Chester v afshar 2004. Chester v Afshar 2023-01-02
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The case of Chester v Afshar, also known as Chester v Afshar [2004] UKHL 41, was a legal case decided by the House of Lords, the highest court in the United Kingdom, in 2004. The case concerned the liability of a doctor for the consequences of a patient's decision to decline a recommended medical treatment.
The case involved Mr. John Chester, who suffered from chronic back pain. His doctor, Dr. Afshar, recommended that he undergo a lumbar laminectomy, a surgical procedure to relieve pressure on the spinal cord. Mr. Chester declined the surgery, opting instead for alternative treatments such as physiotherapy and acupuncture. Mr. Chester's condition worsened, and he eventually became paralyzed from the waist down. He sued Dr. Afshar for negligence, alleging that the doctor had not adequately warned him of the potential risks of declining the surgery.
The House of Lords held that Dr. Afshar was not liable for Mr. Chester's injuries. The court found that Mr. Chester had made an informed decision to decline the surgery, and that the doctor had fulfilled his duty of care by providing adequate information about the risks and benefits of the surgery. The court held that the doctor could not be held responsible for the consequences of Mr. Chester's decision to decline the recommended treatment.
The case of Chester v Afshar has had significant implications for the legal responsibilities of doctors and the rights of patients to make decisions about their own medical treatment. The decision of the House of Lords established that doctors have a duty to provide patients with information about the risks and benefits of medical treatments, but that they are not liable for the consequences of a patient's decision to decline recommended treatment. This ruling has helped to clarify the legal duties of doctors and the rights of patients in the United Kingdom and has been widely cited in other legal cases involving medical negligence.
Chester v Afshar (1).rtf
The case note by the co-author of the seminal treatise on causation is particularly interesting. The claimant sought damages for the reduction in his prospects of disease-free survival for. Therefore, he was responsible for her injuries. THE CHESTER EXCEPTION Chester v Afshar concerned a claim brought in negligence by Ms Chester against her surgeon, Mr Afshar. Therefore, by focusing upon what a rational person would have done and then concluding Ms Diamond would not have wanted to behave irrationally, the court prioritises ideal desire autonomy masked as best desire autonomy. A claimant is entitled to be compensated for the damage which the negligence of another has caused to him or her. To rely on the exception, however, the claimant must do so explicitly, setting out the reasons why they would have delayed treatment.
It will not serve any useful purpose to cite at length from the judgments. Mrs Hart was ready to accept any general risks of the operation of which she was warned. This links to one of the compensatory aims of tort which is to put claimants in the position they would have been in but for the negligence. Held: The claimant would have declined the operation if he had been properly advised of the risk of impotence and bladder malfunction,. The claimant argued that if she had been warned she would not have taken the decision to have the operation straight away but would have taken time to consider other options and discuss the risks with her family and would thus not have had the surgery on the day which she did have it.
Correia, Diamond and the Chester Exception: Vindicating Patient Autonomy?
In the wake of this judgment, the General Medical Council issued revised guidance. He submitted that there was no causation as the possibility of the claimant to have consented to the surgery at some point did not change the fact that it bore the risks. At the very least, however, this Australian case reveals two fundamentally different approaches, the one favouring firm adherence to traditionalist causation techniques and the other a greater emphasis on policy and corrective justice. It allows us to lead our lives rather than be led along them, so that each of us can be, to the extent a scheme of rights can make this possible, what we have made of ourselves. I do not for my part think that the law should seek to reinforce that right by providing for the payment of potentially very large damages by a defendant whose violation of that right is not shown to have worsened the physical condition of the claimant. 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. Cited — The patient claimed damages.
The operation involved three stages with the purpose of the third stage being relocation of the nerve with a view to preventing the neuroma recurring. Cited — The doctor had failed to warn the patient of the risks inherent in the planned operation. As long as some harm foreseeable, no need for all of the consequences to be foreseen, consequences could be far more serious than those foreseen. This is well illustrated in the case of Diamond. The injury was intimately involved with the duty to warn. The claim for psychiatric injury had been rightly dismissed.
Cited — Professional to use Skilled Persons Ordinary Care Negligence was alleged against a doctor. As a consequence of the surgeries and their after-effects, Ms Diamond suffered with depression and anxiety. 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? I think it is the latter and for the following reason. Recognizing an individual right of autonomy makes self-creation possible. However, there is a vast body of ethical literature which builds on this simple starting point and engages with the notion of what it means to be acting autonomously.
After an involved legal process, the award of compensation to the patient was finally ordered in the House of Lords. This reflects a subjective approach to causation. The claimant had established causation. He therefore found for the claimant. Background Ms Diamond had an extensive history of chronic back pain and underwent spinal fusion surgery. .
For my part I found the dissenting judgment of McHugh J particularly powerful, and rightly counsel for the surgeon relied heavily on it. It is, however, inconsistent with the application of current desire autonomy which does not demand reflection upon the reasons for a decision, or require the exclusion of particular information from decision-making. She went further, drawing upon her attitude towards her ability to conceive and carry a child to justify her decision best desire autonomy. 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. A doctor, the defendant, advised her to do a surgery. Her consultant, Mr Afshar, failed to warn of the risks of the surgery. Unfortunately, the surgeon performing the operation, Mr Rayatt, negligently omitted the third stage and post-operatively, Ms Correia developed chronic regional pain syndrome in her right foot.
He noted that the Chester exception was intended to be narrow and applied: If there has been a negligent failure to warn of a particular risk from an operation and the injury is intimately connected to the duty to warn, then the injury is to be regarded as being caused by the breach of the duty to warn and this is to be regarded as a modest departure from established principle of causation. It was also established that she would have had the operation at some point in time, regardless of whether she was warned of the risk. If the patient had the operation on a subsequent occasion, the outcome would probably have been uneventful. . From this perspective, her decision to proceed with a suture repair is not irrational, simply a different weighting of values. Cited — The patient claimed damages after suffering injury in an operation, saying the doctor had failed to warn of the risk. Lord Steyn majority : The right of a patient to consent to an operation and to be informed of the risks is very important and must therefore be given legal force.
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