Court Opinion

ID: 9528353
Source: CourtListenerOpinion
Date Created: 2023-08-07 03:40:15.969839+00
Date Added: 2024-06-11T13:25:48.002523
License: Public Domain

Robert W. Hansen, J.
(dissenting). Very recently this court made clear that a physician or surgeon is “. . . not an insurer of the results of his diagnosis or procedures.” 1 Even the very best of them, we then and there noted, “. . . can be wrong in diagnosis or procedure.” 2 In a lawsuit claiming medical malpractice, the question is not whether a physician has made a mistake but, rather, “. . . the question is whether he was negligent.” 3 For, “. . . [u] nless the untoward result was caused by the failure to conform to the accepted standard of care, he is not liable in negligence for damages.” 4
*21As to the proper standard of care, for the breach of which a physician or surgeon is liable in negligence, this court at this term held the standard to be:
“‘[A] qualified medical (or dental) practitioner, be he a general practitioner or a specialist, should be subject to liability in an action for negligence if he fails to exercise that degree of care and skill which is exercised by the average practitioner in the class to which he belongs, acting in the same or similar circumstances.’ ” 5
Of this standard of professional care or duty owed, this court at this term, in Francois, held that in a medical malpractice lawsuit:
“‘[A] plaintiff must prove the defendant failed to give him, not the highest degree of care, but merely the reasonable care and skill usually possessed by physicians of the same school....’” 6
To make crystal clear that it is the standard of care of the class that is involved, the members of the medical profession, this court at this term added:
“. . . The standard to which they [members of the medical profession] must conform, however, is determined by the practices of neither the very best nor the worst of the class. Like automobile drivers, engineers, common laborers, and lawyers, they are obliged to conform to reasonable care in the circumstances.” 7
In the Francois Case, a few weeks ago, this court applied this standard of care or duty owed by a physician or surgeon to (1) diagnosis, and (2) care and treatment. Directing that the complaint be dismissed, this court there found no evidence that would have permitted the *22case to go to the jury, since “. . . no physician testified that what was done did not comport with approved medical practice under the circumstances.” 8 That clearly is the majority rule followed in most states.9 As clearly it is the standard of care found applicable by the trial court in the case before us as to (1) diagnosis, and (2) care and treatment. He so instructed the jury,'10 and no issue is raised on this appeal as to the correctness of such application of the Francois standard as to care.
The trial court additionally instructed the jury as to the duty of a physician or surgeon to make reasonable disclosure to his patient of all significant facts under the circumstances.11 The trial court correctly stated *23this in terms of a duty on the part of the doctor, not a right or expectation on the part of the patient. There was and is a theory of surgery as an intentional tort of battery, with the fact of informed consent the crucial issue. However, our court has found this approach inadequate in situations “. . . where the alleged misconduct on the part of the physician amounts to a failure to disclose the ramifications of a pending course of treatment, therapy, or surgery . ...” 12 So, instead, our court has recognized “. . . a legal duty, bottomed upon a negligence theory of liability, in cases wherein it is alleged that the patient-plaintiff was not informed adequately of the ramifications of a course of treatment.” 13 Thus, we accepted the “ ‘. . . prevailing view . . . that the action, regardless of its form, is in reality one for negligence in failing to conform to the proper standard, to be determined on the basis of expert testimony as to what disclosure should be made.’ ” 14
This standard of complying with medical standards in the profession under the circumstances was here followed by the trial court, as to duty to inform as well as to care and treatment. The trial judge instructed the jury that the duty to disclose was 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.” The majority opinion finds this too limited, but does “. . . surmise [that such disclosures] would be adequate to fulfill the doctor’s duty of disclosure in most instances.” The writer would agree with the trial court that it is adequate in all instances. If the standards of the profession are adequate as to the duty of a brain surgeon in diagnosis, treatment and surgical *24procedures, they ought be equally adequate as to what ought be disclosed as to nature of the surgery and collateral risks involved. The majority does limit any duty of the surgeon to disclose to exclude disclosures that might . . detrimentally alarm the particular patient,” or “. . . where the patient is a child ... or a person is emotionally distraught or susceptible to unreasonable fears.” The writer has more confidence in the standards of the professional group involved than in court or jury deciding what disclosures need or ought be made to a patient facing the surgeon’s scalpel. Children play at the game of being a doctor, but judges and juries ought not.
The majority opinion substitutes a standard requiring the doctor 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 the disclosure to intelligently exercise his right to consent or to refuse the treatment or procedure proposed.” There are several things wrong with the more elusive standard thus substituted, not as to diagnosis or treatment, but as to the duty to inform only.
The majority cites Trogun but ignores its clear mandate that, once the plaintiff has established a prima facie showing of a failure of the physician to inform the patient, “. . . the physician must come forward with his explanation of the reasons for not so informing the patient, including evidence that such advice was not customarily given.” (Emphasis supplied.)15 The Trogum. decision further states: “As to the scope of the physician’s duty to disclose, see Shier v. Freedman, supra.” (Emphasis supplied.)16 That decision, quoted above, clearly states that a physician or surgeon is to be subject to liability in an action for negligence only “. . . if he *25fails to exercise that degree of care and skill which is exercised by the average practitioner in the class to which he belongs, acting in the same or similar circumstances. . . .” 17 The standard of care, reiterated by this court at this term in Francois, as to care and treatment, is the same standard of care that Trogun held applicable to the duty to inform.
The majority opinion states that the “. . . right of the patient and the duty of the doctor are standards . . . not entirely dependent upon the customs of a profession.” This blurs, sub silentio, the Trogun substitution of a duty to inform for a requirement of consent to avoid a battery. It rejects, without saying so, the standard of care in Shier made applicable by Trogun as to the duty to disclose. More inexplicably, it abandons, without mention, the holding at this term, in Francois, that the duty of a doctor is based on “. . . approved medical practice under the circumstances.” Eeference in the majority opinion to “customs of a profession” is strange for the reason that the added hairshirt of the average man test, here placed on the backs of the medical profession, is placed, in malpractice lawsuits, on no other professional group. When a lawyer is sued for malpractice, the client-plaintiff mupt establish a failure to meet the standard of professional competence in the legal profession. The standards of the profession, not the expectations of the average client, set the duty owed. The claim of legal malpractice must rest upon a breach of a duty owed under the standard of professional competence of the legal profession. While the duties involved are different, the writer sees no reason why the standard of care devolving upon the doctor should be higher or different from that placed upon the lawyer next door.18 The writer would affirm *26the judgment of the trial court which confirmed the jury verdict and dismissed the complaint of the plaintiff.
I am authorized to state that Mr. Justice Leo B. Han-ley joins in this dissent.

 Francois v. Mokrohisky (1976), 67 Wis. 2d 196, 201, 226 N. W. 2d 470.

 Id. at page 201.

 Id. at page 201.

 Id. at page 201.

 Id. at page 200, quoting and following Shier v. Freedman (1973), 58 Wis. 2d 269, 283, 284, 206 N. W. 2d 166, 208 N. W. 2d 328.

 Id. at page 201, quoting and reaffirming Trogun v. Fruchtman (1973), 58 Wis. 2d 569, 584, 207 N. W. 2d 297.

 Id. at page 201.

 Id. at page 201.

 See: 61 Am. Jur. 2d, Physicians, Surgeons, etc., p. 230, sec. 110, stating: “Medical malpractice is a particular form of negligence that consists of not applying to the exercise of the practice of medicine that degree of care and skill which is ordinarily employed by the profession generally, under similar conditions and in like surrounding circumstances. . . . [I]n short, a physician is hound to bestow such reasonable and ordinary care, skill, and diligence as physicians and surgeons in good standing in the same neighborhood, in the same general line of practice, ordinarily have and exercise in like cases. ...”

 °The trial court instructed the jury: “You are instructed that it was the duty of the defendants, Dr. Hamper and Dr. Hughes, in rendering medical services to the plaintiff in treatment of his injuries, to exercise that degree of care, skill, and judgment which is usually exercised by reputable physicians and surgeons of the same school of medicine in Milwaukee County or in the same, similar, or surrounding localities, under like or similar circumstances, having due regard for the advanced state of medical science at the time in question. Failure on the part of the defendant doctors to have exercised that degree of care, skill, and judgment in their treatment of plaintiff’s injuries would constitute negligence.”

 The trial court instructed the jury that: “. . . 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 . . . .”

 Trogun v. Fruchtman, supra, footnote 6, at pages 598, 599.

 Id. at page 600.

 Id. at page 598, quoting Prosser, Lem of Torts (4th ed. 1971), p. 165, see. 32.

 Trogun v. Fruchtman, supra, footnote 6, at page 604.

 Id. at page 604, footnote 69.

 Shier v. Freedman, supra, footnote 6, at pages 283, 284.

 Prosser, Law of Torts (4th ed. 1971), pp. 161,-162, sec. 32, stating: “. . . Most of the decided cases have dealt with physicians and surgeons, but the same is undoubtedly true of dentists, *26pharmacists, psychiatrists, attorneys, architects and engineers, accountants, abstracters of title, and many other professions .... [Ajllowing for the inevitable differences in the work done, the principles applied to all of these appear to be quite identical .... The formula under which this usually is put to the jury is that he must have the skill and learning commonly possessed by members of the profession in good standing; and he will be liable if harm results because he does not have them. . . .”