Bioethics News

A landmark case transforms informed consent in the UK

A ruling by a UK court last year forces doctors to tell their patients the full range of treatment options and allowing them to choose. The Royal College of Surgeons has warned of “a dramatic increase in the number of litigation pay-outs” made if doctors and hospitals do not make changes to the processes they use to gain consent from patients before surgery.

Traditionally it was up to British doctors to decide what risks to communicate to patients. But last year the UK Supreme Court held in a case called Montgomery vs Lanarkshire Health Board, that doctors must ensure patients are aware of any and all risks that an individual patient, not a doctor, might consider significant.

In other words, doctors can no longer be the sole arbiter of determining what risks are material to the patient.

In the past, litigation in malpractice suits was governed by the Bolam principle, which saw the judgement of medical experts as the main criterion for assessing reasonable care in negligence cases and for deciding what risks should be communicated to the patient for a chosen treatment.

Now the pendulum has swung from the “reasonable doctor” to the “reasonable patient”. This could mean a huge increase in the workload of doctors. A spokesman for the College said:

“It’s not hard to see how in many hospitals gaining a patient’s consent has become a paper tick-box exercise, hurriedly done in the minutes before a patient is wheeled into theatre for their procedure. Operating lists and consultation clinics are packed leaving little time for these important consent discussions.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.