Intended for healthcare professionals

Rapid response to:

Letters New UK law on consent

New law on consent will overload seriously ill patients

BMJ 2015; 350 doi: (Published 07 April 2015) Cite this as: BMJ 2015;350:h1787

Rapid Response:

Paternalism as a choice

Tim Lott, in his Guardian column, bemoans the oppressive effect of choice in all aspects of life.(1).

With regards to choice in healthcare setting, he observes that “This problem of choice and complexity is ubiquitous. It applies in medicine. If I am ill and asked to make a choice about treatment, I would often rather leave the choice to the doctor, if only because if the wrong choice is made, I am not going to feel nearly so bad about it. I had a prostate cancer scare recently, and I just wanted to be told what to do – not decide whether, say, I should choose an operation that would guarantee impotency in order to stave off a 5% chance of cancer. The burden of choice was too big”.

His comments are not much dissimilar to that of Franz J Ingelfinger, the former editor of the New England Journal of Medicine, who, as a cancer patient, preferred a certain degree of paternalism from his doctors.(2).

Is it time to offer the option of paternalism to our patients?

1. Why I choose to have less choice | Tim Lott [Internet]. the Guardian. [cited 2015 May 18]. Available from:
2. Ingelfinger FJ. Arrogance. N Engl J Med. 1980 Dec 25;303(26):1507–11.

Competing interests: No competing interests

18 May 2015
Santhanam Sundar
Consultant Oncologist
Nottingham University Hospital NHS Trust