Ian Paterson denied his patients autonomy. Unfortunately, so do many NHS doctors

Almost every single doctor in the NHS believes they are supporting their patients to make sound, autonomous decisions about their health. Unfortunately, most of them are getting it wrong, writes Alexis Paton

‘Monster’ surgeon Ian Paterson was jailed for 15 years in 2017, a sentence that was subsequently increased to 20 years (PA)

In the wake of the report on rogue breast surgeon Ian Paterson, questions are being raised about what patient consent and autonomy really mean. That the struck-off surgeon managed to operate on so many women without them properly consenting has brought to light how important information and understanding are to patient autonomy. Paterson may have “informed” his patients about what he wanted them to know, but in omitting and lying about important aspects of their diagnosis and care, the consent he obtained was far from the gold standard of “informed consent” required by the NHS and the law.

After all, patient consent is much more than a signature on a page – it is the immutable line that medical professionals cannot cross. A patient’s right to make decisions about their own healthcare, their autonomy, is considered almost absolute. Consent is enshrined in law and medical ethics, not just in Britain but across the globe. That patients have a properly informed understanding of the decisions they are making is part of this right. In the UK, to overturn a patient’s decision on their care requires drastic action. They must be incapable of understanding the decisions they have to make. They are deemed incompetent, sectioned for their own wellbeing, or taken to court so that others can gain decision-making powers over their healthcare.

Almost every single doctor in the NHS believes they are supporting their patients to make sound, autonomous decisions about their health. Respect for this autonomy is part of good clinical practice. Unfortunately most of them are getting it wrong, and they don’t even know it.