Isn't Bolam some grumpy Geordie actor, and Montgomery an WW2 general? and why do they matter to trans people ?

As I have said before in a number of my blog posts, I used to be a Registered Nurse.   Consequently my  status as ' A member of the Oppressor Class' - as I was described by  a reasonably well known trans academic, who has since been perfectly decent with me  both on social media and IRL, once she understood  what my viewpoint actually was on the topic in question; does impact  my world view on certain topics around how healthcare is provided for trans people.

With regard to the title of the piece - We aren't talking about James Bolam (who is actually from Wearside, even though his character in The Likely Lads was a Geordie) or Field Marshal Montgomery though  - as alluded in  the title of the post

There's a term used in  professional discourse ' The reasonable practitioner test'  - it's a caveated version of the ' the view of the man on the Clapham omnibus' ...

Bolam and Bolitho inform this as does the more recent Montgomery case...

All three of these are Civil court legal actions following adverse incidents in a healthcare setting.

The Wikipedia page on the Bolam judgement  also provides links and references to a number of other cases 


However the most recent and most significant case is Montgomery and the discussion of disclosure of material  risks  in a  proposed course of treatment ( or equally not intervening)

from the MDU link given above

The key passages from the Montgomery judgment involve what a patient would consider to be material risk:


'The doctor is therefore under a duty to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments.

'The test of materiality is whether, in the circumstances of the particular case, a reasonable person in the patient's position would be likely to attach significance to the risk, or the doctor is or should reasonably be aware that the particular patient would be likely to attach significance to it.'

Judgment in Montgomery v Lanarkshire Health Board [2015] UKSC 11, paragraph 87.

Some other key points were:

whether a risk is material doesn't only depend on how frequently it occurs
your advisory role involves talking to the patient to make sure they understand the risks and benefits of their treatment, so that they can make an informed decision
simply providing the information or getting a signature on a consent form may not be enough to evidence proper consent, but can be helpful as part of the consent process.

The fact is that trans care does not operate in a bubble and consequently this stuff informs the reality of clinical practice.

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