We have recently completed a major report for the DoH/NHS Executive on
patient consent and confidentiality in relation to medical records, which
may add some weight to my comments below, but does not give me any ex
cathedra authority on this topic.

Key to the answer to your question is what was the actual consent to - in
the context of the gaining of consent (presumably in a written form) what
was the context of the gaining of consent (why was it requested, through
whom was it obtained, etc?) - what would the patient reasonably have
expected that to be consent to.

If the original consent were for a report to an employer X in relation to a
specific illness or accident, then that consent would not cover a further
medical report to a different employer or a different illness or accident,
unless the consent form clearly provides for such a broad interpretation.
In respect of the same illness or accident, then further reports might be
covered if the nature of the illness or the need for a further report is
clearly continuous with the first request (e.g. while treatment is still
ongoing - though for a chronic condition this would not be so clear cut).

If your question relates to consent having been given, but the request for a
report coming significantly later, then the issue is whether such a delay is
reasonable or not.  I am not aware of any clear guidelines existing, but one
can draw a parallel with the validity of banking cheques, where banks
generally refuse to accept cheques more than six months old.  This is more
of a policy decision rather than a legal criterion (though by being common
practice, it would be deemed to be reasonable to follow it).

I do not believe that there is a single clear answer - you must weigh the
circumstances of the case - would the patient reasonably have expected the
consent to cover the present request?; would it be unreasonable in terms of
time and cost to ask for further consent (would the patient be likely to
object too?)?; do there seem to be good reasons for the delay/further
request?; does it appear to be in the patient's best interests to respond to
the request (if so, then the original consent is more likely to subsist - if
not, then a further consent should be obtained).  Asking for further consent
may delay matters which may disadvantage the patient, so one should avoid
being too bureaucratic over this point.

I don't know if this helps at all.  More helpful might be - if you were the
patient what would you feel?  You cannot hope to exactly emulate the
patient's position, but generally in law if you take a 'reasonable'
position, then you don't usually get shot for it.

Regards

Peter Singleton
Cambridge Health Informatics Limited

Tel.:      +44 (0)1223 523608
Mobile: +44 (0)7803 987661

-----Original Message-----
From: This list will be of interest to all practitioners of occupational and
envi [mailto:[log in to unmask]]On Behalf Of mark.newson-smith
Sent: 08 July 2001 09:51
To: [log in to unmask]
Subject: Duration of Validity of Consent

I would be grateful for the voews of list members on the duration of
validity of consent to obtain a medical report (for the same condition). I
have heard views ranging from requiring a new consent for each report to the
consent being valid for 6 months provided it is for the same condition.

Dr Mark Newson-Smith
Consultant Occupational Physician