Ethics briefings

Brannan, Sophie; Campbell, Ruth; Davies, Malcolm; English, Veronica; Mussell, Rebecca; Sheather, Julian

doi:10.1136/medethics-2015-102823

Cited by 3 publications

(5 citation statements)

References 2 publications

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“…As previously reported here,1 in February 2015, the Supreme Court of Canada ruled in Carter v Canada that the country's prohibition on assisted dying violated constitutional rights 2. The Court suspended its ruling for 12 months to give governments time to enact legislation consistent with its decision and, following an appeal to the Court in January 2016, granted an extension to give governments until 6 June 2016 to act 3…”

Section: Assisted Dyingmentioning

confidence: 57%

Assisted dying

et al. 2016

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Section: Assisted Dyingmentioning

confidence: 57%

Assisted dying

et al. 2016

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“…A dominant claim in the literature on Montgomery is that it transformed the law of informed consent 3‐26 . For example, one paper suggests that ‘the Montgomery decision redefined the standard for informed consent and disclosure’ 7 .…”

Section: Resultsmentioning

confidence: 99%

“…In response to this concern, many papers question the premise that Montgomery actually creates new burdens, highlighting that the GMC has long imposed similar disclosure requirements 4,7,8,17,19,20,25‐27,29,31‐34,36,38‐54,88‐90,99,101 . For example, Lamb argues that ‘it is unlikely that a slightly greater focus on the particular patient…will lead to any real practical impact on the day‐to‐day action of doctors’ 36 .…”

Section: Resultsmentioning

confidence: 99%

“…44 In response to this concern, many papers question the premise that Montgomery actually creates new burdens, highlighting that the GMC has long imposed similar disclosure requirements. 4,7,8,17,19,20,[25][26][27]29,[31][32][33][34]36,[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][88][89][90]99,101 For example,…”

Section: Additional Pressures On Doctorsmentioning

confidence: 99%

“…Even if Montgomery significantly changed the law, some argue that its impact on doctors' duties is at most symbolic because the General Medical Council (GMC) has long imposed a similar patient-oriented professional duty of risk disclosure. 4,7,8,17,19,20,[25][26][27]29,[31][32][33][34]36,[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54]88,89,99,101 The GMC's patient-centred duty was in fact highlighted by the Supreme Court in Montgomery, which cited passages from the GMC's 2008 and 2013 guidelines and noted that the 1998 guidelines that were in place at the time of Nadine Montgomery's pregnancy were 'broadly similar in effect' (although the lower courts may not have been aware of this). 1 The existence of GMC guidance is one reason that Lamb argues that the case has mostly 'symbolic' value, 36 but this account is challenged on three grounds in the literature.…”

mentioning

confidence: 99%

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Montgomery's legal and practical impact: A systematic review at 6 years

Gallez

Skopek

Liddell

et al. 2021

Evaluation Clinical Practice

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Rationale, Aims and Objectives Six years ago, the Supreme Court judgement in Montgomery v Lanarkshire changed medical law. It introduced a new patient‐based standard of care for the communication of treatment risks and alternatives, rejecting the doctor‐based standard that had long governed all aspects of medical negligence. This is the first systematic review to analyse the literature on Montgomery. Our aim is to appraise and synthesize the literature on Montgomery's impact on medicine and the law and to identify areas for further academic enquiry and implications for professional guidance and training. Methods Searches were run in Medline, Embase, PsycINFO, Web of Science, Scopus, Westlaw UK, HeinOnline, and LexisNexis. Two reviewers screened papers. Extracted data was analysed and discussed by an interdisciplinary team. PRISMA guidelines were followed. Results Of the 1134 papers identified, 100 met the inclusion criteria. These papers revealed significant disagreement on four core sets of issues, focusing on Montgomery's impact on: (1) legal and professional duties; (2) medical practice; (3) the patient experience; and (4) litigation. The first set addresses whether the case actually changed doctors' legal and professional duties, the relationship between GMC guidance and medical law, and the boundaries of Montgomery. The second explores whether the decision has incentivized defensive medicine, its resource implications, and doctors' knowledge of it. The third concerns whether and how the decision has promoted patient autonomy and involvement in their own care. The fourth focuses on whether the case has caused an increase in litigation. Conclusions Despite the abundance of legal and medical literature on Montgomery, many issues remain unresolved. Empirical research is required for many of the questions. Doctrinal analysis informed by medical knowledge is also required to assess whether Montgomery may have unrecognized ramifications—for example, whether it will require the disclosure of risks associated with diagnostic uncertainty, where doctors advise patients without performing procedures.

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