Week 20: Liability for Psychiartric Harm

Question 1

Why might a cautious approach be employed when considering psychiatric or emotional injury claims?

Answer 1

A cautious approach might be employed because aside from physical injury, a person may suffer nervous system or mental health harm, which can be subjective and harder to prove or quantify.

Question 2

Who does the duty of care extend to in psychiatric injury cases?

Answer 2

The duty of care in psychiatric injury cases extends to those who it is reasonably foreseeable might suffer mental harm due to another’s negligence.

Question 3

What kind of ‘shock’ is actionable in psychiatric injury claims?

Answer 3

Only a shock that is sudden, extreme, and results in a recognized psychiatric illness is generally actionable.

Question 4

What did the court decide in Bourhill v Young [1943] AC 92 regarding psychiatric injury?

Answer 4

In Bourhill v Young, the court decided the claimant could not recover damages for psychiatric injury as she was not in the area of foreseeable harm, and the shock was not immediate or direct.

Question 5

What did the case Walker v Northumberland CC [1995] establish about employer duty and psychiatric injury?

Answer 5

Walker v Northumberland CC established that employers owe a duty of care to protect employees from foreseeable psychiatric harm, especially after a prior mental breakdown signals clear risk.

Question 6

What is the difference between primary and secondary victims in ‘nervous shock’ cases?

Answer 6

The difference between primary and secondary victims is that primary victims are directly involved and at risk of physical harm, while secondary victims suffer psychiatric injury from witnessing harm to others without being personally at risk.

Question 7

Who qualifies as a primary victim in nervous shock claims?

Answer 7

A primary victim is someone owed a duty of care, who was within the zone of physical danger and may have been physically harmed or feared for their own safety.

Question 8

What must be shown to claim as a primary victim in a nervous shock case?

Answer 8

To claim as a primary victim, it must be shown that the claimant participated in the traumatic event and was owed a duty of care that included guarding against personal injury.

Question 9

What did the case Dooley v Cammell Laird & Co Ltd [1951] establish about primary victims?

Answer 9

Dooley v Cammell Laird established that a person can be a primary victim even if no one was actually harmed, as long as they reasonably believed others were in danger and suffered psychiatric injury as a result.

Question 10

Who qualifies as a secondary victim in nervous shock cases?

Answer 10

A secondary victim is someone who suffers psychiatric injury from witnessing harm to another person, without being in physical danger themselves.

Question 11

Are damages recoverable for secondary victims in nervous shock claims?

Answer 11

Yes, damages may be recoverable for secondary victims, but strict requirements and limitations apply to establish liability.

Question 12

How is ‘shock’ defined in the context of psychiatric injury according to Simpson v ICI [1983]?

Answer 12

In Simpson v ICI, shock is not just fear or emotional upset; it must lead to a visible disability or a provable psychiatric illness to be legally recognized.

Question 13

What does Simpson v ICI [1983] tell us about emotional reactions and psychiatric claims?

Answer 13

Simpson v ICI tells us that a mere emotional reaction is not enough—there must be a recognised psychiatric condition to claim damages for shock.

Question 14

According to Page v Smith [1996], what kind of impact must cause the shock for it to be actionable?

Answer 14

Page v Smith states that shock must result from an immediate and horrifying impact that causes a recognisable psychiatric illness, beyond normal emotional distress.

Question 15

What principle did Page v Smith [1996] establish about foreseeability and psychiatric harm?

Answer 15

Page v Smith established that if personal injury (physical or psychiatric) is foreseeable, a claimant can recover for psychiatric illness even if the actual injury suffered wasn’t foreseeable.

Question 16

What did the court decide in Dulieu v R White & Sons [1901] about a pregnant woman suffering shock?

Answer 16

In Dulieu v R White & Sons, the court allowed damages for psychiatric injury when a pregnant woman suffered shock after a horse van crashed into her workplace, causing premature birth—she was a primary victim in the danger zone.

Question 17

How did Page v Smith [1996] affect the definition of personal injury for primary victims?

Answer 17

Page v Smith confirmed that personal injury includes psychiatric harm, and a claimant can recover even if only psychiatric injury occurs, as long as some form of personal injury was foreseeable.

Question 18

What kind of injury did the claimant suffer in Page v Smith, and why was recovery allowed?

Answer 18

In Page v Smith, the claimant’s ME (chronic fatigue syndrome) was reactivated by a car crash; recovery was allowed because psychiatric harm counts as personal injury if some injury was foreseeable.

Question 19

What did Hambrook v Stokes [1925] establish about shock from fear for a loved one?

Answer 19

Hambrook v Stokes established that a mother could recover damages for psychiatric shock caused by fear for her children’s safety, but only for what she witnessed directly, not what she was later told.

Question 20

Can secondary victims recover for shock based on what they are told by others?

Answer 20

No, Hambrook v Stokes clarified that secondary victims generally cannot recover for shock based on second-hand accounts—they must witness the event or its immediate aftermath themselves.

Question 21

What did the House of Lords decide in Alcock v Chief Constable of South Yorkshire [1992] about secondary victims and psychiatric injury?

Answer 21

In Alcock, the House of Lords held that secondary victims can only recover for psychiatric injury if they meet strict criteria: a close tie of love and affection, direct perception of the event or its aftermath, and psychiatric shock from a sudden, horrifying event.

Question 22

What key test was established in Alcock v Chief Constable of South Yorkshire [1992] for secondary victim claims?

Answer 22

The Alcock test requires (1) a close tie of love and affection with the victim, (2) presence at the event or its immediate aftermath, and (3) direct perception—shock must come from sudden sensory experience of a horrifying event.

Question 23

How is “shock” defined in Alcock in the context of psychiatric claims?

Answer 23

In Alcock, “shock” is defined as the sudden appreciation by sight or sound of a horrifying event, not a psychiatric illness caused by gradual or accumulated stress.

Question 24

Why did the claim in Robertson v Forth Road Bridge Joint Board [1995] fail under the Alcock criteria?

Answer 24

The claim in Robertson failed because although the loss was tragic, a strong friendship or work relationship does not satisfy the required close tie of love and affection.

Question 25

Why was the claim unsuccessful in Young v McVean [2015] even though the claimant saw the crash scene?

Answer 25

In Young v McVean, the claim failed because although the claimant saw the aftermath, they did not know at the time that their son was involved, so there was no sudden shock from direct perception.

Question 26

What happens when psychiatric harm is caused intentionally?

Answer 26

When psychiatric harm is caused intentionally, the wrongdoer will generally be liable and damages are available for the resulting distress or bodily harm.

Question 27

What did Wilkinson v Downton [1897] establish about intentional infliction of harm?

Answer 27

In Wilkinson v Downton, the court held the defendant liable for psychiatric harm after he falsely told the claimant her husband was seriously injured, causing her shock and physical illness—intent to cause harm was key.

Question 28

Do medical professionals owe a duty of care for psychiatric harm to non-patients?

Answer 28

Generally, doctors owe no duty to non-patients, but an exception is made for psychiatric harm when the non-patient suffers due to witnessing negligent treatment of someone close to them.

Question 29

Who is the secondary victim in a medical negligence case involving psychiatric harm?

Answer 29

In medical negligence, a secondary victim is a close relative or loved one of the patient who suffers psychiatric illness due to witnessing the negligent care of the patient.

Question 30

What must a secondary victim prove in medical negligence cases involving psychiatric harm?

Answer 30

The secondary victim must show a recognised psychiatric illness and satisfy the Alcock criteria: close tie of love, direct perception, and proximity in time.

Question 31

Did the grandmother in Re (a minor) v Calderdale NHS Trust [2017] satisfy the Alcock criteria?

Answer 31

In Re (a minor), the grandmother witnessed the traumatic delivery and was present at the birth, likely satisfying the Alcock requirement of direct perception and presence.

Question 32

Why did the claim fail in Liverpool Women’s Hospital v Ronayne [2015]?

Answer 32

In Ronayne, the claim failed because the events unfolded gradually over 36 hours, not as a sudden shocking event—so it did not meet the Alcock test for psychiatric injury.

Question 33

What were the facts behind the Paul v Royal Wolverhampton NHS Trust appeal?

Answer 33

The appeal joined three cases: (1) children witnessing their father's sudden cardiac arrest, (2) parents seeing their child die from undiagnosed lung disease, and (3) a parent discovering their deceased child after undiagnosed pneumonia—all alleging earlier medical negligence.

Question 34

What legal criteria must still be satisfied in Paul v Royal Wolverhampton NHS Trust [2024]?

Answer 34

Claimants must still satisfy the Alcock criteria: close tie of love, direct perception, and sudden shocking event—as well as establish sufficient proximity between the negligence and the psychiatric harm.

Question 35

What might be the consequences if the appeal in Paul is allowed?

Answer 35

If the appeal is allowed, it could broaden the scope of liability in clinical negligence by allowing claims where death occurs later, creating more responsibility for healthcare providers toward secondary victims.

Question 36

What principle was established in Taylor v A Novo (UK) Ltd [2013] about psychiatric injury and timing?

Answer 36

Taylor v A Novo held that for a secondary victim to claim psychiatric injury, the shocking event (like death) must be closely connected in time to the original negligent act—not just to the death itself.

Question 37

Can psychiatric harm be actionable even if the claimant did not witness injury to another person but instead saw property damage?

Answer 37

Yes—Attia v British Gas [1988] shows that psychiatric harm can be actionable where the claimant witnesses serious property damage, if the harm was reasonably foreseeable.

Question 38

What did the court decide in Attia v British Gas plc [1988] about nervous shock from seeing one’s home destroyed?

Answer 38

In Attia, the Court of Appeal held that Attia could recover for psychiatric harm caused by witnessing the destruction of her home, provided the harm was reasonably foreseeable.

Question 39

What is the legal distinction between primary and secondary victims in psychiatric injury cases?

Answer 39

Primary victims are directly involved and may fear for their own safety; secondary victims witness harm to others and must meet strict criteria to claim.

Question 40

How do we define "shock" in the context of psychiatric harm?

Answer 40

Shock must involve a sudden, horrifying event causing a recognised psychiatric illness—not just distress—per Simpson and Page v Smith.

Question 41

Under what conditions can a secondary victim successfully claim for psychiatric harm?

Answer 41

A secondary victim must show (1) a close tie of love and affection, (2) proximity in time and space to the event, and (3) direct perception, as outlined in Alcock.

Question 42

How does the Alcock criteria apply differently in medical negligence cases?

Answer 42

In healthcare, the Alcock criteria may still apply to non-patients who suffer psychiatric harm, but success depends on proving proximity and a sudden shocking event—Paul v Royal Wolverhampton illustrates the limits.