Canterbury v. Spence - 150 U.S. App. D.C. 263, 464 F.2d 772 (1972)

Rule:

The patient's right of self-decision shapes the boundaries of the duty to reveal. That right can be effectively exercised only if the patient possesses enough information to enable an intelligent choice. The scope of the physician's communications to the patient, then, must be measured by the patient's need, and that need is the information material to the decision. Thus the test for determining whether a particular peril must be divulged is its materiality to the patient's decision: all risks potentially affecting the decision must be unmasked.

Facts:

Canterbury (plaintiff), a minor, went to Dr. Spence (defendant) in order to address his upper back pains. Following diagnosis, the defendant concluded that a laminectomy was required as the plaintiff already had a ruptured intervertebral disc. After going through with the procedure, which was initially successful, he fell out of bed while still in the hospital – which caused paralysis and incontinence. As such, the plaintiff sued the defendant for malpractice, and one of his main contentions was that he had not been advised of the risk of paralysis. The lower court, however, dismissed the case in favor of the defendant for failure of the plaintiff to produce any witness that would establish his contention.

Issue:

Is a doctor mandated to disclose all risks to a patient, before undergoing a medical procedure?

Answer:

Yes.

Conclusion:

The court reversed the lower court’s judgment, holding that a doctor must disclose all risks to a patient prior to a medical procedure, because a reasonable person would consider such disclosure significant in deciding whether to go through such procedure. As a universally accepted rule, a patient must give his / her consent before going though with a surgical procedure. Also, such consent must be an informed one, as an ordinary unassisted patient would not have the capacity to decide as to the propriety of a particular medical procedure. As to the question of what risks must be disclosed, the court ruled that the standard in reaching an answer to such issue must be borne out of reasonableness – “would a reasonable patient consider a particular risk significant in evaluating whether or not to go with the procedure?” This standard is consistent with the general precepts of tort and malpractice law, and does not require expert testimony.