General Medical Council advises doctors on seeking consent

BMJ 1999;318:553 ( 27 February )

News
GMC advises doctors on seeking consent
Linda Beecham , BMJ

The UK General Medical Council (GMC) has issued advice for doctors on seeking patients" consent.

The new guidance, prepared by the GMC"s standards committee, discusses the ethical issues that doctors should consider before, during, and after obtaining the consent of patients to investigation, treatment, screening, and research.

The publication points out that the amount of information patients are given will vary and that doctors should do their best to find out about patients" individual needs and priorities. Doctors should not make assumptions about patients' views but should ask whether they have any concerns about the treatment or the risks it may involve.

Doctors should not exceed the scope of the authority given by a patient except in an emergency, and they should give a clear explanation of the scope of consent being sought. This is particularly important if different doctors are involved or if there will be several different investigations or treatments. In emergencies doctors may provide treatment limited to what is "immediately necessary to save life or avoid significant deterioration in the patient's health."

The GMC warns about relying on a patient"s apparent compliance with a procedure as a form of consent. "For example, the fact that a patient lies down on an examination couch does not in itself indicate that the patient has understood what you propose to do and why."

The guidance advises that doctors should not withhold information unless they judge that providing the information would cause the patient serious harm. In cases in which doctors decide to withhold relevant information they should record the fact.

Seeking Patients' Consent: the Ethical Considerations is available from the GMC, 178 Great Portland Street, London W1N 6JE.

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