Sidaway v Board of Governors of the Bethlem Royal Hospital [1985]
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Sidaway v Board of Governors of the Bethlem Royal Hospital [1985] AC 871 is a landmark House of Lords case in English tort law, specifically addressing medical negligence and the duty of a surgeon to inform a patient of the risks associated with a surgical procedure. While once a defining case, it has seen a substantial shift in legal principles, particularly with the advent of the Montgomery v Lanarkshire Health Board [2015] decision.
The claimant, experiencing pain in her neck, right shoulder, and arms, underwent cervical cord decompression as recommended by her neurosurgeon. However, the surgeon did not disclose the rare risk of paraplegia associated with the procedure, and the claimant subsequently developed paraplegia.
The court, rejecting the claim for damages, held that the consent process did not necessitate an elaborate explanation of remote side effects. The majority opinion aligned with the Bolam test, suggesting that the professional medical standard determined the adequacy of information disclosure. However, in dissent, Lord Scarman argued against the application of the Bolam test to issues of informed consent, advocating for a duty on doctors to inform patients of inherent and material treatment risks.
Lord Diplock, in the majority, highlighted the professional nature of the decision, stating that the doctor's duty of care extends to the individual patient, and that the Bolam test should be applied to determine the appropriate level of risk disclosure.
The landscape shifted significantly with the case of Montgomery v Lanarkshire Health Board [2015]. The UK Supreme Court overturned the principles established in Sidaway, stating that the Bolam test was not applicable to the disclosure of risks to patients. The court emphasised that doctors should not only provide sufficient information regarding risks but also consider these risks from the patient's perspective. This marked a departure from the professional-centric approach of Sidaway, recognising the importance of patient autonomy and a more patient-centric approach to informed consent.
In summary, Sidaway v Board of Governors of the Bethlem Royal Hospital, once a leading authority, has been eclipsed by Montgomery, a case that shifted the paradigm by placing greater emphasis on the patient's perspective in the informed consent process, thus reshaping the legal standards in medical negligence law.
The claimant, experiencing pain in her neck, right shoulder, and arms, underwent cervical cord decompression as recommended by her neurosurgeon. However, the surgeon did not disclose the rare risk of paraplegia associated with the procedure, and the claimant subsequently developed paraplegia.
The court, rejecting the claim for damages, held that the consent process did not necessitate an elaborate explanation of remote side effects. The majority opinion aligned with the Bolam test, suggesting that the professional medical standard determined the adequacy of information disclosure. However, in dissent, Lord Scarman argued against the application of the Bolam test to issues of informed consent, advocating for a duty on doctors to inform patients of inherent and material treatment risks.
Lord Diplock, in the majority, highlighted the professional nature of the decision, stating that the doctor's duty of care extends to the individual patient, and that the Bolam test should be applied to determine the appropriate level of risk disclosure.
The landscape shifted significantly with the case of Montgomery v Lanarkshire Health Board [2015]. The UK Supreme Court overturned the principles established in Sidaway, stating that the Bolam test was not applicable to the disclosure of risks to patients. The court emphasised that doctors should not only provide sufficient information regarding risks but also consider these risks from the patient's perspective. This marked a departure from the professional-centric approach of Sidaway, recognising the importance of patient autonomy and a more patient-centric approach to informed consent.
In summary, Sidaway v Board of Governors of the Bethlem Royal Hospital, once a leading authority, has been eclipsed by Montgomery, a case that shifted the paradigm by placing greater emphasis on the patient's perspective in the informed consent process, thus reshaping the legal standards in medical negligence law.
