Home / How Consent Law Changed
An interactive · seventy years in three minutes
The law that decides your consent claims did not arrive fully formed. It climbed, case by case, from a standard set by doctors to a standard set by patients, and now by the regulator. Scroll to watch it rise, and to see what each step added to the burden your records have to carry. Most consent paperwork stopped climbing decades ago.
The rising standard
Each one added something you now have to be able to prove. Watch how much the ground has shifted under a signature.
Step 1 of 2 Scroll down through the seven cases, 1957 to today, and watch the standard climb with each ruling. Step 2 of 2 Hover or tap any glowing point on a card to see exactly what that case added to the burden your records now carry.
The profession sets the bar
Scroll the cases. The standard climbs with you.
The profession sets the bar.
A doctor is not negligent if they act in line with a responsible body of medical opinion. For decades, peer practice was the yardstick, and consent barely featured.
Doctor knows best, confirmed.
The House of Lords held that how much to disclose about risks was still, largely, a matter of responsible medical judgement rather than patient choice.
Opinion has to be logical.
A responsible body of opinion only protects you if it can withstand logical scrutiny. A court can reject peer practice that does not stand up to reason.
Failing to warn has a price.
The House of Lords relaxed the rules on causation where a patient was not warned of a small but material risk that then occurred.
The patient sets the bar.
Consent became what a reasonable patient in this patient's position would want to know, plus anything this particular patient would find significant. The centre of gravity moved from the doctor to the patient.
And the alternatives.
Clinicians must discuss the reasonable alternative treatments, including no treatment, and record which alternatives were considered and why.
Now the regulator, too.
A traffic-light licensing scheme for non-surgical cosmetic procedures moves from proposal to draft regulations, with the highest-risk tier consulted on first.
Where that leaves you
The standard your records are judged against today is not the one most consent forms were built for. Between Bolam and McCulloch, the law went from trusting the profession to demanding evidence of a tailored conversation and the alternatives you weighed. The clinical work did not get harder. The proof did.
The only question that matters now is a simple one: where do your records sit on this timeline?
The Readiness Score checks your consent, records and consultation against the standard as it stands today, not as it stood in 1957. No email required, and only you see the result.
The cases, in plain English
Bolam (1957) established that a doctor is not negligent if they acted in line with a practice accepted as proper by a responsible body of medical opinion. It still governs the standard of treatment, but consent is now judged by the separate, patient-centred Montgomery test. More on Montgomery →
Bolitho (1997) added that a body of medical opinion only protects you if it can withstand logical analysis. A court can reject peer practice that is not logically defensible, so pointing to what others do is no longer a complete answer on its own.
Montgomery (2015) moved consent from a doctor-centred to a patient-centred test. You must disclose the material risks a reasonable patient would want to know, plus anything this patient would find significant. Consent became a documented dialogue, not a signature.
McCulloch (2023) confirmed you must also discuss and record the reasonable alternatives, including no treatment. It adds a second documentation burden on top of the material-risk disclosure Montgomery requires.
No. The signature has never been the legal requirement. The requirement is the consent process: capacity, disclosure of material risks and reasonable alternatives, a voluntary decision and time to reflect. The signature is only evidence that some of that happened. What protects you is a record of the process, not the signature alone.