Seven principles of consent

The guidance begins by setting out the seven principles of decision making and consent.

All patients have the right to be involved in decisions about their treatment and care and be supported to make informed decisions if they are able.
Decision making is an ongoing process focused on meaningful dialogue: the exchange of relevant information specific to the individual patient.
All patients have the right to be listened to, and to be given the information they need to make a decision and the time and support they need to understand it.
Doctors must try to find out what matters to patients so they can share relevant information about the benefits and harms of proposed options and reasonable alternatives, including the option to take no action.
Doctors must start from the presumption that all adult patients have capacity to make decisions about their treatment and care. A patient can only be judged to lack capacity to make a specific decision at a specific time, and only after assessment in line with legal requirements.
The choice of treatment or care for patients who lack capacity must be of overall benefit to them, and decisions should be made in consultation with those who are close to them or advocating for them.
Patients whose right to consent is affected by law should be supported to be involved in the decision-making process, and to exercise choice if possible.

Some key aspects of the new guidance are explained below.

Scope and application

At the outset, doctors are reminded that the guidance applies to every health and care decision made with every patient (paragraph 1). This applies equally to decisions about mental and physical health regardless of where the interaction takes place. It also acknowledges that many consultations now take place remotely (paragraph 3).

However, it's recognised that not every paragraph will be relevant to every decision made (paragraph 5), and doctors will need to apply their judgement in individual circumstances, allowing a proportionate approach - such as might arise during the treatment of emergencies where consent is still needed if the patient is conscious, but there will be less time to apply the guidance in detail.

As well as time constraints, the guidance considers availability of resources. Obtaining consent doesn't always need to be a formal, time-consuming process (paragraph 6), particularly in circumstances where verbal consent can be relied upon, such as minimally or non-invasive interventions like examinations (paragraph 7).

Seven principles of consent: latest GMC guidance

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Seven principles of consent: latest GMC guidance