In a famous
case tried in 1957, important legal principles were pronounced by the judge and they have subsequently become part of the
to the case was that Bolam, a mentally ill patient, suffered fractures during electroconvulsive treatment. This type of treatment
was accepted as a normal treatment for mental disorders at that time. The patient had consented to the procedure.
suffered a fracture he sued in court. Two problems arose. He was not given full information when he was making his consent
because he was not told about the risk of fracture associated with electroconvulsive therapy which was estimated at 1 in 10,000. He was also not given a muscle relaxant that decreases the risk of fracture during
time there existed differences in professional opinions. Some physicians considered informing the patient about the risk of
fracture and using a muscle relaxant as necessary whereas others did not think so. There was therefore no single standard
of care against which the actions of the attending physician could be judge to find him negligent or not negligent.
ruled that doctors could not be found negligent if they acted according to a professional opinion accepted by a reasonable
body of medical opinion even if there could exist a contrary opinion by another responsible body of medical opinion.
a subsequent case of Bolitho, a patient who suffered brain damage because the doctor failed to intubate, the court ruled that
doctors are expected to follow responsible medical opinion but would not be found negligent in cases in which that opinion
did not stand up to logical analysis. The court thus set a principle that the court could over-rule medical opinion that was
not logical in a specific case. The implication of this was that medical opinion was not the final arbiter of the standard
of care to be used in defining negligence.