Hot topic: Consent

Making decisions with an adult who has capacity to decide

June 2015

Consent is about patients and doctors making decisions together. It is a familiar theme in the care of children and young people, older patients, patients who are dying, and patients who have limited mental capacity. However issues of consent can arise in all areas of care.

A recent high profile case, NM Vs Lanarkshire (pdf), enforces the need for doctors to make sure they seek informed consent from patients and their families. NM, the mother of a child born with cerebral palsy, sued Lanarkshire Health Board arguing that her treating consultant should have warned her of the particular risks to her and her baby of shoulder dystocia (a mechanical problem) occurring during delivery. She also argued that she should have been advised about the alternative possibility of delivery by caesarean section, which would have avoided these risks and prevented her child’s injury. We were asked to clarify the correct position for doctors in this situation, as follows.

“Fundamental to the doctor and patient relationship is the requirement that a patient with capacity to decide should be informed about the treatment options open to him or her; the risks and benefits of each option; and be supported to make their choice about which treatment best meets their needs.”

The judgement is complicated – and the implications for doctors are summarised here in this blog from GMC’s Assistant Director for Standards and Guidance, Mary Agnew. We keep all our guidance for doctors under review, and we expect to begin outlining the potential scope of new consent guidance at the end of this year. Keep an eye on our website for further details.

How we can support you in this area

GMC case studies, interactive tools and resources

The following GMC resources relate specifically to this case and making decisions together with a patient who has capacity. Find a broader range of our learning materials relating to other areas of consent and other ethical practice on our learning materials pages.

GMC guidance

We have selected here elements of our guidance which relate to consent in decision making with adults who have capacity. Our guidance is applicable to all UK doctors and reflects the law of the four UK countries. Find a broader range of our guidance relating to other areas of consent and other ethical practice on our guidance pages.

Our Better care for older people pages also provide advice on working in partnership with older patients, their families and carers.

Related articles

The following articles look at the Montgomery case  and other consent questions in context.

Other sources of information and guidance

Case summaries

Northern Ireland

Scotland

Wales

Our GMC Consent guidance pages contain more signposts.

Talk to us – book a meeting with our local liaison teams

  • Our regional liaison advisers are available for meetings with doctors, medical students, patients right across the UK. Contact them on: rls@gmc-uk.org
  • Our teams in Northern Ireland, Scotland and Wales work with their Parliament/Assembly, health departments, political parties, groups representing patients, groups representing doctors, medical schools and students, employers and deaneries. Contact them for meetings at:

  • Our employer liaison advisers help medical managers deal with concerns about doctors, including advising on when to refer a case to the GMC. Contact them on: EmployerLiaisonService@gmc-uk.org.