Watching a loved one die,
and what the law allows.

Paul and another v Royal Wolverhampton NHS Trust, Polmear and another v Royal Cornwall Hospitals NHS Trust and Purchase v Ahmed [2024] UKSC 1 were three cases heard together. In each, a family sought damages for psychiatric injury after watching a relative die from a condition that had negligently not been diagnosed: undiagnosed heart disease, pulmonary veno-occlusive disease and pneumonia.

The Supreme Court, with Lord Burrows dissenting, held that the claims did not satisfy the legal requirements for damages by secondary victims who suffer injury as a result of another person's death. All three appeals were dismissed. Doctors do not owe relatives a duty to protect them from the shock of witnessing a patient's death or medical crisis.

The Paul decision concerns people claiming because of what happened to someone else. Where the claimant is themselves the patient, the position is quite different.

Zeromska-Smith v United Lincolnshire Hospitals NHS Trust [2019] EWHC 980 (QB) is the clearest illustration. The claimant's daughter died in the womb before induction and she had to labour for 18 hours to deliver her stillborn daughter. The trust admitted negligence. She developed pathological grief disorder and major depressive episodes with suicidal ideation. Martin Spencer J awarded £271,901 in total, comprising £35,000 general damages for psychiatric injury, £6,000 for loss of the satisfaction of bringing the pregnancy to a successful conclusion, interest, past losses of £96,619 and future losses of £132,613.

She had claimed about £2.17 million and the trust valued the claim at about £158,000, which shows how widely parties can differ on psychiatric injury and its consequences.