Chester v afshar 2004. Chester v Afshar [2004]: Case Analysis 2022-10-11
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Chester v Afshar, 2004 is a leading UK case on the principle of informed consent in medical treatment. The case involved a patient, Mrs. Chester, who underwent a hysterectomy (a surgical procedure to remove the uterus) at the hands of Dr. Afshar, a consultant obstetrician and gynecologist. Mrs. Chester later suffered from a complication known as "urinary retention," which caused her to experience extreme pain and discomfort.
The case came to court when Mrs. Chester sued Dr. Afshar for medical negligence, alleging that he had failed to obtain her informed consent before performing the procedure. Mrs. Chester argued that if she had been properly informed of the risks and alternatives to the procedure, she would not have gone through with it.
The court ruled in favor of Mrs. Chester, finding that Dr. Afshar had indeed failed to obtain her informed consent. The court held that a doctor has a duty to provide a patient with sufficient information about the proposed treatment, including any risks or alternatives, in order to allow the patient to make an informed decision about their care.
The principle of informed consent is central to medical ethics and is designed to protect the autonomy and dignity of patients. It ensures that patients are not subjected to medical treatment against their will and are able to make decisions about their own health and well-being.
The case of Chester v Afshar serves as a reminder to doctors of the importance of obtaining informed consent from their patients before embarking on any course of treatment. It also serves as a reminder to patients to ask questions and be proactive in seeking information about their medical care.
In conclusion, Chester v Afshar is a landmark case that has established the principle of informed consent as a cornerstone of medical ethics and practice in the UK. It serves as a reminder to both doctors and patients of the importance of open communication and respect for patient autonomy in the healthcare setting.
Chester v Afshar [2004]: Case Analysis
In the absence of evidence that the breach had no effect or that the injury would have occurred even if Dr Chappel had warned her of the risk of injury to the laryngeal nerve and of the consequent risk of partial or total voice loss, the breach of duty will be taken to have caused the injury. Logically, the correct comparison of risk is between having that operation on that occasion and not having it … If it is more likely than not that the same damage would not have been suffered, then by causing her to have the operation that day he has caused her to sustain it. We allow someone to choose death over radical amputation or a blood transfusion, if that is his informed wish, because we acknowledge his right to a life structured by his own values. It was the product of the very risk that she should have been warned about when she gave her consent. The Chester vs Afshar case is mentioned highlighted in green however there is minimal space to list the various warnings as demanded by the ruling of the Chester vs Afshar case! It was not foreseeable that the failure to disclose pregnancy risks prior to the mesh surgery would lead to Ms Diamond being told by another doctor 3 years later that she could not carry a child. The judgments are illuminating. Department of Health, Reference guide to consent for examination or treatment.
If the operation had been performed on another date, her injuries may not have been worsened. But the timing of the operation is irrelevant to the injury she suffered, for which she claims to be compensated. They are better answered by asking whether, all things considered, the defendant should be held liable for the harm which ensued, or, on another view, whether the harm was foreseeable as within the risk, or was within the scope of the rule violated by the defendant. This principle reflects the right of patients to determine what happens to their own bodies, and is a fundamental part of good practice. He had not been warned of the risk, and sought damages.
Correia, Diamond and the Chester Exception: Vindicating Patient Autonomy?
If he would have been unable or unwilling to take that opportunity and the risk eventuates, the failure to warn has not caused the damage. In the second scenario, causation will be made out in accordance with conventional principles. A surgeon owes a legal duty to a patient to warn him or her in general terms of possible serious risks involved in the procedure. In a majority judgment 3:2 , it was held that patients should be told of any possible serious risks associated with their proposed medical treatment. So, in the wake of Chester v Afshar, it is imperative that care is taken to warn patients about all risks material to their decision and, when time permits, that they are encouraged to consider their options over time before deciding whether or not to undergo treatment. A doctor, the defendant, advised her to do a surgery.
Chester v. Afshar [2004] UKHL 41 (14 October 2004)
She argued that she may not have consented to the surgery if she was aware of the possible risks. This became quite severe and at times she was unable to walk or control her bladder. Cited — The defendant published a film showing the claimant involved in sex acts with prostitutes. Post-operatively, the risk materialised and Ms Chester brought a claim in negligence against Mr Afshar based upon his failure to disclose the risk. Some information might confuse and other information might alarm the patient.
This is well illustrated in the case of Diamond. The judge held that the operation was not negligently performed but that Mr Afshar was negligent in not properly informing Ms Chester of the risks. A modification of causation principles as was made in Fairchild will always be exceptional. In the second section, we critically examine the autonomy-based justification the majority in Chester gave for departing from those principles. The claimant had the operation and unfortunately it worsened her condition. Her consultant neurosurgeon Mr Afshar was under a duty to warn her of this risk although he failed to do so.
If healthcare professionals or other healthcare staff fail to obtain proper consent and the patient subsequently suffers harm as a result of treatment, this may be a factor in a claim of negligence against the healthcare professional involved. He later continues: In my opinion this argument is about as logical as saying that if one had been told, on entering a casino, that the odds on No 7 coming up at roulette were only 1 in 37, one would have gone away and come back next week or gone to a different casino. That should be sufficient to establish a causal link. Best desire autonomy, therefore, may seem to be an acceptable compromise but its use does not tell us how to manage conflicting values influencing decision-making. He therefore found for the claimant.
I would prefer to approach the issue which has arisen here as raising an issue of legal policy which a judge must decide. The function of the law is to enable rights to be vindicated and to provide remedies when duties have been breached. Declarations: Economic and Social Research Council Award Ref: 1653376. ACKNOWLEDGEMENTS The author would like to thank Professor Rob Heywood Professor of Medical Law, School of law, University of East Anglia for his helpful comments on an earlier draft. The function of the law is to enable rights to be vindicated and to provide remedies when duties have been breached. In these circumstances I do not find it improbable that, in an attempt to reassure, he deflected her inquiries by answering them in the light-hearted terms which she has described — and which he accepts that he may have used at some stage.
It was nine months before treatment was begun. Their employers pointed to several employments which might have given rise to the condition, saying it could not be clear which particular employment gave rise to the. In the wake of this judgment, the General Medical Council issued revised guidance. Chester vs Afshar Consequences General Medical Council. He will naturally be anxious to avoid alarming or confusing the patient unnecessarily. It is whether, in the unusual circumstances of this case, justice requires the normal approach to causation to be modified. Poor handling of the consent process may also result in complaints from patients through the NHS complaints procedure or to professional bodies.
Subscribe to ProNeg Litigation News. He argues against using ideal and best desire autonomy in medical negligence claims on the grounds that both focus on the notion of what a patient should want and are, therefore, paternalism masked as autonomy and undermine the principle that patients should be allowed to refuse treatment for irrational reasons, or for no reason at all. Given that the law states that patients can refuse treatment for irrational reasons, or for no reason at all reflecting current desire autonomy , utilising best desire autonomy in relation to causation involves the use of a more demanding concept of autonomy then is otherwise required. Davies LJ said the judge had asked the right question: what would Ms Diamond have done armed with the knowledge of the pregnancy risks associated with a mesh repair and the advice that a suture repair would almost probably fail? In addition to traditional questions of legal interest, the following are all within the purview of the journal: comparative and international law, the law of the European Community, legal history and philosophy, and interdisciplinary material in areas of relevance. . But he would not have found him liable for a failure to warn, because he was not satisfied that the claimant would not have had the operation if he had been properly advised.
As in the present case the position was that the patient would not have had the operation at the time and place when she did. The trial judge found that the surgeon had not been negligent in performing the operation but his failure to warn her of the risk was a breach of duty. On these facts the court decided by a majority of three Gaudron, Gummow and Kirby JJ to two McHugh and Hayne JJ that the patient was entitled to recover substantial damages from the surgeon for the physical injuries suffered as a result of the operation performed on her. We allow someone to choose death over radical amputation or a blood transfusion, if that is his informed wish, because we acknowledge his right to a life structured by his own values. Sometimes it is done by saying that there is a break in the chain of causation. There must be genuine agreement to receive the treatment.
