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Gates v. Jensen - 92 Wash. 2d 246, 595 P.2d 919 (1979)


Application of the doctrine of informed consent to circumstances other than treatment of a diagnosed disease is not new. The physician's duty of disclosure arises whenever the doctor becomes aware of an abnormality that may indicate risk or danger. The facts that must be disclosed are all those facts the physician knows or should know which the patient needs in order to make the decision. To require less would be to deprive the patient of the capacity to choose the course his or her life will take.


A patient, Elisabeth Gates, filed a suit for malpractice against her ophthalmologist and the Eye Clinic of Seattle. In May 1972, she complained of difficulty in focusing, blurring, and gaps in her vision. Mrs. Gates was 54 years old at the time and had a severe myopia which doubled her risk of glaucoma. Over the next 2 years Mrs. Gates revisited the clinic 12 times complaining of blurring, fog, and gaps in her vision, as well as loss in visual acuity. In April 1974, doctors at the clinic diagnosed Mrs. Gates as having open angle glaucoma. By the time Mrs. Gates' glaucoma was discovered her vision had deteriorated from near 20/20 with glasses to 20/200 with glasses and she was functionally blind. At trial, Gates requested instructions on the doctrine of informed consent and the reasonable prudence rule. Defendants countered, arguing that the doctrine of informed consent did not apply to questions of appropriate diagnostic procedures. The court denied the request for both instructions. The jury reached a verdict in favor of the doctors and the court entered judgment accordingly. On appeal, the court of appeals affirmed the judgment for the doctor and eye clinic.


Should the trial court have granted the instructions regarding informed consent and the reasonable prudence rule to the jury?




The court held that the trial court erred in refusing the requested instructions on the doctrine of informed consent and the reasonable prudence rule. The treating physicians had available to them at least two additional diagnostic procedures that were simple, inexpensive, conclusive, and risk free. When the patient's condition indicated the necessity for further examination due to inconclusive medical tests, reasonable prudence required the use of alternative tests. The court found that reasonable prudence required a standard of practice that was higher than that exercised by the relevant professional community. The court reversed the decision from the court of appeals and remanded the matter for a new trial.

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