I IN THE EYES OF THE LAW, WHAT IS A ‘REASONABLE’ REMEDY?

Short answer: restitutio in integrum.

Translation from Latin: Restoration to the original condition.

 Here’s a question which we hear time and time again as law students: is such conduct ‘reasonable’?

In a case where the defendant was found to be negligent, what does it mean for a plaintiff to be entitled the ‘reasonable’ costs for rectifying a wrong? How do we gauge the floor and the ceiling of what is ‘reasonable’?

As of 2026 we now have a definitive answer from the High Court of Australia. In this article, we explore how Stewart v Metro North Hospital and Health Service [2025] HCA 34 (‘Stewart’) came to its decision through the principle of restitutio in integrum, overturning decades of judicial interpretation where reasonableness was instead a stringent cost-benefit analysis.

II THE FACTS

In 2016, Michael Stewart (then aged 63) sought treatment for abdominal pain at Redcliffe Hospital.[1] Due to admitted medical negligence, he suffered catastrophic injuries including bowel perforation, sepsis, a stroke, and profound brain damage.[2]

Before the injury, Mr. Stewart lived in a rented home with his brother and shared custody of his teenage son, who visited regularly with the family dog. After the injury, his disability forced him into a nursing home (Ozanam Villa).[3] Mr. Stewart was miserable there; he was largely non-verbal and his health was deteriorating. He communicated clearly to his family and doctors that he wished to return to a "home setting" where his son and dog could stay with him. As the trial judge (Cooper J) noted,

(i) “Mr Stewart’s tendency to immerse himself in photographs from his past life and possessions;

(ii) Mr Stewart’s communication by sounds and gestures to Ms Schwarzman that he would like to stay in a home where Jesse and a dog could stay with him and that he did not want to stay at Ozanam;

(iii) Mr Stewarts communication to Dr Rotinen Diaz (a rehabilitation physician) by "a very clear verbal and non verbal answer" that he did not want to live in a nursing home and wanted to live in a private dwelling, and "a very strong and clear 'no'" indicating that he was not happy at Ozanam; and

(iv) Mr Stewart's facial expressions communicating answers to Ms Coles (an occupational therapist) that he wished to live in his own home.”[4]

III HOME OR INSTITUTION?

The legal battle centred on the cost of Mr. Stewart's future care for his remaining five-year life expectancy:

·      The Plaintiff’s Claim: ~$4.9 million to fund 24-hour private nursing care in a rented home.

• The Defendant’s Offer: ~$1.1 million to keep him in the nursing home with an “external care assistant and the provision of more frequent therapy and exercise”. [5]

IV PRIOR PROCEEDINGS

In prior proceedings both the Trial Judge and the Queensland Court of Appeal ruled against Mr. Stewart. The courts applied a cost-benefit analysis. The trial judge found that “consistent provision of additional care from external care assistants … would in turn be likely to provide health benefits similar to those which he would receive if he was to be cared for in his own home”.[6] The judgments stated that the home-care claim was ‘unreasonable’ because it was disproportionately expensive compared to the care facility alternative.

V OUTCOMES

The High Court unanimously overturned those decisions. It held that "reasonableness" is not a mathematical exercise of weighing costs against health gains. Instead, Chief Justice Gageler stressed the “compensatory principle”:

“The injured party should receive compensation in a sum which, so far as money can do, will put that party in the same position as he or she would have been in if … the tort had not been committed”.[7]

Hence,

1. Restoration is the Goal: Since Mr. Stewart lived in a home before the injury, a "reasonable" response to the negligence was to return him to a home setting.

2. Dignity Matters: A person's desire to live with their family and pets is an ordinary, reasonable human preference, not an "extravagant" luxury.

3. The Shift: The court increased the award by nearly $4 million, granting Mr. Stewart the full cost of home-based care.[8]

VI EVOLUTION OF THE ‘REASONABLENESS TEST’

The history of the reasonability test in damages is a story of the High Court moving away from a mathematical cost-benefit analysis approach, and towards a more restorative, human-centric approach.

For nearly 50 years, the law was dominated by Sharman, a 1977 case[9] that spoke of a “touchstone of reasonableness” which involved considering the “cost matched against health benefits to the plaintiff”.[10] From 1977, lower courts interpreted this as a mathematical formula. If home care cost $1 million more than a nursing home but only provided slight health benefits, the court would reject the home care as unreasonable.[11]

Crucially, this led to plaintiffs institutionalised in lower courts because nursing homes are almost always cheaper than private, at home care. Such was the case in Sharman, and such would have been the case in Stewart if the plaintiff did not appeal.

This is where the High Court comes in almost 50 years later in 2025. In law, a strict “cost-benefit analysis” seemed to imply a cold mathematical formula. The 2025 High Court pointed out that Sharman contained two conflicting ideas:

1. The “calculus” quote: reasonableness “is cost matched against health benefits.”

2. The principle of compensation: The goal is to put the plaintiff back to their original position. Restitutio in integrum.[12] 

For decades, lower courts focused only on the “calculus” and ignored the principle. The 2025 High Court essentially said: “You’ve been reading one sentence of the 1977 case and ignoring the rest of the judgement”. By emphasizing the Compensatory Principle as their main ratio decidendi, they clarified that the cost-benefit part was only meant to catch extravagant or unusual claims to damages, not to stop a person from living in their own home.

Restitutio in integrum is important because it delivers justice by righting the wrongs of the past. This idea – that when someone is wronged, the community’s first concern is to repair the harm and restore the relationship, not to punish or enrich either side – upholds the value of fairness that the law aims to achieve. Under-compensation feels unfair to victims; over-punishment feels unfair to offenders. It is this pragmatic view of corrective justice that says “You broke it, you fix it. Move on”.

The decision suggests that being able to participate in family and domestic life is not a luxury add-on once basic care is met; it’s part of what we think a life worth living looks life. By insisting that reasonableness is not confined to balancing costs against health outcomes, the High Court pushes back against a purely utilitarian, budget-driven view of personal injury law, and asserts that tort damages are about corrective justice rather than optimising the health system’s Excel spreadsheet. While earlier eras might have seen institutionalised care as normal; by 2025, the Court confirmed that “it is commonly accepted nowadays that significant benefits will flow to a person from modifications which would allow him or her to live at home, rather than in an institution”. In other words, the exercise of a person’s autonomy of choice will usually be associated with mental well-being, indicating a shift in what society counts as an acceptably post-injury life.[13]

 In short, just remember:

Restitutio In Integrum.

V FOOTNOTES

[1] Stewart v Metro North Hospital and Health Service [2025] HCA 34 at [5]-[6] (‘Stewart’).

[2] Ibid at [6].

[3] Ibid at [7].

[4] Stewart v Metro North Hospital and Health Service [2024] QSC 41 at [64]-[65], [73]-[76].

[5] Ibid at [178]-[179].

[6] Ibid at [185].

[7] Haines v Bendall (1991) 172 CLR 60 at 63.

[8] Stewart (n 1) [55].

[9] Sharman v Evans (1977) 138 CLR 563.

[10] Ibid at 573-574.

[11] Ibid at 597.

[12] Stewart (n 1) [48].

[13] Ibid at [42].