Forensic Medicine · Consent, Professional Negligence and Medical Ethics (Consumer Protection, Vicarious Liability)

A patient signed a consent form for laparoscopic cholecystectomy but develops bile duct injury, a recognised complication with an incidence of approximately 0.3%. The patient claims negligence. Which legal test is MOST applicable to determine whether the doctor is negligent?

  • A The but-for test exclusively — the injury would not have occurred but for the doctor's act
  • B Res ipsa loquitur — bile duct injury is inherently self-evidencing of negligence
  • C Bolam test — the doctor is not negligent if his actions conformed to a practice accepted as proper by a responsible body of medical opinion
  • D The Daubert standard — only scientific peer-reviewed evidence about surgical technique is admissible
Correct answer: C. Bolam test — the doctor is not negligent if his actions conformed to a practice accepted as proper by a responsible body of medical opinion

Explanation

The Bolam test (from Bolam v Friern Hospital Management Committee, 1957, adopted in Indian law) holds that a doctor is not negligent if he acts in accordance with a practice accepted as proper by a responsible body of medical professionals skilled in that particular art. A recognised complication occurring despite correct technique does not constitute negligence. Res ipsa loquitur (the thing speaks for itself) applies when negligence is so obvious that it requires no expert opinion, which does not apply to a known complication. The Daubert standard is a US evidence law test, not the Indian standard.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

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