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Informed consent is key, eye doctors told at special session

Doctors need to scrupulously record in detail their pre-treatment discussions with patients and ensure consent is fully informed, delegates attending a special session on medical ethics at the ICO Annual Conference were told.

Speakers at the session included Ms Patricia McGettrick, ICO Ethics Committee, as well as GP Dr Diarmuid Hegarty and Barrister-at-Law Mr Asim Sheikh, both of whom are on the faculty of the RCSI MSc in Healthcare Ethics and Law course.

Clinicians need to appropriately manage patients’ expectations as well as their own and record carefully their discussions on what exactly they are offering patients, the risks and expected outcomes, the session stressed. Additionally, patients should have a record of this.

Speaking to MI, Dr Hegarty stressed that doctors need to write down the details of their discussions and “exercise caution”. He commented: “Consent is vital and sometimes that is not taken seriously enough, but it should be. It is also important to point out that a lot of medico-legal cases hinge on record-keeping and it cannot be over-emphasised how important that is.”

Dr Hegarty noted that “times have changed and patients do not want a paternal attitude” when discussing their care. Doctors also have to accept that patients have the right to refuse treatment and make their own informed choices, he added.

Also speaking to MI, Mr Sheikh said discussions have to be tailored to patients’ individual needs so they can fully understand the conversation.

“Consent has been an issue for a long time and the key message now, emerging from the law and courts, is the importance of dialogue, actual physical dialogue between doctors and patients. The main thing now from every working group, every report, every organisation, when a problem occurs, is the necessity of putting the patient at the centre. So real discussion now has to focus on how we actually do that,” he said.

Mr Sheikh also stressed the importance of keeping comprehensive records of all patient treatment and consent discussions. Often, clinicians cannot remember the exact details of the particular consultation that a patient may take a case over. The doctor may thus lose a case even if they feel informed consent was obtained and all risks were discussed.

Meanwhile, the meeting also featured an inspiring talk from motivational speaker Mr Mark Pollock. He has overcome significant physical challenges, including full blindness in 1998 at the age of 22 and a fall in 2010 that left him paralysed.

Mr Pollock has competed in ultra-endurance races across deserts, mountains and the polar ice caps and was the first blind person to race to the South Pole. He won silver and bronze medals for rowing at the Commonwealth Rowing Championships in 2002.

Mr Pollock is now exploring the frontiers of spinal injury recovery as the world’s leading test pilot of Ekso robotic legs, combined with aggressive physical therapy, neuro-modulation and innovative electrical stimulation. He is on a mission to find and connect people around the world to fast-track a cure for paralysis. Mr Pollock told the meeting that it was reassuring to be “talked to like a real person” by his consultants and emphasised how important this is for doctors to do.

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