Bolam v Friern Hospital Management Committee

Bolam v Friern Hospital Management Committee is a landmark case in English tort law, particularly in the area of medical negligence. The case established the "Bolam test," which is used to determine the standard of care owed by professionals to their clients or patients.

Background

Electroconvulsive therapy machine

The case arose from an incident in 1954 involving a patient, John Bolam, who was undergoing electroconvulsive therapy (ECT) at Friern Hospital, a mental health facility in London. During the procedure, Bolam was not given any muscle relaxants or restraints, which was a common practice at the time. As a result, he suffered serious injuries, including fractures, due to the convulsions induced by the treatment.

Bolam sued the hospital, claiming that the medical staff had been negligent in their treatment. The central issue was whether the hospital had breached its duty of care by not providing muscle relaxants or restraints during the ECT procedure.

The Bolam Test

The case was heard in the Queen's Bench Division of the High Court by Justice McNair. The court had to determine the appropriate standard of care for medical professionals. Justice McNair articulated what became known as the "Bolam test," stating that a doctor is not negligent if they act in accordance with a practice accepted as proper by a responsible body of medical opinion, even if there is a body of opinion that takes a contrary view.

The Bolam test essentially means that as long as a doctor follows a practice that is accepted by a reasonable body of medical professionals, they are not considered negligent. This test has been influential in medical negligence cases, providing a benchmark for assessing the actions of healthcare providers.

Impact and Criticism

The Bolam test has been both influential and controversial. It has been praised for providing a clear standard for medical professionals, but also criticized for being too deferential to the medical profession, potentially allowing substandard practices to continue if they are widely accepted.

In subsequent cases, the Bolam test has been refined and sometimes limited. For example, in the case of Bolitho v City and Hackney Health Authority, the House of Lords held that the court must be satisfied that the body of opinion relied upon is reasonable and responsible.

Related pages

• Medical negligence
• Standard of care in English law
• Bolitho v City and Hackney Health Authority