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11. Teaching

Is it necessary to seek the patient’s consent for students or other observers to be present at a consultation?

Yes. The doctor carrying out the consultation should explain to the patient that an observer would like to sit in on the consultation, who that person is and why he or she wishes to observe.

Patients should feel able to refuse consent to the presence of students or other observers during their consultation and/or examination. They should be reassured that their decision will, in no way, affect their treatment. Wherever possible, patients should be given the option of considering this request prior to the arrival of the observers.


Is it necessary to seek consent prior to a patient being questioned and examined by students for teaching purposes?

Teaching hospitals should draw up detailed protocols about the extent to which students will be present during, and involved with, treatment. Patients should be made aware of this in advance and, where students will be directly involved with providing treatment, specific consent should be sought.


Is specific consent required to teach additional practical procedures on a patient who has been anaesthetised?

Yes. A patient who is anaesthetised has the same right to give and withhold consent as any other patient. Before any anaesthetic is given, the specific consent of the patient should be obtained to additional practical procedures being carried out solely for teaching purposes.


Is it necessary to seek consent from patients for the use of visual and audio recordings of procedures made for teaching purposes?

Yes. It is necessary to seek the consent of the patient prior to a recording being made and for its subsequent use for teaching purposes. In relation to adults lacking capacity the law is untested. In the BMA’s view it is difficult to see how such a decision could be in the individual’s best interests.

Legal advice should be sought on a case-by-case basis for the use of identifiable recordings for reasons other than treatment and research. If the recording is of a child unable to give consent him or herself, consent should be sought from someone with parental responsibility and consent to its continued use should be sought from the child him or herself when he or she is sufficiently mature to make a decision. Patients may vary or withdraw their consent to the use of visual and audio recordings in teaching at any time. If consent is withdrawn, the recording should be erased. (See also Card 1 list: ‘Recordings’, ‘0-18 years’, ‘Children’, ‘Capacity’, ‘Scotland’, ‘MCA’.)


What type of consent is required for the use of human tissue for educational purposes?

The storage and use of human tissue removed after death for educational purposes requires consent from the donor, a person with parental responsibility, ‘a qualifying relative’, or ‘nearest relative’. Consent should be documented.

Consent is not required for the storage and use of material from living individuals for teaching purposes provided it is anonymised. (See also Card 1 List: ‘HTL’.)


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Card 11: Teaching