Informed Consent
The principle that a doctor must take reasonable care to ensure a patient is aware of material risks and reasonable alternatives before the patient consents to treatment, applying the test set out by the Supreme Court in Montgomery v Lanarkshire Health Board [2015] UKSC 11: whether a reasonable person in the patient's position would attach significance to the risk.
Independent editorial summary — not the official statute text. Read the official version on legislation.gov.uk.
In Montgomery v Lanarkshire Health Board [2015] UKSC 11, the Supreme Court unanimously departed from the previous 'Bolam test' approach to consent (applying professional medical opinion) and held instead that 'the doctor is under a duty to take reasonable care to ensure that the patient is aware of any material risks involved in proposed treatment, and of reasonable alternatives'. The Court held that a risk is '"material" if a reasonable person in the patient's position would be likely to attach significance to' it, or if the doctor is or should reasonably be aware that the particular patient would attach significance to it — making materiality a fact-sensitive, patient-centred test rather than one dictated by the medical profession's own view of what should be disclosed.
The case arose from an obstetrician's decision not to advise a diabetic patient of a 9-10% risk of shoulder dystocia during vaginal delivery, because in the doctor's view the risk of a grave outcome for the baby was small and warning the patient might prompt her to opt for a caesarean section, which the doctor considered against the mother's own interests. The Supreme Court held this was not a decision for the doctor to make unilaterally: the Court reasoned that an adult of sound mind is entitled to decide which, if any, of the available treatments to undergo, so that the doctor must engage in dialogue with the patient, and any 'therapeutic exception' allowing information to be withheld is limited and should not be abused.
Example
A pregnant patient with diabetes who is not told of a substantial risk of shoulder dystocia during vaginal delivery, and who would have opted for a caesarean section had she been told, may have a claim in negligence following Montgomery even though the doctor's non-disclosure was supported by a body of responsible medical opinion.
Related terms
Official sources
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