My story in the Daily Mail today, http://dailym.ai/1JfVhTB should be seen as a tribute to two outstanding individuals who have fought unsafe medical practice that has been ruthlessly supported by the authorities - on behalf of all of us.
John Clarke discovered that his mother Marlene's consent form appeared to have been changed post-surgery to accommodate mistakes made during the op. His extraordinary persistence - as first told in HSJ (http://bit.ly/1BIXPHm) - in holding to account those responsible led to a CQC visit to a ward in the hospital where she was treated - with the CQC recording its finding that 85 per cent of consent forms had been retained by the hospital.
Nadine Montgomery and her family spent 16 years fighting in the courts to challenge the view that Nadine’s consultant obstetrician was right to make a decision on her patient’s behalf - that resulted in avoidable brain damage to her son, Sam, now 16. Her doctor’s view was upheld by the British courts until three months ago. Now the Supreme Court has judged in favour of Nadine Mongtomery, 'ending paternalism in healthcare'.
If these two individuals had not devoted years of their lives to heart-breaking & exhausting effort in holding to account the doctors who they believed had acted without consent, we would know nothing about either of these terrible injustices. Which suggests that this is happening more often than is good for us.
Shared decision-making isn't a simple issue. Doctors have to find extra time to discuss complex choices. And patients may be unaware of the importance of informed consent, uninterested in participating - and, as lawyers point out, may well know next to nothing about how to weigh up competing risks. But it’s health policy and there’s evidence that it’s good medicine. As such doctors can’t carry on ignoring it - as they clearly are doing.
For doctors who can’t or don’t want to spend the time discussing decisions, there are shared decision aids (sdm.rightcare.nhs.uk) - a little known but cutting edge and potentially powerful new source of support for people facing difficult health choices - developed by people like risk genius Prof David Spiegelhalter. Yet doctors whose patients could benefit ignore them, says Angela Coulter of the Informed Medical Decisions Foundation. Who in the Department of Health take a lead to bring shared decision-making in healthcare into the 21st century?
My view on what counts in healthcare
Health risks of MedApps – How I helped MHRA to do its Job
How I helped to MHRA to police Health Apps If you Googled ‘skin cancer’ two weeks ago, you may have found a health app, Mole Detective, on Google Play that Read more…
Do we really need a reporters’ guide to rheumatoid arthritis?
As far as I know, RA is a disease with well-established therapy that is becoming increasingly uncommon – and am curious to know the rationale for paid-for publication in a Read more…
A way forward for quality peer review
July 31, 2014, BMJ
Blind faith that the publication of medical research in peer reviewed journals elevates a study to the status of “the evidence,” and therefore “the truth,” may be on the wane among those in the know. But for the public, and a vast number of doctors, this “naïve and misplaced” credulousness persists.
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