20th Anniversary of Landmark Informed Consent Case, Arato v. Avedon

Twenty years ago today, on September 30, 1993, the California Supreme Court issued its opinion in Arato v. Avedon.



Arato had been diagnosed with pancreatic cancer.  The oncologists recommended a course of chemotherapy medication and radiation treatment.  But Arato and his wife were never told the statistical probability of his survival (which was quite low). About eight months after his surgery, Arato’s cancer returned and quickly spread. He died shortly thereafter. 



In the subsequent lawsuit, Arato’s wife alleged that the oncologists had not adequately disclosed statistical mortality information of the cancer and thus failed to obtain his informed consent to undergo the treatment.  Arato's wife claimed that had he known the bleak truth regarding his chance for survival Arato would not have sought treatment and, instead would have chosen to die peacefully at home. 



But the jury found in favor of the defendants . The court of appeals reversed and ordered a new trial.  The California Supreme Court reversed, reinstating the defense verdict.



Today, twenty years later, I am optimistic that clinicians have a clearer and stronger duty to inform patients about end-of-life options.  There are new statutes in California and New York.  And the expanded California duty is now being tested in the Hargett v. VITAS case.