Information & warnings: Singapore Court of Appeal

Hii Chii Kok v Ooi Peng Jin London Lucien and another [2017] SGCA 38 concerned a patient whose central complaint was that he underwent a major pancreatic surgery that turned out to be unnecessary. The issue provided the court with an opportunity to revisit its earlier decisions favouring the Bolam / Bolitho determination of the standard of care for provision of information to patients.

At [2] the court said:

The question before us in this appeal is whether we too should gravitate towards a more patient-centric approach. If so, should such an approach apply to all aspects of the doctor’s interaction with the patient? And insofar as we do apply a patient-centric approach, how should the court prescribe the test for determining whether the standard of care has been satisfied?

The Attorney-General felt constrained to intervene having regard to the possible consequences that the decision might have on the cost of healthcare.

The court (at [4]) saw it as:

…appropriate to move towards a somewhat more patient-centric approach when prescribing the standard of care in relation to the doctor’s duty to advise the patient and to provide the patient with the requisite information to enable him to participate meaningfully in decisions affecting the medical treatment he will receive. This is a function of the central principle that the patient has autonomy over such matters. However, this will not mean that the doctor’s views will cease to be significant. In our judgment, the appropriate standard of care is one that strikes a balance between the interests of the doctor and the patient.

Extensive discussion (the judgment runs to 112 pages, but the principles are dealt with at [52] – [163]) of the provision of information included comment on the UK Montgomery decision, the Australian Rogers v Whitaker decision and the Australian Review of the Law of Negligence.

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