Clin Med
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The national clinical guidelines for Rehabilitation following acquired brain injury were developed by a multidisciplinary working party convened by the British Society of Rehabilitation Medicine, and are published in collaboration with the Royal College of Physicians (2003). They have been produced to complement the National Institute of Clinical Excellence head injury guidelines, and to address the medium- to longer-term needs of patients with acquired brain injury and of their families/carers. This article serves as an introduction to make physicians aware of the guidelines, and to highlight in particular the advice to doctors in the acute services regarding early discharge and referral to rehabilitation.
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An essential component of an action in negligence against a doctor is proof that the doctor failed to provide the required standard of care under the circumstances. Traditionally the standard of care in law has been determined according to the Bolam test. This is based on the principle that a doctor does not breach the legal standard of care, and is therefore not negligent, if the practice is supported by a responsible body of similar professionals. ⋯ The effect of Bolitho is that the court will take a more enquiring stance to test the medical evidence offered by both parties in litigation, in order to reach its own conclusions. Recent case law shows how the court has applied the Bolitho approach in determining the standard of care in cases of clinical negligence. An understanding of this approach and of the shift from the traditional Bolam test is relevant to all medical practitioners, particularly in a climate that is increasingly litigious.