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Montgomery Consent Standard — FRCA Final MCQ

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ModerateMedicolegal & EthicsMontgomery Consent StandardFRCA Final

A 58-year-old man (ASA III) with cirrhosis has an elective hernia repair cancelled because his MELD score is 18 and the team feel the risk is too high. The patient insists on surgery. The surgical team defer to the anaesthetist. According to the Montgomery ruling (2015), what standard of consent disclosure applies?

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Correct answer: B — Material risks that a reasonable person in the patient's position would consider significant

The Montgomery v Lanarkshire (2015) Supreme Court ruling established that the standard for consent disclosure in UK law is the 'material risk' standard: a doctor must disclose any risk that a reasonable person in the patient's position would attach significance to, OR that the particular patient would attach significance to (if the doctor is or should be aware of this). This replaced the previous Bolam standard (what a reasonable body of medical opinion would disclose). For this patient, the ~20-25% perioperative mortality risk with MELD 18 must be clearly communicated.

Reference: Montgomery v Lanarkshire Health Board – 2015 – [2015] UKSC 11; GMC – 2020 – Decision making and consent