a.        Plaintiff had hairy-cell leukemia.  His treatment included removal of his spleen.
b.        He had to travel back and forth b/t Seattle and LA for the various treatments.
c.        The issue was that the cells were used in a research project that resulted in the development of a lucrative cell line.  This was without the plaintiff’s knowledge.
d.        Plaintiff sued for conversion.
e.        The court rejected the claim for conversion.  If they had said there was conversion, then consent would have to be made for even normal disposal through along chain of handlers.
f.        The court addressed failure to inform and obtain consent then.  A reasonable patient would want to know.
i.        There was a fiduciary duty to the patient.  Usually if a person is in a position of power for another and has responsibility for their well-being, then this is fiduciary duty.  The court here applies it to a doctor’s responsibility in informed consent.
ii.        It is the only case found in which this duty is applied to informed consent.  This is probably b/c of the financial nature.
g.        The court called this material disclosure.
i.        If it was material to the patient’s need to make the decision, then it should be included in informed consent.
ii.        It is a reasonable patient standard, not a reasonable doctor.
h.        Apply this to a more common situation:
i.        Doctor advises a person with a back problem to stay at home and rest or have an operation.
ii.        What kind of disclosure should be made in this case where there are no research interests?  There are still economic interests involved.
1.        Should the doctor factor in any economic considerations?
a.        There is the obvious distinction that the doctor will make more money off of the surgery.
iii.        If this man has a cancer of the blood, do you think he would have turned it down if he did know that they would use his cell line?
1.        No, since he probably just wants to make money.
2.        The problem here is that the doctor had a good idea, but it wasn’t until he was able to test the spleen tissue that he really knew what was available.  This is hard to predict on an individual case.
i.        Would the result have been different if the patient didn’t have to travel and the economic gain was not realized until a few years later?
j.        This case has not dramatically changed informed consent, but it has changed them in research institutions to some extent.