Court of Appeal Personal Injury Decision 2025: Clarke v Poole Set to Test Bodily Integrity in Litigation

Clinical care settings like this underscore the high-stakes nature of future care claims in catastrophic injury cases.

What Clarke v Poole Means for Autonomy, Medical Testing, and Expert Evidence

On 11 April 2025, the Court of Appeal granted permission to appeal on all grounds in the high-profile case of Clarke v Poole & Ors [2025] EWCA Civ 447. This move reopens the legal debate around a claimant’s right to refuse medical testing, even when the outcome may materially affect the damages awarded in a personal injury claim.

This Court of Appeal personal injury decision in 2025 has significant implications for expert witnesses, particularly those involved in neurology, psychiatry, and life expectancy assessment. At issue is whether the court can or should order a stay of proceedings when a claimant declines testing central to the defendant's case on quantum.

Background to the Case

Samantha Clarke, aged 31 at the time of a serious 2018 road traffic accident, suffered a catastrophic brain injury that now necessitates full-time care. Liability was admitted in 2020. Her provisional claim exceeds £22 million—mostly related to future care costs.

The aftermath of road traffic collisions often leaves behind both visible wreckage and lifelong, invisible injuries—central to claims like Clarke v Poole.

The defendants allege Clarke may suffer from myotonic dystrophy type 1 (DM1), a progressive, inherited condition affecting life expectancy. Her mother and maternal grandfather carry the gene, and there is a 50% chance Clarke does too. If confirmed, her claim could be reduced by around £10 million.

To clarify whether DM1 is active, the defendants requested electromyographic (EMG) testing, which involves inserting multiple fine needles into muscles. Clarke refused, citing a profound psychological aversion and a long-standing desire not to know her genetic status. Expert psychological opinion supported the claim that forcing the issue could damage her mental health.

Chronology of Key Events

• 2018: Ms Clarke is injured and later exhibits signs (e.g., ptosis) that may indicate DM1.

• 2020: Consent judgment on liability.

• 2022–23: Defendants request EMG testing to assess for DM1. Ms Clarke refuses, citing the emotional and psychological impact of a potential diagnosis.

• April 2024: The High Court stays the damages claim unless she consents to testing.

• July 2024: First permission to appeal refused by Nicola Davies LJ.

• Sept 2024: Claimant invokes CPR 52.30 to reopen the refusal decision.

• Feb 2025: The Court of Appeal agrees: permission to appeal granted on all grounds.

Judicial decisions in complex personal injury cases like Clarke v Poole hinge on the balance between legal fairness and personal autonomy.

The Legal Journey

In June 2024, the High Court ordered a stay on her claim for future loss unless Clarke agreed to testing. That decision was appealed, but initial permission to appeal was denied by Nicola Davies LJ in August 2024.

In February 2025, the Claimant’s team sought to reopen that decision under CPR 52.30—an exceptional route permitted only where real injustice might occur. On 11 April 2025, Lord Justice Underhill and Lady Justice Whipple ruled that permission to appeal should be granted on all five grounds, including:

1. Whether Laycock v Lagoe requires a two-stage test or whether courts must apply a third-stage balancing of autonomy vs fairness;

2. Whether the testing request interferes with bodily integrity and personal autonomy;

3. The failure to properly consider the psychological harm associated with even deciding to test.

Lady Justice Whipple described personal autonomy as “the issue which stands at the centre of this appeal.”

Legal and Ethical Themes Raised

This appeal raises foundational questions for the medico-legal and expert witness fields:

• Can the court compel EMG testing where the claimant raises real psychological objections?

• Does the claimant’s refusal limit the defendant’s ability to obtain a fair trial on quantum?

• How should courts weigh physical evidence against the right to not know a diagnosis that could harm mental health?

• Is Laycock’s “two-stage test” still good law, or has it evolved into a three-stage proportionality exercise as argued by the High Court?

Clarke v Poole sits at the intersection of legal principle, ethical autonomy, and the role of expert medical opinion—challenging courts to balance all three.

These issues lie at the crossroads of ethics, law, and expert evidence.

What This Means for Medico-Legal Experts

At Apex Experts, this case underscores the vital role of medical expert evidence in shaping not only the substance of claims but also their procedural dynamics. The decision reinforces the need for:

• Balanced, independent opinion from neurologists and neuropsychologists on both symptoms and psychological resilience;

• Psychiatric evaluations that address capacity, mental health risk, and choice in the context of complex injuries;

• Enhanced collaboration across disciplines where testing intersects with autonomy and prognosis.

Importantly, this case signals to all experts that their assessments may directly influence judicial decisions about autonomy and bodily intervention.

Conclusion: What the Court of Appeal Personal Injury Decision Means for Claims in 2025

The Court of Appeal’s decision to hear Clarke v Poole reopens a pivotal discussion at the heart of personal injury litigation in 2025: how far the courts can go in compelling medical testing when it conflicts with a claimant’s psychological wellbeing and autonomy. This appeal is set to clarify the limits of judicial intervention in cases involving disputed diagnoses—particularly where future losses hinge on expert evidence and genetic uncertainty. The outcome is poised to shape how similar claims are approached in the future, especially those involving progressive conditions, psychiatric vulnerability, or ethical refusals of medical procedures.