1992. professor of maternal and fetal health and director of Tommy’s Centre for Maternal and Fetal Health. But doctors must judge what is appropriate for each patient and how their exercise of judgment might be assessed by the courts. But doctors should have already been following GMC guidance, which highlights the importance of communication.13. Georgiev v Kings College Hospital NHS Foundation Trust [2016] EWHC 104 (QB). We do not capture any email address. Legally, consent law has been clarified and aligns with current GMC guidance, and the Montgomery test has already been applied in several cases. Two years on, Sarah Chan and colleagues discuss the consequences for practising doctors. Whitepages people search is the most trusted directory. http://creativecommons.org/licenses/by-nc/4.0/, http://www.bmj.com/content/350/bmj.h1481/rr-23, Elysium Healthcare: Specialty Ward Doctor, Elysium Healthcare: Consultant Psychiatrist, Brighton and Sussex University Hospitals NHS Trust: Consultant Oncologist, Women’s, children’s & adolescents’ health. Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: AS represented the GMC in the Supreme Court in the Montgomery case. So the Montgomery principles have been known—or should have been known—by doctors for many years. Although the Medical Defence Union and the Medical Protection Society have each issued statements and updated their guidance, as have some royal colleges (such as the Royal College of Surgeons), other bodies such as the GMC and the Royal College of Obstetricians and Gynaecologists (RCOG) have yet to do so. We have produced a short introduction to this video and also a video on the legal context of consent. Ethically, it clarifies the existing shift towards a more cooperative approach in the consultation room.
The doctor’s role is to ensure that relevant information is presented to enable the patient to use it meaningfully.
NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. Guidance in effect at that time from the GMC,17 BMA,18 NHS, and the Scottish Office19 supported a doctor’s duty to disclose relevant information and risks. The Montgomery decision redefined the standard for informed consent and disclosure. Supreme Court decision changes doctor-patient relationship forever. In practical terms, the ruling should apply at least back to 1999, when Montgomery saw her obstetrician. The court applied the Montgomery test and decided that the risk was not material, because neither a reasonable patient nor the patient herself would have attached significance to it. Planning for labour emergencies is essential, so that the doctor and patient can discuss the patient’s wishes if an emergency should arise. Two years after the Supreme Court’s decision, we examine the effects of the Montgomery ruling on clinical and medicolegal practice. Join Facebook to connect with Nadine Montgomery and others you may know. Doctors at the coalface have received little official direction on how their practice should change in light of the ruling. http://creativecommons.org/licenses/by-nc/4.0/ The claimant alleged that the trust was negligent in failing to advise of this possibility. The full implications of the case are undoubtedly still unknown, but Montgomery has clear relevance for medical law and ethics. Update on the UK law on consent]. The Montgomery case in 2015 was a landmark for informed consent in the UK. Nadine Montgomery, Actress: All's Fair in Love & War. Aquí nos gustaría mostrarte una descripción, pero el sitio web que estás mirando no lo permite. View the profiles of people named Nadine Montgomery.
Nadine Montgomery’s full report may contain information on how to contact them such as phone numbers, addresses, and email addresses. We (ESC) have noticed that a considerable proportion of cases of obstetric negligence raised since Montgomery involve consent in addition to standard complaints of substandard care. Rather it shows that the communication process has a strong influence on how patients understand, remember, and evaluate information—all of which are essential to informed consent. Healthcare policy should cover, for example, which treatments should be available and how consent procedures should be handled.17 The doctor’s duty is simply to treat patients according to their interests, which might include being given more information than usual. One such attempt in Scotland has, so far, been unsuccessful.20 Two English cases have allowed consent claims to be added after the Montgomery decision.21 22 Some cases have succeeded on a Montgomery basis23; we (AA) understand that others have settled before litigation ever started or was concluded, as the claims were unanswerable in the light of Montgomery. The Patient’s Charter: What Users Think.
Many organisations (in particular the General Medical Council, who intervened to make submissions in the case) said that the Montgomery decision had simply enabled UK law to catch up with current GMC guidance; others hailed it “the most important UK judgment on informed consent for 30 years.”4 Doctors have expressed their concerns about its potentially radical effects on patient care and clinical practice.5 We held a public debate in 2015, including doctors, lawyers, and medical students, which showed renewed tension between the professional discretion of doctors and patients’ choices6; indeed, the verdict has been characterised as supporting patient autonomy over medical paternalism.3 7 8 9 But what are the implications for doctors’ practice and their legal liability? Previously, the Bolam test14 in England and the Hunter v Hanley test15 in Scotland were used to determine what should be disclosed. Some clinicians said that retrospective application of the judgment could “open the floodgates” for claims in relation to doctors’ past actions.10 Others thought that the Montgomery ruling was unlikely to have this effect, however “excited the claimant law firms might become initially.”11 Legal opinions were reserved, describing the ruling as “the belated obituary, not the death knell, of medical paternalism.”12 Some argued that the standard imposed by the Montgomery decision merely reflected good practice as already specified by the GMC13 and would make little practical difference to clinicians.8 Nevertheless, the concern generated by the ruling might affect doctors’ behaviour and other potential cases.
These tests ask whether a doctor’s conduct would be supported by a responsible body of clinicians. SWC and JEN are the guarantors. But allocation of health resources should be tackled systematically rather than individually. Spencer v Hillingdon Hospital NHS Trust [2015] EWHC 1058 (QB). The personal information that is included in the full report could contain schools that they attended, degrees earned, and … Please note: your email address is provided to the journal, which may use this information for marketing purposes. The Bolam test was affirmed in Sidaway v Bethlem Royal Hospital Governors and others,2 although the ruling was not unanimous, with judges placing different weight on the patient’s right to make informed treatment decisions versus the doctor’s professional judgment in disclosing information. But this is a false dichotomy—the idea of a fully autonomous patient making choices completely independent of the doctor’s input does not reflect the complex reality of medical decision making, nor does the caricature of a paternalistic doctor riding roughshod over patients’ objections. If you are unable to import citations, please contact . It is understood that an application to appeal to the Supreme Court is being presented and if allowed, some of the issues raised in this article may be further discussed. Sidaway v Board of Governors of the Bethlem Royal Hospital and others [1985] 871 AC. Training and educational materials must be fit for purpose. Join Facebook to connect with Nadine Montgomery and others you may know. Making sure that patients understand all the information they need to make a decision will inevitably take longer. These “emergencies” might be exempt from the Montgomery ruling, depending on their nature and timing, but complications of labour (such as sudden and profound fetal distress or major maternal haemorrhage) are not, even though, as was noted in the judgment, choices about management of labour cannot generally be deferred. But the ethical and legal position is clear: doctors must not withhold information simply because they disagree with the decision the patient is likely to make if given that information. GMC guidance says that the consenting process is not a snapshot but an ongoing process.
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