BMJ  2005;330:1086-1087 (7 May), doi:10.1136/bmj.330.7499.1086-b

Letter

Influence of guidelines in determining medical negligence

The first 150 words of the full text of this article appear below.

EDITOR—In his article on the influence of evidence based guidelines in determining medical negligence Hurwitz argues to reject guidelines in favour of a "responsible body of medical opinion," the fundamental principle laid down in the Bolam test on the standard of care, as he cites.¹

Eighty eight per cent of specialty guidelines did not give any information on searches,² yet they are accepted by most practitioners as the yardstick of clinical practice. A change in clinical practice on the basis of evidence based medicine is a recent phenomenon.³ In 1957, when Bolam was pronounced, evidence based medicine, specialty guidelines, and institutions such as the National Institute for Clinical Excellence were not known. Therefore the principle laid down in the Bolam test, that of an ordinary skilled man exercising and professing to have a special skill, was important to the court's decision then.

The General Medical Council recommends following . . . [Full text of this article]

Diana, Princess of Wales Hospital, Grimsby DN33 2BA kailashmohanty@hotmail.com

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