Informed Consent changed significantly in 2015. What is the Montgomery Ruling and why is it so important? |

Informed Consent changed significantly in 2015. What is the Montgomery Ruling and why is it so important?

Tue 11:38 pm +01:00, 18 Oct 2022

posted by danceaway

When doctors and patients are deciding on the best course of treatment for a patient, certain ethical standards regarding ‘consent’ are required to be met, so that the treatment is administered within the law. Obviously, forced medicine is illegal, and so is medicine delivered under false pretences, i.e., in a situation where the patient hasn’t been given the full facts on the possible consequences of the treatment, including and especially the risks.

Doctors’ obligations to disclose risk-level to patients changed very significantly in 2015, when the Montgomery ruling was introduced. Prior to this ruling, consent within medicine was governed by the Bolam test, which stated that doctors were only obliged to tell patients of any risks that were “in line with a responsible body of medical opinion”.

In other words, if other doctors didn’t consider a risk significant, the administering doctor was not obliged to tell the patient about it – even if the doctor was aware of it as a possibility, and knew the consequences could be severe. This meant that if the patient then went on to develop that serious side effect the doctor had not warned about, the doctor would be insulated from any punitive action, since the Bolam test would protect him – he would point out other doctors don’t consider the risk significant enough to disclose, so he was not obliged to, either.

The problematic nature of this approach is obvious. Just because some doctors consider a risk rare, doesn’t mean it’s non-existent, nor that it is insignificant to those that develop that effect. By not disclosing the full facts to patients, their consent remained partially obscured, and given in the absence of information which, had they had, they may have made different choices.

This was decisively illustrated by the case of Nadine Montgomery, a woman who experienced a traumatic birth which left her son with significant disabilities. It was known by the treating doctor there was a chance of these disabilities occurring if Mrs. Montgomery had a natural birth, due to the fact she was both very petite and diabetic, and the risk would have been greatly reduced with a Caesarean section. However, the doctor did not advise her of these facts and so she consented to a natural birth – something which she would not have done had she been fully informed of the risks.

Nadine Montgomery therefore took the NHS to court to challenge their definition of ‘informed consent’ – and won. The result of this seminal case was that the paternalistic ‘Bolam test’ – where doctors’ opinions were considered the final word – was replaced by the far more patient-centric Montgomery ruling, which states patients must be warned of “all material risks to which a reasonable person in the patient’s position would attach significance”.

The Montgomery ruling made a point of emphasising that the frequency of a risk is not the sole defining factor of whether it is significant – e.g., just because a risk is considered rare, is not a reason for a doctor not to tell a patient about it.

Therefore, if a patient attends a doctors’ surgery or other healthcare environment for a vaccination, and is not told in advance of all material risks of that vaccine – which, in the case of the Covid vaccination, are known to include serious disorders of the heart, brain, and nervous system – then their consent is not informed, as per the tenets of the Montgomery ruling, and, as a result, those who administer that vaccine are operating outside of the law.

“Are you a healthcare professional?”

This question is often directed at the founders of Informed Consent Matters by people who critique our work, the implication being, if you are not, why are you dispensing health advice?

The answer to this is, while we are not formally employed within the healthcare sector, the unfortunate reality is that most of those who are are not fulfilling the obligations ot their profession, nor operating within the law, where it comes to informed consent. Healthcare professionals who administer vaccinations are not fulfilling their legal and ethical duties to disclose to patients the full risk profile of vaccinations, and, therefore, it is incumbent on those of us outside of that particular profession that care about ethics, lawfulness, and optimising patient wellbeing, to draw attention to these startling omissions and derelictions of duty.

Please note that lay people challenging healthcare professionals is key to ensuring the profession remains rigorous and integrity-based, as it was exactly such a challenge which galvanised the change within medicine from the Bolam test to the Montgomery ruling. Healthcare professionals are not omnipotent, and can make mistakes (and be prone to arrogance and closing ranks when challenged). Therefore, they must be kept fully accountable to those they serve. Please always remember that your doctor works for you, not the other way round, and it is your taxes that pay his wages. Therefore, if he is acting unethically or illegally, you have every right and obligation to challenge this.

One reason that healthcare professionals often do not fulfil their obligations regarding informed consent is that most were trained prior to 2015 and so learned about informed consent through the framework of the Bolam test, which represented a far more paternalistic, “you’ll do as doctor tells you” school of medicine, rather than the much more patient-centric Montgomery ruling, which makes it clear the final choice – once they have been furnished with all salient facts – is the patient’s, not the doctor’s.

A patient cannot make an informed choice without the full facts, and healthcare professionals are routinely not dispensing these where it comes to vaccination.

To ensure your consent is fully informed to vaccination, and any other medical procedure, it is advisable to first ask the administering member of staff whether they are familiar with the Montgomery ruling and whether they have fulfilled their legal obligations under this ruling, by informing you of all material risks of the treatment.

If they cannot comprehensively answer, they are operating outside the law and we therefore strongly advise against allowing them to administer any medical treatment to you or your family.

Remember that your health does not belong to your doctor, the NHS, the WHO, or any other individual or body, no matter how impressive their credentials. It belongs to you, and ultimately, it will be you left bearing the responsibility if a medical procedure goes wrong (there is very little help or support available from the state for the vaccine injured). Sadly, we can no longer rely on the state medical system to give us the facts we need to make an informed choice, which is why this resource exists – to give you all the facts, and ensure any medical choices you make are made knowledgeably, confidently, and freely – and that your consent really is, fully informed.

Help spread the word about the importance of informed consent with our specially designed leaflet – ideal to hand out at events, gatherings, and amongst family and friends

https://www.informedconsentmatters.co.uk/post/what-is-the-montgomery-ruling-and-why-is-it-so-important