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Breen v Williams (1996) 186 CLR 71

Equity – Trust and Confidence – Fiduciary Relationship – Fiduciary Duty

Each time you visit a doctor, are you always in a vulnerable position? And do you place trust and confidence in that very doctor? If yes, have you wondered why most of the time you walk out of the doctor’s office feeling dissatisfied because the doctor advises you to drink plenty of water and to take off-the-counter medication?

This is because a fiduciary relationship between a doctor-patient cannot be made out, hence a doctor does not owe patients a fiduciary duty – which the following case below exactly summarises.

Facts; Ms Breen underwent a bilateral breast augmentation in 1977, where silicones were implanted into Ms Breen’s breasts. Shortly after Ms Breen’s augmentation, complications develop and consulted a plastic surgeon, Dr Williams who performed surgery on Ms Breen, but did not remove the silicone implants.

Ms Breen suffered further complications, and in 1993 she wished to participate in a US class action against the manufacturer of silicone implants, Dow Corning. In order to participate in the class action, Ms Breen had to supply her medical records, for which she sought access to her records, kept by Dr Williams. Ms Breen could have opted to use the discovery process in Civil Litigation, but asserted for an independent right of access to her medical records, to the extent that her records were created for her benefit.

Dr Williams denied Ms Breen had such a right – (please note that this was the law in the past, today medical records can be accessed and… we have legislation regulating a right of access).

In the meantime, Dr Williams offered to allow Ms Breen access to her medical records, on the condition that she releases him from any claims that may arise, in relation to the procedure she underwent by Dr Williams. Obviously, Ms Breen declined such offer and argued that Dr Williams owed her a fiduciary duty and a doctor-patient relationship is fiduciary.

Holding; The High Court held that Dr Williams did not owe Ms Breen a fiduciary duty, which also includes Ms Breen a right of access to her medical records. Brennan CJ asserted that a doctor-patient is not generally an agency-principal relationship, that would give rise to a fiduciary relationship, nor is it on the facts in this case that the relationship is of, verbatim “ascendancy or influence by one party over the other, or dependence or trust on part of another”. Therefore, there is no fiduciary relationship, because the engagement of Dr Williams was to advise and treat Ms Breen.

But, if Ms Breen were to seek for skilled, confidential advice and treatment, then that gives rise to a fiduciary relationship, nonetheless a doctor-patient relationship is not fiduciary for other purposes.

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