Education And Debate

Consent may not be needed to save life

BMJ 1997; 315 doi: (Published 06 December 1997) Cite this as: BMJ 1997;315:1531
  1. Patrick Hoyte, deputy heada
  1. a Medical Advisory Services, Medical Defence Union, Manchester M22 4RZ
  1. Correspondence to: Dr Hoyte


    Dr McFadzean and colleagues had to wrestle with some difficult problems over consent, but they had not reached a definitive conclusion when they were pre-empted by the patient's sudden death. Three particular strands of consent had to be considered in this case—the patient's competence to make a decision about her treatment, her past rejection of surgery for this condition, and her subsequent inability to give consent to emergency surgery.


    A competent adult patient has a fundamental right to give, or withhold, consent to any examination, investigation, or treatment. For the incompetent adult, no mechanism exists in English and Welsh law for any other person, or indeed a court, to authorise or consent to treatment. In Scotland, however, an application may be made to the Court of Session for the appointment of a Tutor Dative who may deal with issues of consent on behalf of an incompetent patient.1

    While it is always good practice to involve …

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