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New patient consent guidance “lacks substance”, says expert

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6 June 2008

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Proposals to overhaul the approach to obtaining patient consent lack detail, contain advice that is nonspecific, and might prevent doctors from making major changes to their practice, an expert has warned.

Writing in response to the publication of the General Medical Council (GMC) guidance on patient consent to be implemented in June, Professor Glyn Elwyn says this fails to address how doctors will obtain patient consent this in busy clinical settings.

The process of obtaining consent from patients for procedures such as surgical operations often just involves patients signing a piece of paper declaring that they understand the nature of the procedure and its consequences, only a few hours before an operation.

According to Professor Elwyn, although the “much-needed” GMC guidance encourages doctors and patients to discuss procedures and treatments to help patients make more informed decisions, it lacks important finer details.

For example, Professor Elwyn says, the guidance provides no detail about suggested risk thresholds for specifying the problem of harm, or suggestions on how to achieve balance, to tailor information, or how to explore personal preferences.

Professor Elwyn argues that shared decision-making needs to integrated into the way mutlidisciplinary teams are set up to provide care, patients should receive information early and patient preference should be considered and documented.

BMJ

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