Opinion ID: 1989451
Heading Depth: 1
Heading Rank: 2

Heading: The Sawyers' Professional Negligence Claims

Text: [2, 3] ¶ 26. Whether a third-party professional negligence cause of action against a therapist and psychiatrist [3] to recover damages stemming from injuries caused by a patient's false memories of abuse may be maintained in Wisconsin is a question of law. See Miller v. Wal-Mart Stores, Inc., 219 Wis. 2d 250, 259, 580 N.W.2d 233 (1998). This court reviews questions of law de novo. Id. ¶ 27. The defendants make two arguments opposing our recognition of the Sawyers' cause of action. First, they argue that the Sawyers' cause of action has not been recognized under Wisconsin law, and was in fact specifically rejected by this court in Wells Estate, 183 Wis. 2d 667. They ask that we preclude the Sawyers' recovery on the grounds articulated therein. Second, the defendants argue that the Sawyers' claim must be rejected on public policy grounds. [4] ¶ 28. As to their argument that Wells Estate is controlling authority under which we must reject the Sawyers' third-party professional negligence claim, we find that the defendants are in error. While both in Wells Estate and here the claim at issue involves third-party professional negligence, the claims are distinguishable. In Wells Estate, we held that Wisconsin law would not recognize a mother's professional malpractice claim against her adult daughter's physicians seeking damages for the mother's loss of society and companionship when her daughter died following treatment. Wells Estate, 183 Wis. 2d at 679. In contrast, the Sawyers have not alleged that their injuries are due to loss of society and companionship, but rather are due to past and future pain, suffering and loss of enjoyment of life. While the circuit court and the defendants characterize the Sawyers' allegations as the equivalent of a claim seeking compensation due to the loss of society and companionship, [5] the difference between the nature of the injury alleged in Wells Estate and the nature of the injury alleged by the Sawyers is more than semantic. ¶ 29. A claim for the loss of society and companionship seeks damages for a tortfeasor's interference with a personal relationship. The plaintiff's recovery in such cases is predicated upon the emotional ties he or she shares with the injured party. Id. at 675. In contrast, the Sawyers' claim does not allege that the defendants' negligence interfered with their relationship with their daughter, nor is their recovery predicated upon the emotional ties they shared with their daughter. Instead, the Sawyers' recovery is predicated upon the direct injury they themselves suffered as a result of the defendants' negligence which was responsible for their daughter's accusations that they were abusive. The harm arising from the loss of a daughters' companionship is different than the harm that arises from accusations of sexual assault. ¶ 30. We have previously noted that those accused of sexual assault feel the pain and stigma associated with the accusations. See Doe v. Archdiocese of Milwaukee, 211 Wis. 2d 312, 355, 565 N.W.2d 94 (1997). However, the pain and suffering and loss of enjoyment of life arising from a false accusation are injuries not predicated upon an accused's personal relationship with his or her accuser. As will become clear from the public policy discussion which follows, the difference between the injury claimed in Wells Estate and the injury claimed here is substantial, and the public policy concerns upon which we precluded the imposition of liability in Wells Estate are not present in this case. We find that Wells Estate does not control. ¶ 31. While we rejected the third-party professional negligence claim in Wells Estate, rejection of third-party professional negligence claims under other circumstances is not foreordained. Indeed, this court has recognized the legitimacy of third-party professional negligence claims in certain circumstances. See, e.g., A. E. Investment Corp. v. Link Builders, Inc., 62 Wis. 2d 479, 214 N.W.2d 764 (1974) (recognizing that architects may be held liable to a lessee harmed by the negligent construction of a building); Auric v. Continental Cas. Co., 111 Wis. 2d 507, 331 N.W.2d 325 (1983) (recognizing that an attorney may be held liable to the beneficiaries of a will harmed by negligent drafting of the will on the behalf of a testator); Citizens State Bank v. Timm, Schmidt & Co., 113 Wis. 2d 376, 335 N.W.2d 361 (1983) (recognizing that an accountant may be held liable to a lender harmed by reliance on an audit report negligently prepared for borrower). Of most import, in a case closest to the facts we face here, we held that a psychiatrist may be held liable to third parties for failure to warn a patient of a medication's side effects. Schuster, 144 Wis. 2d 223. ¶ 32. Relying upon Schuster, the plaintiffs argue we should recognize their cause of action as merely the application of a new set of facts to established law. Although we recognized three separate third-party causes of action in Schuster, the one most closely on point to the issue we face here involved the question of whether a psychiatrist could be held liable to third parties for injuries the third parties sustained as a result of the psychiatrist's negligent diagnosis and treatment of a patient. Id. at 229. The plaintiff in Schuster was injured in an automobile accident while her mother, who was medicated, was driving. The daughter alleged that her mother's psychotherapist did not warn her mother of the side effects of her medication. We held that a psychotherapist may be held liable in negligence for failure to warn of the side effects of a medication if the side effects were such that a patient should have been cautioned against driving, because it was foreseeable that an accident could result, causing harm to the patient or third parties if the patient drove while using the medication. Id. at 232-33. ¶ 33. The defendants argue that Schuster is not controlling on the question before this court because it may be distinguished from the case before us on the facts. First, Schuster involved physical injury, not the non-physical injuries alleged by the plaintiffs in this action. Second, the diagnosis and treatment that was in issue in Schuster, and which the defendants characterize as properly prescribing medication, was not as complex as is the diagnosis and treatment of mental health patients. ¶ 34. We observe that the facts involved in Schuster differ from those here. However, whether these factual differences merit rejection of the Sawyers' cause of action turns on whether considerations of public policy should preclude the imposition of liability under the facts of this case. The parties agree and have provided detailed public policy analyses of the question we face. [4] ¶ 35. We have explained that [t]he fundamental principle of Wisconsin negligence law. . .[is] that a tortfeasor is fully liable for all foreseeable consequences of his act except as those consequences are limited by policy factors. Citizens State Bank, 113 Wis. 2d at 386. Our decisions have established that when a negligence action is properly pled, and all of the elements of the cause of action met, liability may be limited as a matter of law where considerations of public policy require dismissal of the claim and relieve the defendant of liability in a particular case. See Bowen v. Lumbermens Mut. Cas. Co., 183 Wis. 2d 627, 654, 517 N.W.2d 432 (1994); Peters v. Menard, 224 Wis. 2d 174, 193, 589 N.W.2d 395 (1999). The denial of liability upon public policy grounds is best determined following a trial and a full consideration of the facts. Bowen, 183 Wis. 2d at 654. However, where the facts presented are simple and the question of public policy is fully presented by the complaint and the motion for summary judgment, this court may make the public policy determination. See id. at 654-55. This is such a case. [5] ¶ 36. In deciding whether public policy precludes imposing liability on the defendants, we consider whether: (1) the injury is too remote from the negligence; or (2) the injury is too wholly out of proportion to the culpability of the negligent tort-feasor; or (3) in retrospect it appears too highly extraordinary that the negligence should have brought about the harm; or (4) allowance of recovery would place too unreasonable a burden on the negligent tort-feasor; or (5) allowance of recovery would be too likely to open the way for fraudulent claims; or (6) allowance of recovery would enter a field that has no sensible or just stopping point. Garret [v. City of New Berlin], 122 Wis. 2d [223], 233-34, [362 N.W.2d 137 (1985)]. Schuster, 144 Wis. 2d at 242-43. In addition to these public policy considerations, the defendants express deep concern that our recognition of the Sawyers' cause of action will seriously damage the therapist-patient relationship; we address these collateral burdens identified by the defendants as well. ¶ 37. Our first consideration is whether the Sawyers' injuries are too remote from the defendants' negligence. We believe that they are not: the Sawyers' injuries stem directly from their daughter's accusations that they abused her, and the accusations stem from the defendants' negligent treatment that implanted or reinforced in Anneatra her false memories of sexual abuse. The Sawyers' injuries stand apart from the defendants' negligence the same degree the plaintiff's injury stood apart from the defendant's negligence in Schuster. See Schuster, 144 Wis. 2d 223 (plaintiff was injured by the patient of the defendant psychotherapist). The proximity of the injury to the negligence in Schuster did not preclude our imposition of liability there, and it should not here. In third-party causes of action, a plaintiff's injury will be separated from a defendant's negligence to at least the degree involved here, and this public policy consideration does not preclude liability in those circumstances. Privity is not required per se to maintain a negligence action in Wisconsin. See id. Furthermore, the defendants have not contended that the Sawyers' injuries were remote from their negligence. ¶ 38. We also do not believe that the alleged injuries are too wholly out of proportion to the culpability of the negligent tortfeasor, and the defendants appear to be in agreement as to this point as well. This court has tied culpability in negligence jurisprudence to foreseeability. Beacon Bowl v. Wis. Elec. Power Co., 176 Wis. 2d 740, 762, 501 N.W.2d 788 (1993). In their brief, the defendants conceded that damage to a person accused of abusive behavior is certainly foreseeable, an understanding with which we are in full agreement. Even those jurisdictions which have declined to impose liability under facts similar to those here have acknowledged that the harm to a parent accused of sexual abuse is foreseeable. See, e.g., Bird v. W.C.W., 868 S.W.2d 767, 768 (Tex. 1994). ¶ 39. We have previously observed the great harm that accompanies an accusation of sexual abuse of a child. See Doe, 211 Wis. 2d at 355 n.31. (`Society's justifiable repugnance toward (sexual abuse of a child). . .is the reason why a falsely accused [person] can be gravely harmed.' (citation omitted)). Others have observed that [i]t is indisputable that `being labeled a child abuser (is) one of the most loathsome labels in society' and most often results in grave physical, emotional, professional, and personal ramifications. Hungerford v. Jones, 722 A.2d 478, 480 (N.H. 1998)(citation omitted). We are quite confident that negligent treatment which encourages false accusations of sexual abuse is highly culpable for the resulting injury. ¶ 40. As for our consideration of the third public policy, we do not find the Sawyers' injuries to be too highly extraordinary that the defendants' alleged negligence should have brought about the harm. The harms the Sawyers have alleged are the ordinary and predictable injuries one might expect following negligent therapy which implants and reinforces false memories of sexual abuse at the hands of family members which results in accusations of that abuse. ¶ 41. We next consider whether allowance of recovery would place too unreasonable a burden on the negligent tortfeasor. The defendants argue that allowing the parents of an adult child a claim for third-party professional negligence would unreasonably burden the tortfeasor with multiple suits premised upon a single negligent act. They rely upon Wells Estate for support that this public policy consideration should act to preclude imposing liability under the facts here. However, our consideration of this public policy does not lead us to the result reached in Wells Estate, for as noted in our discussion above, the defendants misconceive the nature of the Sawyers' allegations, allegations which we do not believe give rise to excessive liability. ¶ 42. When in Wells Estate we concluded that Wisconsin law did not recognize a parent's claim for the loss of an adult child's society and companionship, we recognized that to allow recovery for such a claim would impose excessive liability upon the tortfeasor because the possible universe of claimants is limited only by the number of persons with whom the injured person has established personal relationships. Wells Estate, 183 Wis. 2d at 675. Under Wisconsin law, a negligent tortfeasor may be liable to the victim for the injuries sustained, and to the victim's spouse and minor children for loss of society and companionship. Id. at 677-78. We concluded that sound public policy dictates that a limit be placed upon the liability facing negligent tortfeasors, id. at 677, tying this conclusion to our concern that the death of any one person would leave unknown numbers of individuals with potential claims for loss of society and companionship. ¶ 43. However, as we have noted, in contrast to Wells Estate, the Sawyers are not claiming loss of society and companionship or damages that resulted from their estrangement from their daughter. The Sawyers' claim is related to the harm that arose directly as a result of Anneatra's accusations. Importantly, unlike the claim involved in Wells Estate, the Sawyers' claim may be brought only by those who have been wrongfully accused of sexually abusing their accuser, not by the unknown numbers of individuals whose relationship with the patient is negatively affected by the negligent therapy. Under the Sawyers' theory of the case, therapists may be held liable only to those who are wrongly accused by a patient of sexually abusing that patient. Therefore, the defendants fear of excessive liability is misplaced. ¶ 44. Fifth, we consider whether allowing the Sawyers to recover would be too likely to open the way to fraudulent claims. The defendants contend that the potential for fraudulent claims involves the possibility that an individual will claim that his or her relationship with a patient was negatively affected by the patient's therapy and as a result was emotionally harmed. Fraud, the defendants claim, will be manifest in claims brought by those who did not in fact share a substantial relationship with their patient. However, as we noted above, the Sawyers' claim is not tied to personal relationships, but rather to accusations of abuse. Defendants need not be concerned with the difficult task of rebutting evidence of a plaintiff's close personal relationship with a patient who was treated negligently, because this cause of action is not premised upon the relationship, but rather the accusation. Further, we doubt that there is a significant possibility of fraud when a claim is based upon accusations of abuse, particularly in light of the extraordinary stigma our society places upon those accused of sexually abusing a child. We find that it is too unlikely that a claim premised upon being falsely accused of sexual abuse will be brought by someone who has not, in fact, been so accused. ¶ 45. Finally, we disagree that allowing the Sawyers in this case to bring an action will enter a field that has no sensible or just stopping point. The defendants express concern that by imposing liability in this case this court will open the door to claims of emotional harm and damaged personal relationships from all manner of individuals who believe that their relationships with a patient have been negatively affected by the patient's therapy. However, as we have discussed above, the Sawyers' claims differ from those claims alleging interference with personal relationships. The Sawyers' claims are not related to their estrangement from Anneatra. Their claims are appropriately limited to those who are harmed by the accusations of sexual abuse arising from false and reinforced memories arising from negligent therapies. So limited, the claim has a sensible and just stopping point. ¶ 46. None of these public policies lead us to the conclusion that liability should be limited in this case. However, we also consider the collateral burden our recognition of the Sawyers' claim may have on the therapist-patient relationship. The defendants have identified two primary manifestations of the burden. ¶ 47. First, the defendants argue that a therapist who is held liable to third parties for their emotional health will push therapists to either cease treating patients who believe they may have been sexually abused, or refrain from using new and untested forms of therapy which they believe are best suited for treating their patients. The defendants believe that in either event a patient's well-being will be substantially harmed. ¶ 48. Those courts which have concluded that claims similar to the Sawyers should be rejected have done so by recognizing these concerns. In Flanders v. Cooper, 706 A.2d 589 (Maine 1998), for instance, the Maine Supreme Court concluded that public policy precluded imposing upon a health care professional a duty of care to injured third parties because such a duty would intrude directly on the professional-patient relationship. Id. at 591. The court observed that by placing such duty of due care to third parties upon therapists, [a] health care professional who suspected that a patient had been the victim of sexual abuse and who wanted to explore that possibility in treatment would have to consider the potential exposure to legal action by a third party who committed the abuse. Id. This, the court concluded, would improperly restrict the treatment choices of the health care professional. Id. ¶ 49. The Supreme Court of Illinois, in Doe v. McKay, 700 N.E.2d 1018 (1998), reached a similar conclusion, expressing the concern raised in Flanders that third-party liability would intrude too closely on the therapist-patient relationship. Hoping to avoid liability to third parties the court wrote, a therapist might instead find it necessary to deviate from the treatment the therapist would normally provide, to the patient's ultimate detriment. This would exact an intolerably high price from the patient-therapist relationship and would be destructive of that relationship. Id. at 1024. ¶ 50. We are not unsympathetic to the therapist-patient relationship. However, we are not convinced that therapists will be limited in their treatment choices by virtue of being subject to third-party professional negligence claims. We agree with the reasoning of the Supreme Court of New Hampshire in Hungerford, 722 A.2d 478, which wrote that the defendants' public policy concerns with restricting a therapist's choice of treatments, and discouraging therapists to treat those who believe they may have been sexually abused in the past out of fear of liability, overlooks the fact that the standard of care by which a therapist's conduct is measured is not heightened [by a third-party cause of action]. Id. at 481-82. The cause of action imposes `no more than what a therapist is already bound to providea competent and carefully considered professional judgement.' Id. at 482 (citing Althaus by Althaus v. Cohen, 710 A.2d 1147, 1157 (Pa. Super. Ct. 1998); see [Montoya by Montoya v.] Bebensee, 761 P.2d [285], 288-89 [(Colo. Ct. App. 1988)]). ¶ 51. In Wisconsin, a medical practitioner, `be he a general practitioner or a specialist, should be subject to liability in an action for negligence if he fails to exercise that degree of care and skill which is exercised by the average practitioner in the class to which he belongs, acting in the same or similar circumstances.' Shier v. Freedman, 58 Wis. 2d 269, 283-84, 206 N.W.2d 166, 208 N.W.2d 328 (1973). Schuster, 144 Wis. 2d at 229. We have further explained that we could conceive of no reason why a psychiatrist, as a specialist in the practice of medicine, should not be compelled, as are all other practitioners, to meet the accepted standard of care established by other practitioners in the same class. Id. at 230. The Sawyers' third-party action will not burden the therapist with a standard of care more onerous than that under which he or she is already required to act in treating his or her patients. Therefore, the therapist's treatment choices need be limited only by the duty of care the therapist owes his or her patient. ¶ 52. The defendants insist that the treatment of sexual abuse is so much more complex than is prescribing medication that our conclusion in Schuster is not applicable here. We disagree as to this point as well. Our holding in Schuster with respect to the standard of care to which a psychiatrist would be held was not dependent upon the complexity of the therapy or treatment involved. Furthermore, complexity of therapy or treatment necessarily is a factor that informs what is found to be the standard of due care in a particular case. Presumably, the more complex the health problem a therapist is faced with, the more latitude a therapist will have in treatment choices. However, we do not believe that a therapist should be relieved from liability when his or her treatment is negligent simply because the problem he or she is treating is complex. ¶ 53. As to this burden, we conclude that the therapist is in the best position to avoid harm to the accused parent and is solely responsible for the treatment procedure. Hungerford, 722 A.2d at 482. [A]n accused parent should have the right to reasonably expect that a determination of sexual abuse, `touching him or her as profoundly as it will, will be carefully made.' Id. at 482 (citing S. v. Child & Adolescent Treatment, 614 N.Y.S.2d at 666). [6] ¶ 54. The second manifestation of the burden the defendants believe weighs against recognizing the Sawyers' cause of action involves the importance of confidentiality in the therapist-patient relationship. The defendants believe that recognition of the Sawyers' claim will unduly burden the therapist and his or her patient because such claims place confidentiality between the patient and the therapist at substantial risk. Because the patient holds the privilege of confidentiality, the defendants in third-party actions may not be able to successfully defend themselves, for they will not be able to breach their duty of confidentiality to their patients. ¶ 55. The problem identified by the defendants is not present in this case. Due to Anneatra's death, the plaintiffs have access to her medical records. Perhaps problems of confidentiality would preclude liability from being imposed in a future case, but here it does not. [6] ¶ 56. In sum, we find that none of the public policy considerations identified by the defendants should preclude the imposition of liability in this case.