Making Your Mind Up, UK

Main Category: Mental Health
Also Included In: Alzheimer's / Dementia;  Primary Care / General Practice
Article Date: 21 May 2008 - 1:00 PDT

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New GMC guidance launched urges doctors to rethink their approach to discussing medical issues with their patients. Doctors should actively engage patients in discussions, allowing them to make decisions based on their individual needs and circumstances. As part of this approach, consent should not be seen as a tick box exercise, but as part of a wider decision making process, in which both parties have an important role to play.

Consent: Patients and doctors making decisions together, which replaces Seeking patients' consent: the ethical considerations, focuses on the importance of the doctor-patient partnership. It sets out the key principles of good decision making, which apply to all care, from simple treatments for minor conditions to major surgery.

The new guidance will have an impact on all patients, but in particular on those who cannot make decisions for themselves, or where their ability to do so is impaired or fluctuating. This reflects recent legislation which protects those who lack capacity to make particular decisions but also recognises the need to maximise their ability to make decisions for themselves.*

For the first time the GMC provides advice for doctors on how to approach discussions with patients about the risks and possible side effects of treatment. The guidance emphasises that risk should be explained in a way a patient can understand.

The guidance also contains advice on what to do if a patient does not want to know about their condition or the proposed treatment, or asks their doctor or someone else to make the decision for them.

Jane O'Brien, Head of Standards and Ethics at the GMC said:

"We hope that this new guidance will prompt doctors to think about their approach to discussions with patients. The relationship between a doctor and a patient should be about partnership not paternalism. This means that doctors should work with patients to allow them to make decisions tailored to individual views, needs and circumstances, and respect the choices which they make."

Neil Hunt, Chief Executive from the Alzheimer's Society said:

"A diagnosis of dementia does not mean someone can no longer make decisions for themselves. It is vital people with dementia and their carers are fully involved in making choices about medical care. We welcome new GMC guidance, which was developed following consultation with Alzheimer's Society and our Living With Dementia programme whose members include people with the condition and their carers.

It is crucial to assume people with dementia have capacity, even though this may fluctuate over time. Written records of patient/doctor discussions and involving close friend or relatives are useful ways of supporting people with dementia and their carers to make decisions for as long as possible."

To download a copy of the guidance please visit http://www.gmc-uk.org

The guidance is being circulated to all registered doctors in GMC today from 22 May 2008, and will come into effect from 2 June 2008.

For further information please contact the Media Relations Office on 020 7189 5454, out of hours 020 7189 5444, fax 020 7189 5401, email press@gmc-uk.org, website http://www.gmc-uk.org.

* Mental Capacity Act 2005 (England and Wales) and Adults with Incapacity (Scotland) Act 2000.

General Medical Council