Decision making and consent

The dialogue leading to a decision continued

If you disagree with a patient's choice of option

48

You must respect your patient’s right to decide. If their choice of option (or decision to take no action) seems out of character or inconsistent with their beliefs and values, it may be reasonable to check their understanding of the relevant information (see paragraph 10) and their expectations about the likely outcome of this option and reasonable alternatives. If it’s not clear whether a patient understands the consequences of their decision, you should offer more support to help them understand the relevant information. But you must not assume a patient lacks capacity simply because they make a decision that you consider unwise.*

*xii

See paragraphs 27–30 for ways of Supporting patients’ decision making.

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If a patient asks for treatment or care that you don’t think would be in their clinical interests, you should explore their reasons for requesting it, their understanding of what it would involve, and their expectations about the likely outcome. This discussion will help you take account of factors that are significant to the patient and assess whether providing the treatment or care could serve the patient’s needs. If after discussion you still consider that the treatment or care would not serve the patient’s needs, then you should not provide it. But, you should explain your reasons to the patient and explore other options that might be available, including their right to seek a second opinion.* 

*vi

See paragraphs 16–20 on Finding out what matters to a patient.