Hood v. Phillips
554 S.W.2d 160 (1977)
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Rule of Law:
A physician is liable for medical malpractice for undertaking a mode of treatment if a reasonable and prudent member of the medical profession would not have undertaken it under the same or similar circumstances. A physician also has a duty to make a reasonable disclosure of risks incident to a medical treatment so that the patient can make an informed decision.
Facts:
- Shelton Hood suffered from emphysema.
- In 1966, Dr. John R. Phillips treated Hood's emphysema by surgically removing one of Hood's carotid bodies.
- Dr. Phillips admitted this surgical procedure was not a generally accepted treatment for emphysema and was highly controversial.
- Dr. Phillips claimed that in his experience performing the surgery 1,200 to 1,500 times, 85 percent of his patients were helped.
- Three expert physicians testifying for Hood stated that carotid surgery was an unaccepted, ineffectual, and abandoned mode of treatment for emphysema.
- Hood and his wife testified that Dr. Phillips guaranteed a cure, promised a small incision, and did not disclose significant risks.
- Dr. Phillips testified that he informed Hood of numerous risks, including death, stroke, and heart attack, and did not guarantee a cure.
Procedural Posture:
- Shelton Hood sued Dr. John R. Phillips in state trial court, seeking damages for medical malpractice.
- The trial court refused to submit jury issues on ordinary negligence and informed consent.
- The case was submitted to the jury only on the issue of gross negligence.
- The jury found that Dr. Phillips was not grossly negligent, and the trial court entered a judgment in his favor.
- Hood, as the appellant, appealed to the court of civil appeals (an intermediate appellate court).
- The court of civil appeals reversed the trial court's judgment and remanded for a new trial, holding that the proper standard was ordinary negligence under a 'respectable minority' test.
- Both Hood and Dr. Phillips, as petitioners, appealed to the Texas Supreme Court (the state's highest court).
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Issue:
Does a physician commit medical malpractice by using a form of treatment not generally accepted by the medical community if a reasonable and prudent physician would not have undertaken the same treatment under similar circumstances?
Opinions:
Majority - Justice Sam D. Johnson
No. A physician is not liable for malpractice simply because a chosen treatment is not generally accepted; liability attaches only if the physician undertook a mode of treatment which a reasonable and prudent member of the medical profession would not have undertaken under the same or similar circumstances. The court rejected the 'respectable minority' standard adopted by the lower appellate court, finding it could improperly suggest that the standard of care is determined by a poll of the medical profession. Instead, the court adopted the traditional 'reasonable and prudent doctor' standard, applying it to the choice of treatment itself, not just the skill of its performance. Based on the expert testimony that the carotid surgery was ineffectual and abandoned, a fact issue existed for the jury regarding whether Dr. Phillips's choice of treatment constituted ordinary negligence. Furthermore, the expert testimony was sufficient to raise a fact issue as to gross negligence, defined as conscious indifference to the patient's welfare. Finally, the conflicting testimony between the Hoods and Dr. Phillips regarding the disclosures of risks and potential outcomes created a clear fact issue on informed consent that should have been submitted to the jury.
Analysis:
This decision establishes the standard of care in Texas for medical malpractice cases involving experimental or non-traditional forms of treatment. By rejecting specialized tests like the 'respectable minority' rule, the Texas Supreme Court affirmed that the general 'reasonable and prudent' professional standard applies to a physician's choice of treatment. This holding balances the need to protect patients from unproven or dangerous procedures with the need to allow for medical innovation and professional judgment. The case solidifies that the reasonableness of a physician's actions, even in controversial areas, is a question of fact for the jury to decide based on expert testimony.
