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Why Bolam v Friern Hospital Management Committee is important

In Bolam v Friern Hospital Management Committee, the Court stated and applied what has become the ‘Bolam principle’. This is: a professional who follows conduct advocated by a reasonable proportion of their respective profession will not have failed to take reasonable care.


A doctor at Friern Hospital administered electroconvulsive therapy treatment on the claimant. This therapy caused Bolam to spasm, fall off the bed and break both of his legs.


Bolam brought an action against the Hospital committee in the tort of negligence. The claimant argued the doctors had been negligent in:

  1. Not warning him about the risks of the therapy,
  2. Failing to administer a relaxant drug, and
  3. Failing to use more manual control (beyond shoulder control) to avoid the claimant falling off the bed.


Whether the defendant had failed to take reasonable care. This question was to be decided by a jury.

Direction to the jury

Mcnair J explained to the jury the meaning of negligence. He directed that the standard is based on the ordinary man, but in the context of a medical professional the standard is of a person who exercises and professes to exercise that specialist knowledge and skill. In defining what standard is expected of a reasonable doctor, McNair J directed that the jury should consider the opinions of any reasonable body of doctors.

The jury was not asked to decide what action the doctor should have taken (which requires comparing alternative techniques and therapies), but only whether the doctor acted reasonably in choosing which treatment to give. McNair J said:

A doctor is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art … Putting it the other way round, a man is not negligent, if he is acting in accordance with such a practice, merely because there is a body of opinion who would take a contrary view.

McNair J then outlined the medical evidence that was put before the jury. The jury concluded that the defendants had not been negligent.

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