Things you may assume your doctor tells you.. but he may not….even though he is legally bound to!
Things you should be able to TRUST your doctor to do…
but you can not!.
Am writing this, because sadly a close friend of mine has had very negative, lifechanging experience. Thus i have personally had direct experience of this.
and since then despite HUGE amounts of researching, i have found large amounts of anecdotal evidence to suggest that this is a common practice! This is to be read in a general context as information flow, and partnership regarding sharing of information is at the very HEART of healthcare. Information open flow… between partners… i’d imagine partners to be equal…alas not here..
There are in NHS some very ethical doctors and there are some very arrogant do not question me practitioners!
This is a MASSIVELY important issue to me personally….and i can’t count the amount of my life that i have spent questioning, researching, and sometimes PROVING that Doctors need to realise they are not infallible!
I abhor the God-Complex of many healthcare providers, or to give it the more polite and equally superior and condescending medical term…it is “Medical Paternalism”.
A lot of medical legal cases depend on “informed consent” of the patient being given.
If you are given ONE tablet, you are meant to understand its use, its reason and its potential side effects.
There is a PIL – a Patient Information Leaflet with your drug. This legally warns you of the potential complications….although its only fair to tell you, that through bad experience, we have learned that the PIL in UK may not have the level of detail on complications as the PIL in USA -a more legislative society, seems to merit more ass covering on drug company behalf.
If you have any problem then with your medication, as cited on the leaflet, and as firstly explained by the Doctor, then you go back and report it…your Adverse Drug Reaction…and you together discuss new plans of treatment appropriate for your case.
in your timed 10 minute slot, is your doctor/GP meant to examine, diagnose, notate and record in your file and explain to you possible problems with meds? YES
this stands equally true for:
- an adult
- a child
- a child with mental impairment
- an adult with mental impairment
so YOU the patient, YOU the parent or YOU the carer should ALWAYS be giving informed consent to any change in prescription or treatment.
The GMC is the General Medical Council…the governing body for GPs, specialists, Trust employees….states in its good practice guide some VERY conflicting and contradictory advice! These are available on line at http://www.gmc-uk.org/ where the catchy slogan is
“Regulating Doctors, Ensuring good medical practice”
Let me give you a few examples, which MAY surprise you.
In the GMC “Ethical Guidelines” , in a section called Discussing Side Effects and other Risks:
28. …”the amount of information about risk that you should share with patients will depend on the individual patient and what they want or need to know”
29. .. “you MUST identify the adverse outcomes that may result from the proposed options”
now does this mean a doctor, any Doctor decides what I NEED TO KNOW? If he is treating my child, he decides how much information I NEED TO KNOW? i don’t think so!.
To compound the confusion i would like to share with you a section from the guidelines given by the Royal College of Paediatrics and Child Health. http://www.rcpch.ac.uk/child-health
Many drugs used in children, are not actually licensed for use on children – as they are generally not the trial sample. So doctors make their decisions on use cautiously, i presume, as the effects of these drugs on children are unknown/unrecorded officially. if you google “the use of unlicensed medicines or licensed medicines for unlicensed applications in paediatric practice” you will find the full leaflet, but let me save you time a quote a few bits..they are told
“in general, it is not necessary to take additional steps, beyond those taken when prescribing unlicensed medicines, to obtain the consent of parents, carers and child patients to prescribe or administer unlicensed medicines or licensed medicines for unlicensed applications”
or in real terms, an adult medication can be used on your child, or a medication designed not quite for the condition they are using it on your child for, and you MAY NOT be given any more information than if he were on Calpol.
now i do not want to alarm you, but imagine your child cannot communicate? How are you to know if there are serious side effects if you are not told what to look for? This is NOT good enough to me…as a parent.
but the final and most important statement which is my rule of thumb, comes from The GMC in its guidelines for “good practice in prescribing and managing medicine and devices”
71…”you MUST give patients (or their parents or carers) sufficient information about the medicines you propose to prescribe to allow them to make an informed decision.”
At this stage i was still galled at the “SUFFICIENT” in this sentence but they put it very definitely in the next sentence when they say:
72…”you must ALWAYS answer questions from patients (or their parents or carers) about medicines fully and honestly!”
So next time:
- you feel rushed by a GP as he looks at the clock,
- you feel a bit unwell on a new tablet,
- your GP refuses to give you information you request from him on a medicine
- you visit your child in hospital
- or your parent in care, when you lift up the notes ad see the list of drugs…ans almost feel you are being sneaky and will get in trouble
- QUESTION , QUESTION, QUESTION EVERYTHING!
Read all information you get!
Ask are all the drugs you child is on licensed for use in children!
Ask about the cocktail of drugs used on your elderly parent!
Do not stop until you are happy that you have full information!
Check the possible combinations of repeat prescriptions you are on…!
DO NOT ASSUME that you have so far been given a full disclosure of information….
but GET IT!
NOBODY will play GOD with my health or the health of any of my family!