‘Martha’s rule’ gives patients the legal right to a second opinion and is the result of campaigning by the teenager’s parents following their daughter’s avoidable death from sepsis after a fall from her bike.

A coroner ruled last year that Martha, who was 13 when she died, would probably have survived had doctors heard her mother’s concerns about potential sepsis and moved her to intensive care.

The rule, which the NHS in England is working to introduce as soon as possible, looks likely to recognise the uniquely personal and powerful relationship nurses build with patients and their families.

It will be similar to ‘Ryan’s law’ in Queensland, Australia, where a three-step escalation process recognises nurses’ central role in supporting and guiding patients and relatives who want a second opinion. Under this law, patients and families can raise their concerns with a nurse, escalate to the nurse in charge of the shift and, in the final step, ask a nurse to request a clinical review of care.

Nurses are often the patient’s confidant and advocate thanks to the rapport built through the continuity of care and close monitoring they provide. Trust is at the heart of this therapeutic relationship.

Meanwhile, studies suggest the quality of the nurse-patient relationship enables a greater understanding of a person’s clinical need and, in turn, better outcomes.

There will, naturally, be concerns about potential misuse of Martha’s rule and more detail is needed.

However, the rule is designed to strengthen processes for raising concerns when all other mechanisms have failed.

And it recognises the pivotal importance of the nurse-patient relationship.

See news, page 6