Bill Harvey: I won’t do what you tell me
Author: Bill Harvey
In the current scheme for registration run by the College of Optometrists, one area where many trainees fall down is regarding the issue of consent.
Interestingly, most seem to understand the need to follow the rules about data protection and the need for informed consent before contacting a third party regarding personal clinical information. It is when you introduce real life situations that confusion seems to arise. For example, when asking what you might do if a worried relative contacts the practice about a patient you have seen recently, most feel it is their duty to explain the findings of the test and reassure the caller without any resort to consent from the patient first.
On the other hand, most adhere so strictly to confidentiality rules. They feel there are no circumstances where it is appropriate to contact a third party without informed consent. Never mind if there is an argument that the need for consent is overruled by a concern about public safety, as with the case of a driver well outside the legal vision limit. Obviously, the general swing towards primary care clinicians having greater freedom to contact bodies like the DVLA in such situations has not yet been accepted.
In a recent dispensing CET, the redoubtable Peter Black noted that ‘GOS forms say that a child’s parent should sign on their behalf, but they do not say must. This means legally the child may sign their own forms if competent to do so, with children who have attained the age of 16 automatically assumed to have the capacity to consent.’ It seems that a whole generation of younger teenagers with busy parents are currently at risk of missing eye care.
Look out for your feedback from our last interactive CET exercise regarding informed consent for dilation, which ran earlier this summer, in the next few weeks. Perhaps it is not just for trainees that the issue can be somewhat muddied.