Tuesday, August 27, 2013

Duty of Candour

Duty of Candour
There is a campaign led by Will Powell following the death of his son to introduce a Duty of Candour for healthcare professionals. This implies that there is no existing duty of candour for doctors and nurses and others working in the health service. This is emphatically not the case. There is already a duty of candour on healthcare professionals. They have a professional duty of candour, which will be enforced by the relevant regulatory body (General Medical Council or Nursing and Midwifery Council for example). There is also a contractual duty of candour, where the NHS insists on its employees and contractors are candid. Last and not least there is arguably a legal duty of candour to patients, as per obiter by Lord Donaldson MR in Lee v South West Thames Regional Health Authority [1985] 1 W.L.R. 845, where he considered there may be a common law duty of candour (Chester v Afshar strengthens the argument for this).
What Will Powell is campaigning for is a statutory duty of candour, which would also have only one remedy - money. In the case of his son's death, he wished to sue for compensation in relation to the alleged cover-up. He took this issue to the European Court of Human Rights, where he failed in his plea. He was not able to recover damages, as the doctors owed no duty of candour to the parents of their patient after his death, as they owed no duty of care to them. The statutory duty of candour would also provide an unequivocal legal duty of candour to patients, although I believe there is already a common law duty.
So a statutory duty of candour will achieve nothing more or less than the right to get more compensation - because that is the only remedy available. This is not to imply that Will Powell is motivated by money - clearly there is a lacuna in the law here. This is also not to say that I do not believe in the moral and ethical duty of candour - I do. Indeed a legal duty of candour would be desirable in a different context. I just don't see that within the common law adversarial system that it would be beneficial.
If the medical negligence were orientated more on therapeutic jurisprudence lines, with a wider range of remedies, then candour makes perfect sense. Many litigants don't want compensation (and Will Powell turned down compensation) but rather honesty, an apology, lessons to be learned and things to be changed for the better.

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