Scaria v. St. Paul Fire & Marine Insurance

227 N.W.2d 647, 68 Wis. 2d 1, 1975 Wisc. LEXIS 1570
CourtWisconsin Supreme Court
DecidedApril 10, 1975
Docket311
StatusPublished
Cited by68 cases

This text of 227 N.W.2d 647 (Scaria v. St. Paul Fire & Marine Insurance) is published on Counsel Stack Legal Research, covering Wisconsin Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Scaria v. St. Paul Fire & Marine Insurance, 227 N.W.2d 647, 68 Wis. 2d 1, 1975 Wisc. LEXIS 1570 (Wis. 1975).

Opinions

Beilfuss, J.

The issues raised by the plaintiffs upon appeal are the following:

1. Did the trial court properly instruct the jury as to informed consent?

2. Did the trial court err in applying the locality rule?

3. Did the jury return a valid five-sixths verdict?

[10]*104. Did the trial court err in refusing to change the jury answers on causation from “No” to “Yes?”

5. Should a new trial be granted in the interest of justice?

The trial court instructed the jury with respect to the issue of informed consent as follows:

“With respect to your answer to the question inquiring as to the negligence of Dr. Kamper, Question No. 1, you are instructed that a physician and surgeon has a duty to make reasonable disclosure to his patient of all significant facts under the circumstances of the situation which are necessary to form the basis of an intelligent and informed consent by the patient to the proposed treatment or operation and the patient must have given such consent to the treatment or operation. This duty, however, is limited to those disclosures which physicians and surgeons of good standing would make under the same or similar circumstances, having due regard to the patient’s physical, mental and emotional condition.
“Now, with respect to your answer to Question No. 2, inquiring as to the causal negligence of Dr. Kamper, you are instructed that if you find that the defendant Dr. Kamper did not reasonably disclose to the plaintiff K. S. Scaria all of the significant facts, then you are instructed that there must be a causal relationship between the physician’s failure to adequately divulge and damage to the plaintiff. A causal relationship exists only when disclosure of significant risks incidental to treatment would have resulted in a decision against it. There is a causal connection only if it has been established that had the plaintiff been so informed, that then he would have declined the treatment as proposed.”

We will first consider the doctor’s duty to disclose and the patient’s right to be informed of the risks of the proposed treatment or surgery.

The plaintiffs’ principal objection to the instruction as given is the limitation of duty on the part of a physician or surgeon to inform the patient as to “those disclosures which physicians and surgeons of good standing [11]*11would make under the same or similar circumstances, having due regard to the patient’s physical, mental and emotional condition.”

This court in Trogun v. Fruchtman (1973), 58 Wis. 2d 569, 207 N. W. 2d 297, recognized that a patient had a right to know of significant potential risks involved in proposed treatment or surgery so that he could make a rational and informed decision of whether he would undergo the proposed procedures. In order for a patient to he able to give an informed consent, the physician or surgeon is under the duty to provide the patient with such information as may be- necessary under the circumstances then existing.

The physician or surgeon, through education, training and experience, knows or should know the inherent risks of the proposed procedures and the probability of a successful result. He also appreciates the potential risks generally known by doctors in good standing. A physician or surgeon is not required to know every potential risk but only those known to a reasonably well-qualified practitioner or specialist commensurate with his classification in the medical profession.

The duty of a physician or surgeon is to exercise ordinary care. The first sentence of the challenged instruction is, in our opinion, an adequate general statement of that standard. Slightly paraphrased, it provides that a physician has a duty to make a reasonable disclosure to his patient of the significant risks in view of the gravity of the patient’s condition, the probabilities of success, and any alternative treatment or procedures if such are reasonably appropriate so that the patient has the information reasonably necessary to form the basis of an intelligent and informed consent to the proposed treatment or procedure. The patient then has a right to give or withhold his consent to the proposed treatment or procedure.

[12]*12The second sentence of the challenged instruction limits the doctor’s disclosures to “those disclosures which physicians and surgeons of good standing would make under the same or similar circumstances, having due regard to the patient’s physical, mental and emotional condition.”

We believe this limitation is too broad in that it limits the duty to a standard adopted by the physicians and surgeons as a group. We are not dealing primarily with the professional competence nor the quality of the services rendered by a doctor in his diagnosis or treatment. The right to be recognized and protected is the right of the patient to consent or not to consent to a proposed medical treatment or procedure. Because of the patient’s lack of professional knowledge, he cannot make a rational reasonable judgment unless he has been reasonably informed by the doctor of the inherent and potential risks. The right of the patient and the duty of the doctor are standards recognized and circumscribed by the law and are not entirely dependent upon the customs of a profession. The need of a particular patient for competent expert information should not necessarily be limited to a self-created custom of the profession.2 The disclosures which would be made by doctors of good standing, under the same or similar circumstances, are certainly relevant and material and we surmise would be adequate to fulfill the doctor’s duty of disclosure in most instances. However, the duty to disclose or inform cannot be summarily limited to a professional standard that may be nonexistent or inadequate to meet the informational needs of a patient.

We do recognize there must be some limitation upon the doctor’s duty to disclose risks involved. A doctor [13]*13should not be required to give a detailed technical medical explanation that in all probability the patient would not understand. He should not be required to discuss risks that are apparent or known to the patient. Nor should he be required to disclose extremely remote possibilities that at least in some instances might only serve to falsely or detrimentally alarm the particular patient. Likewise, a doctor’s duty to inform is further limited in cases of emergency or where the patient is a child,3 mentally incompetent or a person is emotionally distraught or susceptible to unreasonable fears.

In short, the duty of the doctor is to make such disclosures as appear reasonably necessary under circumstances then existing to enable a reasonable person under the same or similar circumstances confronting the patient at the time of disclosure to intelligently exercise his right to consent or to refuse the treatment or procedure proposed.

We therefore conclude the instruction on informed consent as given was inadequate.

The plaintiffs also contend the instruction given to the jury on causation was erroneous in that it required the jury to apply an objective standard rather than a subjective one. They argue that Trogun v. Fruchtman, supra, failed to specify which standard should be used.

In deciding Trogun,

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Bluebook (online)
227 N.W.2d 647, 68 Wis. 2d 1, 1975 Wisc. LEXIS 1570, Counsel Stack Legal Research, https://law.counselstack.com/opinion/scaria-v-st-paul-fire-marine-insurance-wis-1975.