Chapter 2 Key facts checklists

The components of medical negligence are: duty of care; breach of duty; and causation.
A duty of care usually exists in doctor–patient relationships. Matters are more complex in ‘good Samaritan’ situations or where the claimant is not the patient.
The standard of care expected from doctors is judged by the Bolam test. There is no breach of the standard of care if a doctor has acted in accordance with practice accepted as proper by a responsible body of medical professionals skilled in that particular art.
The Bolam test is subject to the Bolitho principle, which requires that the practice accepted as proper can withstand logical analysis.
The claimant must prove that the breach caused the damage. The traditional test is the ‘but for’ test.
Causation can be difficult to establish because patients are generally unwell in some respect. This means that there could be at least two possible causes for the poor outcome: negligence or the natural history of the patient’s condition.
Causation must be proved on the balance of probabilities.
The courts appear to be taking a more patient-centred approach when establishing causation.