Doreika v. Blotner

ANDREWS, Judge,

dissenting.

Because the General Assembly has defined the doctrine of informed consent for medical procedures in OCGA § 31-9-6.1, and the chiropractic neck adjustment at issue is not a procedure covered by the informed consent provisions set forth in OCGA § 31-9-6.1, the trial court correctly refused to instruct the jury on the informed consent claim.

Paul J. Doreika’s action for professional negligence against his chiropractor, Gregg M. Blotner, D.C., was tried before a jury, which rendered a verdict in favor of Dr. Blotner. Mr. Doreika claimed that a neck adjustment performed on him by Dr. Blotner injured him by either causing, a herniated disc or aggravating a pre-existing disc condition, and that he was required to undergo surgery to repair the injury. Mr. Doreika did not claim that the manner in which Dr. Blotner performed the neck adjustment was negligent. Rather, the claim was that Dr. Blotner was negligent because he performed the neck adjustment without doing an examination and history on Mr. Doreika adequate to establish a clinical basis for the adjustment, and without obtaining Mr. Doreika’s informed consent for the adjustment.19

Citing this Court’s opinion in Ketchup v. Howard, 247 Ga. App. *85854 (543 SE2d 371) (2000), Mr. Doreika enumerates as error the trial court’s refusal, over his objection, to give requested instructions to the jury based on Ketchup that Georgia law required Dr. Blotner to obtain Mr. Doreika’s informed consent for the neck adjustment by informing him of the material risks of and the available alternatives to the proposed treatment. In Ketchup, this Court held that Georgia “will recognize the common law doctrine of informed consent” and that “a medical professional in Georgia . . . must inform a patient of the material risks of a proposed treatment or procedure which are or should be known, and they must inform a patient of available alternatives to the proposed procedure or treatment.” Id. at 54, 59. Ketchup imposed these informed consent requirements (prospectively only) on dentists performing a dental procedure, even though the procedure at issue was not covered by the doctrine of informed consent as defined under the provisions of OCGA § 31-9-6.1. Id. at 54-55. Relying on Ketchup, the majority now finds that a chiropractor performing the neck adjustment at issue is a “medical professional” performing a “treatment or procedure” under the common law of informed consent, and that the trial court committed reversible error by failing to instruct the jury that Dr. Blotner was required to obtain Mr. Doreika’s informed consent. Instead of applying Ketchup to impose new informed consent requirements on a case-by-case basis, this Court should recognize that it had no authority in Ketchup to adopt a common law version of informed consent at odds with the General Assembly’s definition of informed consent in OCGA § 31-9-6.1.

The General Assembly has codified the informed consent doctrine in Georgia in OCGA § 31-9-6.1, which sets forth six categories of information that must be disclosed by medical care providers to patients before the patients undergo specified surgical or diagnostic procedures. The trial court did not err by refusing to give Mr. Doreika’s requested informed consent instructions because the neck adjustment performed by the chiropractor in this case is not covered by the informed consent provisions of OCGA § 31-9-6.1. Our Supreme Court held in Albany Urology Clinic v. Cleveland, 272 Ga. 296 (528 SE2d 777) (2000), that there was no common law doctrine of informed consent in Georgia prior to the enactment of OCGA § 31-9-6.1, and that, after the General Assembly codified the informed consent doctrine in OCGA § 31-9-6.1, it was beyond the power of the Supreme Court or this Court to expand upon those statutory informed consent provisions. Id. at 298-299; see Ketchup, 247 Ga. App. at 74-75 (Andrews, E J., concurring specially joined by Blackburn, R J., Ruffin and Miller, JJ.). This Court erred in Ketchup by disregarding the Supreme Court holding in Albany Urology Clinic *859as dicta. See Ketchup, 247 Ga. App. at 75-76 (Ruffin, J., concurring specially joined by Andrews, E J., Blackburn, E J., and Miller, J.). Contrary to the majority’s claim, the Supreme Court’s subsequent opinion in Nathans v. Diamond, 282 Ga. 804 (654 SE2d 121) (2007), did not abandon the holding in Albany Urology Clinic and did not endorse Ketchup’s imposition of informed consent requirements in addition to those set forth in OCGA § 31-9-6.1. Rather, the facts in Nathans show that the case concerned a claim that a medical doctor failed to comply with informed consent requirements on a surgical procedure covered by the provisions of OCGA § 31-9-6.1. Id. at 804.

Decided June 18, 2008 — Reconsideration denied July 23, 2008 Warshauer, Poe & Thornton, Steven R. Thornton, for appellant.

It follows that Ketchup is contrary to the General Assembly’s codification of the informed consent doctrine in OCGA § 31-9-6.1, and contrary to the Supreme Court’s decision in Albany Urology Clinic, supra, recognizing that the power to define the doctrine of informed consent in Georgia rests, not with the judiciary, but with the people through their elected representatives in the General Assembly. Nevertheless, the majority opinion implies that to return to the informed consent doctrine, as codified by the General Assembly, would violate the United States and Georgia Constitutions, and would represent “a gigantic step backward for the people of Georgia” from the expanded informed consent requirements preferred by this Court in Ketchup. It is not within the jurisdiction of this Court to hold forth on the constitutionality of a statute, nor is it the province of this Court to chide the judgment of the General Assembly. The Georgia Constitution requires this Court to conform its decisions to statutes lawfully enacted by the General Assembly and to the binding precedents of the Supreme Court of Georgia. Fullwood v. Sivley, 271 Ga. 248, 254 (517 SE2d 511) (1999); Ga. Const. of 1983, Art. VI, Sec. Y, Far. Ill; Art. VI, Sec. VI, Far. VI. Because Ketchup conforms to neither, it is entitled to no deference under the doctrine of stare decisis and should be overruled. I respectfully dissent from the majority opinion applying and extending the holding of Ketchup.

I am authorized to state that Fresiding Judge Ruffin, Presiding Judge Blackburn, Judge Miller, and Judge Mikell join in this dissent.

*860Owen, Gleaton, Egan, Jones & Sweeney, Milton B. Satcher III, Melissa P. Reading, for appellee.

Even though Mr. Doreika’s complaint did not specifically assert a negligence claim based on lack of informed consent, the case was tried before the jury, without objection, on expert testimony setting forth varying opinions on the standard of care for chiropractors with respect to obtaining informed consent, and disputing whether the standard required that Dr. Blotner inform Mr. Doreika of the risk of disc injury and alternative treatment before performing the neck adjustment. Accordingly, the claim that Dr. Blotner was negligent for failing to obtain informed consent was addressed during the trial by express or implied consent of the parties. OCGA § 9-11-15 (b); Holliday v. Jacky Jones Lincoln-Mercury, 251 Ga. App. 493, 496 (554 SE2d 286) (2001).