Bolam v Friern Hospital Management Committee [1957] 1 WLR 582 (QB)

Facts

Mr Bolam was a patient at Friern Hospital undergoing electro-convulsive therapy (ECT) for mental illness. During treatment, he was not given muscle relaxants or physical restraints. As a result, he suffered a fractured pelvis.

Mr Bolam claimed that the doctors and hospital staff had acted negligently by failing to exercise reasonable care in administering the ECT. At the time, there was professional debate about whether muscle relaxants or restraints were necessary for safe treatment.

The case tested the standard of care for skilled professionals when medical opinion is divided.

---

Issue

What is the appropriate standard of care for medical professionals in negligence? Specifically, can a doctor be found negligent if their treatment follows a practice accepted by some responsible practitioners, even if others disagree?

---

Decision

The court held that Mr Bolam’s treatment did not amount to negligence. The doctors had acted in accordance with a practice accepted as proper by a responsible body of medical opinion. The existence of differing professional opinions did not make the chosen practice negligent.

---

Legal Principle

Professionals are judged by the Bolam test:

A professional is not negligent if acting in accordance with a practice accepted as proper by a responsible body of peers.

This establishes an objective-professional standard, where the views of a responsible body of skilled practitioners determine reasonable care, even if other practitioners would have acted differently. The test applies to all skilled professions, not just medicine.

---

Importance

• Fundamental authority on professional negligence.

• Forms the basis for later refinements, e.g., the Bolitho addendum, which allows courts to reject professional opinion if it is illogical or unreasonable.

• Widely cited in cases involving doctors, lawyers, accountants, and other professionals.