1. Samira Kohli v. Dr. Prabha Manchanda & Others (2008, Supreme Court of India)

This is the most important Indian case on informed consent.

Facts:

The patient went to a hospital for diagnostic laparoscopy and D&C (a limited diagnostic procedure). While under anesthesia, doctors also performed a hysterectomy (removal of uterus) and removal of ovaries without prior specific consent for that major surgery.

Issue:

Whether consent for a diagnostic procedure also allows doctors to perform a major surgical operation.

Judgment:

The Supreme Court held:

• Consent must be procedure-specific, not general.
• Consent for diagnosis does NOT imply consent for therapeutic surgery.
• Performing a different or additional major procedure without consent = battery (unauthorized touching), not just negligence.

Principle Established:

• Doctors must obtain informed and specific consent for each procedure.
• “Blanket consent” is not valid for major medical decisions.

2. Canterbury v. Spence (1972, U.S. Court of Appeals)

Facts:

A patient underwent spinal surgery. The doctor did not fully explain the risk of paralysis. The patient later became paralyzed after a fall post-surgery.

Issue:

Whether doctors must disclose all material risks even if the patient does not ask.

Judgment:

The court ruled:

• Doctors have a duty to disclose material risks, even if not asked.
• Material risk = any risk that a reasonable patient would consider important in making a decision.

Principle Established:

• Shift from “doctor-centered” standard to patient-centered disclosure standard.
• Consent is valid only when the patient understands significant risks and alternatives.

3. Montgomery v. Lanarkshire Health Board (2015, UK Supreme Court)

Facts:

A diabetic pregnant woman was not informed of the risk of shoulder dystocia (baby getting stuck during childbirth). The risk was small but significant. The baby suffered injury during birth.

Issue:

Whether doctors must disclose all risks a reasonable patient would consider important.

Judgment:

The court held:

• Doctors must disclose material risks that a reasonable patient would attach significance to.
• Medical paternalism (“doctor knows best”) is outdated.
• Patients have autonomy over their own bodies.

Principle Established:

• Strong recognition of patient autonomy.
• Consent requires disclosure of risks even if statistically small, if significant to the patient.

4. Rogers v. Whitaker (1992, High Court of Australia)

Facts:

A woman underwent eye surgery to improve vision in one eye. The doctor did not warn her about a rare risk of “sympathetic ophthalmia” that could cause blindness in the other eye. She became nearly blind.

Issue:

Whether doctors must disclose rare risks.

Judgment:

The court held:

• A doctor is obliged to warn of material risks, even if rare.
• The standard is not what doctors usually disclose, but what a reasonable patient needs to know.

Principle Established:

• Strengthened duty of disclosure beyond medical practice norms.
• Risk materiality depends on patient perspective, not doctor practice standards.

5. Chester v. Afshar (2004, House of Lords, UK)

Facts:

A patient underwent spinal surgery. The surgeon failed to warn her of a small but real risk of paralysis. The complication occurred even though the surgery was properly performed.

Issue:

Whether failure to warn automatically leads to liability even if surgery was not negligent.

Judgment:

The court held:

• Even if surgery was performed properly, failure to disclose material risk violates consent.
• Causation was satisfied because, had she been warned, she might have delayed or reconsidered surgery.

Principle Established:

• Emphasized right to autonomy over outcome-based reasoning.
• Strengthened liability for non-disclosure of risks.

6. Poonam Verma v. Ashwin Patel (1996, Supreme Court of India)

Facts:

A homeopathic doctor prescribed allopathic medicine, which led to the patient’s death.

Issue:

Whether treatment without proper qualification and consent is lawful.

Judgment:

The Supreme Court held:

• Practicing outside authorized medical system is negligence.
• Patients have the right to expect treatment from a qualified practitioner acting within their field.

Principle Relevant to Consent:

• Consent is meaningful only when treatment is given by a competent and authorized doctor.
• Lack of proper qualification can invalidate the legitimacy of treatment itself.

Key Legal Principles Derived from These Cases

Across jurisdictions, courts consistently establish:

1. Patient Autonomy is Supreme
   • Patient decides what happens to their body.
2. Disclosure must be Material and Meaningful
   • Not just technical details, but what a reasonable patient would care about.
3. Consent Must Be Specific
   • General consent is not enough for major procedures.
4. Right to Refuse Treatment is Fundamental
   • Even life-saving treatment cannot be forced (except limited legal exceptions).
5. Failure to Obtain Proper Consent = Legal Liability
   • Can amount to negligence or even battery (unauthorized touching).