Informed Consent

Navy title card reading "Brown v Meaney: The limits of clinical judgment, affirmed on appeal" from paulcahill.ca, a Paul Cahill case comment.

Brown v Meaney: Clinical Judgment, Informed Consent, and Commonsense Causation on Appeal

The Court of Appeal dismisses the appeal in Brown v Meaney, upholding findings that two pediatric neurologists breached the standard of care and the duty to obtain informed consent when they abandoned a pyridoxine trial in an infant with a rare epilepsy. The decision affirms that a defensible first impression does not excuse the failure to revisit it, and that causation need not be proven with scientific precision.

June 19, 2026

Case comment on J.C. v Jugenburg, 2026 ONSC 3061, on clinic surveillance, intrusion upon seclusion, and aggregate privacy damages in a patient class action. By Paul Cahill, LSO Certified Specialist in Civil Litigation.

J.C. v Jugenburg: Undisclosed Patient Surveillance and the Tort of Intrusion upon Seclusion

A cosmetic surgery clinic recorded patients in consultation rooms and the operating room without telling them. In J.C. v Jugenburg, 2026 ONSC 3061, the court awarded $21.5 million in aggregate damages and $1 million in punitive damages, and clarified how intrusion upon seclusion applies inside the doctor-patient relationship.

June 5, 2026

Reistad v La Berge, 2026 BCSC 575, Supreme Court of British Columbia. A prophylactic laparoscopic hysterectomy bowel injury claim dismissed for want of expert evidence on the standard of care. Case comment by Paul Cahill, Law Society of Ontario Certified Specialist in Civil Litigation.

Reistad v La Berge: Bowel Injury, Informed Consent, and the Need for Expert Evidence

The Supreme Court of British Columbia dismisses a prophylactic laparoscopic hysterectomy bowel injury claim where the plaintiff led no expert evidence. Informed consent, the modified objective test, and the indispensability of expert evidence.

April 1, 2026

Case comment on CPSO v Nahas, 2026 ONPSDT 8 (Ontario Physicians and Surgeons Discipline Tribunal), discipline decision imposing four-month suspension, substantial practice restrictions, mandatory six-month clinical supervision, and ongoing compliance monitoring on chronic pain management physician with multiple clinical deficiencies across 19 patient charts and a consent failure during clinical examination, applying the progressive discipline framework given pattern of prior ICRC cautions and previous discipline finding. By Paul Cahill, LSO Certified Specialist in Civil Litigation.

CPSO v Nahas: Chronic Pain Practice, Consent Violations, and the Progressive Discipline Framework

Ontario discipline tribunal imposes four-month suspension, practice restrictions, and mandatory supervision on chronic pain physician with pattern of prior concerns.

March 20, 2026

Navy title card reading "CPSO v Maharaj, Case Comment" with the line "Revocation after unconsented, non-evidence-based care," from paulcahill.ca

CPSO v Maharaj: A Revoked Licence, and What It Means For Patients

The Ontario Physicians and Surgeons Discipline Tribunal revoked Dr. Maharaj’s licence after finding his care of 17 patients fell below the standard of practice and that he was incompetent. A look at the consent, evidence-based-treatment and privacy findings, and what a discipline decision does and does not mean for an injured patient.

March 11, 2026

Case comment on Crawford Estate v Aouida, 2025 NBKB 88 (Court of King's Bench of New Brunswick), plaintiff trial win against anesthesiologist who chose spinal anesthesia for septic morbidly obese patient who suffered intraoperative respiratory arrest, hypoxic-ischemic injury, and died six weeks later from the cascade of complications. By Paul Cahill, LSO Certified Specialist in Civil Litigation.

Crawford Estate v Aouida: Anesthetic Choice, Informed Consent, and Hemodynamic Management

New Brunswick court holds anesthesiologist negligent in death of 36-year-old patient with severe obesity and sepsis after spinal anesthesia choice and management.

May 22, 2025

Case comment on Brown v Meaney, 2024 ONSC 7256 (Ontario Superior Court of Justice), plaintiff trial win on pediatric PDE treatment delay. On the low-risk alternative framework, the bounded operation of the common-practice defence, and the twin sister as natural experiment in causation. By Paul Cahill, LSO Certified Specialist in Civil Litigation.

Brown v Meaney: Pyridoxine, Informed Consent, and the Low-Risk Alternative

Ontario Superior Court finds pediatric neurologists negligent for delayed pyridoxine treatment in PDE. The low-risk alternative framework and twin sister causation.

February 13, 2025

Case comment on Noel v Hawrylyshyn, 2024 ONSC 4525, on the battery vs informed consent doctrinal distinction, the Reibl v Hughes modified objective test as a defence framework, the operative urgency framework in informed consent analysis, and multi-ground defence dismissal in obstetric malpractice. By Paul Cahill, LSO Certified Specialist in Civil Litigation.

Noel v Hawrylyshyn: Battery, Informed Consent, and Urgent Operative Delivery

A 17-day birth injury trial. Battery, informed consent, five negligence allegations, and causation all addressed and rejected. A multi-ground defence dismissal.

August 26, 2024

Case comment on Kotorashvili v Lee, 2024 ONSC 1495, on the "deviation from own treatment plan" framework, mid-treatment informed consent, and a successful plaintiff outcome in orthopaedic surgery malpractice. By Paul Cahill, LSO Certified Specialist in Civil Litigation.

Kotorashvili v Lee: When a Surgeon Deviates from His Own Treatment Plan

An Ontario orthopaedic surgeon was found liable after removing clavicle hardware six weeks early without revisiting his own documented treatment plan.

April 8, 2024

Case comment card for McLean v. Valadka, 2023 ONSC 6803, an Ontario Superior Court of Justice decision dismissing an informed consent claim arising from a stroke suffered by a young woman after taking the Yaz combined oral contraceptive prescribed by her family physician. By Paul Cahill, LSO Certified Specialist in Civil Litigation.

McLean v Valadka: Informed Consent, Cryptogenic Stroke, and the Modified Objective Test

On December 1, 2023, the Ontario Superior Court of Justice dismissed a medical malpractice lawsuit brought by a young woman who suffered a stroke after taking birth control medication provided by her family physician who allegedly failed to advise her of the increased risk of stroke associated with that particular brand of birth control pill (Yaz).

January 29, 2024

Case comment on Khaleel v Indar, 2023 ABKB 547, on a surgeon's failure to disclose laparoscopic hernia repair as an alternative to open repair, applying the Reibl v Hughes framework. By Paul Cahill, LSO Certified Specialist in Civil Litigation.

Khaleel v Indar: A Failure to Disclose a Reasonable Surgical Alternative

A surgeon was found liable for failing to disclose laparoscopic hernia repair as an alternative, even though the open repair he performed met the standard of care.

October 5, 2023

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