Consent - Do We Have to Mind-Read Now?

July 28, 2015

I have recently been reading an article in the BDJ written by L D'Cruz and H Kaney entitled 'Consent - a new era begins'. For those of you who do not subscribe to the BDJ or have not accessed this article by other means, it is interesting reading. See

In March 2015, the Supreme Court judgement in Montgomerie vs Lanarkshire changed the law relating to consent for clinicians, including dentists. In a nutshell, the way in which dentists are required to practice has changed very little. However, what clinicians are required to do by the GDC in its Standards for the Dental Team is 'find out what your patients want to know as well as telling them what you think they need to know'. Now, is it me or at some point is this process going to require a certain level of mind-reading and/or telepathy? The reason I am pondering over this point is that no matter how far we inform and educate patients about the 'what they need to know' bit, how can we ever be sure that we have fully covered 'telling them what you think they need to know'? Every patient is different and one patient's needs is not necessarily equal to that of another. Every clinician works in an individual way and thinks differently too. In this equation, one plus one does not necessarily make two to me. If a procedure goes wrong or not, couldn't a patient sue their dentist purely on the grounds that their dentist did not tell them 'what they needed to know' pre-treatment?

Being aware of this legal case and giving patients 'fact sensitive' advice may not be enough to avoid a litigious situation. Dentists need to ensure that they are 'sensitive to the characteristics' and subsequent needs of every patient too. How is this possible in the current world of general dental practice and within the time constraints we have to handle. I haven't managed to tune into my husband's characteristics and be sensitive to his every need after 15 years of marriage so how is a clinician expected to do the same with a patient in a tiny fraction of this time?

My feeling is that clearer guidance needs to be given to the process of gaining consent in order to protect clinicians. Hasn't our profession got enough to worry about without another loophole in the system?