A general practitioner's duty of care to a morbidly obese patient extends to advising that weight loss is necessary, discussing means of achieving it, and offering appropriate referrals, but does not require re-referral where the patient has already declined a referral — the duty stops short of requiring an exercise in futility. Where a duty of care can be discharged by either of two alternative courses of action, factual causation must be assessed by asking whether the failure to take either course was a necessary condition of the harm, not whether the failure to take one particular course was a necessary condition. Expert evidence as to breach must address the standard of practice at the relevant time, not current practice.
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