Updated guidance on Decision making and consent

We’ve published our updated Decision making and consent guidance. It comes into effect on 9 November 2020.

Ethical guidance for doctors

We recognise that this is a difficult and worrying for doctors and we’re regularly updating our advice for doctors on Covid-19 as the situation develops.

Our 32 pieces of ethical guidance, set out in 11 categories, provide a framework for ethical decision making in a wide range of situations.  They should be followed as far as practical in the circumstances. 

 

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Good medical practice (1)

Start here with Good medical practice...

Good medical practice is the core guidance for all registered doctors. All our guidance builds on these core principles.

You can find our advice on Covid-19 on our ethical hub page

Front page of Good medical practice guidance
Good medical practice
Good medical practice sets out the principles of good practice which all doctors must be familiar with. It is the foundation on which the rest of our guidance is built.
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Confidentiality (7)

Here you will find our confidentiality guidance. You will also find six supporting pieces of guidance to help you decide if patient information should be disclosed in particular situations, such as when considering if a patient is fit to drive, or when a patient has a serious communicable disease.

Front page of Confidentiality good practice in handling patient information guidance
Confidentiality: good practice in handling patient information
Know when you can make disclosures and when to respect confidentiality. This guidance will help you manage and protect patient information in practice.
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Front page of Confidentiality disclosing information for education and training purposes guidance
Confidentiality: disclosing information for education and training purposes
What to share with medical students, doctors in training and others. This also covers writing case studies and training records.
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Front page of Confidentiality disclosing information for employment insurance and similar purposes guidance
Confidentiality: disclosing information for employment, insurance and similar purposes
Understand what to include in a report and know what you can and can't leave out. This also covers the principle of 'no surprises' for patients.
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Front page of Confidentiality disclosing information about serious communicable diseases guidance
Confidentiality: disclosing information about serious communicable diseases
How to balance privacy with keeping others safe. This guidance covers yours, and your colleagues’ health, as well as your patients’.
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Front page of Confidentiality patients fitness to drive and reporting concerns to DVLA or DVA guidance
Confidentiality: patients' fitness to drive and reporting concerns to the DVLA or DVA
Know what to discuss with patients whose health makes them unfit to drive. Understand when it is their responsibility to report this and when it is yours.
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Front page of Confidentiality reporting gunshot and knife wounds guidance
Confidentiality: reporting gunshot and knife wounds
What to tell the police and when to share information without your patient's consent.
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Front page of Confidentiality responding to criticism in the media guidance
Confidentiality: responding to criticism in the media
Understand what you can and can’t say in response to others’ comments. This covers criticism of you personally and your practice or the health service.
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Maintaining professionalism (7)

Here you will find a range of guidance to help make sure that you remain professional in the variety of situations that you face. This includes advice on maintaining appropriate boundaries and our social media guidance.

Front page of Personal beliefs and medical practice guidance
Personal beliefs and medical practice
Peoples' beliefs and cultural practices can be different from each other’s . Know how to treat all patients with respect, whatever their choices or beliefs.
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Front page of Financial and commercial arrangements and conflicts of interest guidance
Financial and commercial arrangements and conflicts of interest
What to do with fees, charges and gifts. It also covers less obvious ones like relationships with the pharmaceutical industry.
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Front page of Doctors use of social media guidance
Doctors' use of social media
Our guidance on social media, apps and other online tools. This covers professional boundaries, confidentiality and respect for colleagues.
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Front page of Ending your professional relationship with a patient guidance
Ending your professional relationship with a patient
In rare circumstances the trust between you and a patient may break down. This guidance covers when you should and shouldn't end the relationship and what to do. This includes closing or relocating your practice.
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Intimate examinations and chaperones
Examinations can be embarrassing or distressing for patients. This guidance covers examinations of a patient's intimate areas. It can also apply to any examination where it is necessary to touch or be close to the patient.
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Front page of Maintaining a professional boundary between you and your patient guidance
Maintaining a professional boundary between you and your patient
Understand how to keep a suitable doctor patient relationship. This includes advice on former patients and social media.
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Front page of Maintaining boundaries sexual behaviour and your duty to report colleagues guidance
Sexual behaviour and your duty to report colleagues
Know your duty, as a doctor, if you think a colleague is acting inappropriately. Understand how to report concerns and support patients too.
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Children & young people (2)

Our guidance on treating children and young people. You will also find advice on the responsibilities of all doctors in protecting children and young people. 

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Protecting children and young people: the responsibilities of all doctors
How to identify and protect children and young people who are at risk. This includes if they are living with their families or living away from home.
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Front page of 0-18 years guidance
0–18 years
Understand how to provide care to young patients. Including young people who have the capacity to consent. This also covers assessing best interests and discussing sexual activity.
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Prescribing (1)

Our guidance on your responsibilities when prescribing and managing medicines, including if you prescribe online or remotely. 

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Good practice in prescribing and managing medicines and devices
This guidance gives best practice about prescribing to patients. It includes remote prescribing, unlicensed medicines and shared care.
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Consent & shared decision making (3)

Our guidance on making decisions about care and treatment in partnership with your patients. It includes guidance on what to do where patients may lack capacity and specific advice on making audio and visual recordings of patients. 

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Consent: patients and doctors making decisions together
Guidance for making good clinical decisions in collaboration with your patient. Including what to do if you think a patient may not be able to make their own decision.
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Front page of Making and using visual and audio recordings of patients guidance
Making and using visual and audio recordings of patients
Know what you can record and when consent is needed. This covers making covert recordings and recording telephone calls. Understand how to store and delete recordings.
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Front page of Good practice in research guidance
Consent to research
Understand how the principles of decision making and seeking consent apply to research.
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Care at the end of life (2)

Our guidance on providing care to patients reaching the end of their life. It covers adults, children and neonates and includes guidance on advance care planning, clinically assisted nutrition and hydration, and cardiopulmonary resuscitation. 

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Treatment and care towards the end of life: good practice in decision making
Understand decision-making for patients of all ages at the end of their lives. The guidance also covers clinically assisted hydration and nutrition and CPR.
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When a patient seeks advice or information about assistance to die
Responding to patients' who want advice about assisted dying can be difficult. Recognise how you can respect and listen to patients without conflict with the law.
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Leadership & management (8)

All doctors have a leadership role. This guidance supports you in that, and provides additional advice for those in more senior roles.

Front page of Leadership and management for all doctors guidance
Leadership and management for all doctors
Some doctors are formal leaders, accountable for the performance of a team or teams. But all doctors are responsible for identifying problems and solving them. This guidance covers what we mean by shared leadership.
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Raising and acting on concerns about patient safety
If you believe patient care and/or safety is at risk, it is important you know how to take the appropriate action.
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Front page of Openness and honesty when things go-wrong guidance
Duty of candour
Understand your duty to be open and honest with patients, or those close to them, if something goes wrong. This covers when to apologise to patients and sharing mistakes with colleagues.
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Front page of Financial and commercial arrangements and conflicts of interest guidance
Financial and commercial arrangements and conflicts of interest
What to do with fees, charges and gifts. It also covers less obvious ones like relationships with the pharmaceutical industry.
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Front page of Delegation and referral guidance
Delegation and referral
You will often work with colleagues to provide care for your patients. Know where your responsibility stops and where it continues.
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Front page of Acting as a witness in legal proceedings guidance
Acting as a witness in legal proceedings
You may be asked to give evidence to courts and tribunals. Our guidance applies when you appear in a professional or non-professional capacity.
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Reporting criminal and regulatory proceedings
What you do and don't need to tell us when you're subject to criminal or civil proceedings anywhere in the world.
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Writing references
How to make sure you are being honest and fair when writing references. This guidance also covers what you should expect in a reference written about you.
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Candour & raising concerns  (2)

Our guidance to help you when something goes wrong. It covers how to be open and honest with patients and those close to them. You will also find guidance on raising concerns about patient safety and advice on your responsibilities if someone raises concerns with you. 

Front page of Openness and honesty when things go-wrong guidance
Duty of candour
Understand your duty to be open and honest with patients, or those close to them, if something goes wrong. This covers when to apologise to patients and sharing mistakes with colleagues.
Read the full guidance
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Raising and acting on concerns about patient safety
If you believe patient care and/or safety is at risk, it is important you know how to take the appropriate action.
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Cosmetic interventions (1)

Our guidance on what is expected of a doctor who offers cosmetic interventions.  

Front page of Guidance for doctors who offer cosmetic interventions guidance
Guidance for doctors who offer cosmetic interventions
This covers any procedure or treatment aiming to change the way someone looks. Including surgical and non-surgical procedures. These may be invasive or non-invasive.
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Research (2)

Our guidance for doctors involved in research.

Front page of Good practice in research and consent to research guidance
Good practice in research
Research involving people can be key in improving the care and health of the population as a whole. This guidance will help you to protect patients and maintain public confidence.
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Front page of Good practice in research guidance
Consent to research
Understand how the principles of decision making and seeking consent apply to research.
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Our archived ethical guidance dating back to 1993 is available on our guidance archive. We also have a range of patient guides and materials.  

You can order hard copies of our core ethical guidance through our publications order form.

How we develop guidance
When we develop or revise our guidance we talk to a wide range of people and gather evidence from lots of sources. You can find out more about how we do this in the 'setting standards for doctors' section.
Setting the standards for doctors