External second opinions: building trust between health professionals and families

• Published in: Archives of disease in childhood Vol. 109; no. 2; pp. 83 - 87
• Main Authors: Fraser, James, Goold, Imogen, Akindolie, Omowunmi, Linney, Mike
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.02.2024; BMJ Publishing Group LTD
• Subjects: Child; Child Health; Children & youth; Consensus; Courts; Decision making; Dissent and Disputes; Expertise; Families & family life; Family (Sociological Unit); Guidance; Health care; Health Personnel; Humans; Intensive Care Units, Paediatric; Medical personnel; Opinions; Paediatrics; Parents; Parents & parenting; Pediatrics; Professionals; Referral and Consultation; Review; Trust (Psychology); Intensive Care Units, Paediatric; Paediatrics
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2023-325481

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.