What is the Bolam test and when should it be used?
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The Bolam test is a test that can be carried out to ascertain whether a doctor or other medical professional has breached their duty of care to a patient.
All medical professionals have a duty of care towards patients in so much as they must do what they can to keep them safe from harm. If a doctor, nurse, dentist, radiographer or any other medical professional fails in their duty to provide a reasonable standard of care towards a patient then it can lead to a medical negligence compensation claim.
The standard test to measure whether there has been a breach in their duty of care is known as the Bolam test, which was introduced following the landmark clinical negligence claim Bolam v Friern Hospital Management Committee (1957)…
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Bolam v Friern Hospital Management Committee
This case in particular provides us with what has become the accepted rule for assessing what the the appropriate standard of care should have been in cases of medical negligence: the Bolam test. The test basically expects that standards of care have been followed in accordance with a responsible body of opinion – i.e. the medical professional must demonstrate that they acted in a way that a responsible body of medical professionals in the same field would regard as acceptable or reasonable.
Mr Bolam was a patient at a mental health hospital managed by the Friern Hospital Management Committee and had agreed to have electro-convulsive therapy as part of his treatment. The medical professionals carrying out the therapy did not give Mr Bolam any muscle relaxant and his body was not restrained in any way. During the procedure Mr Bolam violently convulsed and flailed about violently and dangerously, injuring himself in several different places before the procedure was stopped – including a fracture in his hip. Mr Bolam subsequently made a medical negligence compensation claim against Friern Hospital Management Committee, arguing that they were negligent in their treatment of him for failing to administer muscle relaxants, not restraining him and not providing full warnings about the risks involved with electro-convulsive therapy.
Mr Bolam’s compensation claim ultimately failed because, at the time, it was not generally the accepted practice to give patients muscle relaxants and some doctors thought that providing a muscle relaxant and/or restraining the patient might actually increase the risk of injury. Also, a standard practice at the time was to not warn patients of the risks of electro-convulsive therapy unless they asked. Therefore it was found that the medical team treating Mr Bolam had acted in an acceptable manner and followed the generally accepted medical practices, and were subsequently found not be negligent in any way.
When is the Bolam test used?
In order to satisfy the Bolam test a medical professional must be able to demonstrate that they acted in a manner in which a responsible body of medical professionals who work in the same field would deem to be acceptable. The Bolam test is basically a peer review system for medical professionals which is used to assess whether they were negligent in any way when administering treatment and care to a patient.
Due to the complex nature of modern medicine, it is possible that some doctors would behave differently to others depending on the given circumstances. The Bolam test isn’t necessarily concerned just with whether the medical professional delivered the same treatment that other doctors would have done, the key aspect is that a group of other medical professionals think that they acted in an acceptable and reasonable manner towards the patient.
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