The modified Montgomery test for medical negligence places a heavy burden on doctors for informed consent, requiring doctors to provide patients with all information relevant and material to proposed treatment.
The recently passed Civil Law Act is welcome as it gives medical professionals a little latitude on consent-taking. Yet, it does not lighten the burden of material information provision on the part of the doctor.
Dr Wang Zhemin highlighted the problems of obtaining a patient’s medical history from electronic health records (Recent tweaks to Act hinder building of doctor-patient relations, Oct 10).
Often, patients are not forthcoming with their own history as they expect the process to locate this information from the system is simple and instantaneous.
However, as Dr Wang has pointed out, in reality, it is complicated and extremely time-consuming.
Moreover, doctors are required to address every concern and answer all questions posed by their patients.
Contrary to the assumption that patients ask only reasonable questions, robust psychology studies demonstrate that emotions, like anxiety, accentuate an aversion to ambiguity. The latter engenders the need for definitives, which is diametrically opposed to the probabilistic nature of medicine.
Explaining options, ambiguity and associated algorithms for each potential outcome takes prodigious amounts of time.
Even when told in reassuring tones the truth that any intervention has a small but real possibility of ending in death, patients are often frightened and accuse doctors of being unsympathetic.
Therefore, in the light of the new law, new policies may need to be implemented. For example, key performance indicators regarding consultation times need to be adjusted, in conjunction with new fee structures.
Patients also need to understand that the practice of medicine carries risk, and they have a part to play in managing this risk.
Their questions should therefore be measured and directed accordingly. This shared responsibility will go a long way to restoring the doctor-patient relationship, now fractured by mutual mistrust.
Lastly, I hope that Dr Wang’s superiors will take his comments in the right spirit. After all, those who highlight the shortcomings of the system they work in intend it for good.