Article by Kristina Fox, Lawyer. This was about 47% of all the recorded Bolam's in the UK. Critical analysis of the ‘Bolam’ principle. The most Bolam families were found in the UK in 1891. THE BOLAM PRINCIPLE The test to determine what is the standard of care demanded of a doctor was established by McNair J. in Bolam v Friern Hospital Management Committee[1], which subsequently became known as the Bolam principle. H�� ��@B�H�u �� Y�8 �x�`k)~ 258 0 obj <>/Filter/FlateDecode/ID[<5620064BC7417689AD7D70F72E5F46ED><36AB100F4F4C224AB919FBF52B9ED47E>]/Index[238 41]/Info 237 0 R/Length 96/Prev 478595/Root 239 0 R/Size 279/Type/XRef/W[1 2 1]>>stream Hull GP Dr Thomas Abraham looks back at the 60-year history of the Bolam test, which has underpinned doctors' defence against medical negligence claims almost since the NHS began. Presented to the Greek/Australian International Legal and Medical Conference 2015, 1 June 2015 Some historical background The modern law of negligence is based upon a general rule that those whose acts or omissions might injure another should exercise reasonable care to avoid that occurring. Facts. 2 The NHSLA Report … Although further jurisprudential Bolam challenge is likely in the wake of the Montgomery ruling, there are grounds for re-examining Bolitho, on its own merits. The Bolam principle for medical negligence cases is codified in section 22 of the Civil Liability Act 2003 (Qld) as well as other State Civil Liability Acts. A test that arose from English tort law, which is used to assess medical negligence. They were in the medical profession but also in the legal profession too (11). supporters in Australia of the Bolam principle. Durham had the highest population of Bolam families in 1891. The Bolam principle1 establishes that a professional is required to exercise the ordinary skill of a competent practitioner in his/her field. The Bolam principle for medical negligence cases is codified in section 22 of the Civil Liability Act 2003 (Qld) as well as other State Civil Liability Acts. 32. It affords anoverview, also, ofthe applicable lawin the UnitedStates andCanada. Since its implementation, the modified Bolam test has been configured by judges as a defence to the common law standard of care in medical diagnosis and treatment. Permanent Link Find in a Library ... Australia: For or Against Euthanasia? D��M��:@"� #C-H#m����� ND The Australian courts did not accept that the setting of standards by the medical profession was an acceptable way of determining the entitlements of a … The Bolam test was established in 1957 following the decision of the court in Bolam v Frierm Barnet HMC[1] in which the court concluded that a doctor might be able to avoid a claim for negligence if he can prove that other medical professionals would have acted in the same way. As the official report of the former liability insurance law in Australia stated, ... proposal was to change the standard of care required of medical practitioners in treating patients referred to in Australia, as a modified Bolam principle and caps and thresholds on damages. 29. The Hon Justice Susan Kiefel AC, High Court of Australia. The judge in Bolam recognised that there could be two or more schools of thought regarding proper medical treatment, so doctors can usually rebut a charge of negligence if they have acted in accordance with practice approved by a body of other responsible doctors. The Bolam family name was found in the USA, the UK, Canada, and Scotland between 1840 and 1920. What is the Bolam principle? BMJ 2000;320:1567–71. "΀qq The facts were these. The Court found that the defendant doctor’s negligent reporting “...was causative of the plaintiff not undergoing some further investigative procedure and of her tumour being undetected.” The Bolam principle for medical negligence cases is codified in section 22 of the Civil Liability Act 2003 (Qld) as well as other State Civil Liability Acts. In February 2004, at the request of the plaintiff’s GP, Dr Webb performed an endoscopy upon the plaintiff. 15 No. The Bolam principle was successfully raised by the defendant doctor. 30. In 1891 there were 415 Bolam families living in Durham. 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 minority one, would find his/her actions acceptable. endstream endobj startxref Keywords Bolam test , Bolitho logic , Bolam test under attack , Bolitho challenge to Bolam , logical sense and obstetric standards , disclosure of information , future rulings 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 such as doctors. A short history of the Bolam test - a keystone of medical negligence law for 60 years. 278 0 obj <>stream It provides that a professional does not breach their duty for the performance of professional services, if they “...acted in a way that (at the time the service was provided) was widely accepted by peer professional opinion...”. In Australia the Bolam test has been rejected by the High Court of Australia following earlier decisions in the State Supreme Courts. The ‘Bolam’ principle was based on the case of Mr Bolam who suffered from serious injury as a result of electroconvulsive therapy (ECT) in 1954. Rogers v Whitaker (1992) 175 CLR 479, it was thought by many that the law on this question in Australia was embodied in the so-called 'Bolam rule', although courts had expressed reservations about its application in Australia. Mr Bolam was not restrained during the procedure 3. In the recent case of Mazza v Webb [2011] QSC 163 a health care provider successfully raised the Bolam principle as a defence. Under Bolam, the plaintiff seeking to prove medical negligence needs to (1) show that there was a duty of care between the doctor or nurse and the patient, which is usually a straightforward exercise, and (2) that the act or omission of the doctor or nurse … In Rogers v Whitaker the High Court, the apex court in Australia, reconsidered the application of the Bolam Principle under Australian law and held that “except in the case of an emergency or where disclosure would prove damaging to the patient, a medical practitioner has a duty to warn the patient of a material risk inherent in the proposed treatment. The Bolam principle. This endoscopy failed to locate a carcinoma located within the third part of the plaintiff’s duodenum (D3) and D4. This reversed the previous adoption by Australian courts of the so-called Bolam principle which provided that a doctor isn't negligent if they act in accordance with practice accepted by a reasonable body of medical opinion even though other doctors adopted a different practice 2. Mr Bolam sought compensation on the basis that his anaesthesia had been negligent because: 1. Does the Court adopt the Bolam principle for Australia? Essentially that principle means that a doctor will not be held to be negligent if he or she acts in accordance with a practice accepted at that time as proper by a responsible body of medical opinion. This tumour was subsequently located by a further endoscopy in 2005. Bolam was rejected in the 2015 Supreme Court decision of Montgomery v Lanarkshire Health Board. %%EOF Mr Bolam's claim failed. This rule is known as the Bolam test, and states that if a doctor reaches the standard of a responsible body of medical opinion, they are not negligent. He sued the Hospital Management Committee for negligence for not giving him a muscle relaxant, not restraining him, and not warning him about the risks involved. The defendant was the body who employed a doctor who had not given a mentally-ill patient (the claimant) muscle-relaxant drugs nor restrained them prior to giving them electro-convulsive therapy. The Court found “...that the usual practice [for the type of endoscope conducted by the defendant doctor]...is to proceed only as far as D2, unless an attempt to go further is warranted by ‘particular symptoms or signs’.” The tumour was located past D2. h�b```f``�e`a`}� �� @1V ���� z����K���)6]XJ��d�����u2�E�IV�?�S��{%&/�(qB�O�T �c��2��g�y������R��c`��1cF@H� �ǯ�g��S G�811Ix���"�-0�IR�. It provides that a professional does not breach their duty for the performance of professional services, if they "...acted in … Despite this, the defence ultimately failed on the basis that the defendant doctor failed to provide an adequate report of the endoscopy. Barry.Nilsson. It particularlyfocuses onthe legal test to be appliedto Bibliographic Citation. The rule derives from a famous statement by McNair J in the English case of Lawyers. Bolam holds that the law imposes a duty of care between a doctor and his patient, but the standard of that care is a matter of medical judgement. 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. 31. LANCET 1992 December 5; 340(8832): 1399-1400. doctors, lawyers, accountants, architect or engineers, to the extent of the Bolam rule. TORT – NEGLIGENCE – STANDARD OF CARE FOR MEDICAL PROFESSIONALS. In Rogers versus Whitaker, the High Court of Australia explicitly rejected the Bolam principle in cases including non-disclosure of the risks of treatment, ruling that judges are the ultimate arbiter of the standard for negligence. Australia November 14 2011 The Bolam principle for medical negligence cases is codified in section 22 of the Civil Liability Act 2003 (Qld) as well as other State Civil Liability Acts. Australia: Bolam Principle Overturned. It has been more than a decade since the modified Bolam test was legislatively enacted by the Australian States following the medical indemnity crisis. The anaesthetist did not administer muscle relaxation before the procedure 2. 0 which the law has distanced itself from Bolam but also to predict where deficiencies 1 Fenn P, Diacon S, Gray A, Hodges R, Rickman N. Current cost of medical negligence in NHS hospitals: analysis of claims database. Bolam holds that the law imposes a duty of care between a doctor and his patient, but the standard of that care is a matter of medical judgement. It concerned a patient who sustained fractures during electro-convulsive therapy. 33. Ragg, Mark. Australia: The Bolam Principle in medical negligence claims – not the be all and end all. 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 Mazza is a reminder that even if the procedure performed accords with peer practice, that is not necessarily determinative of liability in a medical negligence claim. In Bolam, the plaintiff, John Bolam, was a psychiatric patient suffering depressive illness. In short, the law imposes the duty of care: but the standard of care is a Liability limited by a scheme approved under Professional Standards Legislation. Back; Journal Home; Online First; Current Issue; All Issues; Special Issues; About the journal; Journals. … the Bolam principle, after the case of Bolam v Friern Hospital Management Committee (1957) 1 WLR 583, in which it was enunciated. Creator. h�bbd``b`q@�� haverejected'Bolam' MichaelKirby CourtofAppeal, SupremeCourt, Sydney,Australia Abstract Thispointofviewcomparesthe issue ofinformed patientconsentprimarily as it operates inAustralia and the UnitedKingdom. 238 0 obj <> endobj Mrs Whitaker developed an Bolam v Friern Hospital Management Committee [1957] 1 WLR 583. There was therefore a great deal of interest when the case of Rogers v Whitaker ( 12) came for consideration before the High Court of Australia and was determined in November 1992. %PDF-1.5 %���� The Bolam principle may be formulated as a rule that a doctor is not negligent if he acts in accordance with a practice accepted at the time as proper by a responsible body of medical opinion even though other doctors adopt a different practice. What is the fundamental difference between these two categories? What are the criticisms of this approach to determining breach? This Journal. What are the two types of roles that a medical professional does, as characterised by the Court? Doctors had not warned him about the risks involved. Bolam v Friern Hospital Trust is a leading case that establishes a healthcare provider's professional standard of care. 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