The recent Supreme Court ruling in the case of Montgomery v Lanarkshire Health Board[1] has attracted attention in the medical press[2]. The effect of the ruling strikes a fatal blow to medical paternalism, ending once and for all the ‘doctor knows best’ attitudes endorsed in the cases of Bolam and Sidaway.

The Montogomery case requires that doctors take reasonable care to ensure that their patient knows and understands the risks of the treatment that is proposed, taking in to account the circumstances of that particular patient.

The doctor must also take care to ensure that the patient knows about the reasonable alternative options to the proposed treatment, so that they are sufficiently informed to make their own choice about which treatment they prefer.

These are all concepts already embraced by GMC guidance on consent[3], following the cases of Pearce, Rogers, Al-Hamwi and Birch.

To those of us engaged in medico-legal practice, it is useful to hear that ‘the use of a pro forma approach to consent - repeating a memorised script - is a common but ethically and legally dubious practice’[4] as this seems to be the norm for those clinicians that regard the consent process as simply a tick-box exercise.

[1] Montgomery (Apellant) v Lanarkshire Health Board (Respondent) [2015] UKSC 11.

[2] New rules of consent: the patient decides. Fiona Godlee, editor in chief. BMJ 2015;350:h1534 doi: 10.1136/bmj.h1534 (Published 19 March 2015)

[3] http://www.gmc-uk.org/Consent___English_0914.pdf_48903482.pdf

[4] Daniel K Sokol. Update on the UK law on consent. BMJ 2015;350:h1481 doi: 10.1136/bmj.h1481 (Published 16 March 2015)