Month: March 2015

Adam Sandell is a GP in Cumbria, and a barrister at Matrix Chambers. A Supreme Court judgment last week changed the law about the discussions we need to have with patients about the risks posed by treatment. “Doctor knows best” has just suffered another stroke. The busy-doctor version: We must discuss with patients any material risks involved in proposed treatment, as well as reasonable alternative approaches. A risk is ‘material’ if the patient is likely to attach significance to it. Ask yourself whether knowing about the risk might alter the patient’s decision: if so, tell the patient about it. If you’re more interested: Remember the Bolam test? Bolam’s the case about breaching your duty of care. You’re not negligent if you act in accordance with a practice accepted as proper by a responsible body of medical opinion, so long as the practice isn’t nuts. Until now, Bolam was how the courts determined what we have to tell our patients about the risks of treatment. You didn’t have to discuss a particular risk if there were other suitably-qualified doctors who wouldn’t have done so. That’s been changed by Montgomery, a Supreme Court case last week. Mrs Montgomery was small, diabetic and pregnant with a large baby. Her obstetrician didn’t normally warn such women of the risk of shoulder dystocia because she believed the risk of serious harm to be small,...