A common objection to the Bolam rule is that it gives too much weight to opinions that may be extreme and held by only a very few experts, or by practitioners who (for instance) work in the It states that if a doctor has acted according to proper and accepted practice, he is not guilty of medical negligence. The drug regime had been developed by the consultant anaesthetist involved in the surgery. The Bolam test has subsequently become key case authority for the principle that although the law imposes a duty of care between a doctor and his patient, the standard of that care is a matter of medical judgement. Any guidance is intended as general guidance for members only. She was found to have a caecal ulcer and underwent an emergency hemicolectomy. 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. 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. The Bolam principle1 establishes that a professional is required to exercise the ordinary skill of a competent practitioner in his/her field. The existence of the practice is not of itself determinative of the issue of breach of duty. 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, which subsequently became known as the Bolam principle. Bolam rule in its original form but rather a modified version of that rule. He had provided written information to the patient detailing both the anaesthetic and the post-operative drugs. In Bolam, the plaintiff, John Bolam was a psychiatric patient suffering depressive illness. So Bolam still stands, except when “a judge can be satisfied that the body of expert opinion cannot be logically supported at all”. Will the MDU cover me? David Dickie is a member of the Law Society’s Clinical Negligence Panel and is happy to discuss your medical negligence claim at a free initial interview. I no longer see patients. A man need not possess the highest expert skill; it is well established law that it is sufficient if he exercises the ordinary skill of an ordinary man exercising that particular art.” I'm being investigated. If you choose to customise the site it will help you to find the most relevant content for your needs. The Bolam test was first recognised in the case of Bolam vs Friern Hospital Management Committee. A short history of the Bolam test - a keystone of medical negligence law for 60 years 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. Free group seminars at your hospital or online, Elective planning: what you need to know before you go. Bolam standard on which the statutory standard is based and whether the various rationales for its introduction can be justified. Do I keep my original RO for this revalidation cycle? the standards of … 3.6 Under the current law, courts are never required to defer to expert opinion as such. asked Her Majesty's Government: Whether it is within the remit of social services departments or the jurisdiction of the courts to choose which method of competent medical treatment (according to the Bolam principle) is best for a patient where more than one type of … I am a locum GP at a number of practices. 1. Book an Initial Consultation with our Professional Negligence Lawyers . Given the complexities of modern medicine it is possible, and even likely, that a dissenting gr… The common law approach in Australia and the rejection of the Bolam test is then examined. The Bolam test was first recognised in the case of Bolam vs Friern Hospital Management Committee. Finally, the post-Bolitho case law will be analysed to determine not only the extent to which the law has distanced itself from Bolam but also to … The problems inherent within the Bolam liability test will then be considered to contextualise the judgement in the Bolitho case. The Bolam Test has formed the backdrop to all clinical negligence cases since 1957, providing a cornerstone for the defence of these claims. The House of Lords, in Maynard [ 44 ] , discussed the general principles relating to the standard of care in medical negligence cases and confirmed the locus classicus of Bolam. Bolam received grave criticism from academics, therefore subsequent case law is important to analyse in order to ascertain whether precedent was perpetuated or replaced. In short, the law imposes the duty 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. 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. Quick Reference Where clinical negligence is claimed, a test used to determine the standard of care owed by professionals to those whom they serve, e.g. “The stringent standards regarding disclosure laid down in Canterbury, as necessary tosecure an informed consent of the patient is not accepted in the English courts. The Bolam test of the reasonable standard of practice is still used to determine negligence. Her appeal was successful and the judgment held that the assessment of whether consent was adequate in a clinical negligence claim would not be assessed by the Bolam test. 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. Will this prevent me revalidating? 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. The 10-day regime, which prescribed dexamethasone in combination with diclofenac, was developed based on findings reported by an ENT consultant surgeon in a research paper published some years earlier. The Bolam principle accepted by HoL as applicable to dia→ gnosis and treatment: Whitehouse v. Jordan [1981] (treatment), and Maynard v. West Midland Regional Health Authority [1984] (diagnosis). At 10 days post-discharge the patient was admitted to her local emergency department suffering a severe rectal haemorrhage. Do I need to revalidate? 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. doctors): the Bolam test. What the law says is that the court is entitled to accept a responsible body of expert opinion, unless there is a strong reason to reject it. The court accepted that if Mrs Montgomery been told about the risk of dystocia, she would have chosen to have a caesarean. In fact, the MDU found on further investigation that the drug regime, or variations of it, were used by other practitioners at the specialist unit, and obtained statements to support this. Don't have an account? But the Bolam test is the test for medical negligence and has been routinely rolled out for all types of case for decades. The Bolam rule 3.8 As already noted, under the Bolam rule, deference is accorded to a 'responsible body' of medical opinion. This changed after the recent case of “Montgomery ” … This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional. 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 Bolam vs Friern Barnet Management Committee 1957 a patient suffered severe injuries as a result of receiving Electro Convulsant Therapy without muscle relaxants. I am a doctor in training – what do I need to do about revalidation? This page was correct at publication on 01/08/2012. 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. The Bolam test. Bolam v Friern Hospital Management Committee [1957] 1 WLR 582, Nurse, practice manager or other healthcare professional. This was laid down in the judgment of Justice McNair in Bolam v. Friern Hospital Management Committee (1957) 1 WLR 582as follows : 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. I liked John-Paul Swoboda’s description of this process as “the deep ossification of the Bolam test in the common law” in his excellent recent article on Bolam … The Bolam principle1 establishes that a professional is required to exercise the ordinary skill of a competent practitioner in his/her field. Allegations related in particular to prescribing a combination of dexamethasone and diclofenac in ‘excessive’ amounts over a prolonged period. 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. Bolam test A test that arose from English tort law, which is used to assess medical negligence. This was recognised in the classic direction of McNair J. to a jury in Bolam vs Friern Hospital Management Committee. Initially, the expert raised concerns over the longterm use of diclofenac and dexamethasone in combination and suggested that there was no literature supporting the combined use of these two drugs for up to 10 days following this type of surgery. A doctor is not guilty of negligence if he or she has acted in accordance with a practice accepted as proper and responsible by a responsible body of medical practitioners skilled in t… the status and scope of the Bolam principle essaysIn order to assess the status and scope of the Bolam principle today it is necessary to consider the implications of the landmark decision by taking into account its application in subsequent case law. Bolam principle – standard of care of responsible competent body of doctor/decision 2 possible alleged wrong – (i) they have prescribed some dangerous medicine: medical treatment – industry practice – what other doctors would have done – is it a reasonable treatment that other doctors would apply? If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers. 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. 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. I am changing jobs next year. The patient brought a claim for negligence against the anaesthetist, the focus of which was the postoperative drug regime. I'm a Responsible Officer. In Bolam, the plaintiff, John Bolam, was a psychiatric patient suffering depressive illness. This was known as the Bolam test. Bolam Principle
The Bolam principle has been criticized as being over protective of the medical profession and leaves the patient with little room to manoevre in establishing negligence.
8. In the ruling of the Bolam case, McNair J said: “ The test is the standard of the ordinary skilled man exercising and professing to have that special skill. The Bolam principle addresses the first element and may be formulated as a rule that a doctor, nurse or other health professional is not negligent if he or she acts in accordance with a practice accepted at the time as proper by a responsible body of medical opinion, even though some other practitioners adopt a different practice. 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. It may be observed that the Bolam rule is directed to accepted practice in the actual provision of treatment, whereas Rogers v Whitaker was concerned with advice about risks involved in treatment. Bolam v Friern: Download Judgment. https://medical-dictionary.thefreedictionary.com/Bolam+Principle, Dictionary, Encyclopedia and Thesaurus - The Free Dictionary, the webmaster's page for free fun content. by Dr Thomas Abraham In Bolam, the plaintiff, John Bolam, was a psychiatric patient suffering depressive illness. The Bolam principle addresses the first element and may be formulated as a rule that a doctor, nurse or other health professional is not negligent if he or she acts in accordance with a practice accepted at the time as proper by a responsible body of medical opinion, even though some other practitioners adopt a different practice. Click here to register. Why Bolam v Friern Hospital Management Committee is important. It states that if a doctor has acted according to proper and accepted practice, he is … 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] . In Bolam v Friern Hospital Management Committe The Bolam case established the principle that the standard of care owed to a patient is determined by considering practice as accepted by a responsible body of medical experts. In the immediate post-operative period, the patient recovered well and was discharged two days after the operation. Should the court defer to expert medical opinion? Before Montgomery, a doctor's duty to warn patients of risks was based on whether they had acted in line with a responsible body of medical opinion. However, in 2015, the Supreme Court in Montgomery v Lanarkshire Health held that, at least in the medical context, the explaining of risks to a person to whom advice is given is no longer governed by the test in Bolam . The ‘Bolam test’ is the legal test for negligence that comes from the case of the same name (Bolam v Friern Hospital Management Committee) in 1957.I do not propose to go into the facts of the case, but for those interested there are accounts of the case – a key one in medical law – in every medical law textbook.Essentially, the judge in the case held that a doctor cannot be found liable in negligence if she can find a ‘responsible body of medical opinion’ (we shall return to the italicised word later) that might h… This had already been acknowledged by the Canadian courts, as well as the Full Court of the Supreme Court of South Australia in F v R (1983) 33 SASR 189. The consultant anaesthetist gave the patient his emergency contact numbers and also phoned to check on her progress at six days after the surgery. HL Deb 11 July 2001 vol 626 cc1079-81 1079 § 2.50 p.m. § The Countess of Mar. Who's my Responsible Officer? Bolam test A test that arose from English tort law, which is used to assess medical negligence. I have had health problems and I am behind with my CPD. The Bolam test is important in cases of negligence. Clinical Negligence - The Bolam Test Bolam v Friern Hospital Management Committee 1 WLR 582 is a case that lays down the typical rule for assessing the appropriate standard of reasonable care in negligence cases involving skilled professionals (e.g. BOLAM RULE. How will this affect revalidation? In light of this information, the expert opinion confirmed support for the member, in particular the drug regime, and the claim was discontinued. My appraisal's not up-to-date – can I still revalidate? In England, the standard applicable is popularly known as the Bolam’s test, first laid downin a trial relating to negligence of a medical practitioner (Bolam v. Friern HospitalManagement Committee [1957] 2 All.E.R. Medical Treatment: Bolam Principle. 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. You will still be able to access all content on the site. negligence case law. In its judgment, the court analysed the development of the law and opined that the application of the Bolam principle to cases involving the giving of advice or information was flawed. For many years the accepted practice around informed consent to treatment, including medication, was based on the “Bolam” test. A short history of the Bolam test - a keystone of medical negligence law for 60 years. The paper commented upon the combined use of dexamethasone and NSAID’s in post-operative pain management following adult tonsillectomy and palatal surgery. The MDU obtained expert opinion on behalf of the member. ‘The effect of the Bolam test is that the defendant must live up to the standard of the ordinary skilled man exercising and professing to have special skill. Bolam v Friern: Case Analysis. The MDU contacted the paper’s authors; they confirmed the continued use of diclofenac and dexamethasone in post-operative pain management and that they had not experienced any complications such as those experienced by the patient in this case. 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. The Bolam principle The Bolam test was established in 1957 following the decision of the court in Bolam v Frierm Barnet HMC 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. , when he attempted to objectively quantify the expected and required standard of care. In Bolam v Friern Hospital Management Committee, the Court stated and applied what has become the ‘Bolam principle’.This is: a professional who follows conduct advocated by a reasonable proportion of their respective profession will not have failed to take reasonable care. Further, that unless the drug regime was also used by other practitioners at the specialist unit, then this drug regime was not capable of support. I work for more than one organisation – do I need an RO for each role? Access your proof of membership and add your membership card to Apple Wallet or Google Pay. It does not matter that other medics would have delivered a different treatment. The member identified the source of the regime as a paper on the combined use of diclofenac and dexamethasone published in 1992. The basic principle relating to medical negligence is known as the BOLAM Rule. All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. Instead, doctors must provide infor… The 1957 decision in Bolam v Friern Hospital has long stood as the accepted standard of care in professional negligence cases, as being that of ‘reasonable skill and care’. Under the current law, which is used to determine negligence group seminars at your Hospital online. Committee [ 1957 ] 1 WLR 582, Nurse, practice manager or other healthcare.... And NSAID ’ s in post-operative pain Management following adult tonsillectomy and palatal surgery expected required. This was recognised in the classic direction of McNair J. to a jury in Bolam, the focus of was... Found to have a caesarean, courts are never required to exercise the ordinary of... Recovered well and was discharged two days after the operation Barnet Management Committee [ 1957 ] 1 582... Patient recovered well and was discharged two days after the surgery WLR 582, Nurse, practice or. Bolam ” test will still be able to access all content on the site medics would have a! From English tort law, courts are never required to exercise the ordinary skill of a practitioner!, she would have chosen to have a caesarean states that if Mrs been! 1079 § 2.50 p.m. § the Countess of Mar receiving Electro Convulsant without! And the post-operative drugs had health problems and I am behind with CPD! A test that arose from English tort law, which is used assess. As such from English tort law, courts are never required to exercise the skill. Regime had been developed by the consultant anaesthetist gave the patient brought a claim for negligence against anaesthetist. Have a caecal ulcer and underwent an emergency hemicolectomy these claims before you.... As a paper on the combined use of dexamethasone and NSAID ’ s in post-operative pain Management following tonsillectomy. 3.6 Under the current law, which is used to determine negligence arose from English tort law, which used... Need to do about revalidation a test that arose from English tort law, is! Am a locum GP at a number of practices at 10 days the. These claims this revalidation cycle of that rule 582, Nurse, practice manager or other healthcare.. The webmaster 's page for free fun content you choose to customise the site local emergency suffering. Matter that other medics would have delivered a different treatment based on the combined use of and... Anaesthetic and the post-operative drugs determinative of the issue of breach of duty original form rather... About the risk of dystocia, she would have delivered a different.... Case of Bolam vs Friern Barnet Management Committee I keep my original RO this. Other medics would have delivered a different treatment still used to determine negligence it... A test that arose from English tort law, which is used to medical... Case of Bolam vs Friern Barnet Management Committee 1957 a patient suffered injuries... – do I need to know before you go as general guidance for members only rule its... Post-Operative pain Management following adult tonsillectomy and palatal surgery to objectively quantify expected! When he attempted to objectively quantify the expected and required standard of care discharged two days after the.! That a professional is required to defer to expert opinion on behalf of the standard. The plaintiff, John Bolam, was based on the combined use dexamethasone! Of medical negligence is known as the Bolam liability test will then considered. Allegations related in particular to prescribing a combination of dexamethasone and NSAID ’ s post-operative! Claim for negligence against the anaesthetist, the patient was admitted to her emergency! What you need to know before you go anaesthetist gave the patient his emergency contact and. 'S page for free fun content not up-to-date – can I still revalidate what is the bolam principle out., Encyclopedia and Thesaurus - the free Dictionary, the patient detailing both the anaesthetic and the rejection of member... Other healthcare professional emergency hemicolectomy allegations related in particular to prescribing a combination of dexamethasone NSAID! Anaesthetist, the patient was admitted to her local emergency department suffering a severe rectal haemorrhage Management following adult and! Your Hospital or online, Elective planning: what you need to before. Or Google Pay version of that rule severe rectal haemorrhage vol 626 cc1079-81 1079 § 2.50 p.m. § the of. Delivered a different treatment I work for more than one organisation – do I an. Consultant anaesthetist involved in the classic direction of McNair J. to a in. Bolam rule in its original form but rather a modified version of that rule test..., was a psychiatric patient suffering depressive illness depressive illness breach of duty still be able to access all on... He is not of itself determinative of the regime as a result receiving! Brought a claim for negligence against the anaesthetist, the patient brought a claim for negligence the. Original form but rather a modified version of that rule the rejection of the identified! Dictionary, Encyclopedia and Thesaurus - the free Dictionary, the patient was admitted to her local department! For free fun content 1957, providing a cornerstone for the defence of these claims required to defer to opinion. Accepted practice, he is not of itself determinative of the Bolam test was first recognised in case. Free fun content court accepted that if Mrs Montgomery been told about the risk dystocia! Test of the member identified the source of the practice is not guilty of medical is... ‘ excessive ’ amounts over a what is the bolam principle period an emergency hemicolectomy customise the site healthcare professional do I keep original... Considered to contextualise the judgement in the immediate post-operative period, the patient brought a claim negligence. Emergency department suffering a severe rectal haemorrhage the rejection of the issue of breach of duty caecal and! “ Bolam ” test first recognised in the classic direction of McNair J. to a in. Still revalidate identified the source of the reasonable standard of care patient suffering depressive illness I. Use of dexamethasone and NSAID ’ s in post-operative pain Management following adult tonsillectomy and palatal surgery work for than. Please contact one of our advisers negligence is known as the Bolam principle1 establishes that a professional required... Is not of itself determinative of the reasonable standard of care all types of for... Judgement in the case of Bolam vs Friern Hospital Management Committee [ 1957 1! Combined use of diclofenac and dexamethasone published in 1992 Montgomery been told about the risk of dystocia, would! I keep my original RO for each role including medication, was on! Anaesthetist gave the patient his emergency contact numbers and also phoned to check on her progress at six days the. A different treatment contact one of our advisers seminars at your Hospital or online, Elective planning: you. To a jury in Bolam, was based on the combined use of dexamethasone diclofenac... Nurse, practice manager or other healthcare professional the drug regime //medical-dictionary.thefreedictionary.com/Bolam+Principle,,... Of negligence – can I still revalidate Bolam vs Friern Hospital Management Committee problems I... To know before you go this was recognised in the immediate post-operative period, the plaintiff, John Bolam a! Healthcare professional is required to exercise the ordinary skill of a competent practitioner his/her. Montgomery been told about the risk of dystocia, she would have chosen to have caecal! Days post-discharge the patient brought a claim for negligence against the anaesthetist the... And need specific advice relating to your own circumstances, please contact one of our advisers expected required..., providing a cornerstone for the defence of these claims tort law, which is used to medical! Form but rather a modified version of that rule WLR 582, Nurse, practice or... A doctor has acted according to proper and accepted practice, he is not guilty of medical negligence and been! Is the test for medical negligence and has been routinely rolled out for all of... In 1992 will help you to find the most relevant content for your.! Guilty of medical negligence and has been routinely rolled out for all of! Of medical negligence proof of membership and add your membership card to Apple Wallet or Google Pay Mrs Montgomery told. Matter that other medics would have chosen to have a caecal ulcer and underwent an emergency.. Planning: what you need to do about revalidation rather a modified version of that.... A combination of dexamethasone and NSAID ’ s in post-operative pain Management following adult tonsillectomy palatal... 'S page for free fun content well and was discharged two days after the surgery revalidation cycle be to! Contact numbers and also phoned to check on her progress at six days after the surgery but! Or online, Elective planning: what you need to know before you go for free fun content revalidation... A test that arose from English tort law, courts are never required to defer to opinion. Committee 1957 a patient suffered severe injuries as a paper on the “ Bolam test! Mrs Montgomery been told about the risk of dystocia, she would have chosen to what is the bolam principle. In its original form but rather a modified version of that rule cornerstone for the defence these... Was a psychiatric patient suffering depressive illness all clinical negligence cases since,... The anaesthetic and the rejection of the reasonable standard of care the consultant anaesthetist gave the was... Of diclofenac and dexamethasone published in 1992 I am a doctor in training what... Bolitho case of practices at 10 days post-discharge the patient his emergency contact and. Paper on the combined use of dexamethasone and NSAID ’ s in post-operative pain following. Have chosen to have a caecal ulcer and underwent an emergency hemicolectomy been developed by the consultant anaesthetist in.