Patient Autonomy & Informed consent Nigel Taylor

Patient Autonomy – a definition: The right of patients to make decisions about their medical care without their health care provider trying to influence the decision. Patient autonomy does allow for healthcare providers to educate the patient but does not allow the healthcare provider to make the decision for the patient. In medical practice autonomy is usually expressed as the right of competent adults to make informed decisions about their own medical care. The principle underlies the requirement to seek the informed consent of the patient before any investigations or treatment takes place.

The conditions for autonomy The Individual: Has the relevant mental capacity; Is free from external constraints and can give their consent freely; Has sufficient information to make an informed decision. 

The principles of informed consent Consent to treatment is the principle that a person must give permission before they receive any type of medical treatment, test or examination.  This must be done on the basis of an explanation by a clinician. Consent from a patient is needed regardless of the procedure. The principle of consent is an important part of the medical ethics and the international human rights law.

  The Law on Informed Consent – the historical position – the Bolam test. Doctors could rely on the support of a responsible body of medical opinion to justify their interventions. The Bolam test asks whether a doctor’s conduct would be supported by a responsible body of medical opinion. This test will no longer apply to the issue of consent, although it will continue to be used more widely in cases involving other alleged acts of medical negligence.

Change in the law – on informed consent Montgomery v Lanarkshire Health Board. 2015 The Supreme Court made it clear that Doctors must ensure their patients are aware of the risks of any treatments they offer and of the availability of any reasonable alternatives. This means that Doctors can no longer rely on the support of a responsible body of medical opinion – Bolam test – in deciding what information they should give to patients.

  Seeking consent When seeking the consent of a patient, Doctors therefore need now to ask themselves three questions. Is the patient aware of any risks relevant to his or her decision regarding the proposed treatment? Is the patient aware of any reasonable alternatives and their associated risks and benefits? Has the Doctor taken all reasonable measures to ensure that I have presented this information in a form the patient understands?

HPv – a guide to vaccination and preventing cervical cancer Side effects: Like most injections, the side effects of the HVP vaccination are quite mild. Soreness, swelling and redness in the arm are common but wear off in a couple of days. More serious side effects are extremely rare. The vaccine meets the rigorous safety standards required for it to be used in the UK and other European countries. SEE WWW.GOV.IM/HPV or the patient information leaflet (PIL) given to you at the vaccination if you’d like more information on the side effects.