Bioethics

 

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Informed Consent

Refusal

A mentally competent patient has the right to refuse medical treatment regardless of how beneficial or necessary the treatment might be.

However, there is a principle of informed refusal.  The patient should be aware of and understand the risks of refusing therapy.

 

Truman v Thomas (S.F. No. 24054, Supreme Court of California)

A wrongful death action was brought by the patient's two minor children against a physician for his failure to perform a pap smear test on their mother, who died of cervical cancer. She had refused to have a pap smear  when she was his patient.

Expert testimony was presented which indicated that if decedent (deceased patient) had undergone a pap smear during the time she was defendant's patient, the tumor probably would have been discovered in time to save her life.

Plaintiffs contended that defendant's failure to inform the decedent about the material risks of not consenting to a recommended pap smear, so that decedent might make an informed choice, breached his duty of care to decedent.

The trial court: rejected instructions to that effect requested by plaintiffs. The jury rendered a special verdict finding defendant free of any negligence that proximately caused decedent's death. (Superior Court of Butte County, No. 54314, Lucian B. Vandegrift, Judge.)

The Supreme Court: Reversed this decision. The court held that the physician should have disclosed the danger of failing to undergo a pap smear.

 

 

 

 

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