(2) Subjective test. A subjective test of the reasonable person standard
was later developed. The subjective test goes one step farther by recognizing that
the informational needs of an objective reasonable person may not meet the unique
and specific needs of a real patient.
subjective test of the reasonable person standard of disclosure: the
standard whereby the physician's duty to disclose information material to the
decision is determined by the informational needs of the individual patient.
The reasonable person standard of disclosure (subjective test) goes the farthest to
support the autonomy choice model of informed consent, discussed earlier, in which a
two-way dialogue establishes the unique informational needs of the patient.
Informational needs can differ. For example, a person may have unorthodox beliefs,
unusual health problems, or a unique family history that requires a different information
INFORMATIONAL NEEDS CAN DIFFER
In Hales v. Pitman (Ariz., 1978), the patient told the physician that his ability to work
was crucial, so the court ruled that the physician should have informed him of the
risks that could affect his ability to work. This ruling illustrates that when a patient
indicates a need for special information, unique to his or her situation, there can be a
duty to provide it. A female employee with a family history of reproductive problems
might need information that other persons would not need, before becoming involved
in research on sexual and family relations or before accepting employment in certain
industries.
d. Hybrid Standards. Some states have developed hybrid standards. For
instance, in Texas there is the "A list" which delineates certain procedures and what the
patient must be told about them. The "B list" contains another group of procedures for
which there is no obligation to inform the patient about potential risks, unless the
physician so desires. Interestingly, there are no gynecological procedures on the "A
list," even though the obstetrics-gynecology (OB-GYN) specialty is recognized as
having a high incidence of malpractice suits.
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