Montgomery v Lanarkshire Health Board [2015] UKSC 11

KEY POINTS

• A mentally competent adult has the right to choose which, if any, treatments to undergo, and their consent must be obtained before any medical procedures that affect their physical well-being are performed.

• It is the doctor's responsibility to exercise a duty of care in ensuring that the patient is fully informed about any material risks associated with a recommended treatment, as well as any reasonable alternatives or alternative approaches to treatment.

• The test of materiality involves determining whether, in the specific circumstances of the case, either:

  1. A reasonable person in the patient's position would consider the risk to be significant or

  2. The doctor is, or should reasonably be, aware that the patient in question would consider the risk to be significant.

• The Bolam test is not applicable because it is limited to questions related to medical expertise and does not cover value judgments.

FACTS

• Appellant Montgomery gave birth to a baby boy who was born with severe disabilities as a result of complications during the delivery.

• Appellant attributes those injuries to negligence on the part of Dr. Lina McLellan, who was employed by Respondent Lanarkshire Health Board, as she was responsible for Appellant’s care during her pregnancy, labour, and eventual delivery.

• Appellant contends that she should have been informed by Dr. McLellan of the risk of shoulder dystocia (inability of a baby’s shoulders to pass through the pelvis) due to her diabetes, and of the alternative option of delivery by elective caesarean section.

COMMENTARY

• The ruling in Montgomery v Lanarkshire Health Board [2015] UKSC 11 marked a significant shift in the legal landscape regarding informed consent in medical treatment. This case brought to light the importance of patient autonomy and the duty of doctors to provide comprehensive information to their patients.

• It departed from the long-standing precedent established in the case of Sidaway v Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital [1985] AC 871. In Sidaway, the court had held that doctors were only required to disclose the risks that a responsible body of medical opinion would consider necessary. This approach placed considerable emphasis on the medical profession's standard practices rather than the individual patient's right to make informed decisions.

RELATED CASES

• Bolam v Friern Hospital Management Committee

• Sidaway v Bethlem Hospital