ABSTRACT
In 1972, the other landmark case of Canterbury v Spence was decided by the District Court (Canterbury v Spence (1972) 464 F 2d 772), which fully articulated the doctrine of informed consent. The 19 year old plaintiff was a clerk-typist employed by the Federal Bureau of Investigation and had been suffering shoulder pains; suspecting that this was the result of a ruptured disc, Dr Spence ordered a laminectomy, which entailed surgical removal of the bone arches of the patient’s vertebrae to expose his spinal cord. The plaintiff’s mother was told that this was ‘not any more serious than any other operation’ and she signed a consent form. The plaintiff had not been informed by the defendant that paralysis could be expected ‘somewhere in the nature of 1%’ (see p 778, col 2). Shortly after the operation, as a result of lack of postoperative supervision by the hospital (the second defendant), the plaintiff fell from his bed and, hours later, experienced paralysis from the waist down. His mother signed another consent form and the patient underwent another operation, resulting in some improvement of his muscle tone. When the case came for trial, the plaintiff remained partially paralysed, needed crutches to walk, suffered from urinal incontinence and wore a penile clamp. It was argued on behalf of Dr Spence that ‘disclosure of minute risks of complication was not sound medical practice because this could potentially deter patients from undergoing much-needed surgery, and often caused adverse psychological reactions inimical to contemplated treatment’ (Healy (1999), p 92).
