Truman v. Thomas, 27 Cal. 3d 285, 165 Cal. Rptr. 308, 611 P.2d 902 (Cal. 1980)
Truman v. Thomas is a landmark California Supreme Court decision that extended the doctrine of informed consent beyond the risks of undergoing a proposed procedure to the material risks of refusing recommended diagnostic testing or treatment.
Does a physician's duty of informed consent encompass a duty to disclose the material risks inherent in a patient's refusal to undergo a recommended diagnostic test or treatment?
Under California's informed-consent doctrine (as articulated in Cobbs v. Grant), a physician has a duty to disclose all information material to a patient's decision to accept or reject a proposed procedure, which includes the nature and purpose of the intervention, the risks and benefits, and available alternatives. Materiality is measured by the objective patient standard: a risk is material if a reasonable person in the patient's position would consider it significant in deciding whether to proceed. This duty extends to disclosing the material risks of declining or delaying a recommended diagnostic test or treatment. Recognized exceptions include emergencies, situations where disclosure would be detrimental to the patient's well-being (therapeutic privilege), cases in which the patient already knows or specifically waives the information, or where the risk is so remote or obvious that disclosure is unnecessary. Causation in informed-consent cases is assessed by asking whether a reasonable patient, properly informed, would have consented to the recommended test or treatment.
Yes. A physician's informed-consent duty includes the obligation to disclose material risks of refusing a recommended diagnostic test or treatment. The trial court erred by failing to so instruct the jury. The judgment in favor of the defendant was reversed and the case remanded for a new trial under the proper legal standard.
Truman v. Thomas is frequently taught with Cobbs v. Grant to show the full scope of informed consent: physicians must disclose material information not only about the procedure and alternatives but also about the consequences of refusal. For practitioners, it underscores the need to communicate clearly and document informed refusals. For students, it illustrates how tort law uses the objective patient standard to define both duty and causation in informed-consent claims and how doctrinal expansion (from procedure-focused disclosure to non-treatment risks) serves patient autonomy and risk management in clinical settings.