What are the words "general rule" used in medical malpractice cases?

The words which are most often quoted as stating the general rule are those in the passage from Hopp v. Lepp which is quoted in the passage which I have just quoted. It is important to note that it was not said in Hopp v. Lepp that any risk, however slight its magnitude, or however remote the chance that it would come to pass, must be disclosed. Apart from answering specific questions, what must be disclosed is the nature of the proposed operation, its gravity and "any material risks and any special or unusual risks attendant upon the performance of the operation".

The principles laid down in those two cases have been held to apply to the dentist-patient relationship as well as to the relationship of the surgeon and patient. I think the principles clearly do apply, but it should be recognized that dentistry by its nature generally involves less dramatic treatment than surgery of the kind that was being considered in the Hopp and Reibl cases and the number of cases, therefore, in which those principles create a duty of warning is likely to be proportionately less. Leading cases should not be read without regard to their facts. In Reibl the operation was on a carotid artery to improve blood flow. The risk held to be material was that of a stroke and the risk which attended the surgery was that of a stroke or paralysis and possibly death. In Hopp v. Lepp the surgery was extensive decompressive laminectomy of four vertebrae. The risk which materialized was that of permanent damage of certain nerves in the root canal. In applying the language of Hopp v. Lepp, it should not be overlooked that the result of that case was to restore the judgment of the trial judge who dismissed the action.

In this case the appellant relies particularly on two cases in this province which involved similar operations, that is, the extraction of wisdom teeth. The first of those is Rawlings v. Lindsay (1982), 20 C.C.L.T. 301 (B.C.S.C.), a decision of McLachlin J. In that case the finding of fact was that 10 per cent of patients with roots extending into the area of the mandibular canal suffered nerve involvement, that the dentist knew that the symptoms included not only numbness but the pain and tingling associated with paraesthesia and hyperaesthesia, and that while in the majority of cases these symptoms resolved themselves within weeks or months following surgery, in a few cases the impaired sensation would be permanent. It was also found that the removal of the wisdom teeth could have been delayed for years and that there was only a small chance, even if the operation was carried out, that it would result in substantial improvement of the plaintiff's jaw problem. That chance of improvement was put at about 10 per cent.