Court Opinion

ID: 9723436
Source: CourtListenerOpinion
Date Created: 2023-08-26 10:15:03.097126+00
Date Added: 2024-06-11T18:24:48.763313
License: Public Domain

JOHNSON, J., Concurring and Dissenting.
I concur in the result the majority reaches but not in its reasoning.
For the reasons I explained at length in my dissent in Scalere v. Stenson (1989) 211 Cal.App.3d 1446, 1454 [260 Cal.Rptr. 152], a doctor’s duty of disclosure includes the duty of explaining the risks and benefits of nontreatment. (Id. at p. 1455.) This duty arises from the same principle that imposes a duty to explain the risks and benefits of treatment: “so that patients might meaningfully exercise their right to make decisions about their own bodies. . . .” (Truman v. Thomas (1980) 27 Cal.3d 285, 292 [165 Cal.Rptr. *990308, 611 P.2d 902].) Whether the physician’s recommendation is to treat or not to treat, or, as here, to test or not to test, there are risks and benefits to either course which must be explained to the patient.
The principle that a doctor’s duty of disclosure includes the duty of explaining the risks of not performing tests has been recognized in other jurisdictions. For example, in Goldberg by and through Goldberg v. Ruskin (1984) 128 Ill.App.3d 1029 [471 N.E.2d 530, 537], affd. on appeal from a separate issue (Ill. 1986) 499 N.E.2d 406, 407, the court held the parents stated a cause of action for wrongful birth against their obstetrician after their child was bom with Tay-Sachs disease. The basis of the Goldbergs’ action, like the Munros’, was the defendant’s failure to administer any tests for Tay-Sachs or to inform the Goldbergs of the possible occurrence of the disease and the existence of tests for it. In upholding the complaint, the court stated: “Mr. and Mrs. Goldberg have alleged the existence of a duty on the part of the defendants to inform them of the risk of Tay-Sachs disease and of the availability of a testing procedure for the disease and that the breach of that duty was the proximate cause of the birth of [their impaired son.] . . . Assuming these factual allegations of the parents to be true ... ‘it can be said in traditional tort language that but for the defendants’ breach of their duty to advise plaintiffs, the latter would not have been required to assume these obligations [of raising an impaired child.]’ ” (Citation omitted.) In Phillips v. United States (D.C.S.C. 1981) 566 F.Supp. 1, 3, 13, applying South Carolina law, defendants were held liable in a wrongful birth action for failing to explain to the mother the advisability of an amniocentesis.
In the present case, the majority clings to its view, expressed in Scalere, that patient care is a one-sided coin. The duty of disclosure applies when the physician proposes to perform a test but “a physician has no duty to disclose where no diagnostic testing or treatment is recommended.” (Ante, at p. 986.) According to the majority, imposing a duty to disclose the risks and benefits of not performing a test would be like drawing a line with a finger in the air; it would be without precision and predictability. (Ante, at p. 987.) A comparison of Goldberg, Phillips and Scalere to the case before us demonstrates such a line can be successfully drawn.
Whether the physician’s proposed course is to test or not to test, “[t]he scope of the physician’s duty to disclose is measured by the amount of knowledge a patient needs in order to make an informed choice. All information material to the patient’s decision should be given . . . -[if] Material information is that which the physician knows or should know would be regarded as significant by a reasonable person in the patient’s position . . . .” (Truman v. Thomas, supra, 27 Cal.3d at p. 291.)
*991In Scalere, the evidence showed: (1) Dr. Stenson suspected the existence of a blood clot two days after Ms. Scalere’s surgery; (2) if a blood clot exists it is advisable to perform a thrombectomy soon after the angiogram; (3) a thrombectomy for a patient exhibiting Ms. Scalere’s symptoms was a reasonable option. Even if Dr. Stenson only suspected the existence of a blood clot that suspicion was enough to trigger a duty to disclose the possibility of a blood clot and the risks and benefits of treatment versus nontreatment. A jury could have properly found the foregoing information “would have been regarded as significant by a reasonable person” in Ms. Scalere’s position and that Dr. Stenson breached his duty of care in failing to disclose it. Similarly, in Goldberg by and through Goldberg v. Ruskin, supra, 499 N.E.2d 406, defendant failed to administer a test for Tay-Sachs and did not even inform the parents of the existence of such a test despite the obvious fact Mr. Goldberg, at least, was Jewish. And, in Phillips, defendants failed to advise the mother of the availability of prenatal testing procedures, particularly amniocentesis, despite their knowledge the mother’s sister suffered from Down’s syndrome.
In contrast to Scalere, Goldberg and Phillips, nothing Dr. Crandall knew about the Munros triggered a duty to disclose the risks and benefits of not testing for Tay-Sachs. Neither of the Munros was of Jewish heritage. Mr. Munro had some distant relatives of French heritage but Dr. Crandall had no reason to know or even suspect any of these relatives came from a small inbred community of French Canadians which is said to have a slightly higher incidence of Tay-Sachs disease than the general population.
In the present case, summary judgment against the Munros should be affirmed because the undisputed facts show Dr. Crandall was not aware of any facts that would trigger a duty to disclose to the Munros the risk of not performing a test for Tay-Sachs. Thus, the majority reaches the correct result in this case. What concerns me is the majority would have reached the same result in the case of the Goldbergs and the Phillips.
Appellants’ petition for review by the Supreme Court was denied February 15, 1990.