Hopp v Lepp: The Supreme Court of Canada’s First Ruling on Informed Consent — Duty of Disclosure, Specific Questions, and the Limits of the Obligation

On a winter evening in February 1974, Aron Lepp returned to his home in Lethbridge, Alberta after a long drive from British Columbia. The pain that came on that night was, by his account, excruciating, located in his left upper thigh, hip, and groin, so severe that he had to crawl to his bed. What followed was a sequence of clinical events, surgical decisions, and a dispute about what a patient was told before he consented to an operation, a dispute that eventually reached the Supreme Court of Canada and produced the country’s first authoritative ruling on the doctrine of informed consent.

Hopp v Lepp, decided May 20, 1980, was handed down on the same day as Reibl v Hughes, the two cases together forming the foundational informed consent authority in Canadian medical law. Hopp v Lepp provides the framework: the duty to disclose, what must be disclosed without being asked, what must be disclosed in response to specific questions, and how to distinguish risks that require disclosure from those that do not. Reibl v Hughes, addressed in a separate article in this series, builds on that framework by tackling the causation test for informed consent claims.

The Clinical History

Aron Lepp was a retired farmer, sixty-six years of age, who had been physically active, jogging, skiing, motorcycling, and water-skiing. He had enjoyed good health until the night of February 25-26, 1974.

His family physician was called the morning of February 26 and arranged for him to be taken by ambulance to hospital. The initial diagnosis was acute disc syndrome with left sciatica. Conservative treatment (bed rest, pain relievers, muscle relaxants) was prescribed, but there was no appreciable improvement. On March 6, 1974, Dr. Phillip Hopp, an orthopaedic surgeon who had recently begun practicing in Lethbridge, was called in on consultation by the family physician. Dr. Hopp diagnosed the problem as a disc prolapse or protrusion at the fourth lumbar vertebra, a slipped disc causing pressure on the spinal cord.

A myelogram was ordered to confirm the diagnosis. The first attempt on March 7 was unsuccessful. The second, on March 13, 1974, was completed and disclosed a complete block in the spinal canal at the level of the third and fourth lumbar vertebrae, confirming Dr. Hopp’s clinical assessment. Following the myelogram, Dr. Hopp met with Lepp and explained the results. He advised that surgery was “the only solution.”

There then occurred the conversation that would produce years of litigation. Lepp and his wife had already decided, before this conversation, that the operation should be performed in Calgary. In the discussion that followed the myelogram result, Dr. Hopp told Lepp that he could perform the operation “as well as any doctor in Calgary.” When Lepp asked how serious the operation was, Dr. Hopp told him it was “not serious” and that he would be “back home running around like you did before” in six to ten days. Lepp and his wife, persuaded, abandoned their plan to go to Calgary. Lepp signed a formal written consent to the operation.

On March 20, 1974, Dr. Hopp performed a hemilaminectomy: he removed a portion of the disc between the third and fourth lumbar vertebrae. A probe of the area after removal satisfied him that the spinal cord could be freely manipulated. The operation appeared to have achieved its purpose. A subsequent X-ray on March 25 confirmed that the blockage identified in the myelogram had been removed.

But Lepp did not improve as expected. By April 15, further imaging confirmed a complete block still existed at the operative site. Dr. Hopp referred Lepp to a neurologist in Calgary, Dr. Thomas Peter Seland. Dr. Seland referred him in turn to a neurosurgeon, Dr. Hepburn. On April 27, 1974, five weeks after Dr. Hopp’s operation, Dr. Hepburn performed an extensive decompressive laminectomy from the second to the fifth lumbar vertebrae. In the course of this second, more exploratory procedure, a large chunk of extruded disc material was found between the third and fourth lumbar vertebrae and removed.

The permanent consequences were severe. At trial Lepp suffered weakness and loss of sensation in his legs, requiring a cane to walk. He had a disturbance of bowel and bladder function and was impotent. The trial judge was satisfied these disabilities were permanent, caused by damage to nerves in the nerve root canal from undue pressure from the offending disc.

What Lepp Did Not Know About Dr. Hopp

Dr. Hopp had obtained his certification as an orthopaedic specialist in the fall of 1973, a few months before he saw Lepp. He had come to Lethbridge in February 1974 and had not practiced between his certification and his arrival. The operation on Lepp was the first disc operation he had performed since obtaining his specialist certification and entering private practice.

During his post-graduate training, Dr. Hopp had participated in 60 to 75 operations of the type he performed on Lepp. Approximately 30 of those he had done “entirely on his own,” though with a specialist at hand, as required by the teaching hospital’s rules. He had unquestionably received the training his certification reflected. He was a qualified orthopaedic specialist, fully entitled to practise as one.

He did not tell Lepp any of this. He told Lepp he was qualified. He told Lepp he could do it as well as Calgary. He told Lepp it was not serious. What he did not tell Lepp was that the Lethbridge hospital had no neurologist or neurosurgeon on staff: that if neurological complications arose during or after the surgery, no such specialist would be available in Lethbridge. He did not tell Lepp this was his first post-certification operation. And he did not elaborate on what risks, even possible ones, attended the procedure.

The Three Courts: A Three-Way Split

Trial — Brennan J. (April 26, 1977): Dismissal

Brennan J. dismissed all of Lepp’s claims. On the surgical negligence allegations (that Dr. Hopp had failed to find and remove the extruded disc material later found by Dr. Hepburn, and that the post-operative care was deficient), Brennan J. found no evidence to support them. He was not persuaded that the extrusion found by the second surgeon had even been present when Dr. Hopp operated. The first operation appeared to have done what it was designed to do; whatever then occurred was not the fault of Dr. Hopp. Expert witnesses for both sides agreed the post-operative care was reasonable.

On informed consent, Brennan J. found for Dr. Hopp on all three contested points. On the first post-certification operation issue, he held it would be “nothing short of a ridiculous situation” to require a licensed specialist to track every operation he had ever performed so he could inform patients of that number before proceeding. Dr. Hopp was qualified; no disclosure of the first-operation fact was required. On the Lethbridge versus Calgary question, the evidence satisfied him that routine disc operations could be performed as well in Lethbridge as in Calgary. The risk of complications requiring Calgary-based neurological specialists was a possibility, not a probability, and was not a “special or unusual risk” requiring specific disclosure under the Halushka standard. On the seriousness question, Dr. Hopp’s representations did not mislead the plaintiff in any material way.

Brennan J. also held, importantly, that even had he found a breach of duty, no damages flowed from it. The permanent nerve damage most probably originated in the initial disc condition, not from anything Dr. Hopp did. Had the operation been performed in Calgary instead, the same operation would have been performed with the same results. Only token damages could have been awarded even for the battery claim, if established.

Alberta Court of Appeal — Morrow J.A. (Haddad J.A. concurring), March 27, 1979: Majority Allows Appeal

Morrow J.A., writing for the majority, allowed Lepp’s appeal on the consent issue and found both battery and negligence established. His central criticism of the trial judgment was that Brennan J. had used the expert evidence about the adequacy of the Lethbridge facilities (that the operation could be performed as well there as in Calgary) as a substitute for a proper disclosure by Dr. Hopp to his patient. The question was not whether the Lethbridge facilities were adequate; the question was whether Dr. Hopp had given his patient a fair and reasonable explanation of the risks.

Morrow J.A. drew heavily on Smith v Auckland Hospital Board, [1965] NZLR 191, a New Zealand decision where a physician’s reassurance that a patient would be home in “a couple of days” was held inadequate disclosure when a specific question about risk had been asked. He found the situation in Lepp’s case “almost identical”: a specific question about seriousness had been asked, and the answer (“it is not serious, six to ten days and you’ll be back home”) said nothing about risk at all.

On damages, Morrow J.A. disagreed with the trial judge that no damages could flow from the consent failure. In his view, it remained possible that earlier discovery of the post-operative complication, which would have been more likely if Lepp had been in Calgary near neurological specialists, might have reduced his neurological deficit. He also found the defendant’s conduct constituted a “complete failure to be frank.” He awarded $15,000 for resultant impairment and mental distress.

Prowse J.A. — Dissent: The Distinction That the SCC Would Endorse

Prowse J.A.’s dissent, while agreeing with the majority’s articulation of the general law, drew a distinction that would prove critical. He separated two different situations: the general duty of disclosure when seeking a patient’s consent, and the duty of disclosure when responding to specific questions.

In the general case, a surgeon must give a fair and reasonable explanation of the nature of the operation, its probable effects, and any unusual risks. In the specific-question case, the duty expands: a surgeon must make “a reasonably frank and full disclosure” in response to direct patient questions, and that duty extends to “risks which are mere possibilities” if the patient’s questions reasonably direct the surgeon’s attention to such risks and if they could reasonably be expected to affect the patient’s decision.

But, and this was Prowse J.A.’s decisive finding, the conversation between Lepp and Dr. Hopp was not a specific question about risks. It was a question about the surgeon’s qualifications and about whether the operation could be performed competently in Lethbridge. Dr. Hopp answered those questions accurately: he was qualified; he could perform the operation as well as Calgary. The risk of complications requiring neurological specialists was not the subject of a specific question and was not, on the evidence, so substantial as to require unsolicited disclosure. Prowse J.A. would have dismissed the appeal.

Supreme Court of Canada — Laskin CJ (for the Court), May 20, 1980: Appeal Allowed

The SCC allowed Dr. Hopp’s appeal and restored the trial judgment. Laskin CJ’s reasons, delivered for a unanimous court, addressed the three aspects of the consent issue in turn and then articulated the framework that would govern informed consent in Canadian law from that moment forward.

On the first post-certification operation: the trial judge’s finding was correct and unassailable. Dr. Hopp was not inexperienced. He had performed 30 disc operations on his own during training, with 60 to 75 more in which he had participated. The fact that the Lepp operation was the first since certification did not create an obligation to disclose; the test is whether the surgeon was genuinely experienced, not whether a specific numerical or temporal threshold had been crossed after formal credentialling.

On the Lethbridge versus Calgary question: the expert evidence overwhelmingly supported the finding that the operation was a routine disc operation performable as well in Lethbridge as in Calgary. Complications were a possibility, as they are in any operation, but there was no probability of complications requiring neurological specialists, and the risk was not “special or unusual.” The trial judge’s findings were correct; there was no warrant to interfere.

On the seriousness issue: the trial judge found that Dr. Hopp had gone into some detail about the proposed operation after the myelogram results. The question about seriousness, on a fair reading of the evidence, was “subsumed” in the questions about the surgeon’s qualifications and whether the operation could be done as well in Lethbridge. The record did not support the ABCA majority’s conclusion that the plaintiff had made the place of the operation central to his consent, or that Dr. Hopp had failed to provide the information requested.

On damages: the trial judge was also correct on causation and damages. Morrow J.A.’s suggestion that the patient might have suffered less damage if he had gone to Calgary was, in Laskin CJ’s words, “highly conjectural and cannot form the basis of a judgment for the patient.” The operation was competently performed. The same operation would have been performed in Calgary. Only token damages could have been awarded in any event.

The Informed Consent Framework — What Hopp v Lepp Establishes

Laskin CJ’s summary of the duty of disclosure is the passage from Hopp v Lepp most frequently cited in the informed consent literature and in subsequent Canadian cases:

The decided cases appear to indicate that, in obtaining the consent of a patient for the performance upon him of a surgical operation, a surgeon, generally, should answer any specific questions posed by the patient as to the risks involved and should, without being questioned, disclose to him the nature of the proposed operation, its gravity, any material risks and any special or unusual risks attendant upon the performance of the operation. However, having said that, it should be added that the scope of the duty of disclosure and whether or not it has been breached are matters which must be decided in relation to the circumstances of each particular case.

This passage encodes several distinct principles that Canadian courts have applied ever since.

Principle One: The Patient’s Right of Self-Determination

The underlying principle of informed consent in Canadian law, as Laskin CJ articulated it in Hopp v Lepp, is the patient’s right to decide what, if anything, shall be done with their own body. A patient’s consent to surgery “will give protection to his surgeon or physician only if the patient has been sufficiently informed to enable him to make a choice whether or not to submit to the surgery.” The formal signing of a consent document is not the end of the inquiry; what matters is whether the patient had enough information to make a genuine, informed choice. This is the foundation of informed consent in Canada: patient autonomy, not medical authority.

Principle Two: What Must Be Disclosed Without Being Asked

A surgeon seeking a patient’s consent has an unprompted duty of disclosure that covers four things: the nature of the proposed operation; its gravity; any material risks; and any special or unusual risks. These are the baseline requirements. A surgeon who satisfies all four has discharged the general duty of disclosure regardless of whether any questions were asked.

The “nature” and “gravity” elements are relatively straightforward: the patient must be told what is going to be done to them and approximately how serious a procedure it is. The more nuanced elements are the “material risks” and “special or unusual risks” categories.

Principle Three: Material Risks, Special or Unusual Risks, and the Probability-Possibility Spectrum

Hopp v Lepp grapples carefully with how to categorize risks for purposes of the disclosure obligation. The case law at the time used several different classification schemes (probable versus possible, material versus immaterial, special or unusual versus common or inherent), and Laskin CJ addresses each.

Probable risks, those with a meaningful likelihood of occurring, must generally be disclosed without being asked. Mere possibilities, the inherent risks present in any operation (infection, anaesthetic risk, ordinary post-operative complications), do not need to be disclosed in the absence of a specific question.

But this probable/possible dichotomy is not absolute. Gravity is the qualifying factor: a risk that is only a possibility but whose materialization would have grave consequences, such as death or permanent disability, may nonetheless need to be disclosed. A risk of residual stiffness in a limb is in a different legal category from a risk of death, even if both are merely possible. The gravity of the consequence, if a risk should materialize, must be brought into account when determining whether a possible risk rises to the level of a material or special risk requiring disclosure.

The SCC also acknowledged the “material risk” standard developed in American jurisprudence: that a risk is material when a reasonable person in the patient’s position would be likely to attach significance to it in deciding whether to undergo the proposed surgery. Expert evidence on medical custom and practice is relevant to this assessment but not determinative: the question of what a particular patient needed to know cannot be resolved entirely by evidence of what surgeons generally tell patients.

Principle Four: Specific Questions and the Expanded Duty

When a patient asks specific questions about risks, the surgeon’s disclosure obligation expands. In response to a specific question, the surgeon must answer it, and must do so even as to possible risks, not merely probable ones. If a patient’s question reasonably directs the surgeon’s attention to a class of risks, and if a reasonable surgeon in the circumstances could foresee that information about those risks would affect the patient’s decision, the surgeon must respond to those risks honestly and fully, even if they are mere possibilities that would not otherwise require disclosure.

This expansion of the duty is conditional on the question actually being a specific inquiry about risks. A general question about the seriousness of the operation is not necessarily a specific question about particular risks. Prowse J.A.’s dissent, largely endorsed by the SCC, drew this distinction carefully: a question about qualifications and competence is not the same as a question about risks. The duty to answer specific risk questions is only triggered by questions that reasonably call for that kind of answer.

Principle Five: The Qualified Specialist’s First Post-Certification Operation

Hopp v Lepp resolves definitively that a surgeon who is genuinely qualified and experienced need not volunteer, without being asked, that a particular operation is the first since their specialist certification. The test is substantive qualification and genuine experience, not formal numerical thresholds. Dr. Hopp had performed 30 disc operations on his own during training and participated in 60 to 75 more. He was certified as competent by qualified peers. The fact that no earlier post-certification disc operation had been performed in Lethbridge was not information that, on these facts, needed to be disclosed.

This is not a licence for a newly certified surgeon to represent themselves as more experienced than they are. The holding assumes the surgeon is genuinely qualified and experienced, not merely certified. A surgeon who lacks genuine competence and misrepresents that status to obtain consent would stand on different ground entirely.

Principle Six: The Fact-Specific Nature of the Duty

The closing qualification of Laskin CJ’s summary, “the scope of the duty of disclosure and whether or not it has been breached are matters which must be decided in relation to the circumstances of each particular case,” is not mere boilerplate. It reflects the genuine difficulty of applying the disclosure framework to individual facts. The surgeon must assess the emotional condition of the patient, the patient’s apprehension, their reluctance or willingness to submit to the operation, and what explanation is needed to make a genuine consent possible. All of this is context-dependent. No rule can substitute for judgment exercised honestly and responsively in the specific clinical encounter.

The Prowse Dissent and Its Enduring Significance

Prowse J.A.’s dissent in the Alberta Appellate Division, though written in support of dismissal, contributed the most analytically durable insight of the case: the distinction between the general disclosure duty and the expanded duty triggered by specific patient questions. This distinction, endorsed by the SCC in substance, has shaped informed consent law in Canada ever since. It explains why the same risk that need not be disclosed without prompting may become the subject of a mandatory disclosure once a patient’s question has brought it into focus. And it sets the important boundary condition: the question must be genuinely specific enough, in context, to have reasonably directed the surgeon’s attention to the particular risk category at issue.

What the dissent resists, and what the SCC also resists, is a reading of the informed consent doctrine that would require a physician, in every case, to catalogue all conceivable risks of an operation and address each one even where no one has asked and where the risk is not of a character that rises to the level of material or special. The patient’s right of self-determination is paramount, but the law does not require physicians to become encyclopaedias of risk in order to obtain a valid consent to routine surgery.

Damages and the Causation Problem

An often-overlooked aspect of Hopp v Lepp is the damages finding, one that prefigures the causation analysis that Reibl v Hughes would fully develop. Even if the ABCA majority had been correct that there was a failure of informed consent and hence a battery, the question of what damages actually flowed from that battery was deeply problematic.

The trial judge identified the core difficulty: the permanent nerve damage was most likely caused by the original disc condition, something that occurred before Dr. Hopp ever saw Lepp. Had the operation been performed in Calgary, the same operation would have been performed, with the same competence and the same results. The operation itself was not the source of Lepp’s disability. Only token damages, nominal recognition of the invasion of bodily security, could have been awarded in any event.

The ABCA majority tried to navigate around this by suggesting that earlier discovery of the post-operative complication might have been possible in Calgary where neurological specialists were available, and that this might have reduced Lepp’s neurological deficit. The SCC dismissed this as “highly conjectural,” not the kind of evidence on which a damages award can be grounded. The causal link between the failure to disclose and the harm must be established, not merely speculated at. This aspect of Hopp v Lepp points directly to the modified objective test for causation that Reibl v Hughes articulates: it is not enough to show a physician failed to disclose; the plaintiff must establish that a reasonable person in their position, had they been properly informed, would have declined the surgery that caused the harm.

Hopp v Lepp in the Informed Consent Series

Hopp v Lepp is the first foundational pillar of Canadian informed consent law. It establishes the general disclosure obligation, the expanded obligation triggered by specific patient questions, the distinction between probable and possible risks qualified by gravity of consequences, and the primacy of patient autonomy. It addresses the specific clinical scenario of the newly certified specialist and resolves that genuine qualification and experience, not numerical post-certification thresholds, define the obligation to disclose qualifications.

It should be read alongside Reibl v Hughes, 1980 CanLII 23 (SCC), [1980] 2 SCR 880, the companion case decided the same day, which addresses what the plaintiff must establish to prove that a failure of informed consent actually caused their harm. The two cases together form the complete Canadian informed consent framework at the Supreme Court level: Hopp v Lepp defines the disclosure duty; Reibl v Hughes defines the causation test that must be satisfied to turn a breach of that duty into a successful claim for damages.

Both cases are referenced in the Birth Injury Claims Guide and the General Medical Malpractice Claims Guide in this series, where the consent doctrine is addressed as a component of obstetric and surgical malpractice claims. Suwary v Librach, 2015 ONSC 2100 — https://canlii.ca/t/gh8jn in this series applies the Hopp v Lepp framework to the consent for vacuum-assisted delivery, finding that the general consent for labour and delivery covered all standard methods of operative delivery and that no specific consent to the vacuum was required.

Quick Reference: Hopp v Lepp

The Three Decisions

• Trial: Lepp v. Hopp, 1977 CanLII 1667 (AB SCTD), 77 DLR (3d) 321 — https://canlii.ca/t/gwh7l | Brennan J. | April 26, 1977 | Dismissed all claims; no negligence; consent valid; no damages even if breach
• Appeal: Lepp v. Hopp, 1979 ALTASCAD 76 (CanLII), 98 DLR (3d) 464 — https://canlii.ca/t/fp5gz | Morrow and Haddad JJ.A. (majority); Prowse J.A. (dissent) | March 27, 1979 | Majority: battery and negligence; $15,000 damages. Dissent: appeal dismissed
• SCC: Hopp v. Lepp, 1980 CanLII 14 (SCC), [1980] 2 SCR 192, 112 DLR (3d) 67 — https://canlii.ca/t/1mjv6 | Laskin CJ and Martland, Ritchie, Beetz, Estey, McIntyre and Chouinard JJ | May 20, 1980 | Appeal allowed; trial judgment restored; costs throughout to appellant

The Parties

• Plaintiff: Aron E. Lepp — retired farmer, age 66 at time of surgery (March 1974), Lethbridge, Alberta; suffered permanent weakness in legs, bowel/bladder disturbance, and impotence following failed disc surgery
• Defendant: Dr. Phillip G. Hopp — orthopaedic surgeon, recently certified (fall 1973), practising in Lethbridge; the Lepp operation was his first disc surgery since certification; trained in 60-75 disc operations (approximately 30 performed independently) during post-graduate training

The Clinical Facts

• February 26, 1974: Lepp admitted to hospital with acute disc syndrome with left sciatica
• March 6, 1974: Dr. Hopp called in consultation; diagnoses disc prolapse at L3-L4
• March 13, 1974: Successful myelogram confirms complete spinal canal block at L3-L4
• Pre-consent conversation: Dr. Hopp tells Lepp the operation is “not serious,” he will be home in “six to ten days,” and the operation can be done “as well in Lethbridge as in Calgary.” Lepp and wife, who had planned to go to Calgary, agree to proceed in Lethbridge. Written consent signed.
• March 20, 1974: Dr. Hopp performs hemilaminectomy; appears successful; X-ray March 25 confirms block removed
• April 27, 1974: Neurosurgeon in Calgary (Dr. Hepburn) performs extensive decompressive laminectomy L2-L5; finds and removes large chunk of extruded disc material at L3-L4
• Result: Permanent weakness in legs requiring cane; bowel/bladder disturbance; impotence, all permanent
• Lethbridge had NO neurologist or neurosurgeon at the time of the surgery; Lepp was not told this

The Three Informed Consent Questions

• First post-certification operation, Duty to disclose? Trial: NO. ABCA majority: not directly challenged. SCC: NO, genuine qualification and experience satisfy the duty; no obligation to disclose the number of post-certification operations
• No Calgary-based neurological specialists available in Lethbridge, Duty to disclose? Trial: NO, risk was possible, not probable; not special or unusual. ABCA majority: YES breach. Prowse J.A. dissent: NO, not asked as a specific question about risks. SCC: NO, routine disc operation could be performed as well in Lethbridge as in Calgary; possibility of complications not a special or unusual risk requiring unprompted disclosure
• The “not serious” statement, Duty to provide more detail? Trial: No real issue. ABCA majority: YES, misleading. SCC: NO, Dr. Hopp had gone into some detail about the operation; the seriousness question was subsumed in the qualifications and location questions

The Informed Consent Framework (SCC, Laskin CJ)

• Foundation: The patient’s right to decide what shall be done with their own body; consent is valid only if the patient was sufficiently informed to make a genuine choice
• General duty (without being asked): Disclose (1) the nature of the proposed operation; (2) its gravity; (3) any material risks; (4) any special or unusual risks
• Specific questions: If a patient asks specific questions about risks, they must be answered, even as to possible (not just probable) risks, if the question reasonably directs the surgeon’s attention to that class of risk and if a reasonable surgeon could foresee it would affect the patient’s decision
• Probable vs possible risks: Probable risks must generally be disclosed. Mere possibilities (inherent in any operation) need not be disclosed without being asked. BUT gravity of consequences qualifies the distinction: a possible risk with grave consequences (death, permanent disability) may be material even if only possible
• Expert evidence on custom: Relevant but not determinative; the duty runs to the particular patient, not to what surgeons generally do
• Fact-specific inquiry: “The scope of the duty of disclosure and whether or not it has been breached are matters which must be decided in relation to the circumstances of each particular case”
• Qualified specialists: A licensed specialist with genuine experience need not volunteer, without being asked, the number of post-certification operations performed

Damages Finding

• Even if battery/breach had been established: permanent nerve damage most likely originated in the original disc condition, not from any surgical error; same operation would have been performed in Calgary with the same competent results; only token damages available in any event
• ABCA’s $15,000 award for mental distress and “failure to be frank”: rejected by SCC as based on conjectural causation reasoning
• Prefigures the causation analysis in Reibl v Hughes: a failure of disclosure must be shown to have actually caused the harm complained of

Key Cases Referenced

• Parmley v Parmley and Yule, 1945 CanLII 13 (SCC), [1945] SCR 635 — patient’s right to determine what is done with their body
• Kenny v Lockwood, 1931 CanLII 184 (ON CA), [1932] OR 141 — early Canadian authority on duty of disclosure; surgeon-patient relationship as fiduciary; probable risks and seriousness
• Halushka v University of Saskatchewan (1965), 1965 CanLII 439 (SK CA), 53 DLR (2d) 436 — informed consent in medical research; “fair and reasonable explanation of the proposed treatment including the probable effect and any special or unusual risks”
• Smith v Auckland Hospital Board, [1965] NZLR 191 — specific question about risk triggers expanded disclosure duty; misleading reassurance constitutes inadequate disclosure
• Canterbury v Spence (1972), 464 F 2d 772 — American material risk standard; risk is material when a reasonable person in the patient’s position would attach significance to it
• Male v Hopmans (1967), 1967 CanLII 146 (ON CA), 64 DLR (2d) 105 — failure to order required tests; Ontario Court of Appeal on fact-specific duty of disclosure
• Kelly v Hazlett (1976), 1976 CanLII 568 (ON HCJ), 15 OR (2d) 290 — special and unusual risks distinguished from inherent risks of any operation
• Reibl v Hughes, 1980 CanLII 23 (SCC), [1980] 2 SCR 880 — companion SCC decision, same day; the causation test for informed consent claims; separate article in this series

Related Articles in This Series

• Reibl v Hughes, [1980] 2 SCR 880 — the companion SCC decision on informed consent causation; the modified objective test; article in this series
• Suwary v Librach, 2015 ONSC 2100 — https://canlii.ca/t/gh8jn — applies the Hopp v Lepp framework to consent for vacuum-assisted delivery; non-elective procedures covered by general consent; article in this series
• Wilson v Swanson, [1956] SCR 804 — the error of judgment doctrine; specialist standard of care; cited with approval in the Hopp v Lepp litigation; article in this series
• Crits v Sylvester, 1956 CanLII 34 (ON CA) — the “normal prudent practitioner” standard; article in this series