Thank you Adrian for providing the link - a very interesting read that I would
recommend for all Healthcare Professionals. However, the previous list comments
that "The Bolam Test is now superceded" are inaccurate. The Bolam Test was referred
to and discussed by the plaintiff and the judge both in the original trial,
and again by the Law Lords. The conclusions in summary by the Lords are, as
I see it, as follows.
The Bolam Test is still appropriate, i.e. if the (defendant) doctor acts in
according with a respected/responsible/recognised body of medical opinion then
(s)he is not negligent.
If that body of opinion is, in the opinion of the judge, not sensible or appropriate,
or outdated, then the court should find in favour of the plaintiff.
Individual cases should be judged separately on their merits, as cases involving
potential medical negligence will always be complicated.
In the case of spinal boards and immobilisation, there are differing views.
It seems however that a plaintiff could now successfully argue that "full immobilisation
would be safest until the spine can be cleared" as this would be the sensible
thing in lay opinion, despite a "reasonable body of medical evidence" that may
say full immobilisation would not necessarily always be appropriate. Full immobilisation
may considered a cheap, non-hazardous intervention, so little harm result; the
argument against is of course pain, pressure sores, and potential harm occuring
during the immobilisation procedure. (yet to be tested in law).
I would refer list members to the Bolith judgement but basically the defendant
(Healthcare Trust) succeeded as the failure to intubate was according to accepted
opinion (despite plaitiffs expert evidence to the contrary) AND was SENSIBLE
given the risks of RSI in a young child.
Marten C. Howes MRCP(UK)
Specialist Registrar
Accident and Emergency Medicine
Royal Lancaster Infirmary
Lancashire
LA1 4RP
http://website.lineone.net/~mcglone/
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