A Doctor’s Duty to Obtain Informed Consent
In a significant decision, the Supreme Court has issued a crucial ruling in McCulloch v Forth Valley Health Board, shedding light on a doctor’s obligation to secure informed consent from patients regarding their treatment. This ruling provides significant clarity on the interpretation of “reasonable alternative or variant treatments” as established in the renowned case of Montgomery v Lanarkshire Health Board  UKSC 11.
The case presented a contentious issue: whether the determination of a treatment as a “reasonable alternative” should rely on professional skill and judgment using the Bolam test, or if it should be assessed independently, considering the specific circumstances, objectives, and values of individual patients.
In a unanimous decision, the Court clarified that the assessment of a treatment as a reasonable alternative should be conducted through the application of the professional practice test, encompassing the Bolam test as qualified by Bolitho. The Court confirmed the following key points, shaping the doctor’s duty to obtain informed consent:
- Mere preference: Doctors cannot merely inform patients about their preferred treatment options. Instead, once a range of reasonable treatments has been identified, doctors must thoroughly explain all viable alternatives and associated risks to the patient, unless the patient explicitly expresses a contrary preference.
- Obligation to disclose reasonable treatments: Doctors are obligated to disclose all reasonable treatments and their associated risks to patients, provided they are clinically appropriate according to the professional practice test. However, doctors are not obliged to inform patients about treatments deemed unreasonable or clinically inappropriate.
- Alternative body of opinion: Doctors are not required to disclose treatments supported by an alternative body of opinion if they fail to meet the criteria of clinical appropriateness according to the professional practice test.
The Supreme Court’s ruling clarifies the doctor’s duty to obtain informed consent and establishes a robust framework for assessing reasonable alternatives. It emphasizes the importance of considering professional judgment, adhering to prevailing medical standards, and accommodating the specific circumstances and values of each patient.