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Decisions, decisions...new guidance on consent

06 Oct 2020

On 9th November 2020 new guidance from the General Medical Council comes into force surrounding joint decision making and consent for the medical treatment of patients.

The guidance emphasises the importance of informed consent and seeks to assist doctors in ensuring they comply with their duties surrounding consent. Only then can a patient make informed decisions regarding their care. This empowerment of the patient, it is said, helps improve patient outcomes, patient experience, and reduce complaints.

Good practice and framework
The key theme is that doctors need to talk with their patient to ensure the doctor understands what is important to that patient and what information that patient needs to make a decision. The decision ultimately rests with the patient (except in exceptional circumstances.)

Doctors must give patients information they want or need to make a decision regarding their care in a clear and understandable way. This will usually include;

  • diagnosis and prognosis
  • uncertainties about the diagnosis or prognosis, including options for further investigation
  • options for treating or managing the condition, including the option to take no action
  • the nature of each option, what would be involved, and the desired outcome
  • the potential benefits, risks of harm, uncertainties about and likelihood of success for each option, including the option to take no action

It is important doctors do not make assumptions as to what information they think the patient may need. The doctor must remain objective and not put pressure on a patient to accept their advice.

 

Benefits and risks of harm
The discussion surrounding risks and benefits of treatment, for example surgery, are often the cause of complaint.

The guidance discusses the need to give the patient clear, accurate and up-to-date information about potential benefits and risks of treatment but it is accepted it would not be reasonable to share every possible risk or side effect of a treatment. It is expected that the standard recognised risks of a particular treatment should be discussed but what further information could or should have been given regarding risks often leads to complaints when that risk manifests.

It is here where the competent doctor, following the new framework, will have ensured that, as a result of the conversation with the patient discussing individual needs and circumstances, the patient can make an informed decision regarding care and treatment.  The doctor must be satisfied that the patient understands options available to them and any decision reached.

Consent is so often fraught with misunderstanding, and it is hoped the guidance will help both clinicians and patients to reach a decision that both understand and are happy with. The key, and potential difficulty, will be to ensure that clinicians have enough time to spend with their patients in order to put the guidance into practice.

If you would like any further information, please do not hesitate to contact Lauren Hall.