Informing patients: The Bolam legacy

Abstract

In the context of medical advice to patients, the UK decision in Montgomery v. Lanarkshire Health Board rejected the application of Bolam v. Friern Hospital Management Committee. This article argues that the rejection is neither complete nor settled. We explore doctrinal, conceptual and practical limitations of Montgomery to demonstrate the vestiges of Bolam’s relevance to medical advice. Medical advice does not end with disclosure of material risk but incorporates information on prognosis, diagnosis and treatment alternatives. Montgomery does not always apply in these cases, nor outside the medical mainstream or where patients lack capacity to consent. We identify ways in which the extension of patient-centred care in the giving of medical advice can be achieved through incremental development of Montgomery and application of the Bolitho gloss to require that processes conform to Montgomery principles of partnership and autonomy.