Singapore

Doctors to have new guidelines on informed consent

They will help doctors to move away from defensive medicine and ensure patients can make informed decisions

Doctors will be given guidelines on what they need to tell patients about more common procedures, in recommendations to ensure patients are better able to make informed decisions about their own treatment and that doctors are not unfairly penalised for omissions.

A workgroup set up to address concerns surfaced by the medical fraternity regarding informed consent and other matters has recommended that professional bodies themselves come up with the guidelines, which should deal with common side effects, as well as those that are less common but serious.

Other recommendations by the workgroup deal with the long delays faced by doctors in having complaints against them heard.

Its report containing 29 recommendations has been accepted by the Ministry of Health.

The workgroup was set up in March by the ministry following two high-profile cases in which the doctors were first punished, then exonerated in complaints made against them.

Senior Counsel Kuah Boon Theng, co-chair of the workgroup, said at a press conference at the ministry yesterday it was given a "blank canvas" to identify issues and how to correct them, with "patient safety and welfare" the prime consideration.

The group met more than 1,000 doctors as well as patient advocacy groups.

An issue that came up time and again was the assertion that doctors were moving towards defensive medicine, which included overloading patients with information to protect the doctor's own interest, rather than the patient's.

The concerns rose after a case earlier this year in which a doctor was fined $100,000 for not telling a patient about side effects of a common injection.

Some doctors told the workgroup they had stopped offering such steroid injections, raised the price, or were giving patients complete lists of side effects for every treatment.

MORE ANXIOUS

Ms Kuah said as a result, patients were not better informed and could end up more fearful or anxious.

The report said informed consent is key to a good patient-doctor relationship "because it is only when patients know and understand the treatment they are receiving that their interests are served".

Aside from the guidelines, doctors may provide more information, depending on the patient.

Doctors must also answer any questions from patients, and they must not be "selective and steer patients to a particular treatment", said Ms Kuah.

To expedite justice in complaints made against doctors, the workgroup recommended complaints be dealt with within 18 months, instead of up to six years.

Some changes will need amendments to law, Senior Minister of State for Health and Law Edwin Tong told reporters yesterday.

These will be in place by the first half of next year.

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MEDICAL & HEALTH