After a short period of following her doctor's orders, the height of Ms. Matthies' right femur displaced, resulting in a shortening of her right leg and a continuing inability to walk. Five years after her initial injury, and following two hip replacement surgeries, Ms. Matthies is still confined to a bed or chair and is fully dependent upon others. Although Dr. Mastromonaco argued that informed consent is irrelevant in noninvasive treatment cases, his conjecture was rebuffed by the appellate division and ultimately by the state Supreme Court. In turn, the doctor has the duty to evaluate the relevant information and disclose all courses of treatment that are medically reasonable under the circumstances. It is for the patient to make the ultimate decision regarding treatment based on the doctor's recommendations.
Informed consent applies to invasive and noninvasive procedures.
To ensure informed consent, the physician must inform patients of medically reasonable alternatives and their attendant probable risks and outcomes. Physicians do not adequately discharge that duty by disclosing only the treatment alternatives that they recommend. A physician should discuss the medically reasonable course of treatment, including non-treatment. Like the deviation from the standard of care, the doctor's failure to obtain informed consent is a form of medical negligence. Recognition of a separate duty emphasizes the doctor's obligation to inform, as well as treat, the patient.