Opinion ID: 2037728
Heading Depth: 1
Heading Rank: 2

Heading: pre-conception tort

Text: Both defendants argue that the Court of Appeals correctly decided that a pre-conception tort should not be recognized in Indiana. Thus, they assert, because the Walker children have not pled a cause of action for which Indiana allows a recovery, the defendants are entitled to summary judgment. Specifically, Lake Ridge argues that the legislature has, at least in part, addressed the proposition of pre-conception tort and has rejected it by enacting Ind. Code § 34-1-1-11 which provides that [n]o person shall maintain a cause of action ... based on the claim that but for the negligent conduct of another he would have been aborted. Lake Ridge's analysis is flawed because of confusion over the definition of the terms wrongful life and pre-conception tort. In Cowe v. Forum Group, Inc. (1991), Ind., 575 N.E.2d 630, 635, we held that [d]amages for wrongful life are not cognizable under Indiana law. In discussing the concept of a claim for wrongful life as distinguished from wrongful conception or pregnancy or wrongful birth, we said: A brief summary of the prevailing nomenclature may be helpful. An action for wrongful conception or pregnancy refers to a claim for damages sustained by the parents of an unexpected child alleging that the conception of the child resulted from negligent sterilization procedures or a defective contraceptive product. This action is recognized in Indiana. The phrase wrongful birth applies to claims brought by the parents of a child born with birth defects alleging that due to negligent medical advice or testing they were precluded from an informed decision about whether to conceive a potentially handicapped child or, in the event of a pregnancy, to terminate it. When such action seeks damages on behalf of the child rather than the parents, the phrase wrongful life instead of wrongful birth is employed. Id. at 633 (citations omitted). In a footnote, we further distinguished the terms wrongful birth and wrongful life by holding that such phrases do not apply to cases which allege a defendant's tortious conduct as the cause of abnormalities in infants that would otherwise have been born normal and healthy. Id. at 634, n. 2. The latter factual circumstance constitutes a cause of action for a pre-conception tort and encompasses the claims of the Walker children. From this discussion, it is easy to ascertain that Ind. Code § 34-1-1-11 applies to wrongful life cases. Thus, Lake Ridge's reliance on Ind. Code § 34-1-1-11 as a legislative preclusion of an action based upon a pre-conception tort is misplaced. Lake Ridge's primary argument, however, is that because recognition of pre-conception torts works a dramatic innovation on the tort law of this State, the decision of whether to recognize a claim for pre-conception tort is a matter better left to the legislature. We reject this argument for two reasons. First, it is the traditional role of the highest court of a state to determine the common law of that state even if such determination results in an innovative growth of the common law. See e.g., Brooks v. Robinson (1972), 259 Ind. 16, 23, 284 N.E.2d 794, 797 (The strength and genius of the common law lies in its ability to adapt to the changing needs of the society it governs.) Second, we do not envision that the recognition of a pre-conception tort is the new, dramatic innovation of tort law described by Lake Ridge. The dramatic innovation identified by Lake Ridge is the ability of a person not yet conceived at the time of the negligent act to sue the negligent actor. In fact, such has been the case in Indiana for some time. See, e.g., Second Nat'l. Bank v. Sears Roebuck & Co. (1979), 181 Ind. App. 1, 390 N.E.2d 229 (alleged negligent installation of furnace). No one would seriously contend that an infant could not recover for injuries sustained as a result of a defective product, such as an automobile, manufactured prior to the conception of the infant. In those situations, as here, the wrongful conduct occurred prior to the conception of the infant plaintiff. For both of these reasons, we reject the argument that we should refrain from answering the question presented by this case in order to allow the legislature to provide the answer. Dr. Rinck, in his brief, correctly recognizes that duty is the threshold question to be determined when deciding whether a plaintiff may maintain an action in negligence. Without a duty, there can be no recovery in negligence. Webb v. Jarvis, 575 N.E.2d 992, 995. Dr. Rinck argues that he did not owe any duty to the Walker children because the physician-patient relationship never existed between them. Although it is true that there was no direct physician-patient relationship between Dr. Rinck and the Walker children at the time he treated their mother, our analysis of a physician's duty to a patient as discussed in Webb v. Jarvis , compels us to conclude that, nevertheless, Dr. Rinck owed the children a duty. In Webb, we analyzed the duty of a physician to a patient by balancing three factors, namely, (1) the relationship between the parties, (2) the reasonable foreseeability of harm to the person injured, and (3) public policy concerns. Id. at 995. Here, as in Webb, we examine each of these three factors in order to determine whether Dr. Rinck owed the three Walker children a duty to inject their mother with RhoGAM at the time of the birth of their sibling nine years previously.
The duty of a physician to a patient arises from the contractual relationship entered into between the two of them. Webb, 575 N.E.2d at 995. Although we refused to extend this duty to unidentified and unknown third persons in the factual situation presented in Webb, we specifically recognized that a duty may be owed to a beneficiary of the consensual relationship, akin to that of a third-party beneficiary of a contract, where the professional has actual knowledge that the services being provided are, in part, for the benefit of such third persons. Id. at 996. Here, the Walker children were the beneficiaries of the consensual relationship between their mother and Dr. Rinck, and Dr. Rinck had actual knowledge that the only reason for the administration of RhoGAM was for the benefit of future children who may be born to Mrs. Walker. Whether or not RhoGAM was given, Mrs. Walker's health and well-being would not be affected. The giving of RhoGAM was to protect future fetuses of Mrs. Walker from developing injuries in utero. We believe that under those circumstances, Dr. Rinck owed a duty to the Walker children and that such duty may have been breached when he failed to give their mother RhoGAM following the birth of her first child.
It can hardly be argued that the injuries suffered by the Walker children were not foreseeable when the medical reason to give RhoGAM to their mother was to prevent the exact injuries which they allege occurred. In fact, the court in Albala v. City of New York (1981), 54 N.Y.2d 269, 445 N.Y.S.2d 108, 429 N.E.2d 786, relied upon by the Court of Appeals, acknowledged that the potential harm to not yet conceived children was easily foreseeable. In Albala, the issue was whether a cause of action existed in favor of a child for injuries suffered as a result of a tort committed against the mother prior to the child's conception. Seven years before the birth of the child, the defendant physician had performed an abortion on the mother during which her uterus was perforated. The child alleged that the perforation of the uterus caused injury to him. The court acknowledged that it was foreseeable that the mother would conceive again after the abortion and that those later-conceived children might be adversely affected by the damage to the uterus. Here, as well, the injuries allegedly sustained by the Walker children were foreseeable.
In Webb v. Jarvis , we held that we would not place a physician in a position where the physician must weigh the benefits of treatment to the patient against the potential harm to third persons. In Albala, 429 N.E.2d 786, the court declined to recognize a duty under the factual situation presented to it because to do so might lead physicians to forego treatment that might benefit the mother but pose a risk to later children, thus placing physicians in a direct conflict between their moral duty to patients and the proposed legal duty to those hypothetical future generations outside the immediate zone of danger. 429 N.E.2d at 789. No such conflict exists here. The administration of RhoGAM to the mother neither benefits nor harms the mother; it is given only to protect potential fetuses not yet conceived. Surely the public policy of this State follows and is coincident with the well-established medical practice of giving RhoGAM to an Rh negative mother who has given birth to an Rh positive child in order to protect future children of such mother from injury. We conclude, therefore, that an analysis of duty based upon relationship, foreseeability and public policy compels the conclusion that Dr. Rinck owed a duty to the Walker children to use reasonable care concerning the administration of RhoGAM to their mother. Likewise, Lake Ridge owed a duty to the Walker children to use reasonable care in analyzing Mrs. Walker's blood in order to determine whether she was Rh positive or Rh negative. Thus, defendants were not entitled to summary judgment on the issue of whether a duty was owed. Of course, remaining for trial are the questions of whether defendants breached that duty and whether the breach of that duty proximately caused injury to the plaintiffs. Stated another way, whether Lake Ridge failed to properly administer and report on the blood test and whether the standard of care required Dr. Rinck to order additional blood tests, as the Walker children allege, remain questions for the factfinder.