Montgomery v Lanarkshire Health Board [2015]
Court: Supreme Court
Facts: The claimant, Mrs. Montgomery, a diabetic and of small stature, was under the care of the Lanarkshire Health Board during her pregnancy. The doctor did not inform her of the 9-10% risk of shoulder dystocia associated with her condition. Believing that a caesarean section was not in her best interest, the doctor did not suggest it. As a result, Mrs. Montgomery's baby suffered severe disabilities due to shoulder dystocia. She sought damages from the health board, claiming that had she been informed of the risks, she would have opted for a caesarean section.
Issue: The case revolved around whether the doctor was negligent for failing to disclose the risk of shoulder dystocia and the associated options for delivery. It questioned the adequacy of the Bolam test in evaluating the duty of a doctor to inform patients of risks and alternatives.
Held: The Supreme Court, in a landmark decision, departed from the previous legal standards set by Sidaway v Board of Governors of the Bethlem Royal Hospital and altered the Bolam test concerning the disclosure of risks. The court held that the doctor had a duty to inform the patient of material risks and alternative treatments. The test for disclosure is based on whether a reasonable person in the patient’s position would consider the risk significant or if the doctor knows that the particular patient would find it significant.
The Supreme Court rejected the Bolam test's application to risk disclosure, which previously allowed practices based on what a responsible body of medical opinion considered acceptable. Instead, the court emphasized patient autonomy and the necessity for informed consent. The judgment established that patients must be informed of material risks, and their consent must be informed and valid.
Key Judicial Statement: Lord Kerr and Lord Reed stated that the Bolam test, applied to the disclosure of risks, led to variations based on doctors' attitudes rather than objective medical standards. They emphasized that patients have the right to make informed choices about their treatment, which includes being aware of significant risks and reasonable alternatives.
💡 LevelUpLaw: Montgomery v Lanarkshire Health Board marks a significant shift in medical negligence law, moving away from the Bolam test's focus on professional standards to a patient-centric approach emphasizing informed consent. The decision underscores the importance of patient autonomy, requiring doctors to disclose material risks and alternatives to allow patients to make well-informed decisions about their treatment. This change aligns with modern expectations of patient involvement and has redefined the standard for assessing medical negligence related to informed consent.