Will clinical guidelines replace judges?

Medicine is increasingly a science and decreasingly an art. It is increasingly evidence-based. It now has right answers and wrong answers in a way inconceivable even a decade ago. The growth of evidence-based medicine is partly a consequence of genuine demonstration of optimal practice, and partly a consequence of increased dissemination of information. The natural consequence of the growth of evidence-based medicine is that clinical judgment is increasingly circumscribed by clinical guidelines. Clinical guidelines generally aspire to embody the local, national or international consensus emerging from the literature--but that consensus may be modified in the guideline to take account of local clinical, logistical and economic considerations. This paper looks at the effect that the guidelines revolution has had and will have on the way that clinical negligence litigation is conducted in England.