Working with doctors Working for patients

Consent guidance: The scope of decisions

37. You must explain clearly to patients the scope of any decisions to be made. This will apply particularly if:

a. treatment will be provided in stages, with the possibility that changes or adjustments might be needed

b. different doctors or healthcare professionals will provide particular parts of an investigation or treatment, such as anaesthesia and surgery

c. a number of different investigations or treatments are involved

d. uncertainty about the diagnosis or the options might only be resolved when the investigation or treatment has started, when the patient may be unable to make decisions.10

38. In such cases, you should discuss and agree with the patient how decisions will be made about whether to make changes to the investigation or treatment plan. You should establish whether the patient agrees to all or only parts of the proposed plan. If they agree only to parts of it, you should make sure that there is a clear process through which they can be involved in making decisions at a later stage.

39. You must not exceed the scope of the authority given by a patient, except in an emergency. If an emergency arises, you must follow the guidance in paragraph 79.