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While Britain's courts have adopted the Montgomery test since 2015, the test does not have a three-stage inquiry. In 2013, Datuk Seri Hii had sued Singapore surgeon London Lucien Ooi and the National Cancer Centre Singapore (NCCS) for misdiagnosing him and giving him wrong medical advice. Singapore Med J, 43(1), pp.007-011. Previously, Singapore's courts had used only the oft-cited Bolam test, which states that a doctor is not negligent if his actions could be supported by other doctors. 668 Singapore Academy of Law Journal (2015) 27 SAcLJ 4 This paper begins by providing some background to medical negligence and the Bolam test. Datuk Seri Hii Chii Kok (left) alleged that he was informed by Prof London Lucien Ooi and NCCS that he had pancreatic cancer. © 2020 Dentons Rodyk & Davidson LLP, a limited liability partnership registered in Singapore with Registration No. The Singapore Court of Appeal has in its recent judgment in the case of Hii Chii Kok v Ooi Peng Jin London Lucien and another SGCA 38 (Hii Chii Kok v … To proceed, please click Accept. The Court of Appeal made clear that the doctor’s duty to advise is not satisfied by conducting an “information dump”, which tends to cause the patient to be more confused and less able to make a proper decision. But a log-in is still required for our PDFs. The Bolam test was created in the 1950s when medical treatment was paternalistic: doctors would simply prescribe their professional view, which the patient was expected to accept unquestioningly. Now the world's largest law firm, Dentons' global team builds agile, tailored solutions to meet the local, national and global needs of private and public clients of any size in 193 locations serving 77 countries. The applicable standard of care for diagnosis and treatment is as stated in the Singapore case of Gunapathy, which applied the test developed in … 1. Previously, the Singapore Court had applied the Bolam test to adjudicate the standard of care required in all three aspects of medical care, in order to determine whether there was medical negligence on the part of the doctor. Under the Bolam test, a doctor is not liable in negligence if he can demonstrate that there is a respectable and responsible body of medical opinion, logically arrived, that accepts the doctor’s practice as proper. The Court determines at this second stage of the inquiry whether the doctor was in possession of the information (which pursuant to the first stage of the inquiry is relevant and material). the standards of … Working with Dentons, you will have the opportunity to learn from the best lawyers in the industry at the largest law firm in the world. Datuk Seri Hii, who studied law, sued the NCCS and Professor Ooi for damages, claiming that they had failed to provide proper advice, did not consider the results of various other tests and failed to get his informed consent. This test was applied to determine the doctor’s standard of care in relation to the treatment and information given to the patient. This article is now fully available for you, Please verify your e-mail to read this subscriber-only article in full. The discussion on which treatment to pursue is “now best seen as a collaborative process involving the doctor and the patient”. The Court of Appeal noted that the 2016 ECEG reflected the fact that the “nature of the doctor-patient relationship has evolved together with the level of education and access to knowledge of the ordinary Singaporean”. Until we resolve the issues, subscribers need not log in to access ST Digital articles. 1998 - … Legal Clinic LLC director, Ms Kuah Boon Theng, who was the NCCS' lawyer, said the court is saying it is time that "doctors should instead empower patients to exercise their autonomy by giving them the information they need in order to make meaningful decisions about their own care". A separate inquiry may arise in respect of any negligence in diagnosis or treatment (but not advice) if the doctor does not have the information “because he did not conduct the procedure which would have discovered that information or because he lacked the factual or technical knowledge to realise that a particular risk or alternative treatment existed”. Bolam was rejected in the 2015 Supreme Court decision of Montgomery v Lanarkshire Health Board. Simply going through the list of risks and possible complications in patient information sheets and consent addendum forms may not be sufficient. If you are not already a client of Dentons, please do not send us any confidential information. The Bolam test is an assessment that came about from the case of Bolam v Friern Hospital Management Committee [1957] 1 WLR 582. The inquiry at this first stage is “largely a matter of common sense.” Remote risks with minor consequences or very severe consequences with very low chances of occurring will generally be deemed immaterial, and do not have to be disclosed. 2002 Jan;43(1):7-11. An indispensable tool for doing business in Southeast Asia, take a look at our comprehensive overview of legal developments in Singapore across industry sectors. The decision of the Court of Appeal in Hii Chii Kok v London Lucien Ooi is that: The Court of Appeal considered that the material difference between the three aspects of medical care lies in the degree of passivity on the part of the patient. 19 The test is suited for these aspects as it recognises that doctors possess expert knowledge on medical matters. The doctor has to carefully consider whether there are additional risks,  possible complications or any other information which may be material to this particular patient, and for which the doctor should raise for discussion with the patient. A contextualised approach is also adopted at this stage of inquiry to determine the personal circumstances of the patient. Author information: (1)Department of Palliative Medicine, Tan Tock Seng Hospital, Singapore. The court said that such a paternalistic approach was inconsistent with the modern day emphasis on … Because of this, there has been criticism about whether doctors would prioritise protecting themselves, overloading the patient with unimportant information, rather than to provide them with accurate guidance, said Ms Kuah. Bolam v Friern Hospital Management Committee [1957] 1 WLR 582 is a case that lays down the typical rule for assessing the appropriate standard of reasonable care in negligence cases involving skilled professionals (e.g. test that has since been extended to non-medical professional negligence cases as well. A case study of Hii Chii Kok v Ooi Peng Jin London Lucien and another [2017] SGCA 38. They can read the article in full after signing up for a free account. Dentons has launched its previously announced combination with Hanafiah Ponggawa & Partners (HPRP), one of the largest and most elite law firms in Indonesia. 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