‘Don’t tell me the risks’

Getting informed consent is at the forefront of doctors’ minds – but how can you best manage a scenario where a patient doesn’t want to know the risks? Dr Gabrielle Pendlebury advises. 

Consent has evolved in the last decade due to some high-profile and costly cases. Doctors need to make sure they gain informed consent and provide patients with the relevant information so they can make an informed decision. 

Gaining informed consent also allows the doctor to protect their professional welfare, should they need to. 

But what happens when a patient puts their full faith in their treating doctor and feels they don’t need to know the risks? When, if ever, is there scope to ignore consent? 

Previously, medical paternalism trumped any notion of patient autonomy. In Moyes v Lothian Health Board in 1990, Lord Caplan gave a summary of how the law believed the doctor knows best:

‘When the patient entrusts himself to the doctor, he expects, and is entitled, to be kept fully informed about decisions which are to be taken and which may concern his welfare, but the paramount expectation is that the doctor will do what is best to care for the patient’s health …