2.25  GMC Guidelines
 
Hockton (2002) states that the medical profession itself now recognises that it owes a comprehensive duty to inform patients about their treatment.  In October 1997, the Senate of Surgery of Great Britain and Ireland published “The Surgeon’s Duty of Care” which imposed on surgeons a duty to inform patients in relation to proposed treatment which is at least as rigorous as the “prudent patient” test adopted by Lord Scarman in Sidaway.  Subsequently, the General Medical Council (GMC) produced positive guidance to doctors on seeking patient’s consent in “Good Medical Practice” and more recently in February 1999, following the Bristol case, the GMC produced new and comprehensive guidelines on the issue of consent: “Seeking Patients’ Consent: The Ethical Considerations”.

In paragraph (1) of the GMC guidelines, it states “patients must be given sufficient information, in a way they can understand, to enable them to exercise their right to make informed decisions about their care.”

 In the section headed “Consent to Investigation and Treatment: Providing Sufficient Information”, paragraph (4) states that “Patients have the right to information about their condition and the treatment options available to them.  The amount of information you give each patient will vary, according to factors such as the nature of the condition, the complexity of the treatment, the risks associated with the treatment or procedure, and the patient’s own wishes.”  Patients may need more information to make an informed decision about a procedure which carries a higher risk of adverse side effects.

Paragraph 5 gives a list of the information which patients want or ought to know before deciding whether to consent to treatment.  This includes “details of what the patient might experience during or after the procedure including common and serious side effects” and for each option, explanations of the likely benefits and the probabilities of success; and the discussion of any serious or frequently occurring risks, and of any lifestyle changes which may be caused by the treatment.

Paragraph 6 states “When providing information you must do your best to find about the patient’s individual needs and priorities.”  Patient’s beliefs, culture or other factors may have a bearing on the information they need to reach a decision. Doctors are advised not to make assumptions about patients’ views, but discuss these matters with them, and ask about possible concerns about the treatment or the risks it may involve.  Doctors should provide patients with appropriate information, which should include an explanation of any risks to which they may attach particular significance.

Another way of approaching this issue is to recognise that the distinction formerly made between the professional, subjective and objective standards of care is now blurred.  The profession itself recognises that it must heed patients’ need for information and their concerns (Hockton, 2002). The “doctor knows best” approach to clinical practice is no longer tenable.