The Bolam test as applied by Indian courts
Indian courts have consistently adopted the Bolam test, originating in English law (Bolam v. Friern
Hospital Management Committee, 1957), as the starting point for judging a doctor's conduct: a medical
professional is not negligent merely because their chosen course of treatment differs from what another
equally qualified doctor might have done, so long as the conduct conforms to a practice accepted as proper
by a responsible and competent body of medical opinion in that field. This standard recognises that
medicine often involves genuine differences of professional opinion, and that an adverse outcome by itself
does not establish negligence -- the claimant must show that the doctor's conduct fell below what a
reasonably competent professional in that specialty would have done in the circumstances, not merely that
the treatment failed or a complication arose. Indian courts have repeatedly emphasised that an honest
error of clinical judgment, made in good faith and based on a reasonable assessment of the situation, does
not by itself amount to negligence.
The Bolitho refinement and Jacob Mathew's civil-criminal distinction
English law later refined the Bolam test in Bolitho v. City and Hackney Health Authority (1997),
holding that a court is not bound to accept a body of medical opinion as automatically reasonable or
responsible merely because a number of practitioners support it -- the opinion itself must have a logical
basis and must have been reached after the experts directed their minds to the relevant risks and
benefits. Indian courts have generally been receptive to this refinement as an additional check on
purely conclusory expert testimony. Separately, in Jacob Mathew v. State of Punjab (2005), a Constitution
Bench of the Supreme Court held that the same broad standard of reasonable care applies for judging
negligence in both civil and criminal contexts, but that criminal liability requires proof of a much
higher degree of negligence -- one showing such disregard for the life and safety of others as to amount
to a crime against the state, not merely the lower threshold sufficient for civil liability or a
consumer complaint.
Establishing negligence in practice: expert evidence and documentation
Because the applicable standard turns on what a responsible body of medical opinion would have done,
expert medical testimony is typically central to any negligence claim -- both to establish what the
accepted standard of care was for the relevant condition and procedure, and to show how the treating
doctor's conduct departed from it. Contemporaneous medical records (case sheets, nursing notes,
investigation reports, consent forms, and discharge summaries) are usually critical evidence, since they
document what was actually observed, decided, and done at the time, rather than relying on
reconstructed recollection well after the event. This platform recommends that a patient or family
considering a negligence claim request a complete certified copy of the medical records as early as
possible, given that hospitals and doctors are generally obligated to provide these on request and delay
can complicate later access.
Common mistakes people make in assessing possible medical negligence:
- Assuming a bad outcome or failed treatment by itself proves negligence -- Indian courts require
proof that the conduct fell below the accepted standard of care, not just that the result was poor.
- Not obtaining an independent expert medical opinion before pursuing a claim, leaving the case
without the evidentiary foundation courts typically expect.
- Delaying a request for certified medical records, which can make it harder to establish exactly
what was done and decided at the time of treatment.
