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Canterbury v. Spence


    Citation. Spence v. Canterbury, 1972 U.S. LEXIS 348, 409 U.S. 1064, 93 S. Ct. 560, 34 L. Ed. 2d 518 (U.S. Nov. 1, 1972).

    Brief Fact Summary. Plaintiff experienced back pain. Defendant told Plaintiff that he needed surgery, but did not inform of the risks of the surgery. Plaintiff sued Defendant for negligently withholding the risk of the surgery.

    Synopsis of Rule of Law. A doctor has a duty to disclose all reasonable information about a proposed treatment to his patients.


    Facts. Plaintiff consulted Defendant, a doctor, after experiencing severe back pain. Defendant had the Plaintiff undergo a myelogram, which revealed that the Plaintiff suffered from a filling defect in the region of his fourth thoracic vertabra. Defendant told Plaintiff that he needed to undergo a laminectomy to correct what he suspected was a ruptured disc. Defendant did not tell Plaintiff the details of the proposed operation nor did Plaintiff inquire about them. Defendant told Plaintiff’s mom that the operation was a serious one, but not any more serious than any other operation. Defendant performed the operation and discovered Plaintiff’s swollen spinal cord to be in very poor condition. Defendant did what he could to relieve the pressure and left Plaintiff in bed to recuperate. Plaintiff was recuperating, when he slipped off the side of the bed and suffered near-complete paralysis. There was no one there to assist him and no side rail to break his fall. Defendant performed an em
    ergency operation and Plaintiff’s condition improved. Plaintiff sued Defendant for negligence in the performance of the laminectomy and for failure to inform him of the risk involved. Plaintiff introduced no evidence to show medical and hospital practices customarily pursued in regard to the critical aspects of the case. Defendant testified that even without trauma, paralysis can be anticipated somewhere in the nature of one percent. Defendant felt that communication of the risk to Plaintiff was not good medical practice because it might deter him from undergoing needed surgery and might produce adverse physiological reactions, which could preclude the success of the operation. The trial court held that Plaintiff failed to produce any medical evidence indicating negligence. Plaintiff appealed.

    Issue. Does Defendant have a duty to disclose the risk associated with surgery?

    Held. Yes. Judgment reversed. Plaintiff’s evidence was of such caliber as to require a submission to the jury.
    * Defendant did not reveal the risk of paralysis from the laminectomy. Every human being of sound mind has a right to determine what shall be done with his own body. It is a physician’s duty to warn of the dangers lurking in the proposed treatment. There is also a duty to impart information, which the Plaintiff has every right to expect. In this case, Defendant had a duty to make adequate disclosure to Plaintiff.
    * Defendant’s noncompliance with the professional custom to reveal, like any other departure from prevailing medical practice, may give rise to liability to Plaintiff. However, Plaintiff’s cause of action is not dependant upon the existence and nonperformance of irrelevant, professional tradition. The standard measuring performance of the duty to disclose by doctors, as by others, is conduct, which is reasonable under the circumstances.
    * It is unrealistic to expect doctors to discuss with their patients every risk of proposed treatment, no matter how small or remote and generally unnecessary from the patient’s viewpoint. A risk is material when a reasonable person, in what the doctors knows or should know to be the patient’s position, would be likely to attach significance to the risk or cluster of risks in deciding whether or not to forgo the proposed therapy.
    * A doctor bears no responsibility for the discussion of hazards the patient has already discovered.
    * When a genuine emergency arises, the impracticality of conferring with the patient dispenses a need for it. Also, a doctor does not have to disclose the risk of treatment if the disclosure would make the patient become ill or emotionally distraught.
    * The privilege to withhold information does not include the paternalistic notion that the doctor may remain silent simply because divulgence might prompt the patient to forgo therapy the doctor feels the patient really needs.

    Discussion. In this case, the court was concerned with Defendant’s attempt to sensor from the Plaintiff the risk of surgery.


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