You are here

Article Text

Article menu
Download PDFPDF
Review
External second opinions: building trust between health professionals and families
  1. James Fraser1,
  2. Imogen Goold2,
  3. Omowunmi Akindolie3,
  4. Mike Linney4
  1. 1 Bristol Royal Hospital for Children Paediatric Intensive Care Unit, Bristol, Bristol, UK
  2. 2 St Anne's College, University of Oxford, Oxford, Oxfordshire, UK
  3. 3 Child Health, King's College Hospital, London, London, UK
  4. 4 Retired, East Pallant, Chichester, UK
  1. Correspondence to Dr James Fraser, Bristol Royal Hospital for Children Paediatric Intensive Care Unit, Bristol, Bristol, UK; James.Fraser{at}uhbw.nhs.uk

Abstract

In medicine, external second opinions are frequently sought to inform decisions around a patient’s proposed course of treatment. However, they are also sought in more challenging circumstances such as when disagreement arises between the healthcare team and the family, or during complex end-of-life discussions in critically ill children. When done well, external second opinions can help build trust and reduce conflict. However, when done poorly they may antagonise relationships and thwart attempts to bring about consensus. While principles of good medical practice should always be followed, the actual second opinion process itself remains essentially unregulated in all its forms. In this review, we set out what a standardised and transparent second opinion process should look like and recommend key recommendations for healthcare Trusts, Commissioners and professional bodies to support good practice.

  • Paediatrics
  • Intensive Care Units, Paediatric

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

https://doi.org/10.1136/archdischild-2023-325481

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data sharing not applicable as no datasets generated and/or analysed for this study.

    View Full Text

    Footnotes

    • Collaborators We acknowledge the working group and families at the end of the paper.

    • Contributors JF wrote the original draft. All authors contributed in equal measure to subsequent edits.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests JF, ML and OA co-chaired the RCPCH working group on external second opinions. IG was a member of this working group.

    • Provenance and peer review Commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.