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Progress towards a decision record is lamentable

The debate about the decision in Montgomery reveals a much deeper malaise in which hospital practice has failed to keep pace with a silent revolution in medical practice. The use of a Form recording that a patient consents to undergo an operation distracts doctors from the real problem, which is that patients need to undergo a formal training process to take any major decision about their healthcare. This training needs to be recorded for medical as well as legal reasons. It applies to decisions to use conservative therapy as well as surgery. The author describes what such a process might look like and how proper defensible records could be made.