Case 10 - Natanson v. Kline PDF

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Kasey Regulinski Case 10: Natanson v. Kline PHIL P393 22 October 2017

In Kansas in 1960, a woman named Irma Natanson was suffering from breast cancer and needed a mastectomy followed by radiation therapy. During the radiation therapy, she suffered a terrible burn which she sued her doctor for after the injury occurred. Irma sued Dr. Kline because she had not consented to the risk of radiation burn. During the argument, Dr. Kline defended himself saying he had therapeutic privilege. He did not deny the fact that he had failed to tell Mrs. Natanson about the risk of being burned. Frequently in these types of situations doctors will claim that such information might disturb the patient or even cause them to refuse treatment. One of the biggest parts of a patient-doctor relationship is trust. Each patient would want to feel they can rely on their physician before any time of surgery. The principle of fidelity explains this, and says “Most attention is focused on the loyalty of the physician to the patient, but in some settings we are increasingly talking about the obligations or duties of loyalty of the patient to the physician as well” (Veatch, 2016, p. 64). The biggest issue that the principle of fidelity brings is when a physician believes that keeping a promise to the patient will not give them their best outcome. During the argument between Dr. Kline and Mrs. Natanson, his main point in defending himself was that he had therapeutic privilege. The therapeutic privilege is what a physician will claim when they believe that specific information will be harmful or upsetting to the patient. This privilege makes sense in ethics because of paternalistic patient benefit, but is opposing to ethics

giving important place to the principle of autonomy. Another principle that comes into question is the principle of veracity. Some people would argue that because Mrs. Natanson did not ask about being burned, Dr. Kline did not lie. However, the principle of veracity would say that he would have been lying because he did not show her respect by being truthful about the consequences. One of the biggest reasons that Dr. Kline could not be in trouble for not disclosing all information is because no one is insisting that consent must be “fully” informed. All that is said, is that they must provide adequate information, because telling patients everything about a treatment or surgery is an impossible task. When deciding what information is considered adequate and needs to be provided they discusses three standards: the professional standard, the reasonable standard, and the subjective standard. The professional standard is the most traditional. It requires that a physician must tell their patients everything that their colleagues would tell their patients when they are in similar situations. The reasonable person standard says that the physician needs to tell their patient anything that a reasonable patient would want to be told or anything they would find significant, even if their colleagues do not agree. The subjective standard focuses on the patient in question. This standard says that any physician only must tell their patient what the patient wants to know (Veatch, 2016, p. 74). In this case, Dr. Kline would have gone with the subjective standard, if Mrs. Natanson did not ask about the chance of being burned then he did not have to tell her. The principles that are set up for doctors are brought into question to help others understand the choices that they make. Dr. Kline did not disclose all the information about radiation therapy to Mrs. Natanson, however, according to the standards of disclosure, he does not always have to disclose all information to the patient. Some would also argue that the

principles of autonomy and veracity say that all physicians should always disclose all information to their patients. Dr. Kline followed the therapeutic privilege as well as following the standards of disclosure. According to those standards he had the right to withhold information from Mrs. Natanson because he believed that the information would upset her or withdrawal her consent from treatment.

References Veatch, R. M. (2016). The Basics of Bioethics (3rd ed.). New York, NY: Routledge....