Does a physician have a legal obligation to inform patients about the potential risks and alternative options before proceeding with a proposed medical treatment?

Jerry W. Canterbury, a 19-year-old FBI clerk-typist, sought medical treatment for severe back pain from Dr. William Thornton Spence, a neurosurgeon. Dr. Spence recommended a laminectomy, which Canterbury underwent on February 11, 1959, at Washington Hospital Center. The day following the surgery, Canterbury fell while attempting to void unattended. He subsequently became paralyzed from the waist down. Despite a second operation, Canterbury was left with bowel and urinary incontinence, and partial paralysis.

Canterbury filed a lawsuit against Dr. Spence for negligence in performing the laminectomy and failing to disclose the risk of paralysis. He also sued Washington Hospital Center for negligent post-operative care. During the trial, Dr. Spence testified that laminectomies carried a 1% risk of paralysis, which he had not disclosed to either Canterbury or his mother prior to the procedure. The case was initially dismissed by directed verdict at the trial court level.

Canterbury filed suit in the District Court on March 7, 1963. At the conclusion of Canterbury's case in chief, the defendants moved for a directed verdict. The trial judge granted this motion. Canterbury then appealed the decision to the United States Court of Appeals for the District of Columbia Circuit.

(Robinson, J.)

Yes. A physician has a legal duty to disclose material risks of a proposed treatment to a patient. This duty stems from the fundamental principle of patient autonomy and the right to self-determination in medical decision-making. The scope of disclosure is not determined by medical custom, but by the patient's need for information material to the decision. An objective standard for causation applies, asking whether a reasonable person in the patient's position would have declined the treatment if adequately informed. This standard balances the patient's right to information with the practical realities of medical practice. The materiality of a risk is measured by its severity and the probability of its occurrence, not solely by professional standards. Physicians must provide sufficient information to enable patients to make intelligent decisions about their care, including alternative treatments and their risks and benefits. This duty recognizes that patients, not doctors, should make the ultimate decision about their medical care. The failure to obtain informed consent may constitute negligence, even if the treatment itself is performed competently. This approach shifts the focus from the physician's judgment to the patient's right to know and decide. It acknowledges that patients may have individual values and preferences that influence their treatment decisions, beyond purely medical considerations. The doctrine of informed consent thus serves to protect patient autonomy, promote trust in the doctor-patient relationship, and ensure that medical decisions are made with full understanding of their potential consequences.