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Stop sitting on the fence: recommendations are essential to informed decision making

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f7600 (Published 19 December 2013) Cite this as: BMJ 2013;347:f7600
  1. Abeezar I Sarela, consultant surgeon, St James’s University Hospital, Leeds LS9 7TF, UK
  1. a.sarela{at}leeds.ac.uk

It’s compatible with patient autonomy for doctors to express clear opinions—and patients depend on them, says Abeezar I Sarela

Self determination—a patient’s right to make choices about his or her own medical care, however irrational those choices may seem—is universally accepted as fundamental. “Patient choice” is a phrase unchallenged in today’s NHS.

The General Medical Council (GMC) makes it clear that doctors must discuss the risks and benefits of diagnostic or therapeutic options and ultimately abide by patients’ wishes. The GMC’s consent guidance states that “the doctor may recommend a particular option which they believe to be best for the patient, but they must not put pressure on the patient to accept their advice.”1

It goes without saying that coercion is not ethically acceptable. Similarly, paternalism—imposing a course of action without full regard for the patient’s wishes—is now unacceptable. …

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