Whilst this is a Scottish case, the decision represents an important clarification of the law in respect of consent in clinical negligence cases which is also highly relevant in England and Wales. The courts have made inroads into this approach but the test used to ascertain if a doctor has breached their duty of care to a patient has until recently been couched in terms of what is deemed reasonable in the profession. Montgomery (Appellant) v Lanarkshire Health Board (Respondent) (Scotland) British Dental Journal volume 218 , page 473 ( 2015 ) Cite this article 37 Accesses 27 Friday Mar 2015. Nadine Montgomery, a woman with diabetes and of small stature, delivered her son vaginally; he experienced complications … [39] It also accords with the General Medical Council which endorses ‘the replacement of paternalism with a model based on partnership between doctor and patient.’[40] It will also have repercussions throughout medical practice. There is no reason to perpetuate the application of the Bolam test in this context any longer. ; Balfour + Manson LLP. [46] Elspeth Reed, ‘Montgomery v Lanarkshire Health Board and the Rights of the Reasonable Patient’ (2015) 19 Edinburgh Law Review 360, 366. Where a patient was undergoing a procedure which may have a ‘profound effect’[12] on him or her then that patient should be advised of alternative treatments. Nadine Montgomery presents her story that led to the landmark ruling on consent (Montgomery v Lanarkshire Health Board [2015]). The stimulus statement implies that the case has led to end of paternalism in all clinical practice. 84. The approach in Canada is categorised as one that preserves patient autonomy. [35] Canterbury v Spence 464 F.2d (1972), USCA, District of Columbia. Women who have diabetes are more likely to have larger babies. Sometimes the doctor does know best. [54] Department of Health (DoH), The NHS Constitution: the NHS belongs to us all (London DH Publications, March 2013). In-text: (MONTGOMERY (Appellant) v LANARKSHIRE HEALTH BOARD (Respondent) & GENERAL MEDICAL COUNCIL (Intervener) [2015] UKSC 11 | Case Library | 12 King's Bench Walk, 2015) Your Bibliography: 12kbw.co.uk. [37] Emily Jackson, Medical Law: Text, Cases and Materials (4th edn, Oxford University Press 2016) 210. In Pearce v United Bristol Healthcare NHS Trust[10] and in Wyatt v Curtis[11] the courts have embraced a test which shifts the focus towards the patient and what a reasonable patient would want to know. Nadine Montgomery (“NM”) brought a claim against Lanarkshire Health Board arguing that the delivery of her baby Sam Montgomery fell below the standard to be expected of a … As a result of an occlusion of the umbilical cord caused by shoulder dystocia, Sam's brain was starved of oxygen for some 12 minutes. 2. Montgomery (Appellant) v Lanarkshire Health Board (Respondent) (Scotland) before Lord Neuberger, President Lady Hale, Deputy President Lord Kerr Lord Clarke Lord Wilson Lord Reed Lord Hodge JUDGMENT GIVEN ON 11 March 2015 Heard on 22 and 23 July 2014 Montgomery sought damages against Dr McLellan who … [8] Lord Scarman continued that if a person suffers injury as a result of a risk that is undisclosed, and this was a risk that a doctor showing reasonable care would have disclosed, then the injured patient would have a claim in negligence. Furthermore, because the extent to which a doctor may be inclined to discuss risks with a patient is not determined by medical learning or experience, the application of the Bolam test to this question is liable to result in the sanctioning of differences in practice which are attributable not to divergent schools of thought in medical science, but merely to divergent attitudes among doctors as to the degree of respect owed to their patients. Why Montgomery v Lanarkshire Health Board is important. The Montgomery case in 2015 was a landmark for informed consent in the UK. [31] GMC, Consent: Patients and Doctors Making Decisions Together (GMC 2008). The baby suffered from severe disabilities after birth due to shoulder dystocia. The Court of Session concluded that the test for breach of duty of care should be decided by reference to expert medical opinion and applying the Bolam test. Montgomery (Appellant) v Lanarkshire Health Board (Respondent) (Scotland) Judgment date. This Supreme Court judgment is required reading for all medical professionals, because the Supreme Court has made clear that the doctrine of informed consent is … Mrs Montgomery was a primagravida with type I diabetes who booked under consultant‐led care in 1999. During labour the baby was deprived of oxygen due to an occlusion in the umbilical cord which was liked to shoulder dystocia. Mrs Montgomery was around five feet tall, and was also diabetic, which often results in a larger foetus. In conclusion, the case of Montgomery has eroded the notion of traditional paternalism in relation to disclosure of risks in medical law, however, it has not spelt the end of paternalism in the medical profession. 30 July 2010. Nadine Montgomery's son was born with cerebral palsy as a result of shoulder dystocia during birth. The Court saw no reason why this approach should be maintained. MONTGOMERY V LANARKSHIRE HEALTH BOARD ([2015] UKSC 11]) by Hamish Dunlop, Barrister at 3PB Barristers 1. The Supreme Court affirmed the requirement of 'informed choice' or 'informed consent' by patients in medical treatment that rests fundamentally on the duty of disclosure by medical practitioners. She said that she had been advised a cesarian birth for her child, but the doctors had not . [21] Materiality was defined by the Supreme Court as whether in the particular circumstances a reasonable person in the patient’s position would deem the risk to be significant. [33] Nathan Tavares, Webster (a Child) v Burton Hospitals NHS Foundation (2017) 2 Journal of Personal Injury C93, C95. She was noted to have a large baby at her 36‐week scan and was induced at 38 +5 weeks of gestation. [18] Furthermore, the majority opinion in Sidaway itself has been criticised as lacking coherence and a uniform voice among the judiciary leading to confusion in its application. [38] For Vickery ‘[t]he age of paternalistic medical practice can be hailed as being replaced with patient-centred decision-making’. [19] C Foster, ‘The Last Word on Consent?’ (2015) 165 New Law Journal 7647, 8. [2] A case recognised as ‘perpetuating medical paternalism’. [22] In the alternative, it is a risk that a doctor did or reasonably should know that a patient would attach significance to such risk.[23]. Department of Health (DoH), The NHS Constitution: the NHS belongs to us all (London DH Publications, March 2013).GMC, Consent: Patients and Doctors Making Decisions Together (GMC 2008). [17]  And the provision of health care services was becoming more diverse and modern. Montgomery (Appellant) v Lanarkshire Health Board (Respondent) (Scotland) before Lord Neuberger, President Lady Hale, Deputy President Lord Kerr Lord Clarke Lord Wilson Lord Reed Lord Hodge JUDGMENT GIVEN ON 11 March 2015 Heard on 22 and 23 July 2014 [16] Lord Kerr concluded that modern society pointed ‘away from a model of the relationship between the doctor and the patient based upon medical paternalism ’. The doctor’s judgment is not to be questioned. However, such fanciful conclusions overestimate the reality. Paternalism has been dealt a blow by the case but it still survives to an extent. [27] The law tended to defer to the expertise of the medical profession in judging the standards expected. 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