Selected highlights from draft GMC consent guidance Part 5

[holyshedballs]

The GMC have really taken the judgement of the Supreme Court to heart. They make it clear that patients with the capacity to make decisions make their own decisions about their health. The GMC say:

"Where an adult patient has capacity, and unless they are subject to specific legislation that restricts their ability to make decisions (see paragraphs 104–107), they have the right to make their own decisions about their care, and they can do so in consultation with people of their choosing. "

The guidance even goes further, by stating that patients can make their own decisions in consultation with people of their own choosing. So I take this to mean that patients can consult patient support groups such as Thyroid UK.

However, this is temepred with additional advice to doctors:

"If a patient asks for treatment or care that you don’t think would be beneficial to them, you should explore the patient’s reasons for requesting it. When assessing any likely benefit, you should take into account factors that are significant to the patient, including non-clinical factors such as the patient’s beliefs or views and the possible effect on their lifestyle. If after further discussion you still consider that it would not be of benefit to the patient, you do not have to provide the treatment or care. But you should explain your reasons to the patient and explain any other options that might be available, including the option to seek a second opinion".

This applies to our case, for example when doctors will not prescribe T4 if TSH is in the reference range. It does however, advise doctors that they should explore your reasoning for requesting T4 (to continue the example). To my mind this is where the patient produces the evidence from this site, Paul Robinson's books, other internet sites etc. in compliance with paragraph 9.

The draft guidance gives the doctor permission to refuse to provide care if s/he doesn't believe the evidence. That is a discussion for a different post.

[serenfach]

Thank you for this post. It is very pertinent for those of us who take NDT. Most of us have read up on the subject, taken the decision to change to NDT and feel better. We are told to take control of our health, but if we do we are shot down in flames. The GPs do not like us taking NDT as they do not know enough about it, but even if we provide information to them, they dont read it.

Many of us have been on T3 in the past, and found it very beneficial. Now we cannot get it. It is not because it may not be beneficial, it is due to cost. "factors significant to the patient" such as feeling better do not seem to count. I have never been told of any other option apart from taking more T4, which made me ill.

Despite the fact it is in my notes how ill I became on T4, and how much better I am on NDT, my GP does not like it. He can actually see how beneficial NDT is to me, but does not like the fact he is not in control. I refuse to be ill to suit his ignorance. Maybe I will just utter "GMC and Supreme Court" under my breath at the next appointment.

[holyshedballs in reply to serenfach]

The Supreme Court supports you

Can I suggest that you don’t mutter it under your breath but have an out loud discussion with your doctor based on the Montgomery decision and the full Guidance when it is finally published