1. Medical Law Clinical Negligence Hani Azri – LLB Scholar BPP University College Law School London

2.  Medical Law overview  Clinical Negligence  The Duty of Care  Bolam test & Bolitho  Standard of care ; important case law  Consent

3.  An amalgam of various law : criminal, civil, European, administrative etc...  Includes:  Bioethics  Clinical Negligence  Resources Allocation  Consent  Reproduction, Contraception Liability before birth, Abortion & Termination  Organ Donation, transplantation, death & dying

4.  CN refers to professional malpractice within the medical field.  Type of Action:  Criminal  Civil  Regulatory

5.  Why ?  Increased knowledge of patients (internet, rights/law)  Increased pressure on Doctors…..  Legal Aid … “no win no fees lawyers”  Influence from other countries

6.  R v Bateman  Cassidy v Ministry of Health  Barnett v Chelsea & Ken. Hospital  Bull v Devon AHA  Prendergast v Sam & Dee

7.  Main test: Bolam v Friern H.M.C per McNair J  CN claims have 70 % chance of failure!  Non clinical Negligence claims have 70% chance of success!  Critics:  Too generous toward doctors  Choice between different medical opinion  Deviation from standard professional practice  How should a body of medical professional should be determined ?

8.  Court can find a body of professional doctors illogical.

9.  Standard practice : NICE, NHS trust etc...  A reasonable Body ? Defreitas v O’brien 11/1000  Differing opinions : Maynard v W. Midlands R.H.A  Error of judgement : Whitehouse v Jordan  Level of skill: Shakoor v Situ  State of the art defence: Crawford v Charing Cross Hospital  Level of Risk/information:  Sidaway v Board of Governors of BRH  Pearce v United Bristol HC NHS Trust  Chester v Ashraf (2004)

10.  Consent : genuine agreement to treatment  Can be decided by patients, by proxy, by the court or by necessity.  Requirements:  patient is competent  Patient is sufficiently informed:  Dept of Health Code: Good Practice in Consent (2001)  GMC Code of Practice  Consent is totally voluntary Re T (Jehovah Witness)  Insufficient information can lead to :  Criminal liabilities : R v Tabaussum (2005) OR  Negligence :  in not informing the patient of all relevant information: Sidaway v Bethlem HMC  Patient who ask about their treatment  Not sufficiently warned about the risks : Roger v Withaker Chester v Ashraf

11. Bolam test: “as long as another body agree on the treatment” Bolitho: “ the court can decide that the body is illogical” Risks and information given to patient: “ sufficient ? “ 1-2 % Patients request for all information: “all information should be given unless emotionally distress” Principalism : patient’s autonomy (right to refuse treatment), Beneficence, no malfeasance, Justice (no discrimination).