Doctors to adopt patient-centric approach to consent

PRESS RELEASE

For immediate release: Thursday, 10 November 2016

UK-wide medical defence organisation MDDUS is reminding doctors to adopt a patient-centric approach to the consenting process.

Recent guidance from the Royal College of Surgeons (RCS) states that doctors must focus on the specific needs of the patient by explaining treatment options and taking reasonable steps to ensure that they are aware of all material risks.

This follows on from last year’s landmark ruling in the Supreme Court case of Montgomery v Lanarkshire Health Board which crystallised the law in relation to informed consent and more specifically issues around the amount of information a patient is entitled to receive before making a treatment decision.

MDDUS medical adviser Dr Naeem Nazem said: “In our experience, the vast majority of doctors already work in partnership with patients and fully involve them in the decision-making process about their care.

“After all, obtaining informed and valid consent from patients for any planned investigation or treatment is a fundamental principle of medicine, recognising the importance of patient autonomy. However, doctors should be mindful of a recent shift towards the consenting process becoming more patient-specific and tailored to the needs of each individual.”

Where past court judgments in the UK have tended to rely on a “professional standard”, there has been a move to adopt a “reasonable patient standard”, with the medical profession no longer solely responsible for determining which risks are material.

The Montgomery case is important to all doctors involved in consent discussions with patients as it sets out what is expected in terms of information disclosure.

“Crucially, what a patient regards as significant may not accord with their doctor’s view,” said Dr Nazem. “Therefore, a doctor is unable to determine, unilaterally, what is reasonable to disclose to their patient. Instead, doctors should seek to make a shared care decision with their patients, discussing every relevant issue for that individual patient.”

MDDUS has encountered cases in which there was a failure to effectively communicate the risks and benefits of a procedure to the patient. We have also noted cases arising from a lack of detailed discussion between doctors and their patients regarding alternative treatment options and potential outcomes.

“This lack of communication and failure to involve the patient in choices regarding their care can result in a breakdown in communication and ultimately erode the doctor-patient relationship,” said Dr Nazem.

“As part of the consenting process, patients should be given sufficient information regarding diagnosis, prognosis, need for the procedure, potential material risks and benefits, likelihood of success and potential follow-up treatment as well as the alternative treatment options – including doing nothing.

“There are of course some exceptions, such as providing life-sustaining treatment in an emergency.”

GMC guidance Consent: patients and doctors making decisions together states doctors should “share with patients the information they want or need in order to make decisions” and “maximise patients’ opportunities, and their ability, to make decisions for themselves.”

Ends

For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email rihendry@mddus.com.

Note to editors

MDDUS (The Medical and Dental Defence Union of Scotland) is a medical and dental defence organisation providing access to professional indemnity and expert medico- and dento-legal advice for doctors, dentists and other healthcare professionals throughout the UK.

For further information on MDDUS go to www.mddus.com.