ABC v St George's Healthcare Trust and Ors: A new duty of care?

Document Cited in Related
DOI10.3366/elr.2020.0652
Published date01 September 2020
Date01 September 2020
Pages394-399
Author

In modern medicine it is increasingly common for patients to undertake genetic testing for particular disorders. The results of these tests can have life-altering implications for patients and their relatives. A significant ethico-legal dilemma exists here with regards to balancing the potential liability of healthcare professionals (“HCPs”) to disclose such information to those who may be affected, and the duty of confidentiality owed to patients. In other words: to what extent do HCPs owe a duty of care to their patient's family to disclose a hereditary disease? ABC v St George's Healthcare NHS Trust & Ors is an important decision bearing on this issue.1 Although the judgment does not go so far as to answer the above question, it provides a degree of clarification on the scope of that duty and the circumstances in which it would apply. In a compassionately worded judgment Mrs Justice Yip held in the case that three NHS trusts were not negligent in not disclosing to ABC (“the claimant”) that her father (“XX”) had been diagnosed with Huntington's Disease (“HD”). Interestingly, while Yip J held that two of the defendants did not owe a duty of care to the claimant, she found that South West London and St George's Mental Health Trust (“the second defendant”) owed the claimant a duty of care, but that this duty had not been breached. The latter development of the duty of care to a patient's relative, and the lack of breach found therein, are the subject of discussion in this case note.

As Yip J commented in her ruling, the circumstances surrounding this case are “tragic and unusual”.2 In 2007, the claimant's father killed her mother, and was found guilty of manslaughter by diminished responsibility. Pursuant to a hospital order he was placed in the care of the second defendant. Consequently, XX's family were offered family therapy. The reasons for XX's symptoms were also investigated, and from early in his admission it was suspected that he had HD: a neurodegenerative disorder, the clinical features of which include psychiatric and cognitive problems, and abnormalities of movement. This disease is incurable, and markedly reduces life expectancy. There is a 50% chance that the offspring of someone with HD will also inherit the disorder, as it is an autosomal trait.3 In 2009 ABC fell pregnant. By the time that XX's diagnosis was confirmed and made known to XX, her pregnancy was beyond the twenty-four week stage (the limit on abortion, except under exceptional circumstances).4 Throughout the investigations, several discussions took place across XX's clinical teams regarding the effects that his diagnosis may have on ABC, including her decision on whether to continue her pregnancy. XX maintained throughout that he did not want to tell ABC about his diagnosis. In 2010, ABC was informed of her father's diagnosis by his clinician. This was a breach of XX's confidentiality.

ABC tested positive for HD in 2013. ABC brought a claim both in negligence5 and argued that if she had been informed of her father's condition, she would...

Get this document and AI-powered insights with a free trial of vLex and Vincent AI

Get Started for Free

Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant

  • Access comprehensive legal content with no limitations across vLex's unparalleled global legal database

  • Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength

  • Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities

  • Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting

vLex

Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant

  • Access comprehensive legal content with no limitations across vLex's unparalleled global legal database

  • Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength

  • Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities

  • Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting

vLex

Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant

  • Access comprehensive legal content with no limitations across vLex's unparalleled global legal database

  • Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength

  • Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities

  • Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting

vLex

Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant

  • Access comprehensive legal content with no limitations across vLex's unparalleled global legal database

  • Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength

  • Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities

  • Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting

vLex

Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant

  • Access comprehensive legal content with no limitations across vLex's unparalleled global legal database

  • Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength

  • Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities

  • Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting

vLex

Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant

  • Access comprehensive legal content with no limitations across vLex's unparalleled global legal database

  • Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength

  • Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities

  • Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting

vLex

Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant

  • Access comprehensive legal content with no limitations across vLex's unparalleled global legal database

  • Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength

  • Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities

  • Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting

vLex