Legal Case Summary
Bolam v Friern Hospital Management Committee [1957] 1 WLR 583
TORT – NEGLIGENCE – STANDARD OF CARE FOR MEDICAL PROFESSIONALS – THE BOLAM TEST
Facts
The defendant was the body who employed a doctor who had not given a mentally-ill patient (the claimant) muscle-relaxant drugs nor restrained them prior to giving them electro-convulsive therapy. The claimant suffered injuries during the procedure. The claimant sued the defendant, claiming the doctor was negligent for not restraining them or giving them the drug.
Issue
Establishing the tort of negligence involves establishing that the defendant breached their duty of care to the claimant. To establish breach, the claimant must establish that the defendant failed to act as a reasonable person would in their position. This standard is higher in the case of professionals: they must act as a reasonable professional would.
The issue in this case was how to assess the standard of care imposed on a professional defendant where a substantial portion of professionals opposed a particular practice, while others did not.
Decision/Outcome
The High Court held that the doctor had not breached his duty to the patient, and so the defendant was not liable.
McNair J set out the test for determining the standard of care owed by medical professionals to their patients (sometimes referred to as the ‘Bolam test’). The professional will not be in breach of their duty of care if they acted in a manner which was in accordance with practices accepted as proper by a responsible body of other medical professionals with expertise in that particular area. If this is established, it does not matter that there are others with expertise who would disagree with the practice.
As the methods used in this case were approved of by a responsible portion of the medical profession, there was no breach.
Updated 13 March 2026
This case summary accurately states the facts, issue, and outcome of Bolam v Friern Hospital Management Committee [1957] 1 WLR 583 and correctly sets out the Bolam test as formulated by McNair J.
Readers should be aware of two significant later developments. First, the Bolam test was affirmed and extended by the House of Lords in Bolitho v City and Hackney Health Authority [1998] AC 232, which added an important qualification: the body of professional opinion relied upon must also be capable of withstanding logical analysis. A court may therefore reject a practice accepted by a responsible body of professionals if that practice cannot be logically justified. Second, and more substantially, the Supreme Court in Montgomery v Lanarkshire Health Board [2015] UKSC 11 departed from the Bolam test in the specific context of the disclosure of risks to patients. The Court held that the appropriate test for whether a doctor has satisfied the duty to warn a patient of material risks is not the Bolam standard but rather whether a reasonable person in the patient’s position would be likely to attach significance to the risk. Montgomery therefore significantly limits the Bolam test’s application in the area of informed consent, though Bolam continues to govern questions of diagnosis and treatment. Students should ensure they read Bolitho and Montgomery alongside this case.
