In Bolam v Friern Hospital Management Committee, an action was brought against the defendant health authority after the claimant alleged negligence when he sustained fractures to the skull following electro-convulsive therapy. The claimant alleged that the health authority was negligent in not using relaxant drugs or some form of manual control and in failing to warn him of the risk involved before the treatment was given.

The Bolam case established the principle that the standard of care owed to a patient is determined by considering practice as accepted by a responsible body of medical experts. Before considering the application of this principle in subsequent cases, it is necessary to take into account the implications of such an approach and the extent to which the stance taken by the courts is satisfactory in establishing whether a doctor has breached his duty of care. In effect the Bolam principle means that whether the duty of care has been breached is left for the doctors to determine. This can be viewed as a satisfac

In the Bolitho case a doctor failed to attend a patient in breach of duty and the majority considered Bolam in relation to causation by taking into account whether the doctor would have intubated the plaintiff had he been attended to.

'It is not enough for a defendant to call a number of doctors to say that what he had done or not done was in accord with accepted clinical practice. It is necessary for the judge to consider that evidence and decide whether that clinical practice puts the patient unnecessarily at risk.'

'The assessment of medical risks and benefits is a matter for clinical judgment which a judge could not normally be able to make... It would be wrong to allow such assessment to deteriorate into seeking to persuade the judge to prefer one or two views both of which are capable of being logically supported. It is only where a judge can be satisfied that the body of expert opinion cannot be logically supported at all that such opinion will not provide the benchmark to which the defendant's conduct fall to be assessed.'

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