test applies clearly to the question of diagnosis and treatment. �h�!�6��%��4�v���\|�fs!�ez�}�7�����bF��O�W� ��W 0000011671 00000 n In a recent landmark litigation, the Singapore Court of Appeal introduced a new legal standard for determining medical negligence with regards to information disclosure - the Modified-Montgomery test. 0000045856 00000 n The Court of Appeal has qualified the long-standing Bolam test.The courts have also enacted protocols for medical negligence cases, which evince a shift towards a less adversarial approach to resolving such cases, with an increased emphasis on mediation and the appointment of court assessors. 0000000016 00000 n The Court of Appeal was of the view that the Bolam-Bolitho test gives insufficient regard to the autonomy of the patient. �G33˥i�^EO��\�ɧm7�V�w��F����~�)��9�4}NC݄T�CȪ�^KS=��Bl�=�n���:eU��g3]�oɷ�y^�W��rɽ%��%�[�;�{��V�Z%k��e��\�0�~K����i�tZ8�=��&��3;dv�;��~G���1�C~�Z�3;dfd:N�S�:N�S�!�~�_؋�a-�j�/A_�s���GA��3��*��=z����3�GNϜ9=sz�����3�GN�l�`�~� 175 0 obj <> endobj In the Bolitho case the defending doctor was acquitted both at the original trial, in the Court of Appeal, and finally in the House of Lords. 0000008296 00000 n 0000013594 00000 n "C@xW�����&�8 t$ɝ���m�m�d��&�Y��k�ZT�?��*�7���+��k�[�d�>�z��#���b��}™��7�dJ+�,�N.�_爊9-��a�:�\1m �WɌV4g% �#Y���!� �e*�O������f�a����Y%����B��\d�k}rB�ZП�GR�����*ڑ��Զ�E����m�ű6��9.�#o�568�-?N{_�8p&\i͜�*5}#�� G���G��3س���C�rc\����u�{8�^������«/LO}O)�T����0zA���cYlGކ���n�?��6�0臝�n[�66��s���_�s�կ���E�3:�K�+θ���m�tT�7�N���]�_�kX[��U��w^=�o�\�R������Ѩn�������4��eD T�*���A�G�cSL%���L��h4���/�O�"[H�K���/�3��|1�GzhǸѢ��9�%H�� In 2017, the Singapore Court of Appeal decided that the Bolam-Bolitho test used to determine the appropriate standard of care applicable to a medical practitioner in the provision of medical advice to his patient (and the other aspects of diagnosis and treatment) should no longer apply. 0000008105 00000 n c�_����朒��� Ms� �b��ʆ~0���[� Fx�� endstream endobj 190 0 obj <>stream Between May 2013 and February 2014 the claimant developed a left-sided psoas abscess containing gas and fluid. Under the section of “Foundation” on ... traditional Bolam-Bolitho … Where medical situations call for joint responsibility of different specialists, doctors should communicate with each other and also with the patient to avoid … It has been argued before the High Court on at least three occasions in . H��Vmo�6��_qe �y|W��$][��}�!��jK�ml�ߑ�#ɉ��/u$�{�9�����n�a�K8���k�:��g�����ᇢZ@ZV��F��t����F�1$��&�/�7�f��ސ?&.�9��2g��&���u�Je���M��L �;A-�����^tܓ3��3F���43( 7Lp��O�z��ꁸ�,S�cH����I�)��uY��~�O�j�,�˿J�����*/` 83���!%'tL���7��$��z�Y��̖բ���r�G��A��&�L2�����a[�v�Xoa\o���������a���e o='� In Singapore, the Bolam-Bolitho test applies to the standard of care for diagnosis, treatment as well as advice. %PDF-1.4 %���� ,8��k&�]���T3܅� �V���%a��Ҁ� �$��)Pȃ�+.�l)�35�=){ŠVѳ���Ħ��Z2����ͦh�He��?���F]!���4�#�����d�LV�ץSA!^�T! In 2017, the Singapore Court of Appeal decided that the Bolam-Bolitho test used to determine the appropriate standard of care applicable to a medical practitioner in the provision of medical advice to his patient (and the other aspects of diagnosis and treatment) should no longer apply. test Singapore's largest data breach happened in July 2018 when a government hospital became the target of cyber-hackers. 30 H�\�]��0F��+r9s1�Mޤ#�`�^����mtk[j���o�VP8��{�'4i����nV��ih�~VǮo'�S�����>ɵj�f~P�m����a��v��y��d�T�p�2O7��n��M�S맮?�����U���8��g��*S��j�1�|��y�ґsd�����n�T�'�,��Y��6|V���������O=��M�=�t���Y��ޡ h�b```b``����� �� Ā B@16�-̫�p|``p=�'��'`�Хc���.3��bެ�K_��(�䤱�'�L���ʝ/W��o��X�����ISd�~b;;H˂ڗו�� d26/���yL �B�U�1-. Bolam–Bolitho. In medical negligence cases, the courts in England, South Africa and Singapore purport to apply the Bolam/Bolitho test when evaluating the evidence. H��V͎�0��y�eb�#����V�S�U=T{n�[_�8���j4���?�g�Zݷ������۟�������|y3Mc�q~�����?�q�0ضuЛ�W��f-t�b�?�������b�������*tFf��32��M齏:3�A��W|��!=��G�*�����ed7g�cH������}Pk95�a�S�4ѫ�N���)��>z���y�u9A1�vg�N㋳��c{�@��bk��}~�k�=E,z�\$� �����D��q�� \2'p����eyp rLm��`L:w�t��O�ɖ�T5���9� �U��j�+JhQؗ��3ia��f{�4�p.�3� y�Z�;s\��82G�s��r,�3�Bk!���철KT�\iܩ�0�������A"i���Ha~eo^)��2�� �F�j��"7B�aW�^&�T:B�ʪ�B ���n�C |��/����|iTcd����O�T��m$�y����4G0/yȣQuQG�{k�{�����,�2�e���Zp�G���\��:i�R��&f��r Whilst the Bolam-Bolitho test still applies to the areas of medical diagnosis and Bolam / Bolitho test > Assault / battery (performing medical treatment without ... > Singapore may strive to achieve consistency with other common law jurisdictions – UK, Canada, Australia, US and ... test still applies to consent in Singapore, however, this increasingly appears to be on shaky ground. Applying the “Bolam-Bolitho Test”, the central question is whether the decision to defer the TCU date or the elective procedure was reasonably taken in the circumstances of the case. 0000009165 00000 n ���V�n����܆�-i7�y���G�n[j: �T(���P�S�a!cU!�t�U��w������SNJ�C��u�i�,��ҝ�[F��E�`!��x�e��H��U�C�� �px������� �CAX[ �yv��E���+���èEgf&6��ʪ�4@��[��&���5l�C�a���j@aѢ�XN�V���Zl���/�e8O�E) ��!��_� Q/> Thirdly, the case suggests that a higher standard of care is expected of a specialist doctor as compared with a generalist. endstream endobj 196 0 obj <>stream a. This new legal test represented a significant shift from the long-established peer-review standard set out in the Bolam-Bolitho test. 0000134082 00000 n 0000007304 00000 n H�\�͊�@�}���݋&��u�� �� .�q�bR:�1�����iz`��r?���~������ks��;u};���>6���e�ڮ�>����RY��)^���U�����i|��M{=��,�6�q���{��=�?���-�z��xJ�R_�Kt���eߦ���xIk����1DW��Kb�koC�ı��1��v�{���ط�]��O��z̪7/�/����Y��ِW�+�-���� ��9*��{s��=�02=O��������xx|�\"o�7ȯ̯ȴy؄6�Mh؄6�Mh؄6�Mh؄6�Mh؄6�Mh؄6�Mh؄} h�bbb`b``Ń3�� 0 ��s Clinical Negligence – Bolitho Test. advice. While this test originally applied to medical advice in the UKand Singapore, the position in the UK has since been changed by the Supreme Court in Montgomery v Lanarkshire Health Board[Montgomery]where a patient-centric approach similar to the Australian High The test to determine minimum standards is different for diagnosis and treatment (Bolam-Bolitho test) 1 for provision of information and advice (Hii Chi Kok test) 2 and for SMC cases when the charge is professional misconduct (Low Cze Hong test) 3. %%EOF !�`>�]��6�$I ���d������9-��w3[��kJ�n�|>�Bc ,�k-@RE� Bolitho v. City and Hackney Health Authority [1996] 4 All ER 771 is an important English tort law case, on the standard of care required by medical specialists. Expert evidence is therefore readily received on issues relating to, for example, ballistics, engineering, chemistry, medicine, (HZ�\҄ܓ��H�-H>�@��5#�Kf&��%KQ&�Jx�&H26�(P*&� � �^���hf*��܀��A*F�ܖ����>{�!�I������u���z��b��t� ��� 0000009192 00000 n In Singapore, the test currently used to determine whether a doctor has performed up to the minimum standard expected in law, and so has not breached the duty of care, is the Bolam-Bolitho Test 2. Prior to this, the position in Singapore was set out in Khoo James and Another v Gunapathy d/o Muniandy and Another Appeal (2002) 1SLR(R)1024 which followed the principles established in Bolam and Bolitho. 0000182927 00000 n The court said that such a paternalistic approach was inconsistent with the modern day emphasis on “informed consent”. Secondly, Singapore’s apex court expressed its expectations of a hospital’s responsibility as regards its total system for the management of a patient’s care. Bolam / Bolitho test > Assault / battery (performing medical treatment without the Patient’s prior consent) > Potential criminal liability for performing treatment without Patient’s consent. ��\jo���s� �mo���䔐fhN��� � �h�c�\�Rj�51>҄�J^�Y��J�눃v�kNJ�&�’�vEo�1���%����萻>�M��5��7�,���k c) Medical Negligence; in 2017, the Singapore Court of Appeal clarified that the Bolam-Bolitho test in respect of the appropriate standard of care of a medical practitioner no … Applying the “Bolam-Bolitho Test”, the central question is whether the decision to defer the TCU date or the elective procedure was reasonably taken in the circumstances of the case. The Supreme Court judgement in ‘ Montgomery v Lanarkshire Health Board ’ has caused a change in the law concerning the duty of doctors on disclosure of information to patients regarding risks. 0000164832 00000 n 0000004612 00000 n This decision will be of particular interest for all med-mal insurers and healthcare providers operating in the Singapore jurisdiction. The ‘ Bolam ’ principle has long been the traditional test governing how much information is necessary to avoid liability in negligence. c)Medical Negligence; in 2017, the Singapore Court of Appeal clarified that the Bolam-Bolitho test in respect of the appropriate standard of care of a medical practitioner no longer applies to the provision of medical advice. It follows the Bolam test for professional negligence, and addresses the interaction with the concept of causation. In Singapore, the Bolam-Bolitho test applies to the standard of care for diagnosis, treatment as well as advice. This decision will be of particular interest for all healthcare providers operating in the Singapore jurisdiction. 0000015529 00000 n Ann Acad Med Singapore. Singapore and the United Kingdom are latecomers to this trend. Where medical situations call for joint responsibility of different specialists, doctors should communicate with each other and also with the patient to avoid information gaps that can potentially imperil patients. Essentially, the Bolam-Bolitho test laid down a physician-centric approach, where emphasis is placed on peer review to determine whether a doctor’s conduct had fallen short of such standard. Whilst undoubtedly well-intentioned, this test in Hii Chii Kok has led to some uncertainty amongst doctors. The law governing the duty to inform, set out in the United Kingdom Supreme Court in Montgomery v Lanarkshire Health Board 3 (“Montgomery”), ... the defendant could not be found negligent on the Bolam/Bolitho test. <<85FBA301F250804DB485BB34060E5646>]/Prev 231340/XRefStm 1780>> endstream endobj 176 0 obj <>/Metadata 23 0 R/PageLabels 20 0 R/Pages 22 0 R/StructTreeRoot 25 0 R/Type/Catalog/ViewerPreferences<>>> endobj 177 0 obj <>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 595.276 841.89]/Type/Page>> endobj 178 0 obj <> endobj 179 0 obj <> endobj 180 0 obj <> endobj 181 0 obj <> endobj 182 0 obj <> endobj 183 0 obj <>stream From Bolam-Bolitho to Modified-Montgomery - A Paradigm Shift in the Legal Standard of Determining Medical Negligence in Singapore. 9�@$f�|9O�g���3�@k�*#i\���q\4.���Ep�k��p\4.��f�- O�����i�x�[��,�&M� � ��a�c��+�]zq�"���E��ы�G�=-Y�֖�-�B"m! doctor-centric Bolam-Bolithotest which focuses on the doctor’s perspectives. 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