Good Medical Practice describes what is expected of all doctors registered with the GMC. The guidance that follows, which is for all doctors, develops the duties and principles set out in Good Medical Practice and in our other guidance. It focuses on children and young people from birth until their 18th birthday
Comprehensive guidance for doctors on care at the end of life, including difficult decisions on when to provide, withhold, or withdraw life prolonging treatment, will go out for consultation from the UK’s General Medical Council in March. The draft guidance was approved by the council at its February meeting, subject to minor amendments. The consultation will be launched in the week beginning 23 March and will end in July. The new advice takes account of the Mental Capacity Act 2005; government strategies on end of life care in England and Scotland; GMC guidance in 2007 on consent; recent research; and a Court of Appeal judgment on a legal challenge to the GMC’s 2002 guidance Withholding and Withdrawing Life-Prolonging Treatments (Burke).
The GMC is consulting on new draft guidance, End of life treatment and care: Good practice in decision-making. The new guidance updates and builds on our existing publication Withholding and withdrawing life-prolonging treatments (2002) which clarified what we regarded as acceptable practice in this difficult area of end of life care. Since it was published, there have been significant changes in legislation, case law, public policy and the understanding of the effects of treatments, all of which affect the framework within which end of life care is provided. The GMC has also produced new guidance on Consent: patients and doctors making decisions together (2008) which sets out the broad principles of good decision-making which apply across the range of situations that doctors face, including end of life care. It was agreed that the Withholding and withdrawing guidance should be reviewed and updated to take account of these developments.
Doctors are being urged to discuss end-of-life care with the terminally ill well in advance of their final days. The General Medical Council, the profession's regulator, says early discussions can help avoid misunderstandings and conflict. In new guidelines, the GMC says doctors should start from the assumption that life should be prolonged, although not at any cost. Opportunities should also be sought to discuss organ donation.
A retired doctor has been struck off after giving excessively high doses of morphine to 18 dying patients. A disciplinary panel found that former County Durham GP Dr Howard Martin had not acted negligently but had "violated the rights of the terminally ill". He was cleared of murdering three of his patients five years ago. But he has been struck off by the General Medical Council (GMC) for "completely unacceptable" treatment of some patients.
Until 2008, if doctors followed the General Medical Council's (GMC's) guidance on providing information prior to obtaining a patient's consent to treatment, they would be going beyond what was technically required by the law. It was hoped that the common law would catch up with this guidance and encourage respect for patients' autonomy by facilitating informed decision-making. Regrettably, this has not occurred. For once, the law's inability to keep up with changing medical practice and standards is not the problem. The authors argue that while the common law has moved forward and started to recognise the importance of patient autonomy and informed decision-making, the GMC has taken a step back in their 2008 guidance on consent. Indeed, doctors are now required to tell their patients less than they were in 1998 when the last guidance was produced. This is an unfortunate development and the authors urge the GMC to revisit their guidance.
A Dutch doctor who exploited vulnerable people with multiple sclerosis by charging them thousands of pounds for unproven stem cell treatments has been banned from practice in the UK by the General Medical Council. Robert Trossel, 56, who practised in London and Rotterdam, gave “false hope and made unsubstantiated and exaggerated claims to patients suffering from degenerative and devastating illnesses,” said GMC fitness to practise panel chairman Brian Gomes da Costa. The panel held that Dr Trossel’s misconduct was “fundamentally incompatible with being a doctor” and ordered that his name be erased from the UK medical register with immediate effect.
A cardiac surgeon with an international reputation has been given a formal warning by the General Medical Council for undertaking an “adventurous” procedure for which he was not adequately trained and for which he did not obtain informed consent.