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In May 2005, the General Dental Council (GDC) lauched new guidance documents for UK dental professionals (which they are supposed to have read and adhere to). Of particular interest is the booklet "Principles of Patient Consent", which accompanies the core guidance document "Standards for Dental Professionals". The full guidance documents can be downloaded on the GDC's website (www.gdc-uk.org). The below are excerpts from "Principles of Patient Consent":
Our standard guidance, 'Standards for dental professionals', sets out six main principles which you should apply to all aspects of your work as a dental professional.
It is your responsibility to apply the principles to your daily work, using your judgement in the light of the principles.
The guidance says:
'Respect patients' dignity and choice'
* Treat patients politely and with respect, in recognition of their dignity and rights as individuals.
* Recognise and promote patients' responsibility for making decisions about their bodies, their priorities and their care, making sure you do not take any steps without patients' consent (permission).
It is a general legal and ethical principle that you must get valid consent before starting treatment or physical investigation, or providing personal care, for a patient. This principle reflects the right of patients to decide what happens to their own bodies, and is an essential part of good practice.
Patients have the right to choose whether or not to accept your advice or treatment. The guidance identifies, and is limited to, the ethical principles of getting patient consent which you should apply to your work. It cannot cover all situations.
1 Informed consent
1.1 For consent to be valid, the patient must have received enough information to make the decision. This is what we mean by 'informed consent'.
1.2 You should give patients the information they want and need, in a way they can use, so that they are able to make informed decisions about their case.
1.3 Giving and getting consent is a process, not a one-off event. It should be part of an ongoing discussion between you and the patient.
1.4 Find out what your patients want to know, as well as telling them what you think they need to know. Examples of information which patients may want to know include:
* why you think a proposed treatment is necessary
* the risks and benefits of the proposed treatment
* what might happen if the treatment is not carried out
and
* other forms of treatment, their risks and benefits, and whether or not you consider the treatment is appropriate.
1.5 Always make clear to the patient:
* the nature of the contract, and in particular whether the patient is being accepted for treatment under the NHS or privately; and
* the charge for an initial consultation and the probable cost of further treatment.
1.6 Whenever a patient is returning for treatment following an examination or assessment, give them a written treatment plan and cost estimate.
1.7 If, having agreed an estimate with the patient, you think that you will need to change the treatment plan, make sure you get the patient's consent to any further treatment and extra cost and give the patient an amended written treatment plan and estimate.
1.8 Giving a patient clear information to help them make a decision may involve using written material, visual or other aids.
1.9 Try to meet particular communication needs, for example, by suggesting that the patient brings a friend who can sign or interpret for them, or providing a hearing 'loop'.
1.10 Satisfy yourself that the patient has understood the information you have given them.
1.11 Consider whether they would like more information before making a decision, and whether they would like more time before making a decision.
1.12 Respond honestly and fully to any questions the patient has.
1.13 Involve other members of the dental team in the discussion with the patient, where appropriate. They may have valuable knowledge about the patient's background and particular concerns.
2 Voluntary decision-making
2.1 The patient must make the decision.
2.2 Do not pressurise the patient to accept your advice.
2.3 Patients have a right to refuse to give consent for an investigation or treatment. If they do so, you should respect this decision.
2.4 Once a patient has given consent, they may withdraw it at any time, including during the procedure.
2.5 Make sure that once the patient has given consent, they know how to review the decision with the person providing the treatment.
2.6 Make sure that you are clear how much authority they have given you. For example, whether the patient agrees to all or only part of a proposed treatment plan.
Our standard guidance, 'Standards for dental professionals', sets out six main principles which you should apply to all aspects of your work as a dental professional.
It is your responsibility to apply the principles to your daily work, using your judgement in the light of the principles.
The guidance says:
'Respect patients' dignity and choice'
* Treat patients politely and with respect, in recognition of their dignity and rights as individuals.
* Recognise and promote patients' responsibility for making decisions about their bodies, their priorities and their care, making sure you do not take any steps without patients' consent (permission).
It is a general legal and ethical principle that you must get valid consent before starting treatment or physical investigation, or providing personal care, for a patient. This principle reflects the right of patients to decide what happens to their own bodies, and is an essential part of good practice.
Patients have the right to choose whether or not to accept your advice or treatment. The guidance identifies, and is limited to, the ethical principles of getting patient consent which you should apply to your work. It cannot cover all situations.
1 Informed consent
1.1 For consent to be valid, the patient must have received enough information to make the decision. This is what we mean by 'informed consent'.
1.2 You should give patients the information they want and need, in a way they can use, so that they are able to make informed decisions about their case.
1.3 Giving and getting consent is a process, not a one-off event. It should be part of an ongoing discussion between you and the patient.
1.4 Find out what your patients want to know, as well as telling them what you think they need to know. Examples of information which patients may want to know include:
* why you think a proposed treatment is necessary
* the risks and benefits of the proposed treatment
* what might happen if the treatment is not carried out
and
* other forms of treatment, their risks and benefits, and whether or not you consider the treatment is appropriate.
1.5 Always make clear to the patient:
* the nature of the contract, and in particular whether the patient is being accepted for treatment under the NHS or privately; and
* the charge for an initial consultation and the probable cost of further treatment.
1.6 Whenever a patient is returning for treatment following an examination or assessment, give them a written treatment plan and cost estimate.
1.7 If, having agreed an estimate with the patient, you think that you will need to change the treatment plan, make sure you get the patient's consent to any further treatment and extra cost and give the patient an amended written treatment plan and estimate.
1.8 Giving a patient clear information to help them make a decision may involve using written material, visual or other aids.
1.9 Try to meet particular communication needs, for example, by suggesting that the patient brings a friend who can sign or interpret for them, or providing a hearing 'loop'.
1.10 Satisfy yourself that the patient has understood the information you have given them.
1.11 Consider whether they would like more information before making a decision, and whether they would like more time before making a decision.
1.12 Respond honestly and fully to any questions the patient has.
1.13 Involve other members of the dental team in the discussion with the patient, where appropriate. They may have valuable knowledge about the patient's background and particular concerns.
2 Voluntary decision-making
2.1 The patient must make the decision.
2.2 Do not pressurise the patient to accept your advice.
2.3 Patients have a right to refuse to give consent for an investigation or treatment. If they do so, you should respect this decision.
2.4 Once a patient has given consent, they may withdraw it at any time, including during the procedure.
2.5 Make sure that once the patient has given consent, they know how to review the decision with the person providing the treatment.
2.6 Make sure that you are clear how much authority they have given you. For example, whether the patient agrees to all or only part of a proposed treatment plan.
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