Montgomery v Lanarkshire Health Board
[2015] UKSC 11
Ratio Decidendi
A doctor is under a duty to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments. A risk is 'material' if a reasonable person in the patient's position would be likely to attach significance to it, or the doctor is or should reasonably be aware that the particular patient would be likely to attach significance to it.
Fapte
Nadine Montgomery, a diabetic woman of small stature, gave birth vaginally. Her baby suffered severe injuries due to shoulder dystocia (the baby's shoulders becoming stuck). Mrs Montgomery was not warned of the 9–10% risk of shoulder dystocia or offered the alternative of a caesarean section. Her obstetrician admitted she did not routinely discuss this risk because most women would then opt for a caesarean.
Rezumatul hotărârii
The Supreme Court unanimously held that the Bolam test (what a responsible body of medical opinion would do) is no longer the appropriate test for informed consent. Instead, the test is patient-centred: a doctor must disclose any material risk. Lords Kerr and Reed held that adults of sound mind are entitled to decide for themselves what risks to accept, and the doctor's duty is to ensure the patient is aware of material risks and alternatives.
Citate cheie
"An adult person of sound mind is entitled to decide which, if any, of the available forms of treatment to undergo, and her consent must be obtained before treatment interfering with her bodily integrity is undertaken."
— Lords Kerr and Reed
"The doctor is therefore under a duty to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments."
— Lords Kerr and Reed
Tratament ulterior
Montgomery replaced the Bolam/Sidaway approach to informed consent and is now the leading authority on the duty to disclose risks.