Engage patients? Yes, but don't expect doctors to mind-read

The Health Ministry (MOH) has expressed concern that a new legal test used by the Court of Appeal would lead to supplementary procedures and costs for patients (Legal test on doctors' negligence: MOH, AGC studying impact; May 20).

The new test is a modified version of the Montgomery test, where a patient's opinion on the advice received carries greater importance than that of the doctor's colleagues.

The prevailing standard in deciding medical negligence cases has been the Bolam test.

This test essentially means that a medical practitioner will not be deemed negligent, should other doctors of the same speciality agree that he acted responsibly.

Under the Montgomery test, a doctor must make known risks that the average patient would consider to be of importance.

The doctor must engage the patient in a proper dialogue to ensure that he understands the prospect of failure involved in the treatment or surgery.

It appears that the end result of both the Bolam and Montgomery tests would essentially be the same, as the Bolam test already circumscribes the Montgomery analysis.

During clinical consultations, it is standard practice for a doctor to inform his patients of the risks that they should be concerned about.

Any reasonable doctor would want to limit his liability by emphasising both the benefits and drawbacks of a procedure; the patient will then be able to make an informed decision whether to go ahead.

A doctor cannot be expected to read his patient's mind, so he must not be held responsible for not predicting the inner concerns of a patient which were not divulged at the clinic.

Edmund Khoo Kim Hock

A version of this article appeared in the print edition of The Straits Times on May 27, 2017, with the headline 'Engage patients? Yes, but don't expect doctors to mind-read'. Print Edition | Subscribe