Valid Consent in Dental Practice
The Legal Framework
The landmark case of Montgomery v Lanarkshire Health Board emphasised the need for patient-specific consent in healthcare. This ruling requires clinicians to:
- Inform patients about material risks associated with treatment.
- Understand what risks or information each individual patient would find significant.
For children unable to consent, this duty extends to informing their legal guardians about these material risks. Similar principles apply to adults lacking capacity to make decisions. This approach aligns the law with professional regulatory guidance.
The Process of Obtaining Consent
Valid consent is a fundamental requirement before initiating any treatment, physical investigation, or personal care. This process facilitates shared decision-making and involves:
- Discussing all reasonable treatment options, including the option of no treatment.
- Ensuring the patient is aware of the risks and benefits of each option.
Best Practices in Consent Discussions
Key Actions for Practitioners:
- Clearly explain the material risks and benefits of all reasonable options, including the choice to decline treatment.
- Record detailed notes in the patient’s clinical records, including:
- The advice given.
- Risks and benefits discussed.
- The patient’s questions and responses.
- Their final, autonomous decision.
Guiding Principles and Standards
The General Dental Council’s Standards for the Dental Team (Standards 3.1, 3.2, and 3.3) and NICE guidelines stress the importance of tailoring treatment discussions to the patient’s values and preferences. Clinicians must actively involve patients in decisions, ensuring they understand and are comfortable with their chosen path of care.