Montgomery is the belated obituary, not the death knell, of medical paternalism, says Charles Foster
Montgomery v Lanarkshire Health Board [2015] UKSC 11, [2015] All ER (D) 113 (Mar) concerned a pregnant diabetic patient who was not warned by her consultant obstetrician about the risk that her baby, being large relative to the size of the mother’s pelvis, would have shoulder dystocia. The obstetrician thought that the mother would, if given the relevant statistics about the risk, opt for a Caesarean section. That, the obstetrician decided, would not be in the mother’s best interests: the mother would, in effect, make an objectively wrong decision about the risks of serious injury. By not providing the information, the obstetrician was protecting the patient against her own irrationality. The Supreme Court decided that, even though there were some obstetricians who would adopt that approach, the health board that employed the obstetrician was liable. The Bolam test had no place in the consideration of such cases. It adopted wholesale the decision of the High Court of
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