Sidaway v Board of Governors of the Bethlem Royal Hospital [1985]

Court: House of Lords

Facts: The claimant, Mrs. Sidaway, underwent cervical cord decompression surgery recommended by her neurosurgeon to alleviate pain in her neck, shoulder, and arms. The surgeon did not inform her of the rare risk of paraplegia associated with the procedure. Unfortunately, Mrs. Sidaway developed paraplegia post-surgery and sought damages, arguing that she had not been adequately informed of the risks.

Issue: The main issue was whether the surgeon was negligent in failing to disclose the rare risk of paraplegia, and whether the standard for disclosing risks should be determined by the Bolam test (based on the medical profession’s standard) or by considering what a reasonable patient would want to know.

Held: The House of Lords held that the surgeon was not liable. The court applied the Bolam test, which measures the adequacy of the surgeon’s disclosure against what a reasonable medical professional would do. The majority opinion found that the disclosure of the risk was not required under the Bolam standard because it was a rare complication.

Lord Diplock, delivering the majority opinion, emphasized that the duty of care in medical negligence cases is based on professional standards. He stated, "The doctor’s duty is to provide information based on what a competent medical practitioner would consider necessary."

In dissent, Lord Scarman argued that the Bolam test was not suitable for assessing the adequacy of risk disclosure. He proposed that patients should be informed of all inherent and material risks, reflecting a more patient-centric approach.

Key Judicial Statement: Lord Scarman, dissenting, stated, "The duty to inform the patient is not merely a matter of professional practice but of ensuring that the patient is fully aware of the risks involved, which is a fundamental aspect of informed consent."

💡 LevelUpLaw: Sidaway v Board of Governors of the Bethlem Royal Hospital was a pivotal case in medical negligence law, emphasizing the professional standard for risk disclosure. However, it has since been overshadowed by Montgomery v Lanarkshire Health Board [2015], which overturned the Bolam test in the context of informed consent, introducing a more patient-centered approach. This shift underscores the evolving nature of legal standards in medical practice, highlighting the importance of patient autonomy and the need for doctors to consider what information a reasonable patient would find significant.