California Civil Jury Instructions (CACI) (2017)
534. Informed Refusal—DefinitionDownload PDF
[A/An] [insert type of medical practitioner] must explain the risks of
refusing a procedure in language that the patient can understand and
give the patient as much information as [he/she] needs to make an
informed decision, including any risk that a reasonable person would
consider important in deciding not to have [a/an] [insert medical
procedure]. The patient must be told about any risk of death or serious
injury or signiﬁcant potential complications that may occur if the
procedure is refused. [A/An] [insert type of medical practitioner] is not
required to explain minor risks that are not likely to occur.
New September 2003
Directions for Use
This instruction should be read in conjunction with CACI No. 535, Risks of
Nontreatment—Essential Factual Elements.
If the patient is a minor or is incapacitated, tailor the instruction accordingly.
Also, see CACI No. 531, Consent on Behalf of Another.
Sources and Authority
• The deﬁnition of “informed consent” in Cobbs v. Grant (1972) 8 Cal.3d 229
[104 Cal.Rptr. 505, 502 P.2d 1] applies “whether the procedure involves
treatment or a diagnostic test.” (Truman v. Thomas (1980) 27 Cal.3d 285, 292
[165 Cal.Rptr. 308, 611 P.2d 902].)
• In Truman, “the high court extended the duty to make disclosure to include
recommended diagnostic as well as therapeutic procedures and to include
situations in which the patient declines the recommended procedure.” (Vandi v.
Permanente Medical Group, Inc. (1992) 7 Cal.App.4th 1064, 1069 [9
Cal.Rptr.2d 463].) This has been termed the “informed refusal” doctrine.
(Townsend v. Turk (1990) 218 Cal.App.3d 278, 284 [266 Cal.Rptr. 821].)
• “In a nutshell, a doctor has a duty to disclose all material information to his
patient which will enable that patient to make an informed decision regarding
the taking or refusal to take such a test.” (Moore v. Preventive Medicine
Medical Group, Inc. (1986) 178 Cal.App.3d 728, 736 [223 Cal.Rptr. 859].)
5 Witkin, Summary of California Law (10th ed. 2005) Torts, §§ 395, 400–404, 406,
407, 409, 410
California Tort Guide (Cont.Ed.Bar 3d ed.) § 9.12
3 Levy et al., California Torts, Ch. 31, Liability of Physicians and Other Medical
Practitioners, § 31.14 (Matthew Bender)
36 California Forms of Pleading and Practice, Ch. 415, Physicians: Medical
Malpractice, § 415.13 (Matthew Bender)
17 California Points and Authorities, Ch. 175, Physicians and Surgeons: Medical
Malpractice, § 175.23 (Matthew Bender)
33 California Legal Forms, Ch. 104, Health Care Transactions, Consents, and
Directives, § 104.11 (Matthew Bender)
CACI No. 534 MEDICAL NEGLIGENCE