Montgomery v. Lanarkshire Health Board (2015)

1. Case Title and Citation

• Montgomery v. Lanarkshire Health Board (2015)
• [2015] UKSC 11

2. Court Name and Bench

• Court Name: United Kingdom Supreme Court
• Bench:

-Lord Neuberger, President

-Lady Hale, Deputy President

-Lord Kerr

-Lord Clarke

-Lord Wilson

-Lord Reed

-Lord Hodge

3. Date of Judgement

• March 11, 2015

4. Parties Involved

• Nadine Montgomery, Appellant
• Lanarkshire Health Board, Respondent

5. Facts of the case

• Montgomery v Lanarkshire of 2015 is an English tort law case regarding informed consent.
• The claimant, Nadine Montgomery, was a diabetic woman of small stature
• She suffered from birth injuries when delivering her baby vaginally
• Nadine Montgomery’s baby suffered severe disabilities following the birth including shoulder dystocia and cerebral palsy
• She claimed the medical professionals did not inform her of the potential risks or of an alternative procedure for giving birth

6. Issues Raised

• Montgomery sued the doctors for negligence as they failed to inform her of the risks involved with being a small, diabetic woman delivering a larger baby vaginally.
• Failure to inform the patient of the risks to giving birth vaginally
• Failure to inform the patient of potential birth injuries to be sustained
• Failure to give patient the choice with recommended process or procedure

7. Arguments of the parties

• Key contentions by the Plaintiff

-Nadine Montgomery argued that her doctors were negligent

-The Doctors failed to inform her of the risks associated with giving birth vaginally

-Therefore, she could not make an informed decision about her delivery method

• Key contentions by the Defendant

-Argued that many medical professionals are concerned that disclosing too much information or too many options would overwhelm patients with information they may not understand

-Thus, causing distress or poor decision making

8. Judgement/Final decision making

• The Court of United Kingdom released judgement in the Favor of Nadine Montgomery in March of 2015
• The court, emphasized that it is necessary to explain information in a way the patient can understand
• The case was deemed a conflict of standards – informed consent versus medical preference
• The Court affirmed the requirement for informed consent based on this duty of disclosure, setting a significant precedent in medical law

9. Legal Reasoning/Ratio Decidendi

• Through this case, the court mandates that medical practitioners must fully disclose materially relevant risks and benefits of treatment to patients, even those considered small, to ensure valid informed consent
• Informed consent must be clarified and align with ethical guidance for doctors
• As of today, the Montgomery Test has been applied in several cases in the United States surrounding consent and medical ethics
• The case also established the “Montgomery principle,” which shifted the standard for informed consent from the “reasonable doctor” (the Bolam test) to the “reasonable patient”

10. Conclusions/Observations

• This case has now created a patient-centred approach, emphasizing patient autonomy in making informed choices about their own bodies
• Key aspects of the Montgomery Principle- Duty of Disclosure, Materiality, Informed Choice/Consent, Shift in Standard
• Mistakes such as improper labor management or insufficient fatal monitoring not only threaten the newborn’s health but also impose emotional and financial strains that may persist for generations.
• Doctors have a duty to inform patients of the risks involved in any procedure
• Failing to do so could make them liable if a patient is injured