## Facts

- The claimant, with a history of chronic fatigue syndrome, was involved in a road traffic accident caused by the defendant’s negligence.
- Although the claimant suffered no physical injury, the accident exacerbated his pre-existing psychiatric condition.
- The issue arose whether the defendant could be liable for the psychiatric harm suffered by the claimant, given that only physical harm—not psychiatric harm—was foreseeable in the circumstances.
- The claimant was a “primary victim,” being directly involved in the incident and within the zone of potential physical danger.

## Issues

1. Whether a defendant can be liable for psychiatric injury suffered by a primary victim where only physical harm is foreseeable.
2. Whether the “thin skull” rule applies to psychiatric injury, making a defendant liable for the exacerbation of pre-existing psychiatric conditions.
3. How the legal distinction between primary and secondary victims affects recovery for psychiatric injury in negligence claims.

## Decision

- The House of Lords held that as long as physical harm was foreseeable, the defendant could be liable for psychiatric injury to a primary victim, even where psychiatric harm was not itself foreseeable.
- The court confirmed that the “thin skull” rule applies equally to psychiatric injury: defendants must take their victims as they find them, including pre-existing vulnerabilities.
- The distinction was maintained between primary and secondary victims, with primary victims facing a lower threshold—only foreseeability of physical harm was required.
- The defendant was found liable for the claimant’s psychiatric injury which constituted an exacerbation of the claimant’s chronic fatigue syndrome.

## Legal Principles

- Foreseeability of physical harm is sufficient to found liability for psychiatric injury in primary victims.
- The “thin skull” or “eggshell skull” rule applies to psychiatric injuries: a defendant is liable for the full extent of the claimant’s harm, even if the claimant is unusually susceptible.
- Primary victims are those directly involved in the incident and within the range of foreseeable physical harm; they need not show separate foreseeability of psychiatric harm.
- Secondary victims (witnesses or those not directly involved) must satisfy additional criteria, including proximity to the event and relationship to a primary victim, to claim for psychiatric injury.

## Conclusion

Page v Smith established that a defendant’s duty in negligence extends to psychiatric injury suffered by a primary victim if physical harm was foreseeable, reinforcing the application of the “thin skull” rule and clarifying the primary-secondary victim distinction in psychiatric harm claims.


Page v Smith [1996] 1 AC 155