A patient sometimes consents to a particular line of treatment because of the apparent advantages or benefits as described by the dentist. Care should be taken to ensure that the information given is balanced and accurate, and that any claims (as to likely success) can be substantiated. Statements such as “your crown will last for lifeâ€, or “your molar root treatment will be 100% successful†or “I guarantee you will have no problem†may dramatically weaken the value and validity of the consent contained. Continue reading
Author Archives: chzechze
Consent – Dental Protection Part 9
Evidence base
Some clinicians believe that patients must be provided with every last detail of the evidence base, in order to enable them to assess the information objectively and to compare alternative treatment options. Not only is this another onerous prospect for the clinician, it also fails to recognise two important aspects of the consent process. Continue reading
Consent – Dental protection Part 8
Material risks
In an Australian case (Rogers v. Whitaker), the High Court of Australia ruled that a 1 in 14,000 risk of blindness associated with a procedure, should have been disclosed to a patient. In this example, the patient was already almost blind in one eye and the doctor should have warned of the possible risk of blindness to the other eye no matter how slight in these circumstances, regardless of whether the patient had expressly asked the question or not. Continue reading
Consent – Dental Protection Part 7
Avoid restricting the person’s rights
- See if there are other options that may be less restrictive of the person’s rights.
- Weigh up all of these factors to work out what is in the person’s best interests. Continue reading
Consent – Dental Protection Part 6
Assessing lack of capacity
An individual’s capacity must be assessed specifically in terms of their capacity to make a particular decision at the time it needs to be made.
This means that a person may lack capacity to make a decision about one issue but not about others. Care must be taken not to judge an individual’s capacity merely by reference to their age, appearance or medical condition. Continue reading
Consent – Dental Protection Part 5
Children
Most children eventually reach an age where they can grasp relevant facts about their body and about proposed treatment to it. They can give consent to treatment, but the degree of understanding can vary in relation to the complexity of the treatment envisaged. A few children are never, even when adulthood is reached, capable of properly understanding the information given to them and must therefore be considered incapable of giving consent. Continue reading
Consent – Dental Protection Part 4
Competence
In order both to understand the information provided, and to give the necessary authority for consent, a patient must be competent. “Competence†in this context means the patient’s ability to understand the explanations given, about:
- The nature and purpose of a particular procedure;
- Its likely effects and risks; and
- Any alternative treatment and how these alternatives might compare. Continue reading
Consent – Dental Protection Part 3
Influence
We can influence patients consciously or subconsciously by the way in which we communicate with them. For example
The words we use
Whether the words are written or spoken, a patient’s perception can easily be influenced by the words that we choose to use. Some patients will be particularly reactive or sensitive to the use of certain words (eg. “cutâ€, “drillâ€, “injectâ€, “bleedingâ€, “painful†etc); when you are discussing a procedure face to face you can usually see this reaction, and deal with it there and then. But when you use the same words in a letter, you don’t get this opportunity. Continue reading
Consent – Dental Protection Part 2
A landmark legal case involving a medical practitioner (a surgeon) broke new ground just a few years ago and demonstrated just how far the UK courts would go in order to uphold patient autonomy, even in the face of well-established legal principles:
“I start with the proposition that the law which imposed a duty to warn on a doctor has, at its heart, the right of a patient to make an informed choice as to whether, and if so when and by whom, to be operated on†Continue reading
Consent – Dental Protection Part 1
A patient’s informed consent to investigations or treatment is a fundamental aspect of the proper provision of dental care. Without informed consent to treatment, a dentist is vulnerable to criticism on a number of counts, not least those of assault and/or negligence – which in turn could lead respectively to criminal charges and/or civil claims against the dentist. Furthermore, the question of consent arises increasingly at the heart of complaints made under the NHS Complaints Procedure, and complaints to the General Dental Council on matters on professional ethics and conduct. Continue reading