Domain 2: Patients, partnership and communication
The approach and attitude of a medical practitioner can have a lasting impact on a patient. Treating patients with kindness, compassion and respect can profoundly shape their experience of care.
Good medical professionals recognise that patients are individuals with diverse needs, and don’t make assumptions about the options or outcomes a patient will prefer. They listen to patients and work in partnership with them. They do their best to make sure all patients receive good care and treatment that will support them to live as well as possible, whatever their illness or disability.
Treating patients fairly and respecting their rights
You must recognise and respect every patient’s dignity and right to privacy.
If relevant to your practice, you must follow our more detailed guidance on Intimate examinations and chaperones.
You must recognise a patient’s right to choose whether to accept your advice, and respect their right to seek a second opinion.
You must treat patients fairly. You must not discriminate against them or allow your personal views to affect your relationship with them, or the treatment you provide or arrange. You must not refuse or delay treatment because you believe that a patient’s actions or choices contributed to their condition.
You must give priority to patients based on their clinical need if these decisions are within your power. If inadequate resources, policies, or systems prevent you from doing this – and patient safety or dignity may be seriously compromised as a result – you must follow the guidance in paragraph 75.
If you have a conscientious objection to a particular procedure, you must make sure that the way you manage this doesn’t act as a barrier to a patient’s access to appropriate care to meet their needs. You must follow the guidance in paragraph 87 and our more detailed guidance on Personal beliefs and medical practice.
You must treat information about patients as confidential, including after a patient has died. You must follow our more detailed guidance on Confidentiality: good practice in handling patient information.
Treating patients with kindness courtesy and respect
You must treat patients with kindness, courtesy and respect. This doesn’t mean agreeing to every request (see paragraph 7d) or withholding relevant information that may be upsetting or unwelcome (see paragraph 28). It means:
- communicating sensitively and considerately, particularly when you’re sharing potentially distressing issues about the patient’s prognosis and care
- listening to patients, recognising their knowledge and experience of their health, and acknowledging their concerns
- trying not to make assumptions about what a patient will consider significant or the importance they will attach to different outcomes
- being willing to explain your reasons for the options you offer (and the options you don’t) and any recommendations you make
- recognising that patients may be vulnerable, even if they don’t seem it
- being alert to signs of pain or distress, and taking steps to alleviate pain and distress whether or not a cure may be possible.
Supporting patients to make decisions about treatment and care
All patients have the right to be involved in decisions about their treatment and care, and be supported to make informed decisions if they are able to. You must start from the presumption that all adult patients have capacity to make decisions about their treatment and care.
You must be satisfied that you have consent or other valid authority before examining or treating patients, or involving patients or volunteers in teaching or research. More detail about this is given in our guidance on Decision making and consent which you must follow. If relevant to your practice, you must also follow our guidance on Making and using visual and audio recordings of patients.
You must be aware of your legal and ethical duties relating to consent and capacity. This means you must:
- be aware of the relevant law on capacity and mental health
- have regard to relevant codes of practice
- follow our guidance on Decision making and consent.
When treating patients coming to the end of their lives, you must follow our more detailed guidance on Treatment and care towards the end of life: good practice in decision making.
Communicating with those close to a patient
You must be considerate and compassionate to those close to a patient and be sensitive and responsive in giving them support and information. You must follow our more detailed guidance on Confidentiality: good practice in handling patient information.
A case study about a doctor's decision making when requested to share information about a patient with a family member.
Caring for the whole patient
You must support patients in caring for themselves and empower them to improve and maintain their health. This may include:
- helping them to access information and support to manage their health successfully
- supporting them to make decisions that improve their health and wellbeing.
You should ask patients about any other care or treatment they are receiving – including over-the-counter medications – and check that any care or treatment you propose, provide or prescribe is compatible.
If a patient is taking multiple medications, you should discuss the importance of regular reviews to check that the medications continue to meet the patient’s needs and are optimised for them. You should consider the overall impact of the patient’s treatments, and whether the benefits outweigh any risk of harm.
Safeguarding children and adults who are at risk of harm
You must consider the needs and welfare of people (adults, children and young people) who may be vulnerable, and offer them help if you think their rights are being abused or denied. You must follow our more detailed guidance on Protecting children and young people and 0-18 years: guidance for all doctors.
You must act promptly2 on any concerns you have about a patient – or someone close to them – who may be at risk of abuse or neglect, or is being abused or neglected.
This ethical hub topic explores: The underlying principles which define adult safeguarding. The different types of abuse. What you should do when an adult who appears to be at risk refuses help.
Helping in emergencies
You must offer help in an emergency, taking account of your own safety, your competence, and the availability of other options for care.
Making sure patients who pose a risk of harm to others can access appropriate care
Patients must not be denied care because their condition puts others at risk. If a patient poses a risk to your health or safety, you should take all available steps to minimise the risk before either providing treatment yourself, or making alternative arrangements for the patient to access care to meet their needs.
Being open if things go wrong
You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you must follow our guidance on Openness and honesty when things go wrong: the professional duty of candour, and you should:
- put matters right, if possible
- apologise (apologising does not, of itself, mean that you are admitting legal liability for what’s happened)
- explain fully and promptly what has happened and the likely short-term and long-term effects
- report the incident in line with your organisation’s policy so it can be reviewed or investigated as appropriate – and lessons can be learnt and patients protected from harm in the future.
You must respond promptly, fully and honestly to complaints. You must not allow a patient’s complaint to adversely affect the care or treatment you provide or arrange.
You should only end a professional relationship with a patient when the breakdown of trust between you and the patient means you can’t continue to provide good clinical care to them. You must follow our more detailed guidance on Ending your professional relationship with a patient.