Bolam v Friern Hospital Management Committee (1957)
The Case:
Bolam v Friern Hospital Management Committee (1957) is a landmark case in negligence law in England.
John Bolam suffered from depression. He was advised by the consultants treating him that he should have electroconvulsive therapy (ECT).
Prior to this procedure he was not warned that there was a risk of fracture, nor was he physically restrained or provided with relaxant drugs. During the procedure he suffered a fractured hip.
He claimed that the doctors treating him had been negligent by not warning him of the risk, nor, offering relaxant drugs or restraints.
The difficulty was that at the time it was not agreed upon whether to warn the patient of the risk of fracture, nor was it agreed as to whether the patient should be restrained or given relaxant drugs during the procedure to mitigate against the risk of fracture.
The Verdict
McNair J stated:
“A doctor is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a reasonable body of medical [people] skilled in that particular art.”
In this case, the doctors treating John Bolam had not acted in a manner which was contrary to the expert opinion of his peers nor the expected standard of care.
In other words, for the claimant to show that the clinician has been negligent they need to show that the clinician has acted in a manner that is contrary to the usual standard of care that has been set by other doctors in their speciality - this is known as the Bolam Test.
When does this apply?
The Bolam Test applies to clinical decisions which involve clinical skill, such as diagnosing a condition.
It does not apply to any of the following:
Informing a patient of the reasonable treatment options available
Informing the patient of the associated risks of a procedure
Basic diagnosis decisions
Advice which is deemed as being non-medical
It also does not apply to information that the clinician could not have been expected to know. For example, if new guidelines were released after the incident they would not apply to the case as there was no way the clinician could have known them.