Title: Boyer v. Smith

State: pennsylvania

Issuer: Pennsylvania Supreme Court

Document:

345 Pa. Superior Ct. 66 (1985) 497 A.2d 646 Irene and Paul BOYER, Appellants, v. Stephen H. SMITH, M.D. and Quakertown Community Hospital, Appellees. Supreme Court of Pennsylvania. Argued June 20, 1985. Filed August 23, 1985. *67 Peter J. Boyer, Philadelphia, for appellants. Joseph C. Bernstein, Allentown, for appellees. Before MONTEMURO, POPOVICH and WATKINS, JJ. MONTEMURO, Judge: This appeal presents the issue of whether to expand the current applicability of the doctrine of informed consent beyond cases involving medical treatment by operative procedures so as to encompass cases involving solely the administration of therapeutic drugs. This action was commenced on January 31, 1979, before the Arbitration Panels for Health Care. On November 28, 1980, the matter was transferred to the Court of Common Pleas of Bucks County. On November 8, 9 and 10, 1982, a trial was held before the Honorable Edmund V. Ludwig and a jury. The jury returned a verdict in favor of appellee, *68 Stephen H. Smith, M.D.[1] On November 17, 1982, appellants filed a motion for new trial and, following argument, the court below denied the motion on July 23, 1984. Upon appellants' praecipe, judgment was entered for appellee on August 31, 1984, and this timely appeal followed. Appellants' sole post-trial challenge is to the lower court's refusal to charge the jury regarding the doctrine of informed consent. At trial, appellants requested that the jury be instructed in pertinent part as follows: As set forth in the Pa.R.A.P. 1925(b) opinion of the court below, the facts underlying this action are the following: Lower court opinion, 1-2. The doctrine of informed consent was introduced into the law of this Commonwealth in 1966 by our supreme court's opinion in Gray v. Grunnagle, 423 Pa. 144, 223 A.2d 663 (1966). In Gray, an action was commenced seeking recovery for the unsuccessful performance of a surgical procedure. Plaintiff/appellant therein received a verdict in the amount of $80,000.00, the jury having found that the operation was performed without plaintiff/appellant's consent. Thereafter, the lower court en banc granted defendant's motion for judgment non obstante veredicto. On appeal, our supreme court reversed and reinstated the verdict of the jury. In Salis v. United States, 522 F. Supp. 989 (M.D.Pa. 1981), the District Court for the Middle District of Pennsylvania aptly summarized the Gray opinion: Salis, 522 F. Supp. at 997 (citations and footnote omitted). Significantly, as noted by the district court in Salis, "Pennsylvania has placed itself in a decided minority by choosing a `battery' rather than [a] negligence theory in defining informed consent." Id. at 997-98 n. 10. In Cooper v. Roberts, 220 Pa.Super. 260, 286 A.2d 647 (1971), this court stated: Id., 220 Pa.Superior Ct. at 265, 286 A.2d at 649 (footnote omitted).[2] In Malloy v. Shanahan, 280 Pa.Super. 440, 421 A.2d 803 (1980), this court was presented with a novel issue, which we characterized as follows: Id., 280 Pa.Superior Ct. at 442-43, 421 A.2d at 804. Clearly, the issue presently before us is identical to that which was presented in Malloy. However, Malloy resulted in a plurality decision with Judge Watkins writing the opinion of the court, Judge Price concurring in the result, and Judge Hoffman vigorously dissenting. As such, Malloy provides us with ample guidance yet no clear precedence. See Commonwealth v. Davenport, 462 Pa. 543, 342 A.2d 67 (1975). In Malloy, Judge Watkins observed that "informed consent is required of [a] patient, absent an emergency, prior to a surgical operation. . . . However, this has not been extended to therapeutic treatment, which is usually an ongoing treatment upon examination by the treating physician, where any change of condition can be diagnosed and controlled." Id., 280 Pa.Super. at 443, 421 A.2d at 804 (citations omitted). Judge Watkins went on to quote the trial court's opinion noting that: Id. (brackets in original). In his dissent, Judge Hoffman urged the adoption of a negligence theory of informed consent, stating: Id., 280 Pa.Superior Ct. at 446, 421 A.2d at 805-06 (Hoffman, J., dissenting) (citations omitted). Judge Hoffman further posited, "The theory that failure to obtain informed consent to treatment constitutes a form of negligence eliminates the artificial requirement that the physician engage in a `touching' and thus a battery in order to be held liable." Id., 280 Pa.Superior Ct. at 447, 421 A.2d at 806 (Hoffman, J., dissenting). Judge Hoffman concluded that, under a negligence theory of informed consent, recovery would be available in therapeutic drug cases. See generally Comment, Informed Consent in Pennsylvania The Need for a Negligence Standard, 28 Vill.L.Rev. 149 (1982-83). We are of the opinion that the doctrine of informed consent should continue to be limited in its applicability to only those cases involving surgical or operative medical procedures. In Gray, supra, our supreme court expressly grounded its adoption of the informed consent doctrine upon the legal theory that the performance of a medical procedure without a patient's informed consent constitutes a technical assault or battery. To now expand the doctrine's current applicability to cases involving the administration of therapeutic drugs would be to radically depart from, and indeed obliterate, the foundation upon which the Gray decision stands. Not only are we unpersuaded that such expansion is necessary, we consider ourselves bound by our supreme court's pronouncements in Gray. Furthermore, we are also of the particular opinion that, in light of the day-to-day realities of providing professional medical care, traditional medical malpractice actions, sounding *73 in negligence, are an adequate legal medium for compensating patients for the injurious consequences of therapeutic drug treatment. Accordingly, we affirm the judgment of the court below. Judgment affirmed. [1] Appellants' action against Quakertown Community Hospital was dismissed by stipulation of counsel at the commencement of trial. [2] The law of this Commonwealth is that, in determining whether a patient's consent was indeed "informed", a fact-finder utilizes the following so-called "objective standard" and must consider "whether the physician disclosed all those facts, risks and alternatives that a reasonable man in the situation which the physician knew or should have known to be the plaintiff's would deem significant in making a decision to undergo the recommended treatment." Cooper v. Roberts, 220 Pa.Super. 260, 267, 286 A.2d 647, 650 (1971). See also De Fulvio v. Holst, 272 Pa.Super. 221, 414 A.2d 1087 (1979); Jeffries v. McCague, 242 Pa.Super. 76, 363 A.2d 1167 (1976); cf. Act of October 15, 1975, P.L. 390, § 103, 40 P.S. § 1301.103.