Views And Reviews

Patients' treatment must be based on clinical judgment

BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6930.723 (Published 12 March 1994) Cite this as: BMJ 1994;308:723
  1. L Beecham

    The BMA has endorsed the following guidance on patients' access to medical care:

    “Doctors owe a duty of care to all their patients whatever their lifestyle. Each patient must be assessed individually and share in decisions about treatment options. Treatment offered must be based on clinical judgment and sound scientific evidence of likely benefit. It is unethical to refuse an available treatment to any patient who might benefit from it.

    “In a supportive manner, doctors should assist patients to maximise their chances of improved health. Appropriate measures and counselling should be offered to patients willing to consider these as a step to a healthier life. Patients must not be left with the impression that their inability or unwillingness to follow an advised course of action will deprive them of medical attention.”

    The association's medical ethics committee had been asked to produce guidance after some well publicised reports of patients being denied treatment. In most cases the doctors had advised that the patients would not have benefited from treatment at the time because - for example - they were overweight or they smoked. Advice to change their habits was part of the treatment process and not an ethical or rationing judgement.

    The council had opposed previous drafts of the guidance because they implied that if a person's lifestyle materially affected the outcome of treatment for a specific condition it might be ethical to withhold that treatment until the lifestyle was changed. Furthermore, the council did not want to imply that resources had a role to play.

    Doctors want proper consultation with government

    The BMA will challenge the secretary of state for health to ensure that health departments give the profession sufficient time to comment when asked for its views. She will be told that the government cannot expect doctors to cooperate if they are not consulted properly. …

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