Medicolegal Basics – Consent

Medico-legal questions, a daunting world of case law, complications and consents, are probably last on most people's list of interview preparation tasks, with a few examples and basic legal principles, putting a "legal spin" on any question you are asked can set you apart from the rest and help you get an offer.

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Medicolegal questions, a daunting world of case laws, complications and consents – probably bottom of most people’s interview prep to-do lists. However, with a few basic legal examples and principles under your belt, putting a ‘legal-spin’ on any question posed to you can set you apart from the crowd and help secure your offer. Here’s a vital legal concept worth knowing about, and one that is applicable to nearly every question.

Arguably the most important legal concept to be aware of is that of consent. This stems from the ethics of patient autonomy – the right to freedom from external control. In a nutshell, this is the idea that patients have the right to choose whether or not to have a treatment. This means patients can choose to decline treatment and not have it forced upon them, even if the lack of treatment would kill them. It is illegal for doctors to do anything without a patient’s consent (fortunately the law recognises ‘implied consent’, eg patients holding out their arms to give blood, so don’t worry about being prosecuted). The caveat of this legal concept is that the patient must have capacity to make decisions about the treatment (an issue we will cover further later).

However, it is also important that patients are correctly ‘informed before consenting to procedures or treatments – termed ‘informed consent’. This term describes permission (consent) granted in full knowledge of the possible consequences of a treatment. Doctors must thoroughly explain the risk and benefits of procedures and treatment before patients can consent. This is often discussed in the context of operations, were the general risks include infections, treatment failure, anaesthetic complications etc.

However, a very current issue is the question of how much information you give a patient. Do you just list the common complications, or every possible complication (even is the risk is insignificant)? This is an area of recent change and the current ‘advice’ is to focus on the particular patient in question and the risks most relevant to them. For example, there was a recent case in which a gentleman who was not informed about the risk of blindness following a procedure. This gentleman was already blind in one eye and lost sight in his functioning eye as a result of the procedure. Although the doctor had not informed him of this complication, as the risk was incredibly small, it would have been an area of great importance to the patient, and should have been discussed.

However, there are two exceptional case when a doctor when a doctor is not required to disclose the risks of a procedure.
– If the patient tells the doctor they would rather not know the risks
– If the patient is in need of urgent treatment and is unconscious (if it is not urgent, doctors must wait until they regain consciousness)

Informed consent. An essential legal concept to be aware of and a great thing to mention in interviews. Best of luck everyone!

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