Ashe v. Radiation Oncology Assocs. - 9 S.W.3d 119 (Tenn. 1999)

Rule:

The majority approach, or the so-called objective standard, of causation in medical malpractice informed consent cases is resolved on an objective basis in terms of what a prudent person in the patient's position would have decided if suitably informed of all perils bearing significance. The objective view recognizes that neither the plaintiff nor the fact-finder can provide a definitive answer as to what the patient would have done had the patient known of the particular risk prior to consenting to the procedure or treatment. Accordingly, the patient's testimony is relevant under an objective approach, but the testimony is not controlling.

Facts:

Plaintiff, Patricia Ashe, filed suit, asserting claims of medical malpractice and lack of informed consent, after radiation treatment for *** cancer administered by defendants resulted in plaintiff's paralysis. At trial, Ashe testified that she would not have consented to the radiation therapy had she been informed of the risk of paralysis. Defense counsel on cross-examination pointed out that, in her deposition, the plaintiff indicated that she did not know what she would have done had she been warned about the risk of spinal cord injury. The trial court found that the plaintiff's trial testimony conflicted with her deposition testimony regarding whether she would have consented to the procedure had she been warned of the risk of spinal cord injury. The trial court, therefore, struck the trial testimony and granted the defendant a directed verdict on the informed consent claim. The plaintiff's malpractice claim went to the jury. The jury was unable to reach a verdict, and a mistrial was declared. The plaintiff appealed to the Court of Appeals, which held that as part of the plaintiff's informed consent claim she was required to prove that a reasonable person knowing of the risk for spinal cord injury would have decided not to have had the procedure performed. According to the appellate court, discrepancy between the trial testimony and deposition testimony went to the issue of credibility, and therefore, the trial testimony should not have been stricken. The Court of Appeals reversed the trial court's grant of a directed verdict on the informed consent claim and remanded the case for a new trial. Plaintiff appealed.

Issue:

Under the circumstances, did the trial court err in precluding the jury from deciding the issue of informed consent? 

Answer:

Yes.

Conclusion:

The Court noted that the standard to be applied in informed consent cases was the objective standard, namely, whether a reasonable person in a patient's position would have consented to the procedure or treatment in question if adequately informed of all significant perils. In applying the objective standard to the facts of this case, the Court held that the jury should not have been precluded from deciding the issue of informed consent. Under the objective analysis, the plaintiff's testimony was only a factor when determining the issue of informed consent. The dispositive issue was not whether Ashe would herself have chosen a different course of treatment. The issue was whether a reasonable patient in Ashe’s position would have chosen a different course of treatment. The jury, therefore, should have been allowed to decide whether a reasonable person in Ashe’s position would have consented to the radiation therapy had the risk of paralysis been disclosed. Accordingly, the judgment of the Court of Appeals reversing the trial court was affirmed.