A simple contribution to ensuring the correct orientation of doctors to patients is to stop the use of the phrases "seeking consent" & "obtaining consent" as if they are interchangeable.
Obtaining or not obtaining consent are both legitimate outcomes of seeking consent. However, the junior doctor (or other) sent "to obtain consent" may implicitly or explicitly be seen as failing in discharging her duty if the patient says "No" - or the patient may be seen as at fault.
A prerequisite to seeking consent is to seek to engage in a proper process of informing the patient - this is where failure may more legitimately be attributed to doctors if patients do not agree to a medically reasonable or indicated course of action.
But the ruling must not be taken as a "consumerist charter" in which the doctor is not a partner but merely a commodity provider. Medical staff must also give properly informed consent to the course of action which will be pursued.(1,2)
(1) G M Stirrat & Gill R.. Autonomy in medical ethics after O’Neill. J Med Ethics 2005;31:127-130 doi:10.1136/jme.2004.008292
(2) Sutton A.. Authority, autonomy, responsibility and authorisation: with specific reference to adolescent mental health practice. J Med Ethics 1997;23:26-31 doi:10.1136/jme.23.1.26
Competing interests:
Member of BMJ Ethics Committee
01 April 2015
Adrian G Sutton
Doctor
Manchester University, UK & Gulu University, Uganda
Rapid Response:
Re: New rules of consent: the patient decides
A simple contribution to ensuring the correct orientation of doctors to patients is to stop the use of the phrases "seeking consent" & "obtaining consent" as if they are interchangeable.
Obtaining or not obtaining consent are both legitimate outcomes of seeking consent. However, the junior doctor (or other) sent "to obtain consent" may implicitly or explicitly be seen as failing in discharging her duty if the patient says "No" - or the patient may be seen as at fault.
A prerequisite to seeking consent is to seek to engage in a proper process of informing the patient - this is where failure may more legitimately be attributed to doctors if patients do not agree to a medically reasonable or indicated course of action.
But the ruling must not be taken as a "consumerist charter" in which the doctor is not a partner but merely a commodity provider. Medical staff must also give properly informed consent to the course of action which will be pursued.(1,2)
(1) G M Stirrat & Gill R.. Autonomy in medical ethics after O’Neill. J Med Ethics 2005;31:127-130 doi:10.1136/jme.2004.008292
(2) Sutton A.. Authority, autonomy, responsibility and authorisation: with specific reference to adolescent mental health practice. J Med Ethics 1997;23:26-31 doi:10.1136/jme.23.1.26
Competing interests: Member of BMJ Ethics Committee