It has now been three years since the Supreme Court passed down its landmark ruling in the Montgomery v Lanarkshire case. The question for clinicians when considering consent continues to be: do we get it? Yes, the question has an amusing double meaning, but the reality is far more serious. Do we understand what is needed now from the consent process and, more importantly, do we obtain that properly from patients?

The nature of consent taking hasn’t changed, but thanks to Montgomery, the emphasis on spending more time with patients to understand what is materially important to them has become far more critical. Unfortunately, consent litigation cases since Montgomery suggest that lessons have still not yet been learnt, leading us to answer our original question with “no, we don’t get it, and therefore, we don’t get it”!

The Montgomery ruling requires clinicians to divulge risks which are materially significant to each individual patient.  This requires extra (precious) time and in some cases almost the need for a crystal ball…two things that most clinicians probably do not have. However, by not fulfilling these obligations, the risk of being on the end of a consent litigation case is now much higher.

If we don’t fully understand informed consent, how can we obtain it legally? If we don’t understand what is important to our patients, how can we inform them properly?

If we don’t get it, we won’t get it!