Montgomery v Lanarkshire Health Board (2015)

Summary

Nadine Montgomery, a woman with diabetes and of small stature, was not told about the risk of shoulder dystocia during vaginal delivery of a large baby, or offered a caesarean section as an alternative. Her son was born with serious disabilities after complications during birth. Her doctor said she had not mentioned the risk because the chance of serious harm was small and she thought the patient would opt for a caesarean. The Supreme Court ruled that doctors must take reasonable care to ensure patients are aware of any material risks and of reasonable alternatives. A risk is material if a reasonable person in the patient's position would attach significance to it, or if the doctor knows or should know that this particular patient would. This moved the legal standard for consent away from what doctors typically disclose towards what patients want to know, and cemented consent as a dialogue.

Key takeaways

• Doctors must disclose material risks and reasonable alternatives.
• Materiality is judged from the patient's perspective, not the profession's.
• Consent requires dialogue to find out what matters to the patient.

How to use it

Mention in consent scenarios alongside GMC guidance: 'Since Montgomery, the test is what matters to this patient.'

Questions it helps with

• A drug advert claims it 'halves the risk of heart attack'. What does that actually mean for a patient?