## Facts

- Miklos Arato, a 42-year-old electrical contractor, underwent surgery in 1980 during which a malignant tumor on the tail of his pancreas was discovered and partially removed along with his spleen and a kidney.
- Concerned about recurrence, the surgeon referred Arato to oncologists for chemotherapy and radiation therapy that had shown promise in experimental trials for pancreatic cancer.
- At the initial oncology visit, Arato completed a questionnaire indicating he wanted to be told the truth about his condition.
- The physicians discussed treatment and conveyed generally that most pancreatic cancer patients die of the disease and that recurrence would be considered incurable.
- The physicians did not provide detailed statistical survival rates or specific numerical life-expectancy probabilities.
- Arato later died of pancreatic cancer.
- His wife and other heirs sued the treating physicians, alleging negligence and lack of informed consent based on the asserted failure to disclose statistical life expectancy; they contended he would have declined treatment and used his remaining time differently had he been given such statistics.
- A jury returned a defense verdict after receiving a standard informed-consent instruction and hearing expert testimony on medical practice regarding disclosure of survival statistics.
- The Court of Appeal reversed, concluding the physicians should have disclosed statistical life expectancy and faulting the standard jury instruction.

## Issues

1. Whether informed consent requires physicians, as a matter of law, to disclose statistical life-expectancy or survival-rate data for pancreatic cancer.
2. Whether informed consent obligates physicians to disclose information primarily material to a patient’s nonmedical interests (such as financial planning).
3. Whether the standard informed-consent jury instruction adequately states California law.
4. Whether expert testimony regarding medical custom on disclosing survival statistics is admissible in evaluating informed-consent disclosures.

## Decision

- The California Supreme Court reversed the Court of Appeal and directed affirmance of the defense judgment.
- The Court held there is no categorical legal duty to disclose specific statistical life-expectancy probabilities to obtain informed consent.
- The Court rejected any informed-consent duty to disclose information material solely to nonmedical interests; physicians are not required to serve as financial advisers.
- The Court upheld the standard informed-consent jury instruction as legally adequate.
- The Court approved admission of expert testimony on professional practice regarding disclosure of statistical survival information for the limited purpose of informing whether such disclosure is medically appropriate.

## Legal Principles

- A physician must disclose material information needed for a patient to decide whether to undergo a proposed treatment, measured by what a reasonable person in the patient’s position would consider significant.
- The informed-consent duty is directed to medical decision-making about treatment, risks, and alternatives; it does not extend to advising about nonmedical life planning or financial affairs.
- Physicians are not required, as a matter of law, to provide detailed population-based survival statistics in every cancer case; such figures may be unreliable for predicting an individual patient’s outcome.
- A patient’s generalized expression of wanting to “be told the truth” does not, by itself, expand the legal scope of disclosure beyond the material-information standard.
- Expert testimony about medical practice may be admitted to address whether disclosure of specialized statistical information is professionally appropriate, without converting professional custom into the controlling legal standard.

## Conclusion

The court reinstated the defense verdict, holding that informed consent required disclosure of material medical information about the proposed cancer treatment but did not impose a per se obligation to provide statistical life-expectancy probabilities or to disclose information aimed primarily at the patient’s nonmedical financial and personal planning.


Arato v. Avedon, 5 Cal. 4th 1172 (Cal. 1993)