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Consent: patients and doctors making decisions together

This guidance for doctors sets out the principles on which good clinical decisions should be based.

It expands on Good medical practice, which says doctors must be satisfied that they have consent (or other valid authority) before

  • carrying out any examination or investigation
  • providing treatment or
  • involving patients in teaching or research.

Doctors must follow all our guidance: serious or persistent failure to do so will put their registration at risk.

Read the guidance

Mental capacity decision support tool

If you are in doubt about your patient’s capacity to make a healthcare decision, our interactive tool will help by identifying the steps you need to take: first to assess capacity and then, if your patient lacks capacity, to make a decision about how to proceed. The information takes account of capacity legislation across the UK as of May 2016.

It draws on the principles in our guidance Consent: patients and doctors making decisions together  and Treatment and care towards the end of life: good practice in decision making and includes a number of case studies at each stage of the decision-making process to show how the guidance applies in practice. As well as the case studies you can download relevant guidance, a flowchart and a ‘Reflections Record’ for noting your thoughts about the tool and how you use it, so you can reflect on your practice.

What it doesn’t do

This tool will help you assess the capacity of your patients to make healthcare decisions. As a doctor you may be asked to assess a patient’s capacity to make decisions about wider issues such as friendships or sexual relationships. While some of the principles are the same, there are other things to consider if you’re asked to do this (eg safeguarding policies and legislation) and you should seek advice from experienced colleagues.

This tool is not about mental health treatment decisions.

The guidance in practice: learning materials

Case studies from GMP in Action. 

Mr Hartley Mr Hartley has had treatment for abdominal cancer but his condition is deteriorating and he is refusing further surgery. There is disagreement between his adult children, Clementine and Robert, about whether to continue with active treatment. Should the doctors accept Mr Hartley's refusal? And what can they do to help resolve the conflict within the family? Decide what the doctors should do.

Consent and UK law

As the law relating to decision-making and consent - particularly for patients who lack capacity - varies across the UK, doctors need to understand the law as it applies where they work (see paragraphs 62-63).

This guidance takes account of, and is consistent with, current law across the UK. The legal annex gives more detail about relevant common law and legislation, and links to further information.

Serious or persistent failure to follow this guidance will put your registration at risk.

Download the guidance