As recently as 1970 a legal commentator felt certain enough of his ground to say about informed consent: Good medical practice is good Iaw.' Whatever the validity of that statement then, reliance on it in 1973 is dangerous at best. Three opinions in the last year, in the District of Columbia, California and Rhode Island. have specifically repudiated this view and put the medical profession on notice that they can no longer rely on self. imposed standards to determine what constitutes informed consent.

In Canterbury v. Spence, the defendant doctor had informed both his 19 year old patient who suffered back pain and the patient's mother that a laminectomy was no more serious than any other operation. He did not mention that the procedure carried a 1% risk of paralysis. Following surgery, the patient suffered total paralysis from the waist down. Tho court decided specifically that the physician was under an affirmative obligation to disclose this risk information regardless of what was medically customary. The court held that the law, not medical custom, defines the standard of disclosure according to the patient's needs.