GPs may want to review their consent routine to ensure it meets the latest ethical and legal standards. Here some tips:
1. Consent is not one-off. Think of consent as a process not a one-off exercise. It involves providing information, answering the patient’s questions and giving them the opportunity to consider the information and to raise questions.
2. Find out what matters to patients. Start the discussion by asking patients what they want to know and what matters to them. Most people want to hear relevant information which would usually include the options that are realistically available and the associated risks, including the pros and cons of having no treatment. However, some will want to know everything about their condition and you need to be ready for this eventuality.
When discussing complications, it is important to focus on what you think would be of significance to the patient in front of you, rather than just listing those that are most likely to occur.
3. Make sure patients understand. Think about how you can help patients’ comprehension. This might be as obvious as avoiding technical language but could also mean using visual aids and even asking the patient whether they would like someone with them during the consultation. Overwhelming the patient with leaflets is no substitute for talking to the patient about their hopes and fears.
Check the patient’s decision is properly informed. If in doubt, you could ask them to confirm what they have understood or return to the subject at the next opportunity.
4. Don’t leave consent until last minute. For minor surgical procedures, try to avoid leaving the consent discussion until the patient is in the room and the doctor or nurse practitioner is standing by. This might lead to suggestions that consent was given under pressure or without the opportunity to reflect.
5. Record your discussions. Make a detailed record of the discussion including information provided to the patient about the risks involved in proposed treatment, any concerns they have raised and your response.