Intended for healthcare professionals

Observations Ethics Man

Let’s stop consenting patients

BMJ 2014; 348 doi: (Published 19 March 2014) Cite this as: BMJ 2014;348:g2192
  1. Daniel K Sokol, barrister and medical ethicist, London
  1. daniel.sokol{at}

The term negatively affects how clinicians perceive consent

A patient who underwent an unsuccessful operation claimed that the surgeon did not obtain valid consent—that he booked her in for surgery without mentioning the less invasive alternatives. In another consent case, Birch v University College Hospital, the patient was informed of the risks of the catheter angiography that led to her stroke but not the comparative risks of magnetic resonance imaging.1 The clinicians were found negligent for failing to do so. I have elsewhere mentioned the usefulness of a consent acronym popular in some US hospitals: PARQ. It stands for “procedure” (what it entails), “alternatives” (including doing nothing), “risks” (of the procedure and the alternatives), and “questions” (invite the patient to ask questions).2 In these hospitals clinicians write “PARQ” in the notes to show that they have considered each element.

In the first case above the medical notes suggested that …

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