The facts in brief
A mother carrying twins had only one foetal heartbeat monitored. One twin was stillborn; the other was born brain-damaged.
The facts above are stated at the level the LawShortcut Tort notes verify. Read the judgment itself before relying on any further detail.
What the court decided
Finlay CJ set out the principles that govern the standard of care, and it is those principles — not a paraphrase of them — that an examiner wants to see. In substance:
- The core test. A practitioner is negligent only if guilty of such failure as no practitioner of equal specialist or general status and skill would be guilty of if acting with ordinary care.
- Deviation is not itself negligence. Departing from a general and approved practice founds liability only if the plaintiff proves the course actually taken was one no practitioner of like skill, acting with ordinary care, would have taken.
- Compliance is normally a defence — unless the practice has inherent defects which ought to be obvious to any practitioner giving the matter due consideration.
- “General and approved” does not mean universal. It must be a practice approved of and adhered to by a substantial number of reputable practitioners holding the relevant qualifications.
- It is not confined to treatment. The test covers diagnosis as well as treatment, and reaches the practices of hospital administrators.
The ratio
The standard of care in Irish professional negligence is set by reference to the ordinary competent practitioner of like specialisation and skill, not the best in the field and not with hindsight. Conformity with a general and approved practice answers the claim, subject to the inherent-defect exception, which is the point at which an Irish court reserves the last word to itself rather than to the profession.
Why the test is pitched where it is
Finlay CJ was explicit about the balance. Doctors should not have to practise under the constant threat of unsustainable claims; equally, the law must not settle for a lax or permissive standard of care. The inherent-defect exception is where that second concern lives. Read the two halves together and the shape of the test makes sense: deference to the profession, with a reserved judicial power to say that an approved practice was obviously bad.
How far Dunne reaches
The test is not confined to consultants. In Kiernan (a minor) v HSE it was applied to a public-health nurse, on the basis that Dunne governs any professional with the requisite standing. Morrissey v HSE confirms that the principles travel across professions, so the same architecture answers a question about an accountant or a solicitor.
The test also cuts both ways for plaintiffs. In McGowan v O’Rourke [2012] IEHC 266 IE · High Court the absence of any deviation from general and approved practice was fatal to the claim.
Where it sits with consent and the duty to warn
A separate line of authority asks not whether the treatment was competent but whether the patient was told enough to consent to it. In Walsh v Family Planning Services Ltd [1992] IESC 3 IE · Supreme Court Finlay CJ held that the obligation varies with how elective the surgery is: for a clearly elective procedure the duty is more stringent, and known complications must be disclosed however unlikely. Geoghegan v Harris IE · High Court went further, Kearns J favouring a reasonable-patient test.
Irish law therefore leans towards a patient-focused disclosure standard while still formally sitting inside the Dunne framework, and that unresolved tension is one of the better essay points in the topic.
Need the whole professional-negligence topic?
Module 6 covers medical and legal professional negligence in full — every case in a comparison table, the order of attack, worked examples and a model-answer skeleton.
browse all free Tort notes →Common questions
What did Dunne v National Maternity Hospital decide?
The Supreme Court set out the principles governing the standard of care in medical negligence. A practitioner is negligent only where guilty of such failure as no practitioner of equal specialist or general status and skill would be guilty of if acting with ordinary care, and conformity with a general and approved practice is normally a defence unless that practice has an inherent defect which ought to be obvious.
What are the Dunne principles?
They are the limbs set out by Finlay CJ: the core test of the ordinary competent practitioner of like standing; that deviation from general and approved practice is not itself negligence; that compliance is normally a defence subject to the inherent-defect exception; that an approved practice must be adhered to by a substantial number of reputable practitioners rather than universally; and that the test covers diagnosis as well as treatment, and hospital administrators as well as clinicians.
Is Dunne the same as Bolam?
No. Bolam is an English decision and is persuasive only in Ireland. Dunne is narrower: an Irish court may hold that a general and approved practice was negligent where it carries an inherent defect that ought to have been obvious, so following a responsible body of professional opinion is not automatically a complete answer.
Does Dunne apply outside medicine?
Yes. It has been applied to a public-health nurse in Kiernan (a minor) v HSE, and Morrissey v HSE confirms that the principles travel across professions, so the same framework is used for other professional defendants.
Is Dunne still good law?
It remains the seminal Irish authority on the standard of care in professional negligence and is applied as such. Always check the current position before relying on any case.
Want the one-page answer plan?
Leave an address and the one-page answer plan arrives by email. After that, only word of new material and a reminder as each sitting approaches.