This finally raises the issue of concordance, which has been described as ‘a new way to define the process of successful prescribing and medicine taking, based on partnership’, and as, ‘based on the notion that the work of the prescriber and patient in the consultation is a negotiation between equals and the aim is therefore a therapeutic alliance between them’ (Marinker et al, 1997). As Horne et al (2005) point out, the notion of concordance is deeply value laden. What is the difference between achieving informed consent, as outlined above,and achieving concordance? While there is a significant degree of commonality between both notions to the extent that they both consider the patient’s values to be fundamental for health care decision making, their ethical focus differs.