In order to assess the status and scope of the Bolam principle today it is necessary to consider the implications of the landmark decision by taking into account its application in subsequent case law.
In Bolam v Friern Hospital Management Committee, an action was brought against the defendant health authority after the claimant alleged negligence when he sustained fractures to the skull following electro-convulsive therapy. The claimant alleged that the health authority was negligent in not using relaxant drugs or some form of manual control and in failing to warn him of the risk involved before the treatment was given.
The Bolam case established the principle that the standard of care owed to a patient is determined by considering practice as accepted by a responsible body of medical experts. Before considering the application of this principle in subsequent cases, it is necessary to take into account the implications of such an approach and the extent to which the stance taken by the courts is satisfactory in establishing whether a doctor has breached his duty of care. In effect the Bolam principle means that whether the duty of care has been breached is left for the doctors to determine. This can be viewed as a satisfactory approach since medical evidence is often highly complex and the judiciary may not exhibit the necessary skill and expertise to draw conclusions from evidence. Furthermore, Lord Denning MR in Whitehouse v Jordan emphasised some significant factors which reinforce the some of the policy reasons for maintaining the current state of the law by referring to the problem of defensive medicine in the United States where the doctors are insured:
'Experienced practitioners are known to have refused to treat patients for fear of being accused of negligence. Young men are even deterred from entering the profession because of the risks involved. In the interests of all, we must avaoid such consequences in England.'
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