Cobbs v. Grant
502 P.2d 1, 8 Cal.3d 229 (1972)
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Rule of Law:
A physician has a legal duty to disclose to a patient all information material to the patient's decision to undergo a course of treatment. The scope of this duty is determined by the patient's need for information, not by the professional standard of practice in the medical community.
Facts:
- The plaintiff was admitted to the hospital for treatment of a duodenal ulcer.
- His family physician, Dr. Sands, discussed general risks of anesthesia with him.
- The defendant, surgeon Dr. Grant, examined the plaintiff, confirmed surgery was needed, and explained the nature of the operation but did not discuss any of its inherent risks.
- Dr. Grant performed the surgery, and the plaintiff's ulcer disappeared.
- Nine days later, the plaintiff experienced intense pain and was readmitted to the hospital, where emergency surgery revealed internal bleeding from a severed artery near his spleen.
- Dr. Grant removed the spleen, which is a known inherent risk occurring in approximately 5% of such operations.
- Subsequently, the plaintiff developed a gastric ulcer, another inherent risk, requiring a third operation to remove 50% of his stomach.
- After the third surgery, the plaintiff was hospitalized again for internal bleeding caused by the premature absorption of a suture, another inherent risk of surgery.
Procedural Posture:
- The plaintiff brought a medical malpractice suit against Dr. Grant in the trial court.
- The case was consolidated for trial with a similar action against the hospital.
- The jury returned a general verdict in favor of the plaintiff against Dr. Grant in the amount of $23,800.
- Defendant Dr. Grant (appellant) appealed the judgment to the Supreme Court of California.
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Issue:
Does a physician's duty to disclose the inherent risks of a proposed treatment depend on the standard practice within the medical community, or is it governed by the patient's need for information material to their decision-making process?
Opinions:
Majority - Mosk, J.
No. A physician’s duty to disclose is not governed by the standard practice in the community; rather, it is a duty imposed by law to disclose all information material to the patient's decision. The court reasoned that the right to consent to medical treatment is meaningless without adequate information, as adult patients have a fundamental right to exercise control over their own bodies. While a physician is an expert on medical risks and therapeutic alternatives, the patient alone is responsible for the non-medical judgment of weighing those risks against their individual fears and hopes. Therefore, the scope of disclosure must be measured by the patient's need for information, making the test for disclosure the materiality of the information to the patient's choice. The court also held that failure to obtain informed consent sounds in negligence, not battery, and that causation requires the plaintiff to prove that a prudent person in the patient's position would not have consented to the treatment if they had been adequately informed of the risks.
Analysis:
This landmark decision fundamentally shifted the doctrine of informed consent from a physician-centric standard to a patient-centric one. By rejecting the 'community standard' of practice, the court empowered patients, establishing that their right to self-determination dictates the scope of required disclosure. This 'materiality' standard requires physicians to consider what a reasonable patient would want to know, rather than what other physicians typically disclose. The decision also clarified that informed consent claims should be brought under a negligence theory, affecting expert witness requirements, statutes of limitation, and insurance coverage in future medical malpractice cases.
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