From the UK – in 2009, the NHS [National Health Service] released a legally binding charter setting out rights and responsibilities for those who use and work in the system.
Seven years later – just last week the Royal College of Surgeons set out guidelines for doctors that they must no longer tell patient what treament they need, but instead inform them of options and let the patient choose.
Doctors will no longer be able to decide for patients what treatment is best, or what information to withold and what to share about treatment options. Patients will have legal right to all information to make their choice.
Interestingly this has not been about as a way to improve patients ability to make informed choice – but spurred into action by a court case to prevent hospitals getting sued when doctors get it wrong.
Still. It’s way past time doctors stopped thinking its their job to decide for us.
Of course, many clinicians complained, still are complaining and data from trials showed that such consultations do take longer , d’oh! Of course, explaining options and risks takes time, sometimes twice as long [which is a big part in why so many don’t do it already]. But trials data also showed that times for post-op consultations for surgery for instance were reduced – because patients understand better what’s happening an dwhat to expect because they had it explained to them before they made their choice.

Er… about time, Doc ??.
Original at: http://www.telegraph.co.uk/news/2016/10/26/the-end-of-doctor-knows-best-as-medics-are-told-to-let-patients/
See also…
Guardian, Sep 2009
NHS constitution ends era of ‘doctor knows best’
A legally binding NHS [National Health Service] constitution that is designed to end the era of “doctor knows best” will be unveiled today by Alan Johnson, the health secretary.
In a Guardian interview, he said patients will gain a new legal right to information about the options available for free treatment on the NHS in England.
It will no longer be enough for a doctor to recommend painkillers for chronic backache without informing the patient of the benefits and risks of physiotherapy or surgery, if these are medically appropriate alternatives.
The constitution will for the first time set out the rights and responsibilities of patients, NHS staff and the organisations that deliver services, including private hospitals and voluntary bodies that provide care for NHS patients.
A draft version, published for consultation last year, said patients should have the right to make choices about the type of treatment that may be appropriate. Johnson said the public thought the right to choose was meaningless if it was not accompanied by a right to information about the choices available.
The constitution will say: “You have the right to choice about your NHS care and to information to support these choices. The options available to you will develop over time and depend on your needs.”
A senior Department of Health source said: “Gone will be the paternalistic days of being told by the doctor that you can’t have physiotherapy for your back pain, or referral to an orthopaedic consultant. If you have prostate cancer, you will get the information you need to choose whether to go for an operation or opt for a period of watchful waiting. If you need a hysterectomy, you will be told about the benefits and risks of minimally invasive surgery.”
The constitution will give patients limited rights to be treated in other EU countries. Other rights include:
- Choice of GP practice and preference for using a particular doctor;
- Access to drugs and treatments that have been recommended by the National Institute for Health and Clinical Excellence (Nice);
- Access to vaccinations that have been recommended by the Joint Committee on Vaccination and Immunisation;
- Privacy, confidentiality and an expectation that the NHS will keep confidential information secure;
Patients will have a responsibility to:
- Register with a GP practice;
- Treat NHS staff and other patients with respect;
- Follow the agreed course of treatment and talk to the clinician if this is difficult;
- Keep appointments or cancel within reasonable time.
The document says people failing to keep appointments may no longer be entitled to be treated within the maximum waiting times. But there will be no financial penalties on patients who fail to meet their responsibilities. Ministers have ruled out withdrawal of treatment from people who smoke, drink excessive amount of alcohol or are obese.
Johnson said: “Since the NHS was founded in 1948, the public has never had such a clear, concise definition of their rights and responsibilities brought together in one place … I would be most surprised if this constitution does not become something people refer to over and over again.
“Some people have said this is Tory-proofing the NHS [making it harder for a future government to take away services or require people to pay for them.] The only way to Tory-proof the NHS is by electing Labour governments. But much of this constitution would make it more difficult to change the NHS.
“It says NHS services should be free of charge, except in limited circumstances sanctioned by parliament. It says the right of access to NHS services should not be refused on unreasonable grounds. It should be a comprehensive service available to all, with a duty to each and every individual it serves.”
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