10 The addendum requires the expert medical opinion to pass a threshold test of logic; it is met if the medical experts who gave testimony have compared the risks and benefits and come to a defensible conclusion that fulfils a threshold of logic and consistency. 2 In this lawsuit, the Bolam principle was rejected and the surgeon found to be in breach of his duty of care by failing to warn his patient of the potential risk of developing sympathetic ophthalmia following her eye surgery. Title: Legal standard of care: a shift from the traditional Bolam test Created Date: 8/10/2007 5:51:59 PM Bolam v Friern Hospital Management Committee (1957) 2 All ER 118; (1957) 1 WLR 582 pg 586-588. 18. This is further highlighted by changes in English law where the previously sound Bolam test has come under scrutiny as expert witness testimony is being contested in terms of its defensibility. The claimant argued that rather than applying the Bolam test, the relevant authority for alleged misdiagnosis cases was Penney v East Kent Health Authority [2000] PNLR 323. There is no room for a legal Test (Bolam) which allows the medical profession to justify a restrictive approach to disclosure of risk. The Bolam principle1 establishes that a professional is required to exercise the ordinary skill of a competent practitioner in his/her field. This is in contrast with the stage of pre-treatment advice, where patients can still retain control of their treatment. 1 Regrettably, the Australian law underwent profound change following the High Court case Rogers v Whitaker in 1992. To satisfy the Bolam test, a medical professional must show that he acted in a way that a responsible body of medical professionals in the same field would regard as acceptable. Collection of civil cases. However, it may well be that Morris has paved the way for future cases where the court are faced with two experts with ‘contrasting opinions’. In essence this test expects standards which must be in accordance with a responsible body of opinion, even if others differ in opinion. Therefore, in 1997 the Bolam test … As such, the Bolam-Bolitho test would still govern the standard of care with regard to these latter stages, for the practice of medicine is “as much as art as a science”. Bolam v Friern Hospital Management CommitteeBolam v Friern Hospital Management Committee [1957] 1 WLR 582 is an English tort law case that lays down the typical rule for assessing the appropriate standard of reasonable care in negligence cases involving skilled professionals (e.g. Long live Bolam In this article Simon Fox QC reviews the Bolam test for breach of duty in clinical negligence in the light of recent case law and asks – is it still the test for breach? The village is about 20 miles north-west of Newcastle upon Tyne, near Bolam West Houses. Hence the Bolitho case has questioned the authenticity of expert knowledge in view of the Bolam test to the extent that opinion amongst expert groups may not in fact be based on sound current knowledge. Medico-Legal Journal 2015 84: 1, 5-17 Download Citation. The Bolam test of the reasonable standard of practice is still used to determine negligence. So if a GP’s advice was in question, the test was whether a responsible body of GPs would have given similar advice. Where the defendant has represented him or herself as… [48] Mr Justice Foong stated that: “For sometime, the Bolam test i.e., the test expounded by McNair J in Bolam v Friern Hospital Committee (supra) was accepted to be applicable to all provisions of a doctor’s duty to his patient. The Bolam test was later supplemented by the Bolitho addendum in the case of Bolitho v City & Hackney Health Authority [Bolitho]. There are two limbs to the Bolam test. as a guide for the court when dealing with professional expert opinion. This is known as the ‘Bolam’ test. The plaintiff in Bolam’s case, one John Hector Bolam, a salesman, was admitted to Friern Hospital suffering from the after effects of a mental illness of the depressive type. A doctor will be judged to have come up to the required standard of clinical care if a reasonable body of medical opinion, albeit a … It follows the Bolam test for professional negligence, and addresses the interaction with the concept of causation. It is this change in philosophy which signals the end of Bolam in cases of informed consent. Get the full comprehensive details here For everyone else, be they ship captains, architects or solicitors, the courts reserved the right to examine the content of the expert evidence and, if it made no sense, still find negligence. Whitaker test would be a more appropriate and a viable test of this millennium then the Bolam test. A doctor’s duty of disclosure and the decline of ‘The Bolam Test’: A dramatic change in the law on patient consent. On 1 April 1955 it was merged into Belsay. Whilst this is a Scottish case, the decision represents an important clarification of the law in respect of consent in clinical negligence cases which is also highly relevant in England and Wales. To determine the reasonable standard of care, reference would be made to national guidelines, such as those published by professional bodies and NICE, academic textbooks and employers’ policies and protocols. Bolam (Bolam v Friern Hospital Management Committee [1957] 2 All ER 118) principle is not extended, they still have an innate reluctance to abandon it in resp The Bolam test was later modified by Bolitho 6 in 1998, in which the House of Lords, commenting on the validity of expert opinion in determining the Bolam standard, ruled that “…if in a rare case, it can be demonstrated that the professional opinion is not capable of withstanding logical analysis, the judge is entitled to hold that the body of opinion is not reasonable or responsible.” Bolitho v. City and Hackney Health Authority [1996] 4 All ER 771 is an important English tort law case, on the standard of care required by medical specialists. The origin of the Bolam Test was from the ruling by McNair J, in the seminal case of Bolam v Friern H.C.C [1] . The first is that all professionals (people who hold themselves out as holding skills) will have the standard of a reasonable professional. In Pearce v United Bristol Healthcare NHS Trust [10] and in Wyatt v Curtis [11] the courts have embraced a test which shifts the focus towards the patient and what a reasonable patient would want to know. Facts Mr Bolam = patient at mental health institution, underwent electro-convulsive therapy. The author firmly believes that although there have been many problems and changes, the Bolam test is still the prevailing gold standard in medical negligence defence. New decision confirms the end of the Bolam test in consent cases. To appreciate the Bolam Test which is the locus classicus to determine liability for medical negligence in England, it is necessary to first consider the facts of the case itself. The second limb is that doctors aren't liable if they act in accordance with a responsible body of medical opinion. The test is essentially a peer review of the doctor's behaviour - if others would have acted in a similar way, then the doctor is unlikely to have breached his duty of care. In dealing with this claim, the court abandoned the Bolam test and applied the approach used by the Australian courts in Rogers v Whitaker. In 1951 the civil parish had a population of 60. He applied the Bolam test (Bolam v Friern Hospital Management Committee [1957] 1 WLR 582) as to whether that omission was accepted as appropriate by a responsible body of medical opinion. A doctor is under a duty to use that degree of care and skill which is expected of a reasonably competent practitioner in the same class which he belongs, acting in the same and similar circumstances. 30 July 2019 15:56 b) In Bolam’s test, expert opinion is not scrutinzed but in Bolitho’s test, it encourages the court to be vigilant when dealing with the professional expert opinion. To borrow a quote from Lord Woolfe's inaugural lecture in the new Provost Series, delivered in London in 2001, the phrase "Doctor knows best" should now be followed by the qualifying words "if he acts reasonably and logically and gets his facts right ". Bolam v Friern Hospital Management Committee [1957] 1 WLR 582 is an English tort law case that lays down the typical rule for assessing the appropriate standard of reasonable care in negligence cases involving skilled professionals (e.g. , when he attempted to objectively quantify the expected and required standard of care. This was the Bolam test, which still applies to diagnosis and treatment. James Badenoch, QC. Bolam is a village and former civil parish, now in the parish of Belsay in the county of Northumberland, England. This involved considering whether the Bolam test was applicable given that this was not a case of mistreatment but misdiagnosis. The Bolam Test is however still valid in other areas of clinical and medical negligence. doctors): the Bolam test. During treatment, flailed about violently and suffered fractured hip. This point was not a deciding factor in Morris. 2. But the question that still remains is whether India needs to adopt the new test to satisfy the requirements of stricter medical negligence laws and meet the needs of increasing negligence litigation. Negligence This case continues to play an important role in the lives of doctors and patients even after more than 60 years, and almost since the start of National Health Service. The Bolam test may be a reminder of the old days of medical paternalism but it remains an enduring comparator in clinical negligence cases when it comes to pure treatment cases like Dyson. Judgment in the appeal case of Montgomery v Lanarkshire Health Board (Scotland) [2015] was handed down by the Supreme Court last week. The Bolam Test – Where Experts Do Not Agree. BOLAM TEST a) From the above, Bolitho test is regarded as addendum to Bolam’s test i.e. The Bolam Test has formed the backdrop to all clinical negligence cases since 1957, providing a cornerstone for the defence of these claims. This was clearly too lenient, and did too little to protect patients. He argued doctor was negligent for: The Bolam test has been followed for a long time in India, the principle being used and applied in cases like Suresh Gupta. references 1. If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. At time, juries still used for tort cases in England and Wales, so the judge's role was to sum up law and leave it for the jury to decide verdict. The Bolam test relates to a ruling from 1957, which involved a patient who agreed to electroconvulsive therapy. The test was whether a responsible body of doctors practicing the same discipline would have given similar advice. 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