Basic Right of Informed Consent
The concept of informed consent is critical to the practice of medicine in the United States, including California. It stems from the fundamental legal and ethical principle that each individual has sovereignty over their body and can exercise their right to self-determination in making decisions about their health care.
Informed consent entails providing a patient with sufficient information about a proposed medical treatment, including potential risks, benefits, and alternatives, which enables them to make an informed decision about whether to proceed. It forms the cornerstone of medical ethics, reflecting respect for the autonomy and dignity of patients.
A Patient’s Right to Refuse Treatment
The primary law that grants Californians the right to informed consent and the refusal of medical treatment is contained in the California Health and Safety Code. According to the Code, “An adult patient has the right to determine the course of his or her medical treatment, including the right to refuse medical treatment.”
Minors in California, however, typically require parental consent for medical treatments, except in specific situations like emergencies, certain types of reproductive health care, mental health services, or when the minor is emancipated.
It is crucial to note that the right to refuse treatment also extends to end-of-life decisions. The California Natural Death Act allows adults with terminal conditions to make their wishes known about life-sustaining treatment through an Advance Health Care Directive or Physician Orders for Life-Sustaining Treatment (POLST).
The 1972 Court Decision in Cobbs v. Grant
The California Supreme Court’s decision in Cobbs v. Grant (1972) significantly shaped the doctrine of informed consent in California. This case centered around a patient, Thelma Cobbs, who underwent an exploratory surgery performed by Dr. William Grant. The surgery led to a splenic rupture and subsequent complications. Ms. Cobbs contended that Dr. Grant did not inform her about the potential risks associated with the procedure, violating her right to informed consent.
In its ruling, the court defined the scope of the physician’s duty to disclose as follows: “The scope of the physician’s communications to the patient, then, must be measured by the patient’s need, and that need is the information material to the decision. Thus the test for determining whether a potential peril must be divulged is its materiality to the patient’s decision.”
In simple terms, the court held that physicians must disclose all information that could influence a patient’s decision about a proposed treatment, including potential risks and alternatives. This principle set a precedent that profoundly influenced the approach to informed consent in California and across the U.S.
Impact of Cobbs v. Grant Decision
The Cobbs v. Grant decision placed a legal obligation on healthcare providers to ensure that patients are fully informed about the potential outcomes of a proposed treatment, empowering patients to make informed decisions about their health care.
Healthcare providers who fail to secure informed consent may face legal penalties, including malpractice lawsuits. From a practical perspective, the Cobbs v. Grant decision obligates healthcare providers to develop comprehensive consent processes, including detailed discussions with patients and documentation of consent.
Thus, the law in California robustly supports the right of a patient to make informed decisions about their medical treatment. This right is underpinned by the principle of informed consent, which was significantly shaped by the landmark court decision in Cobbs v. Grant.