From: Andrew Tettenborn <A.M.Tettenborn@swansea.ac.uk>
To: Marc Ramsay <marc.ramsay@acadiau.ca>
CC: obligations@uwo.ca
Date: 14/10/2010 14:53:47 UTC
Subject: Re: informed consent/neglience question

On 14/10/2010 15:33, Marc Ramsay wrote:
I have a question about the Reibl v. Hughes test regarding disclosure of material facts.

Suppose the following.

A patient consents to a surgical procedure.

A given risk, let's a 5 percent chance of partial paralysis, is determined to be a material risk, and that risk is not disclosed.  The physician doesn't discuss this risk at all. There are no other problems with the quality of the patient's consent.

The procedure is performed competently, but the patient suffers serious injury.  However, the injury is not a matter of the relevant risk materializing.
The patient's loss concerns another risk which,
1) the patient was informed of (perhaps even signed a waiver regarding), or
2) an unforeseeable or previously unknown risk that the physician cannot been have expected to know about or disclose (perhaps the patient suffers hearing loss or loss of sight).

Is it appropriate to the proceed to the causation question in either of these cases (what a reasonable patient would have chosen in the circumstances), or are these kinds of losses to be treated as outside the scope of the physician's wrongdoing?


Thanks,
Marc Ramsay
Acadia University




There shouldn't be liability here. But the real issue is one of adventitious causation. And there are plenty of examples stating that it's not necessarily enough to show (1) a wrong by D, and (2) harm to P that technically wouldn't have happened but for that wrong. Two below:

A. I drive the wrong way down a one-way street. Despite my exemplary look-out, a valuable Persian cat runs in front of my car and gets squished. I don't think I can be liable for the loss of the cat, even though it wouldn't have been killed had I not (negligently) driven down the one-way street (since I would have been somewhere else). The maritime decision in The Estrella [1977] 1 Lloyds Rep 525 has something of this about it.

B. The shipping case of The Empire Jamaica. [1957] AC 386. Shipowners show personal fault in appointing a technically uncertificated officer. As a result of other negligence by the officer, nothing to do with the lack of the certificate, there is a casualty. Is the casualty due to the actual fault or privity of the shipowners (on the basis that it wouldn't have happened if the owners had done as they should and not appointed the officer)? No.


Best to all

Andrew




--

 
Andrew Tettenborn
Professor of Commercial Law, Swansea University

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Andrew Tettenborn
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