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Arato v. Avedon9/30/1993
SUPREME COURT OF CALIFORNIA
No. S029049
1993.CA.41940 ; 23 Cal. Rptr. 2d 131; 5 Cal. 4th 1172; 858 P.2d 598
Decided: September 30, 1993.
MIRIAM ARATO ET AL., PLAINTIFFS AND APPELLANTS,
v.
MELVIN AVEDON ET AL., DEFENDANTS AND RESPONDENTS.
Superior Court of Los Angeles County, No. WEC074790, Raymond Choate, Judge.
Marian Tully for Plaintiffs and Appellants.
Baker, Silberberg & Keener, Marshall Silberg, John C. Kelly, Veatch, Carlson, Grogan & Nelson, C. Snyder Patin, Horvitz & Levy, Frederic D. Cohen and Ari R. Kleiman for Defendants and Respondents.
Catherine I. Hanson and Alice P. Mead as Amici Curiae.
Opinion by Arabian, J., expressing the unanimous view of the court.
Arabian
A physician's duty to disclose to a patient information material to the decision whether to undergo treatment is the central constituent of the legal doctrine known as "informed consent." In this case, we
review the ruling of a divided Court of Appeal that, in recommending a course of chemotherapy and radiation treatment to a patient suffering from a virulent form of cancer, the treating physicians breached their duty to obtain the patient's informed consent by failing to disclose his statistical life expectancy.
As will appear, we conclude that the Court of Appeal erred in reaching that result. We also conclude that the court erred in holding that an instruction routinely given in informed consent cases fails to convey accurately to the jury the legal standard governing its evaluation of the sufficiency of the disclosures actually made by physician to patient. We hold in addition that the Court of Appeal erred in suggesting, as it appeared to do, that under the doctrine of informed consent, a physician is under a duty to disclose information material to the patient's nonmedical interests. Finally, because the propriety of disclosing statistical life expectancy information to a cancer patient depends on the standard of practice within the medical community, we conclude that expert testimony was properly admitted by the trial court for that limited purpose.
I
A
Miklos Arato was a successful 42-year-old electrical contractor and part- time real estate developer when, early in 1980, his internist diagnosed a failing kidney. On July 21, 1980, in the course of surgery to remove the kidney, the operating surgeon detected a tumor on the "tail" or distal portion of Mr. Arato's pancreas. After Mrs. Arato gave her consent, portions of the pancreas were resected, or removed, along with the spleen and the diseased kidney. A follow-up pathological examination of the resected pancreatic tissue confirmed a malignancy. Concerned that the cancer could recur and might have infiltrated adjacent organs, Mr. Arato's surgeon referred him to a group of oncology practitioners for follow-up treatment.
During his initial visit to the oncologists, Mr. Arato filled out a multipage questionnaire routinely given new patients. Among the some 150 questions asked was whether patients "wish to be told the truth about [their] condition" or whether they wanted the physician to "bear the burden" for them. Mr. Arato checked the box indicating that he wished to be told the truth.
The oncologists discussed with Mr. and Mrs. Arato the advisability of a course of chemotherapy known as "F.A.M.," a treatm
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