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Deprescribing: is the law on your side?
  1. Nina Barnett1,
  2. Orla Kelly2
  1. 1Pharmacy Department, Northwick Park Hospital, Harrow, UK
  2. 2Cantillons Solicitors, Cork, Ireland
  1. Correspondence to Orla Kelly, Healthcare Litigation Solicitor and Pharmacist, Cantillons Solicitors, 38/39 South Mall, Cork, T12 W522, Ireland; orla.kelly{at}cantillons.com

Abstract

Deprescribing can feel risky: prescribers need to consider the consequence of stopping a medication medicolegally, particularly where there may be a guideline or accepted practice that suggests its use. This review aims to provide reassurance and encouragement to safely deprescribe. Experience suggests that for many patients the prescribing of multiple medicines is the norm. In the right setting and at the right time, deprescribing provides a real opportunity to minimise side effects and unwanted interactions through patient-centred conversations. How does the prescriber stand if they stop a medication for which there is an evidence-based guideline to use it? This review explores the concepts of clinical negligence and informed patient consent in the context of deprescribing. Using examples from UK case law, the review discusses the legal tests which are applied to establish an action based on clinical negligence and lack of informed consent. It describes the recent changes in law which reinforce the importance of providing information focused on what is material to individual patients. The use of prescribing tools to support safe deprescribing and informed consent are also discussed. When deprescribing is undertaken in partnership with patients, supported by the knowledge, skills and experience of both patient and clinicians and the patient's values and preferences based on clinical skill, judgement and evidence-based medicine, law presents no barriers to deprescribing.

  • prescribing
  • deprescribing
  • LAW (see Medical Law)
  • clinical negligence
  • consent

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