Good Medical Practice in Paediatrics and Child Health

Good Medical Practice - May 2002Relationships with patientsObtaining consent17. You must respect the right of patients to be fully involved in decisions about theircare. Wherever possible, you must be satisfied, before you provide treatment or investigatea patient’s condition, that the patient has understood what is proposed, and why, anysignificant risks or side effects associated with it and has given consent. You must readand follow the guidance in the GMC booklet Seeking Patients’ Consent: The EthicalConsiderations.• This general obligation applies to paediatricians when the child old enough to understandthe nature, purpose and implications of the treatment.• Paediatricians must also involve parents in the decisions when appropriate.• Written consent is not required for all investigations or treatments, but there must beclear guidelines for those that do need such consent, and those that do not• The Department of Health consent forms must be used for obtaining consent for treatmentsand procedures. Paediatricians should be aware of the correct forms to usewhere children and parents are to give consent and for the circumstances under whichsuch consent is required.• In all cases the paediatrician must document discussions with the child and/or parents inthe notes. It is good practice to be accompanied by a nurse during these discussions.• Where the child is old enough to understand, these discussions and the consent procedureshould involve the child or young person.• Continuing information must be given to the parents, and where appropriate the child,with opportunities to ask questions so that they are involved and consent to the plan ofmanagement can be implicit.• Decisions about a child’s care where the parents disagree with medical advice must behandled sensitively. In exceptional cases, for the safety and best interests of the child orbaby, the medical team will not feel it appropriate to agree with the parents’ wishes.This must be handled properly and must involve due recourse to other bodies such asclinical ethics committees, social services, the police or the courts.• Consideration should be given to consulting the medical defence organisations and thelegal profession.• Where withdrawal of treatment is contemplated this must be handled in accordancewith the guidelines produced by the RCPCH in Withdrawing and Withholding Life-Saving Treatment in Children 10 .Unacceptable practice:• Failure to involve the parents or carers – or where appropriate the child - in decisionsabout care, without good reason• Management of withdrawal of treatment without consideration of the RCPCH guidelinesRespecting confidentiality18. You must treat information about patients as confidential. If in exceptionalcircumstances there are good reasons why you should pass on information without apatient’s consent, or against a patient’s wishes, you must read and follow the GMCguidance on Confidentiality: Protecting and Providing Information and be prepared tojustify your decision to the patient, if appropriate, and to the GMC and the courts, if13