluating the reasonable care in negligence cases involving skilled professionals, particularly doctors. The Bolam test asserted that if a doctor's actions align with the practice accepted by a responsible body of medical opinion, they are not deemed negligent. However, this principle underwent significant reevaluation in the 2015 Supreme Court decision of Montgomery v Lanarkshire Health Board, particularly concerning informed consent.
Mr Bolam, a voluntary patient at Friern Hospital, underwent electro-convulsive therapy without muscle relaxants or restraints. He suffered injuries during the treatment and sued the hospital management committee, alleging negligence for not issuing relaxants, not restraining him, and not warning him of the risks.
Justice McNair at the first instance considered expert witnesses confirming that the medical opinion opposed the use of relaxant drugs and that manual restraints could increase the risk of fracture. The judge emphasised the relevance of common medical practice to the standard of care required, stating that a person falls below the appropriate standard if he deviates from the practice accepted by a responsible body of medical professionals skilled in that particular art — the essence of the Bolam test. The jury delivered a verdict in favour of the hospital, considering the general medical opinions regarding acceptable electro-shock practice.
Bolam's significance lies in establishing the Bolam test as the basic rule for assessing professional negligence over the following decades. The principle provided a framework for determining whether a medical professional's conduct met the standard of reasonable care based on accepted medical practices.
Bolam underwent reexamination and revision in the 2015 Supreme Court decision of Montgomery v Lanarkshire Health Board. The court rejected the Bolam test in matters of informed consent, marking a departure from the professional-centric approach. The court emphasised that doctors should not only follow accepted practices but also consider patients' perspectives. This shift reflected a more patient-centric approach, acknowledging the importance of informed consent and patient autonomy.
The Bolam principle, while historically influential, has seen challenges in specific contexts, particularly in cases involving informed consent. Courts have recognised the need for a more nuanced approach, as illustrated by the evolving legal landscape in subsequent cases and decisions.
Mr Bolam, a voluntary patient at Friern Hospital, underwent electro-convulsive therapy without muscle relaxants or restraints. He suffered injuries during the treatment and sued the hospital management committee, alleging negligence for not issuing relaxants, not restraining him, and not warning him of the risks.
Justice McNair at the first instance considered expert witnesses confirming that the medical opinion opposed the use of relaxant drugs and that manual restraints could increase the risk of fracture. The judge emphasised the relevance of common medical practice to the standard of care required, stating that a person falls below the appropriate standard if he deviates from the practice accepted by a responsible body of medical professionals skilled in that particular art — the essence of the Bolam test. The jury delivered a verdict in favour of the hospital, considering the general medical opinions regarding acceptable electro-shock practice.
Bolam's significance lies in establishing the Bolam test as the basic rule for assessing professional negligence over the following decades. The principle provided a framework for determining whether a medical professional's conduct met the standard of reasonable care based on accepted medical practices.
Bolam underwent reexamination and revision in the 2015 Supreme Court decision of Montgomery v Lanarkshire Health Board. The court rejected the Bolam test in matters of informed consent, marking a departure from the professional-centric approach. The court emphasised that doctors should not only follow accepted practices but also consider patients' perspectives. This shift reflected a more patient-centric approach, acknowledging the importance of informed consent and patient autonomy.
The Bolam principle, while historically influential, has seen challenges in specific contexts, particularly in cases involving informed consent. Courts have recognised the need for a more nuanced approach, as illustrated by the evolving legal landscape in subsequent cases and decisions.
