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Education And Debate

An Ethical Debate: Second opinions: a right or a concession?

BMJ 1995; 311 doi: (Published 09 September 1995) Cite this as: BMJ 1995;311:670

Should patients have a right to a second medical opinion if they are not satisfied with their treatment or should referrals be at the discretion of doctors to prevent waste of scarce resources? The father of a psychiatric patient describes his experiences of trying to obtain a second opinion, and we asked a range of interested professionals for their comments.

Patient's perspective

My daughter, M, now aged 42, has been treated by a long succession of psychiatrists since she was 16 and has been called schizophrenic for at least 10 years. Three and a half years ago, while she was detained for six months under the Mental Health Act 1983 and in a depressing local hospital, a consultant at Maudsley Hospital said that she could take her immediately for assessment provided that her present consultant or her general practitioner would refer her. The consultant refused on the ground that he had a plan for her treatment and that it was “not clinically necessary.” Her general practitioner talked with the consultant and supported him. So M could not go to Maudsley. The consultant's “plan” broke down later, because M would not stay in …

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