Copyright © 2020 BMJ Publishing Group Ltd     京ICP备15042040号-3, , professor of maternal and fetal health and director of Tommy’s Centre for Maternal and Fetal Health. And, in any event, the Supreme Court does not need to cite authority when revising or limiting its own case law. -- Download Leichhardt Municipal Council -v- Montgomery [2007] HCA 6 as PDF--Save this case. Although the Medical Defence Union and the Medical Protection Society have each issued statements and updated their guidance, as have some royal colleges (such as the Royal College of Surgeons), other bodies such as the GMC and the Royal College of Obstetricians and Gynaecologists (RCOG) have yet to do so. A patient, Miss Chester, was under the care of a neurosurgeon, Mr Afshar, for a 6-year history of back pain and she had been shown to have a vertebral disc protrusion on an MRI scan. http://creativecommons.org/licenses/by-nc/4.0/, http://www.bmj.com/content/350/bmj.h1481/rr-23, Brighton and Sussex University Hospitals NHS Trust: Consultant in Stroke Medicine, Practice Plus Group: General Practitioner, Rush Hill & Weston Surgeries: Salaried GP, Herefordshire and Worcestershire Health and Care NHS Trust: Consultant Psychiatry, Women’s, children’s & adolescents’ health. Lord Neuberger, Lady Hale, Lord Kerr, Lord Clarke, Lord Wilson, Lord Reed, Lord Hodge. This case involves a patient, Bolam, who sustained injuries during a course of electro-convulsive therapy being used as a treatment for depression. The doctor’s normal practice was to give ECT without a relaxant and without any physical restraints; the doctor would support the patient’s chin and shoulders while nurses stood at either side of the treatment couch to prevent the patient falling. Georgiev v Kings College Hospital NHS Foundation Trust [2016] EWHC 104 (QB). 2016), 15-1724, Doe v. Backpage.Com, LLC. It should be viewed differently from the process of diagnosis or treatment. The Lords felt that you could only accept a body of medical opinion if the action they supported was felt to be a logical one. Nadine Montgomery, a woman with diabetes and of small stature, delivered her son vaginally; he experienced complications owing to shoulder dystocia, resulting in … The pain could be severe and she had experienced episodes of being unable to walk or control her bladder. The Lord Justices found that, in this case, her surgeon had not been negligent in not informing her of the risk of paraplegia. The Patient’s Charter: What Users Think. What was sufficient information to make a balanced decision could only be decided by the patient, not their doctor, and it should be presented along with information on reasonable alternative options. The ruling overturned a previous decision by the House of Lords,2 which had been law since at least the mid 1980s.3 It established that, rather than being a matter for clinical judgment to be assessed by professional medical opinion, a patient should be told whatever they want to know, not what the doctor thinks they should be told. She had seen her consultant at two week’s over her due date on 27th November to request induction or a Caesarean section. Doctors at the coalface have received little official direction on how their practice should change in light of the ruling. In practical terms, the ruling should apply at least back to 1999, when Montgomery saw her obstetrician. The test of materiality defined in the Montgomery ruling was whether “a reasonable person in the patient’s position would be likely to attach significance to the risk, or the doctor is or should reasonably be aware that the particular patient would be likely to attach significance to it.”1 The solicitor representing Montgomery spoke of the decision as having “modernised the law on consent and introduced a patient focused test to UK law.”16. Most decisions about medical care are not simple yes/no answers. The judge considered the Montgomery ruling and found that failure to inform the patient was a breach of the duty of care. The risk for such surgery was held to be less than one per cent and Mrs Sidaway felt her surgeon had been negligent not to include this risk in the discussion. These tests ask whether a doctor’s conduct would be supported by a responsible body of clinicians. The involvement of seven justices in this final appeal is of particular importance as this is the number of justices required to change or overrule a previous House of Lords ruling; in this case, the ruling in Sidaway. The critical limitation is that the duty is confined to material risk. There can be no ‘one fits all’ approach. Bolam v Friern Hospital Management Committee [1957] 1 WLR 582. His opinions in this case are referred to in the Montgomery ruling. This case was brought by Mr and Mrs Pearce with regards to the obstetric advice she was given during her fifth pregnancy which ended with the stillbirth of her daughter, Jacqueline, in December 1991. Obstetricians urgently need guidance. The advice from the consultant, following an examination and discussion of the risks of induction and Caesarean, was that Mrs Pearce should await the natural onset of labour. Bobbie Jo Stinnett was a pregnant 23-year-old American woman found murdered in her home in Skidmore, Missouri. This decision followed a 16-year legal fi ght which concluded with Mrs Montgomery’s claim being upheld by the Supreme Court. The Montgomery decision redefined the standard for informed consent and disclosure. Update on the UK law on consent]. The discussion and involvement of the patient in the planning of their care mirrors the approach of shared decision making. In 2012, the Supreme Court decided Miller v. Alabama, which held that a mandatory life-without-parole sentence for a juvenile violates the Eighth Amendment. She expressed general concerns throughout her antenatal care. Constitutionally, the Supreme Court cannot make new law; it can only state what, in theory, the law has always been. Even if the risk be material, the doctor will not be liable if upon a reasonable assessment of his patient’s condition he takes the view that a warning would be detrimental to his patient’s health. When she was raped, Ellen thought it was the worst thing to ever happen to her. We do not capture any email address. There are choices to be made, arguments for and against each of the options to be considered, and sufficient information must be given so that this can be done. The concept of the therapeutic exception is also mentioned as a rare occurrence when a doctor may feel that discussion of risks will result in harm or detriment to the patient’s health and wellbeing. But this is a false dichotomy—the idea of a fully autonomous patient making choices completely independent of the doctor’s input does not reflect the complex reality of medical decision making, nor does the caricature of a paternalistic doctor riding roughshod over patients’ objections. Montgomery sought damages against Dr McLellan who was responsible for her care during pregnancy and labour. Having difficulty registering or logging in? All other authors have nothing to declare. Please note: your email address is provided to the journal, which may use this information for marketing purposes. 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