## Professional Negligence vs. Breach of Informed Consent ### Core Distinction **Key Point:** Professional negligence concerns the **quality and standard of care in performing the procedure**, whereas breach of informed consent concerns **failure to disclose material information before the procedure**. ### Comparison Table | Aspect | Professional Negligence | Breach of Informed Consent | | --- | --- | --- | | **Focus** | How the procedure was performed | What information was disclosed before procedure | | **Standard** | Bolam test: what a reasonable doctor would do in similar circumstances | Disclosure standard: material risks, benefits, alternatives | | **Causation** | Negligent act caused harm (causal nexus) | Lack of disclosure prevented informed choice | | **Proof required** | Expert testimony on deviation from standard practice | Evidence that material risk was not disclosed | | **Remedy** | Compensation if negligent act caused injury | Compensation if non-disclosure led to harm | | **Example** | Surgeon uses wrong technique, damages nerve during repair | Surgeon did not inform patient of PDPH risk before spinal anesthesia | ### Elements of Professional Negligence (Bolam Test) 1. **Duty of care** — doctor-patient relationship exists 2. **Breach of duty** — deviation from accepted standard of practice 3. **Causation** — breach caused the injury 4. **Damage** — patient suffered harm **High-Yield:** The **discriminating feature** is whether the negligence lies in the **performance of the procedure** (professional negligence) or in the **disclosure process** (breach of informed consent). ### Clinical Pearl **Key Point:** In the given scenario, the surgeon's failure to disclose PDPH risk is a breach of informed consent, not professional negligence. If the surgeon had performed the spinal anesthesia correctly but did not disclose the risk, the claim would be for breach of informed consent. If the surgeon had deviated from the standard technique in administering anesthesia and caused PDPH, that would be professional negligence. ### Application to the Case - **Breach of informed consent** — failure to disclose PDPH risk - **NOT professional negligence** — unless the surgeon deviated from accepted technique in administering spinal anesthesia - **Distinction** — the harm (PDPH) occurred, but the legal claim depends on whether it resulted from negligent performance or inadequate disclosure **Mnemonic:** **PDPH-DC** — Performance (negligence) vs. Disclosure (consent) [cite:Reddy's Forensic Medicine 34e Ch 2; Parikh's Forensic Medicine 4e Ch 2]
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