Matthies v. Mastromonaco

Supreme Court of New Jersey · Torts

Tortsinformed consentmedical malpracticeinformed consentnoninvasive treatmenttreatment alternativesreasonable patient standardmaterial risk

Facts

After eighty-one-year-old Jean Matthies fractured her hip, Dr. Mastromonaco decided against surgery and prescribed bed rest, which he regarded as a controversial conservative treatment. Plaintiff claimed he did not explain the alternative of surgery, the risks of bed rest, or the probable effect of bed rest on her ability to walk and quality of life. Shortly after bed-rest treatment began, the femoral head displaced, her leg shortened, and she never regained the ability to walk. At trial, the court allowed the doctor to say he had discussed surgery but barred plaintiff from fully contesting that point and refused an informed-consent charge.

Issue

Does the doctrine of informed consent require a physician to obtain consent before implementing a nonsurgical, noninvasive course of treatment? Must the physician disclose medically reasonable treatment alternatives, including alternatives the physician does not recommend?

Rule

A physician must obtain informed consent by disclosing medically reasonable invasive and noninvasive alternatives, including nontreatment, together with the risks and likely outcomes of those alternatives, whenever that information would be material to a reasonable patient's decision. The decisive question is not whether the chosen treatment is invasive, but whether the physician adequately presented the material facts needed for the patient to make an informed choice.

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One of 10 multiple-choice questions for this case. Pick an answer to see why.

In Portland, Oregon, Dr. Lena Iqbal diagnosed Martin Doyle with a torn knee ligament. She recommended six months of immobilization and physical therapy, but did not mention that reconstructive surgery was also medically reasonable and offered a better chance of returning to recreational hiking sooner, though with greater immediate risk. Martin later developed permanent instability after following the conservative plan.

If Martin sues for lack of informed consent, which is the best argument for allowing the claim to go to the jury?

Explanation. The majority held that informed consent is not limited by whether the chosen treatment is invasive. The decisive question is whether the physician disclosed the material facts a reasonable patient would need to choose among medically reasonable alternatives. A physician may be liable for failing to disclose a medically reasonable surgical alternative even when the physician selected a noninvasive course. (Derived from Matthies v. Mastromonaco (n.d.).)