No (,) More Bolam Please: Montgomery v Lanarkshire Health Board

Montgomery v Lanarkshire Health Board concerned a negligent non‐disclose of certain risks involved in natural birth. The Supreme Court departed from Sidaway v Bethlem Royal Hospital, which formerly governed negligent risk disclosure. A new test was adopted: risks that are material must be disclosed, the materiality of a risk to be decided by reference to a reasonable person in the patient's position, or where the medical professional should be reasonably aware a particular patient is likely to attach significance to that risk. The Court emphasised risk disclosure practices must focus on what the patient wants to know. Yet the Court's portrayal of this change as a development of Sidaway is questionable. The decision is problematic in its engagement with precedent, the new test's future implications and statements regarding therapeutic privilege. Despite rejecting Bolam v Friern Hospital Management Committee's relevance to risk disclosure, this case is likely to remain relevant.     

“Democracy as Civilisation”

Since the fall of the Berlin Wall, democracy has come to embody the very idea of legitimate statehood in international politics. It has done so largely through defining a new standard of civilisation, in which “democraticness” determines the limits of international society and helps to construct relations with non-democracies “beyond the pale”. Like the “classical” standard, this new version again reflects a considerable interest in the socio-political organisation of states. Central in this shift back to a more “anti-pluralist” international society has been the democratic peace thesis, which emphasises how the internal (democratic) characteristics of states influence their external behaviour. Against more optimistic interpretations, it is argued that the democratic peace is a distinctly Janus-faced creature: promoting peace between democracies, while potentially encouraging war against non-democratic others. Within the democratic peace, non-democracies become not just behaviourally threatening but also ontologically threatening. Non-democracies are a danger because of what they are (or are not). In sum, the argument presented is that democracy, positioned as the most legitimate form of domestic governance in international society, has become caught up and used in global structures of domination, hierarchy and violence. Thus, the role of “democracy” in international politics is much more complicated, and, at least in its current guise, less progressive than often portrayed.