One step forward, two steps back? The GMC, the common law and ‘informed’ consent

Fovargue, Sara; Miola, José

doi:10.1136/jme.2009.032862

Cited by 13 publications

(12 citation statements)

References 8 publications

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“…Participants’ perceptions reflect the paternalism of the reasonable doctor standard, where the doctor speaks and the patient listens (Fovargue and Miola, 2010). …”

Section: Resultsmentioning

confidence: 99%

“…In a study involving cancer patients in Canada, Sinding et al (2010) found that patients were uncomfortable with what they perceived as an expectation that they were responsible for making decisions about their treatment. When patients are left to decide on the type of treatment, they may feel unsupported through having to make decisions based on information that they might not fully understand (Fovargue and Miola, 2010; Sinding et al, 2010). This supports an argument that requirements to provide patients with more information are being conflated with the informed model, that is where the patient makes the decision, rather than the shared decision-making model (Charles et al, 1999; Fovargue and Miola, 2010; Jones, 1999).…”

Section: Consent To Treatmentmentioning

confidence: 99%

“…Standards expected by doctors’ regulatory bodies in respect of the consent process have arguably sought to restructure the nature of the doctor–patient relationship from paternalism to shared decision-making (AMA, 2009; Charles et al, 1999; Fovargue and Miola, 2010; GMC, 2008; World Medical Association (WMA), 2006). Nonetheless, a substantial gap remains between the practice of informed consent and its intended goals (Grady, 2015).…”

Section: Introductionmentioning

confidence: 99%

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The consent process: Enabling or disabling patients’ active participation?

et al. 2016

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Standards expected by doctors’ regulatory bodies in respect of the process of consent to treatment have arguably sought to restructure the nature of the doctor–patient relationship from one of the paternalism to that of shared decision-making. Yet, few studies have explored empirically, from patients’ perspectives, the extent to which the process of consent to treatment enables or disables patients’ participation in medical decision-making. Our article examines patients’ attitudes towards the consent process, exploring how and why these attitudes influence patients’ active participation in decision-making and considering possible consequent medico-legal issues. Data were collected longitudinally using semi-structured interviews and field observations involving 35 patients and 19 of their caregivers, in an English hospital between February and November 2014. These indicate that generally patients defer to the doctor in respect of treatment decision-making. Although most patients and their caregivers wanted detailed information and discussion, they did not necessarily expect that this would be provided. Furthermore, patients perceived that signing the consent form was an obligatory routine principally to protect doctors from legal action should something go wrong. Our study suggests that patients’ predominantly paternalistic perceptions of the consent process can not only undermine attempts by doctors to involve them in decision-making but, as patients are now considered in law as informed actors, their perceptions of the consent form as not being in their interests could be a self-fulfilling prophecy if signing is undertaken without due consideration to the content.

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“…Participants’ perceptions reflect the paternalism of the reasonable doctor standard, where the doctor speaks and the patient listens (Fovargue and Miola, 2010). …”

Section: Resultsmentioning

confidence: 99%

Section: Consent To Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The consent process: Enabling or disabling patients’ active participation?

et al. 2016

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“…Not only must the patient receive the information typically imparted to those due to undergo the procedure, he or she should also obtain information specific to the circumstances of live broadcast. 7 Of undoubted importance here will be information about any risks attending the presence of the cameras and any other unusual features. Instructions and requests from the director of the broadcast, the camera operators and even members of the audience (such as via Twitter, in the case of the Channel 4 programme) might all be expected to exert some influence on how the procedure is conducted.…”

Section: Respecting the Patient's Autonomy?mentioning

confidence: 99%

Under the Knife and Under the Lens: Ethical Issues in Broadcasting Live Surgery

Huxtable

2013

Clinical Ethics

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Live broadcasts of surgical procedures are most common at professional conferences, but they are not uncommon in the wider public arena, with operations having recently been transmitted in realtime on public television in the UK. This phenomenon raises ethical concerns familiar from the professional context, along with some distinct considerations which merit further attention. In this article I aim to examine the issues in terms of patient autonomy, patient welfare and the public interest. Prompted by the interest recently expressed by the Royal College of Surgeons of England, under each topic I pose a series of questions, before closing with a call for enhanced ethical oversight, such as might be afforded by a clinical ethics committee.

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“…Professional regulatory bodies, such as the General Medical Council, 5 endorse the subjective standard, and it can be argued that such guidance mandates the practice of a 'reasonable' surgeon. 6 In reality, a subjective standard not only creates enormous practical challenges but also may expose surgeons unfairly to the hindsight of dissatisfied patients. Indeed, some eminent bioethicists agree that it imposes unfairly burdensome and unachievable requirements.…”

mentioning

confidence: 99%