Anyone familiar with the Hippocratic oath understands the undeniable bond between medical care and ethics—ideally, physicians are driven by the desire to help patients, not hurt them. Yet, harm does sometimes occur, and patients have the right to hold such doctors accountable in a court of law. While the topic of not telling the truth poses more of an ethical question than a legal one, there are established legal boundaries for medical professionals that, when crossed, could justify a lawsuit.
Are Doctors Legally Bound to Tell Patients the Truth?
Currently, most states have legal precedents that establish an informed consent standard. For instance, in Cobbs v. Grant, 8 Cal.3d 229, 104 Cal. Rptr. 505, 502 P.2d 1 (1972), the California Supreme Court first introduced the premise as “a duty of reasonable disclosure of the available choices with respect to proposed therapy and of the dangers inherently and potentially involved in each.” The Court further defined the physician’s duty in Truman v. Thomas, 27 Cal.3d 285, 611 P.2d 902 (1980), by stating that doctors must also inform patients of all material risks a reasonable person would want to know if deciding not to undergo a treatment or procedure. In other words, if certain information would be relevant to a patient’s understanding of and course of action in regards to a current condition, treatment or procedure, the doctor must share that data with the patient—to not do so would be considered lying as well as illegal.
There’s Always an Exception… But Its Scope Is Limited.
One exception to the general rule of informed consent is that of therapeutic privilege. While uncommon, doctor’s cannot be held responsible for untruths about a patient’s health when a worse threat could exist with complete disclosure. Such an example would be when the revelation of a debilitating condition might prompt suicidal actions on the part of the patient.
This is not to say that doctors can withhold details when they believe a patient might refuse treatment they deem beneficial, though. My father, Barry J. Nace, was actually involved in a seminal case that has helped to further shape the boundaries of informed consent in such situations. Canterbury v. Spence, 464 F2d 772 (D.C. 1972) involved a surgeon who withheld the possibility of paralysis from a spine surgery patient, fearing that anxiety on the part of the individual might lead to postponing the procedure. Ultimately, the patient suffered complications and ended up paralyzed, while the surgeon claimed he was operating within community disclosure standards—an accepted idea at the time that judged whether physicians within a particular “community” would customarily convey such information in similar circumstances.
The D.C. Circuit Court of Appeals disagreed, stating that “true consent to what happens to one’s self is the informed exercise of a choice, and that entails an opportunity to evaluate knowledgeably the options available and the risks attendant upon each … it is the prerogative of the patient, not the physician, to determine for himself the direction in which his interests seem to lie.”
Both an Emory School of Law graduate and MBA graduate of Goizueta Business School at Emory, Chris Nace focuses his practice on areas of medical malpractice, drug and product liability, motor vehicle accidents, wrongful death, employment discrimination and other negligence and personal injury matters.