Observations Ethics Man

“The patient would have died anyway”

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f285 (Published 15 January 2013) Cite this as: BMJ 2013;346:f285
  1. Daniel K Sokol, medical ethicist and barrister, Inner Temple, London
  1. daniel.sokol{at}talk21.com

Determining causation of harm is crucial in establishing whether medical negligence has occurred

William Barnett was a nightwatchman at the Chelsea College of Science and Technology in London. On the morning of 1 January 1965 he and two colleagues had tea. Twenty minutes later they started to vomit. They drove to the nearby hospital, where they were seen by a nurse. The nurse spoke to a doctor on the phone, who advised the men to “go home and call in their own doctors.” They left the hospital. A few hours later Barnett was rushed to the hospital and died from arsenic poisoning. His widow sued the hospital for negligence.1

The court found that the doctor failed in his duty of care. He should have examined the patient. Yet the claim failed because it could not be shown that Barnett would have survived even with proper care. The doctor was ethically culpable, but to establish negligence in law the widow had to prove, on the balance of probabilities, that the doctor’s breach of duty caused her husband’s death. In medicine this can prove …

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