Delivering informed consent in the wake of Montgomery

A patient centred approach

The modern standard of consent has seen a change in focus towards a patient centred approach and should occur as a joint decision making process.  This was emphasised in the Montgomery decision which determined that a doctor is:

‘under a duty to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments’. 

The consent process requires medical professionals to disclose information about the risks that are materially significant to each patient. The test of materiality of a particular risk is set out as:

‘…whether, in the circumstances of the particular case, a reasonable person in the patient’s position would be likely to attach significance to the risk, or the doctor is or should reasonably be aware that the particular patient would be likely to attach significance to it’. 

In this context the medical professionals role in the consent process should be regarded as advisory and should involve a dialogue to enable the patient to make an informed decision. Information needs to be provided in a comprehensible manner, should be thorough and the process should not be rushed. 

Provision of patient information leaflets or online resources, adequate time to assess the risks and clear documentation of the discussions will aid the health care professional in delivering consent that adheres to the standards required by law and to deliver high quality care.