Intended for healthcare professionals

Student Practical skills

Obtaining consent for an operation

BMJ 2017; 358 doi: (Published 18 September 2017) Cite this as: BMJ 2017;358:j3821
  1. Dafydd Loughran, clinical leadership fellow1,
  2. Aliya Mackenzie, core surgical trainee year 1,2,
  3. Natalie Farmer, fifth year medical student3
  1. 1Aneurin Bevan University Health Board, Newport, UK
  2. 2Medway Maritime Hospital, Gillingham, UK
  3. 3Newcastle University, Newcastle, UK

How to support patients in making informed decisions about their treatment options

More than 10 million operations and procedures are performed each year in the UK.1 Weighing up whether to go under the knife is a major decision, and doctors need to play a supportive role in making sure that patients are fully informed about the risks and benefits of undergoing a treatment.

Obtaining consent for a procedure is one of the core competencies for graduates expected by the General Medical Council,2 and is a common scenario in medical school objective structured clinical examinations (OSCEs). In this article we offer guidance on how to take a patient centred approach to sharing information about a procedure and obtaining consent.

What is consent and why is it important?

The law states that patients have the right to determine what happens to their bodies, which means that performing a procedure on a patient who hasn’t signed a consent form is a form of battery and can lead to criminal charges.3

In the past, the consent process has sometimes been paternalistic, with surgeons recommending their preferred option and patients following in tow. However, the importance of shared decision making is beginning to gain recognition. In 2008, the GMC amended their consent guidance to put greater focus on shared decision making.4 In 2012, a King’s Fund report stated that patients’ involvement in decisions about their care is often inadequate, and that shared decision making often leads to different treatment choices and better outcomes for patients.5

In 2015, a landmark decision by the UK Supreme Court in the Montgomery v Lanarkshire Health Board case prompted a change in the law (box 1). The court ruled that doctors must now take “reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and …

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