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KembaraXtra-Case Law-White v Turner (1981)
This study guide examines the key principles of informed consent in medical negligence, focusing on the case of White v Turner (1981) and related precedents. Understanding the concept of "material risk" is crucial.
I. Central Issue: Material Risk vs. Ordinary Risk
Material Risk: Risks that a reasonable patient would consider significant in deciding whether to undergo a procedure. These risks must be disclosed by the physician. In White v Turner, asymmetrical nipples, misshapen breasts, and significant scarring were deemed material risks. The failure to disclose these constituted negligence.
Ordinary Risk: Risks that are common, general, obvious, or inherent to the procedure. These do not need to be disclosed. Examples include bleeding, pain, and some degree of scarring from an incision (as per Linden J in White v Turner). The analogy of not needing to warn about a knife cutting or a match burning is used.
II. Case Summary: White v Turner (1981)
Facts: The plaintiff underwent breast reduction surgery performed by the defendant. The surgery resulted in misshapen breasts and extensive scarring. The plaintiff alleged negligence in both the performance of the surgery and the failure to adequately inform her of the risks.
Decision: The Ontario High Court found the defendant negligent for failing to warn the plaintiff about the material risks of asymmetrical nipples, misshapen breasts, and significant scarring (2-3 inches). The court distinguished these from ordinary risks inherent in the procedure.
III. Supporting Cases & Clarifications
Venner v North East Essex HA (1987): A woman became pregnant after stopping birth control pills on her doctor's advice. The court held that pregnancy after stopping the pill was an obvious risk and didn't require disclosure. This reinforces the distinction between material and ordinary risks.
Sidaway v Board of Governors of the Bethlem Royal Hospital (1985): Lord Diplock emphasized that surgeons are not obligated to warn patients of general risks, even if rare, that are inherent to the procedure. This highlights that the duty to disclose is risk-specific and focuses on material, non-obvious risks.
Patient-Specific Nature of "Ordinary Risk": What constitutes an "ordinary" risk can depend on the patient's individual knowledge and understanding. While some patients might have general awareness of potential risks, they may lack understanding of the specific extent and nature of those risks associated with a particular procedure.
IV. Key Concepts & Application
Informed Consent: The patient must be provided with sufficient information to make an informed decision about their treatment. This includes the disclosure of material risks.
Reasonable Patient Standard: The key question is whether a reasonable patient, in the plaintiff's position, would have considered the undisclosed risks significant in making their decision.
Bolam Test (Not Directly Applicable, But Relevant): While not explicitly mentioned in these cases, the Bolam test (a doctor's actions are not negligent if supported by a responsible body of medical opinion) is indirectly relevant. The question of whether a reasonable doctor would have disclosed a particular risk remains a factor. However, the focus here is on the patient's perspective and the materiality of the risk.
V. Study Questions:
Define "material risk" and "ordinary risk" in the context of medical negligence. Provide examples.
How does White v Turner distinguish between material and ordinary risks?
How do Venner and Sidaway support the concept of material risk disclosure?
Explain how the concept of "ordinary risk" can be patient-specific.
How does the principle of informed consent relate to the concept of material risk?
This study guide aims to provide a comprehensive understanding of the legal principles surrounding informed consent in medical negligence, focusing on the significance of distinguishing between material and ordinary risks in determining a doctor's duty of care. Remember to consult the original cases for complete details.
This study guide examines the key principles of informed consent in medical negligence, focusing on the case of White v Turner (1981) and related precedents. Understanding the concept of "material risk" is crucial.
I. Central Issue: Material Risk vs. Ordinary Risk
Material Risk: Risks that a reasonable patient would consider significant in deciding whether to undergo a procedure. These risks must be disclosed by the physician. In White v Turner, asymmetrical nipples, misshapen breasts, and significant scarring were deemed material risks. The failure to disclose these constituted negligence.
Ordinary Risk: Risks that are common, general, obvious, or inherent to the procedure. These do not need to be disclosed. Examples include bleeding, pain, and some degree of scarring from an incision (as per Linden J in White v Turner). The analogy of not needing to warn about a knife cutting or a match burning is used.
II. Case Summary: White v Turner (1981)
Facts: The plaintiff underwent breast reduction surgery performed by the defendant. The surgery resulted in misshapen breasts and extensive scarring. The plaintiff alleged negligence in both the performance of the surgery and the failure to adequately inform her of the risks.
Decision: The Ontario High Court found the defendant negligent for failing to warn the plaintiff about the material risks of asymmetrical nipples, misshapen breasts, and significant scarring (2-3 inches). The court distinguished these from ordinary risks inherent in the procedure.
III. Supporting Cases & Clarifications
Venner v North East Essex HA (1987): A woman became pregnant after stopping birth control pills on her doctor's advice. The court held that pregnancy after stopping the pill was an obvious risk and didn't require disclosure. This reinforces the distinction between material and ordinary risks.
Sidaway v Board of Governors of the Bethlem Royal Hospital (1985): Lord Diplock emphasized that surgeons are not obligated to warn patients of general risks, even if rare, that are inherent to the procedure. This highlights that the duty to disclose is risk-specific and focuses on material, non-obvious risks.
Patient-Specific Nature of "Ordinary Risk": What constitutes an "ordinary" risk can depend on the patient's individual knowledge and understanding. While some patients might have general awareness of potential risks, they may lack understanding of the specific extent and nature of those risks associated with a particular procedure.
IV. Key Concepts & Application
Informed Consent: The patient must be provided with sufficient information to make an informed decision about their treatment. This includes the disclosure of material risks.
Reasonable Patient Standard: The key question is whether a reasonable patient, in the plaintiff's position, would have considered the undisclosed risks significant in making their decision.
Bolam Test (Not Directly Applicable, But Relevant): While not explicitly mentioned in these cases, the Bolam test (a doctor's actions are not negligent if supported by a responsible body of medical opinion) is indirectly relevant. The question of whether a reasonable doctor would have disclosed a particular risk remains a factor. However, the focus here is on the patient's perspective and the materiality of the risk.
V. Study Questions:
Define "material risk" and "ordinary risk" in the context of medical negligence. Provide examples.
How does White v Turner distinguish between material and ordinary risks?
How do Venner and Sidaway support the concept of material risk disclosure?
Explain how the concept of "ordinary risk" can be patient-specific.
How does the principle of informed consent relate to the concept of material risk?
This study guide aims to provide a comprehensive understanding of the legal principles surrounding informed consent in medical negligence, focusing on the significance of distinguishing between material and ordinary risks in determining a doctor's duty of care. Remember to consult the original cases for complete details.
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