ADDENDA
From the archives: Only a misadventure
DoCtoRS will always make mistakes – it’s only human to do so. But when do they constitute medical negligence? The landmark court case in England that helped established the criteria for assessing negligence was Bolam v Friern Hospital Management. In 1954 a salesman named John Hector Bolam was admitted to
Friern Hospital suff ering from persistent depression. There he was advised by a consultant to undergo electro-convulsive therapy (ECT). Bolam signed a consent form but was not warned of the small risk of fracture in the treatment. Later in one of the treatment courses he sustained dislocation of both hips and fractures of the pelvis. The use of relaxant drugs would have excluded the fracture risk but
these were not administered nor were manual restraints used, though nurses were in attendance throughout the treatment. Among
Crossword
professionals skilled in ECT there were two bodies of opinion on fracture risk. One favoured the routine use of relaxant drugs or manual restraints; the other considered the use of such drugs was attended by mortality risks and manual restraints in some cases increased the risk of fracture. Bolam sued the hospital for negligence in the
administration of the treatment and for not warning him of the risk of fracture. The case centred on the question of professional skill. In
summing up, the presiding judge directed the jury: “…a doctor is not guilty of negligence, if he has acted in
accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art. The test is the standard of the ordinary skilled man exercising and professing to have that special skill…” The judgment was handed down in favour of the hospital and principles established in an earlier Scottish case (Hunter v Hanley) were cited in support. There was a visionary undertone in the judge’s direction to the jury when he quoted an earlier judgement by Lord Denning: “…we should be doing a disservice to the community at large if we
were to impose liability on hospitals and doctors for everything that happens to go wrong. Doctors would be led to think more of their own safety than the good of their patients…We must insist on due care for the patient at every point, but we must not condemn as negligence that which is only a misadventure.” Legal precedent has moved on since then with further case law but
the historic importance of Bolam remains undisputed. Adapted from MDDUS history - A Century of Care
Object obscura: Thumb sucking guards
ACROSS 1.
Ciprofl oxacin, for instance (10)
8. Central parts of cells (6) 9. Ireland (abbr.) (3) 11. Executioner (7) 12. Ballroom dance (5) 13. Bear-like (6) 16. Marilyn (6) 18. Prefi x, nose (5) 19. Physician, pharma researcher and pasta dish? (7)
21. Information privacy legislation (3)
22. Reveal the presence of (6) 24. In which Salmond wants yes vote (10)
DOWN 2.
Synthetic rubber material (abbr.) (3)
3. Famous medico-legal case (5) 4. Position correctly (6) 5. Fire (7) 6. One-sided (10) 7.
Involuntary oscillatory movement of muscle (6)
10. Shambolic Happy Mondays vocalist (5-5)
14. Of 20 (6) 15. Newborn infant (7) 17. Alternative forms of same gene (6)
20. Backbone (5) 23. Rare and fatal brain disease (abbr.) (3)
See answers online at
www.mddus.com. Go to the Notice Board page under News and Events.
22 SUMMONS
THESE thumb guards dating from the early twentieth century could be mistaken for medieval instruments of torture. Most particularly the 1906 Babe Mitts – a metal sock fi tted over a baby’s fi st and tied around the wrist.
IMAGE COURTESY OF BDA MUSEUM
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