On 13 May 2025, at Gatehouse Chambers, members of the Medico-Legal Society held a symposium on the Montgomery case and its implications for consent in clinical practice and law. The event was co-chaired by Linda Lee, Solicitor and former President of the Law Society of England and Wales and by Dr James Pattison, Consultant Nephrologist and a Trustee of the Medico-Legal Society. The symposium featured contributions from clinicians, lawyers, academics and commentators. including Dr Katy Peters, Nadine Montgomery, Mr Chris Callaghan, Dr Daghni Rajasingham, Dr Zoe Fritz and Dr Alison Wright.
A report of the session can be found below and you can view the Recordings of the entire event via the following links:
1 – Conversations on consent https://vimeo.com/1085034169?share=copy
Dr Katy Peters – Solicitor and Associate Professor in Medical Law & Ethics at the University of Surrey, specialising in legal developments in consent
2 – A way forward https://vimeo.com/1096303423?share=copy
Nadine Montgomery – Patient advocate and solicitor whose landmark Supreme Court case, Montgomery v Lanarkshire, redefined the legal standard for informed consent in the UK.
3 – A clinician’s view https://vimeo.com/1100269257?share=copy
Mr Chris Callaghan – Consultant Transplant Surgeon at Guy’s and St Thomas’ NHS Foundation Trust, focusing on the practical implications of consent in organ transplantation.
4 – Obstetric practice https://vimeo.com/1100303814?share=copy
Dr Daghni Rajasingham – Consultant Obstetrician and Deputy Chief Medical Officer at Guy’s and St Thomas’ NHS Foundation Trust on the effect of Montgomery on obstetric practice.
5 – A way forward 2 https://vimeo.com/1100350705?share=copy
Dr Zoe Fritz – Consultant Physician, Fellow and Director of Studies in Clinical Medicine at Gonville & Caius College, University of Cambridge, examining future directions for consent.
6 – Panel Discussion https://vimeo.com/1100360143?share=copy
All speakers and also Dr Alison Wright – Consultant Obstetrician and Gynaecologist, President-Elect of the Royal College of Obstetricians and Gynaecologists (from December 2025).
Montgomery Symposium Report by Geoffrey Simpson-Scott
Introduction
The Medico-Legal Society hosted its highly anticipated symposium on 13th May 2025. The aim was to reflect on the landmark ruling of Montgomery v Lanarkshire Health Board and its continuing impact on medical and legal practice. Opening remarks were delivered by Linda Lee and Dr James Patterson, who reiterated the Society’s commitment to upholding professional standards in both medicine and law and outlined the objectives of the symposium, which included revisiting the implications of MontgomeryI v and exploring evolving approaches to consent.
- Prof. Kelly Peters: Legal Perspectives on Consent
Prof. Peters, Associate Professor of Law and Ethics at the University of Surrey and Clinical Nurse Specialist, provided a comprehensive review of the legal foundations of consent. She debated whether consent is primarily a clinical, legal, or ethical issue – or a combination of all three and considered key judgments such as Airedale NHS Trust v Bland (1993) and the Mental Capacit y Act 2005 and traced the principle of self-determination and its legal implications.
Prof. Peters reviewed cases including Chatterton v Gerson (1981) and the Creutzfeldt-Jakob litigation, noting how pre-Montgomery cases were judged under the Bolam standard and explained that Montgomery had shifted the standard for advice away from professional consensus to patient-centric significance, highlighting newer cases such as McCulloch (2023) and Butler v Ward (2025). She emphasised the complex balance between capacity, risk, and patient autonomy, concluding that while Montgomery advances the requirements for informed consent, limitations remain, especially in light of capacity, vulnerability, and system constraints.
- Nadine Montgomery: The Patient’s Experience
Ms Nadine Montgomery delivered a powerful account of her personal experience. Representing the charity Birthrights, she recounted her journey through the legal process, from the original trial to the Supreme Courtand described how her medical history and the communication failures during childbirth led to long-lasting consequences for her and her son, now aged 25.
Her goal remains to reframe informed consent as “supportive decision-making”. She criticised Bolam for institutionalising outdated practices and praised Lady Hale’s acknowledgment of moral bias in clinical decisions. Ms Montgomery called for genuine conversations over reliance on signed forms, noting that these often fail to capture patient understanding.
- Mr Chris Callaghan: The Clinician’s View
Mr Chris Callaghan, Consultant Transplant Surgeon at Guy’s and St Thomas’ Hospitals, offered a practitioner’s perspective. Focusing on treatment options for end-stage kidney disease, he outlined the consent challenges in discussing complex choices, such as dialysis versus transplant.
While Mr Callaghan praised Montgomery for bringing clarity he cautioned against the “tick-box” mentality now prevalent. He questioned whether clinicians and patients can realistically comprehend every material risk, especially when faced with “unknown unknowns.” He proposed that technology, improved questioning, and possibly recorded consultations might improve understanding, though he acknowledged the growing burden of information.
- Ms Daghni Rajasingam: Obstetric Implications
Ms Rajasingam, Consultant Obstetrician, echoed Mr Callaghan’s concerns and examined the practical realities of implementing Montgomery in a busy obstetric practice. She urged a reassessment of assumptions, especially under time constraints and emergency scenarios. Drawing on case examples, Ms Rajasingam questioned whether consent can be fully valid if patients’ cultural, linguistic, and social contexts are not adequately understood.
Her closing reflections posed critical questions on the quality and equity of data informing legal decisions, the risk of bias, and the uneven application of increased health literacy.
- Prof Zoë Fritz: Future Directions
Dr Fritz, Consultant Acute Physician and Associate Professor of Medical Ethics, explored systemic and ethical evolution post-Montgomery. Emphasising autonomy and personalised care, she presented empirical research comparing doctors’ explanations of uncertainty with patients’ expectations.
Her findings suggested patients prefer full disclosure, even when uncertainty exists. She proposed five reforms: enhanced legal education for clinicians, broader public engagement before patients enter healthcare, less reliance on tick-box forms, use of audio recordings for consent, and ongoing evaluation of consent processes.
Dr Fritz questioned whether Montgomery is being truly interpreted as patient-led and noted that ten years on, many clinicians still lack awareness of the case.
Panel Discussion and Closing Remarks
A panel discussion followed, joined by Dr Alison Wright of the GMC’s Council. Speakers revisited the tensions between patient autonomy, clinical responsibility, and systemic constraints. Prof. Fritz reiterated that audio-recorded consent should be a standard, while Mr Callaghan pointed out that the time between consent and treatment affects accuracy.
Ms Rajasingam raised concerns about inequality in how information is shared across ethnic groups. Dr Wright concluded with reflections on supportive consent, emphasising that informed choice, rather than merely shared decisions, should be the goal.
The symposium closed with James Badenoch KC offering a thoughtful legal synthesis. He observed that legal structures balance fairness with clinical practicality and reminded us that a shared commitment to meaningful, informed consent in every patient interaction serves to avoid issues arising.
