Doctor Knows Best...

This week on Universal Medicine, we will explore the shift in guidelines proposed by the RCS – Royal College of Surgeons.

Traditionally, a paternalistic approach has been adopted in regards to providing treatment. This encapsulates the ideology that the doctor “knows best” and restricts the freedom of decision by the patients. However, this approach has led to hospitals being taken to court if the decision ends up inflicting harm. NHS trusts have had to pay out more than £1.4 billion during 2015-2016 (figure by NHS Litigation Authority). Consequently, the RCS has put forward a new guideline which means that clinicians are now required to present all options and let the patient decide – an approach following from the principles of autonomy.

Autonomy is a key pillar of medical ethics whereby patients have the self-government over their health: they are free to make a decision as to which treatment is  to be undertaken. Certainly, as presented by Leslie Hamilton – RCS council member who drew up the guidance – the surgical profession requires a “culture change”. Whereas in the past only information presenting a statistical risk of more than 1% was conveyed, this new principle will require full knowledgeability to reach a conclusion.

Indeed, this change enhances overall patient awareness in regards to their treatment. However, it has been projected that this will increase consultation time from 20 to 40 minutes. Resulting from this, it may mean that it reduces the overall number of patients which can be seen on a daily basis. Nevertheless, there could be scope for the benefit in the long term if correct procedures are undertaken now to prevent long term legal actions as these can act as a detriment.

We would love to hear your views in regards to this recent change in guidelines. Feel free to comment below. Have a great week!

Written by Gagandeep Sachdeva
Universal Medicine

Sources:
https://www.bma.org.uk/advice/employment/ethics/medical-students-ethics-toolkit/2-autonomy-or-self-determination

http://www.telegraph.co.uk/news/2016/10/26/the-end-of-doctor-knows-best-as-medics-are-told-to-let-patients/

https://recoverynet.ca/2016/11/03/an-end-to-doctor-know-best/

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