Still No(,) More Bolam Please: McCulloch and others v Forth Valley Health Board

Abstract

McCulloch v Forth Valley Health Board concerned an allegation of negligence, in failing to consider treating pericarditis with non‐steroidal anti‐inflammatory drugs as a reasonable alternative treatment and not discussing this option with the patient. Montgomery v Lanarkshire Health Board held that a medical professional must disclose to a patient material risks and any reasonable alternative treatments. The materiality of a risk is to be decided by reference to a reasonable person in the patient's position, or where the medical professional should be reasonably aware that the particular patient is likely to attach significance to that risk. However, Montgomery did not define the legal standard relating to the assessment of whether an alternative treatment is reasonable. McCulloch held the correct legal test to be applied as to whether an alternative treatment is reasonable is the professional‐practice test in Bolam v Friern Hospital Management Committee. There are practical, doctrinal and normative reasons to question whether Bolam is the correct legal test in respect of the assessment of reasonable alternative treatments. Additionally, the conceptualisation of Bolam in McCulloch is overly deferential. McCulloch fails to fully consider Montgomery’s emphasis that autonomy‐respecting principles are the values that risk disclosure practices are sensitive to.