§671-3 Informed consent. (a) The Hawaii
medical board may establish standards for health care providers to follow in
giving information to a patient, or to a patient's guardian or legal surrogate
if the patient lacks the capacity to give an informed consent, to ensure that
the patient's consent to treatment is an informed consent. The standards shall
be consistent with subsection (b) and may include:
(1) The substantive content of the information to be
given;
(2) The manner in which the information is to be
given by the health care provider; and
(3) The manner in which consent is to be given by the
patient or the patient's guardian or legal surrogate.
(b) The following information shall be
supplied to the patient or the patient's guardian or legal surrogate prior to
obtaining consent to a proposed medical or surgical treatment or a diagnostic
or therapeutic procedure:
(1) The condition to be treated;
(2) A description of the proposed treatment or
procedure;
(3) The intended and anticipated results of the
proposed treatment or procedure;
(4) The recognized alternative treatments or
procedures, including the option of not providing these treatments or
procedures;
(5) The recognized material risks of serious
complications or mortality associated with:
(A) The proposed treatment or procedure;
(B) The recognized alternative treatments or
procedures; and
(C) Not undergoing any treatment or
procedure; and
(6) The recognized benefits of the recognized
alternative treatments or procedures.
(c) On or before January 1, 1984, the Hawaii
medical board shall establish standards for health care providers to follow in
giving information to a patient or a patient's guardian, to ensure that the
patient's consent to the performance of a mastectomy is an informed consent.
The standards shall include the substantive content of the information to be
given, the manner in which the information is to be given by the health care
provider and the manner in which consent is to be given by the patient or the
patient's guardian. The substantive content of the information to be given
shall include information on the recognized alternative forms of treatment.
(d) Nothing in this section shall require
informed consent from a patient or a patient's guardian or legal surrogate when
emergency treatment or an emergency procedure is rendered by a health care
provider and the obtaining of consent is not reasonably feasible under the
circumstances without adversely affecting the condition of the patient's
health.
(e) For purposes of this section, "legal
surrogate" means an agent designated in a power of attorney for health
care or surrogate designated or selected in accordance with chapter 327E. [L
1976, c 219, pt of §2; am L 1982, c 95, §1; am L 1983, c 223, §2 superseded by
c 284, §1; am L 2003, c 114, §2; am L 2008, c 9, §3]
Cross References
Mental illness, informed consent for nonemergency treatment,
see §334E-1.
Law Journals and Reviews
Consent for Testing and Treatment of Minors in Hawaii. 13
HBJ, no. 13, at 165 (2009).
Keomaka v. Zakaib: The Physician's Affirmative Duty to
Protect Patient Autonomy Through the Process of Informed Consent. 14 UH L.
Rev. 801 (1992).
Holding Hawai`i Nursing Facilities Accountable for the
Inadequate Pain Management of Elderly Residents. 27 UH L. Rev. 233 (2004).
Case Notes
Patient-oriented standard applies to physician's duty to
disclose risk information prior to treatment. 79 H. 475, 904 P.2d 489 (1995).
Under circumstances of case, physician did not have
affirmative duty to inform patient that physician was not plastic surgeon and
did not have hospital privileges. 86 H. 84, 947 P.2d 952 (1997).
Where defendant doctor never properly established at trial
the "therapeutic privilege exception" to the requirement that
informed consent be obtained before starting patient on antipsychotic
medication, trial court erred in refusing to instruct jury concerning the tort
of negligent failure to provide informed consent. 98 H. 470, 50 P.3d 946
(2002).
Circuit court did not err in denying defendant's motion for
judgment as a matter of law on plaintiff's informed consent claim as this
section requires the physician to inform patients of recognized alternative
treatments, and defendant did not show that Hawaii courts have directly held
that plaintiffs claiming the failure to disclose an alternative treatment are
required to show that they suffered an injury that the physician failed to
disclose. 125 H. 253, 259 P.3d 569 (2011).
The circuit court erroneously allowed plaintiffs' standard of
care expert to testify that physician owed a duty to disclose physician's and
the medical community's experience with the treatment, and that physician
failed to meet that obligation, where expert's testimony was contrary to the
plain language of this section and Hawaii law. 125 H. 253, 259 P.3d 569 (2011).
Under the patient-oriented standard adopted by Hawaii courts
for determining whether particular information must be disclosed to a patient,
an alternative dosage can constitute a "recognized alternative treatment"
within the meaning of subsection (b)(4); where plaintiffs adduced evidence that
recognized alternative dosing regimens had a lower risk of steroid myopathy,
plaintiffs adduced evidence that a reasonable person would need to hear about
the different recognized pulsing methods to make an informed decision. 125 H. 253,
259 P.3d 569 (2011).
Plaintiffs did not waive their
claim that physician failed to inform them of all information mandated under
this section, where: (1) although plaintiffs' complaint omitted the
specific statutory provisions, plaintiffs' allegation that physician treated
minor "without obtaining the informed consent of Plaintiff[ ]"
clearly implicated a physician's duty of disclosure, which included the duties
enumerated in this section; and (2) at trial, plaintiffs adduced evidence of
recognized alternative treatments and raised the issue of physician's failure
to inform plaintiffs of those alternatives. 136
H. 54, 358 P.3d 26 (2015).
Plaintiffs' presentation of expert medical
testimony, in conjunction with manufacturer's insert for medication alleged to
have caused minor patient's death from cardiac arrest resulting from
hypovolemic shock, established prima facie that administering physician failed
to supply plaintiffs with "recognized material risks of serious
complications or mortality associated with" the medication, as required by
this section. 136 H. 54, 358 P.3d 26
(2015).
Genuine issue of material fact existed as to whether
physician accurately disclosed to patient the "recognized material risks
of serious complications" associated with the performance of back surgery,
and thus physician was not entitled to summary judgment on patient's claim of
negligent failure to obtain informed consent under this section. 137 H. 388,
375 P.3d 167 (2016).
In considering a claim against a physician for negligent
failure to obtain informed consent to a proposed medical or surgical treatment
or a diagnostic or therapeutic procedure, while it is not erroneous for a court
to apply a common law factor establishing the materiality of the risks
associated with the treatment or procedure when that factor is identical to the
statutory requirements of this section, this section governs the analysis, and
it is error to require evidence upon a materiality factor that does not
coincide with a requirement of this section. 137 H. 388, 375 P.3d 167 (2016).
Informed consent doctrine discussed. 8 H. App. 518, 811 P.2d
478 (1991).
A consent form is no substitute for a physician's affirmative
duty to inform his or her patient. 86 H. 93 (App.), 947 P.2d 961 (1997).
Notes of Decisions
Ray v. Kapiolani Med. Specialists, 259 P.3d 569 (Haw. 2011).
· cites it 47× “” The circuit court denied the motions because HRS § 671-3 (Supp.2009) requires the physician to inform patients of recognized alternatives.”
Carr v. Strode, 904 P.2d 489 (Haw. 1995).
· cites it 22× “(a) The board of medical examiners, insofar as practicable, shall establish standards for health care providers to follow in giving information to a patient, or to a patient’s guardian if the patient is not competent to give an informed consent, to insure that the patient’s…”
Garcia v. Robinson., 375 P.3d 167 (Haw. 2016).
· cites it 65× “Robinson maintained that HRS § 671-3(b) governs the physician-owed duty of disclosure and contended that to proceed on a lack of informed consent claim, a plaintiff must adduce expert testimony as to “the nature of risks inherent in a particular treatment, the probabilities of…”
Cuc Thi Ngo v. Queen's Med. Ctr., 358 P.3d 26 (Haw. 2015).
· cites it 67× “Before the informed consent doctrine was codified in HRS § 671-3, Hawaii courts recognized the common law doctrine of informed consent.”
Alghussein v. Kaan., 485 P.3d 68 (Haw. App. 2021).
· cites it 64× “Medical Informed Consent The liability issues in this case involve the Hawai#i medical informed consent statute, HRS § 671-3. The statute prescribes the standard for a physician's duty to disclose information to a patient, supplanting the common-law formulation of the doctrine…”
Ditto v. McCurdy, 947 P.2d 952 (Haw. 1997).
· cites it 5× “HRS § 671-3 provides in pertinent part: (a) The board of medical examiners, insofar as practicable, shall establish standards for health care providers to follow in giving information to a patient, or to a patient’s guardian if the patient is not competent to give an informed…”
Barcai v. Betwee, 50 P.3d 946 (Haw. 2002).
· cites it 4× “See HRS § 671-3 (1993). In addition, the law requires that written informed consent be obtained from psychiatric patients before providing non-emergency psychiatric treatment.”
Alan Andersen v. Sohit Khanna & Iowa Heart Ctr., 913 N.W.2d 526 (Iowa 2018).
· cites it 2× “1997) (“Hawaii’s statute on informed consent expressly mandates that the board of medical examiners establish standards for physicians or surgeons to follow in disclosing information to a patient ‘to ensure that the patient’s consent to treatment is an informed consent.”
State v. Kotis, 984 P.2d 78 (Haw. 1999).
· cites it 2× “HRS § 671-3(a) (1993) provides in relevant part: The board of medical examiners, insofar as practicable, shall establish standards for health care providers to follow in giving information to a patient, or to a patient’s guardian if the patient is not competent to give an…”
Mroczkowski v. Straub Clinic & Hosp., Inc., 732 P.2d 1255 (Haw. App. 1987).
· cites it 8× “Thus, in 1980, HRS § 671-3 (1976) 1 required the physician to specifi *568 cally itemize to the patient or the patient’s guardian “the probable risks and effects of the proposed treatment or surgical procedure,” which is description (C) above.”
Keomaka v. Zakaib, 811 P.2d 478 (Haw. App. 1991).
· cites it 5× “Hawaii Revised Statutes (HRS) § 671-3(a) (1985) requires the medical board of examiners to establish standards for physicians or surgeons to follow in disclosing information to a patient “to insure that the patient’s consent to treatment is an informed consent.”
Ketchup v. Howard, 543 S.E.2d 371 (Ga. Ct. App. 2001).
· cites it 2× “Hawaii: HRS § 671-3 creates a statutory medical tort for the rendering of professional services without informed consent.”
— Haw. Rev. Stat. § 671-3(a) — 5 cases
State v. Kotis, 984 P.2d 78 (Haw. 1999).
“HRS § 671-3(a) (1993) provides in relevant part: The board of medical examiners, insofar as practicable, shall establish standards for health care providers to follow in giving information to a patient, or to a patient’s guardian if the patient is not competent to give an…”
Ditto v. McCurdy, 947 P.2d 952 (Haw. 1997).
“HRS § 671-3 provides in pertinent part: (a) The board of medical examiners, insofar as practicable, shall establish standards for health care providers to follow in giving information to a patient, or to a patient’s guardian if the patient is not competent to give an informed…”
Keomaka v. Zakaib, 811 P.2d 478 (Haw. App. 1991).
“Hawaii Revised Statutes (HRS) § 671-3(a) (1985) requires the medical board of examiners to establish standards for physicians or surgeons to follow in disclosing information to a patient “to insure that the patient’s consent to treatment is an informed consent.”
Alghussein v. Kaan., 485 P.3d 68 (Haw. App. 2021).
“Medical Informed Consent The liability issues in this case involve the Hawai#i medical informed consent statute, HRS § 671-3. The statute prescribes the standard for a physician's duty to disclose information to a patient, supplanting the common-law formulation of the doctrine…”
— Haw. Rev. Stat. § 671-3(b) — 10 cases
Carr v. Strode, 904 P.2d 489 (Haw. 1995).
“(a) The board of medical examiners, insofar as practicable, shall establish standards for health care providers to follow in giving information to a patient, or to a patient’s guardian if the patient is not competent to give an informed consent, to insure that the patient’s…”
Ray v. Kapiolani Med. Specialists, 259 P.3d 569 (Haw. 2011).
“” The circuit court denied the motions because HRS § 671-3 (Supp.2009) requires the physician to inform patients of recognized alternatives.”
Garcia v. Robinson., 375 P.3d 167 (Haw. 2016).
“Robinson maintained that HRS § 671-3(b) governs the physician-owed duty of disclosure and contended that to proceed on a lack of informed consent claim, a plaintiff must adduce expert testimony as to “the nature of risks inherent in a particular treatment, the probabilities of…”
Cuc Thi Ngo v. Queen's Med. Ctr., 358 P.3d 26 (Haw. 2015).
“Before the informed consent doctrine was codified in HRS § 671-3, Hawaii courts recognized the common law doctrine of informed consent.”
Keomaka v. Zakaib, 811 P.2d 478 (Haw. App. 1991).
“Hawaii Revised Statutes (HRS) § 671-3(a) (1985) requires the medical board of examiners to establish standards for physicians or surgeons to follow in disclosing information to a patient “to insure that the patient’s consent to treatment is an informed consent.”
— Haw. Rev. Stat. § 671-3(b)(2) — 1 case
Alghussein v. Kaan., 485 P.3d 68 (Haw. App. 2021).
“Medical Informed Consent The liability issues in this case involve the Hawai#i medical informed consent statute, HRS § 671-3. The statute prescribes the standard for a physician's duty to disclose information to a patient, supplanting the common-law formulation of the doctrine…”
— Haw. Rev. Stat. § 671-3(b)(3) — 2 cases
Garcia v. Robinson., 375 P.3d 167 (Haw. 2016).
“Robinson maintained that HRS § 671-3(b) governs the physician-owed duty of disclosure and contended that to proceed on a lack of informed consent claim, a plaintiff must adduce expert testimony as to “the nature of risks inherent in a particular treatment, the probabilities of…”
Cuc Thi Ngo v. Queen's Med. Ctr., 358 P.3d 26 (Haw. 2015).
“Before the informed consent doctrine was codified in HRS § 671-3, Hawaii courts recognized the common law doctrine of informed consent.”
— Haw. Rev. Stat. § 671-3(b)(4) — 5 cases
Ray v. Kapiolani Med. Specialists, 259 P.3d 569 (Haw. 2011).
“” The circuit court denied the motions because HRS § 671-3 (Supp.2009) requires the physician to inform patients of recognized alternatives.”
Garcia v. Robinson., 375 P.3d 167 (Haw. 2016).
“Robinson maintained that HRS § 671-3(b) governs the physician-owed duty of disclosure and contended that to proceed on a lack of informed consent claim, a plaintiff must adduce expert testimony as to “the nature of risks inherent in a particular treatment, the probabilities of…”
Alghussein v. Kaan., 485 P.3d 68 (Haw. App. 2021).
“Medical Informed Consent The liability issues in this case involve the Hawai#i medical informed consent statute, HRS § 671-3. The statute prescribes the standard for a physician's duty to disclose information to a patient, supplanting the common-law formulation of the doctrine…”
Cuc Thi Ngo v. Queen's Med. Ctr., 358 P.3d 26 (Haw. 2015).
“Before the informed consent doctrine was codified in HRS § 671-3, Hawaii courts recognized the common law doctrine of informed consent.”
— Haw. Rev. Stat. § 671-3(b)(5) — 3 cases
Garcia v. Robinson., 375 P.3d 167 (Haw. 2016).
“Robinson maintained that HRS § 671-3(b) governs the physician-owed duty of disclosure and contended that to proceed on a lack of informed consent claim, a plaintiff must adduce expert testimony as to “the nature of risks inherent in a particular treatment, the probabilities of…”
Alghussein v. Kaan., 485 P.3d 68 (Haw. App. 2021).
“Medical Informed Consent The liability issues in this case involve the Hawai#i medical informed consent statute, HRS § 671-3. The statute prescribes the standard for a physician's duty to disclose information to a patient, supplanting the common-law formulation of the doctrine…”
Cuc Thi Ngo v. Queen's Med. Ctr., 358 P.3d 26 (Haw. 2015).
“Before the informed consent doctrine was codified in HRS § 671-3, Hawaii courts recognized the common law doctrine of informed consent.”
— Haw. Rev. Stat. § 671-3(b)(5)(A) — 2 cases
Garcia v. Robinson., 375 P.3d 167 (Haw. 2016).
“Robinson maintained that HRS § 671-3(b) governs the physician-owed duty of disclosure and contended that to proceed on a lack of informed consent claim, a plaintiff must adduce expert testimony as to “the nature of risks inherent in a particular treatment, the probabilities of…”
Cuc Thi Ngo v. Queen's Med. Ctr., 358 P.3d 26 (Haw. 2015).
“Before the informed consent doctrine was codified in HRS § 671-3, Hawaii courts recognized the common law doctrine of informed consent.”
— Haw. Rev. Stat. § 671-3(b)(6) — 2 cases
Alghussein v. Kaan., 485 P.3d 68 (Haw. App. 2021).
“Medical Informed Consent The liability issues in this case involve the Hawai#i medical informed consent statute, HRS § 671-3. The statute prescribes the standard for a physician's duty to disclose information to a patient, supplanting the common-law formulation of the doctrine…”
Cuc Thi Ngo v. Queen's Med. Ctr., 358 P.3d 26 (Haw. 2015).
“Before the informed consent doctrine was codified in HRS § 671-3, Hawaii courts recognized the common law doctrine of informed consent.”
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