Asset or burden? Informed consent and the role of the family: Law and practice

The paper discusses the issue of family involvement in the process of obtaining consent to treatment. Legally, doctors have a duty to inform the patient, and the patient has a right to be informed before making a decision. In this context, however, there is no requirement to involve relatives or to take into account their interests or requests. Yet, findings from in-depth interviews with NHS general practitioners presented in the paper indicate that in reality relatives have a substantial impact on the process of informed consent. Their presence may lead the doctor to provide more information to the patient and help the patient better understand the information conveyed by the doctor. Ultimately, the relatives' involvement enhances the patient's ability to make an informed decision, even though in some cases - when the relative is dominant - this may have a negative impact on the channel of communication between doctor and patient. These findings reflect a relational approach to patient autonomy. They lead the author to suggest that the current doctor-patient partnership model in English medical law would benefit by the addition of relatives as an integral component of the decision making team. Such a significant shift in the legal approach requires changes in the type of information conveyed by the doctor to the patient; in the means to increase the patient's understanding; and lastly at the point when decisions are actually made.