Opinion ID: 2101537
Heading Depth: 1
Heading Rank: 1

Heading: Failure To Protect Patient From Rape

Text: To the extent that Count IV is viewed as a paternity action seeking to impose vicarious liability, the Court of Appeals found it without merit. We agree and pursuant to Ind. Appellate Rule 11(B)(3) summarily affirm the decision of the Court of Appeals upon this issue. To the extent that Count IV otherwise presents a claim for damages to Cowe from Forum's failure to protect its patient from rape, the Court of Appeals reversed the summary judgment and remanded for trial not only applying a theory of negligence, but also advancing a separate wrongful life theory of liability. We now reexamine these determinations. 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. Siemieniec v. Lutheran Gen. Hosp. (1987), 117 Ill.2d 230, 237, 111 Ill. Dec. 302, 307, 512 N.E.2d 691, 696. This action is recognized in Indiana. Garrison v. Foy (1985), Ind. App., 486 N.E.2d 5. 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. Garrison, 486 N.E.2d at 7; Siemieniec, 117 Ill.2d at 235, 111 Ill.Dec. at 307, 512 N.E.2d at 696; Harbeson v. Parke-Davis, Inc. (1983), 98 Wash.2d 460, 467, 656 P.2d 483, 488. When such action seeks damages on behalf of the child rather than the parents, the phrase wrongful life instead of wrongful birth is employed. Garrison, 486 N.E.2d at 7; Siemieniec, 117 Ill.2d at 236, 111 Ill.Dec. at 306-07, 512 N.E.2d at 695-96; see, e.g., Azzolino v. Dingfelder (1985), 315 N.C. 103, 107, 337 S.E.2d 528, 531; Turpin v. Sortini (1982), 31 Cal.3d 220, 225, 182 Cal. Rptr. 337, 340 n. 4, 643 P.2d 954, 957 n. 4. [2] We first observe that the Court of Appeals erroneously considered the existence of a potential cause of action for wrongful life as if it were distinct from the plaintiff's tort action for negligent failure to prevent the rape. Claims seeking damages for wrongful life fall within generally applicable common law tort principles. Lininger v. Eisenbaum (1988), Colo., 764 P.2d 1202, 1209; Turpin, 31 Cal.3d at 229, 182 Cal. Rptr. at 342, 643 P.2d at 959; Becker v. Schwartz (1978), 46 N.Y.2d 401, 410, 413 N.Y.S.2d 895, 899, 386 N.E.2d 807, 811. The question is not whether the plaintiff may have separate causes of action for negligence and for wrongful life, but rather whether the plaintiff's negligence action may seek damages related to his birth and its circumstances. An overwhelming majority of other jurisdictions considering the issue have rejected claims for wrongful life by children born with congenital disorders. See generally Lininger, 764 P.2d at 1210; Siemieniec, 117 Ill.2d at 238, 111 Ill.Dec. at 307, 512 N.E.2d at 696; Azzolino, 315 N.C. at 110, 337 S.E.2d at 533. There are two interrelated grounds upon which the denial of recovery usually rests. The first is a general conceptual unwillingness to recognize any cognizable damages for a child born with a genetic impairment as opposed to not being born at all. Becker, 46 N.Y.2d at 412, 413 N.Y.S.2d at 900, 386 N.E.2d at 812; Siemieniec, 117 Ill.2d at 239, 111 Ill. Dec. at 308, 512 N.E.2d at 697. Judicial recognition of the defective child's birth as an injury to the child would raise profound questions. [T]he implications of any such proposition are staggering. Would claims be honored, assuming the breach of an identifiable duty, for less than a perfect birth? And by what standard or by whom would perfection be defined? Becker, 46 N.Y.2d at 411, 413 N.Y.S.2d at 900, 386 N.E.2d at 812. The second basis for rejecting wrongful life claims is the impossibility of calculating compensatory damages to restore a birth defective child to the position he would have occupied were it not for the defendant's negligence. Because children with genetic disorders ... are impaired from the moment of conception, it is impossible for them to have a fundamental right to be born as whole individuals. Hence, the only alternative to their suffering, and the standard against which their compensation must be determined, is nonexistence. Siemieniec, 117 Ill.2d at 242, 111 Ill.Dec. at 309, 512 N.E.2d at 698. The wrongful life action thus involves a calculation of damages dependent upon the relative benefits of an impaired life as opposed to no life at all. Siemieniec, 117 Ill.2d at 240, 111 Ill.Dec. at 308, 512 N.E.2d at 697. This is a comparison the law is not equipped to make. Becker, 46 N.Y.2d at 412, 413 N.Y.S.2d at 900, 386 N.E.2d at 812. In contrast, courts in the states of California, New Jersey, and Washington have authorized damages for wrongful life, permitting a child's recovery of extraordinary medical expenses attributable to the congenital defect, although generally disallowing general damages. Turpin, 31 Cal.3d 220, 182 Cal. Rptr. 337, 643 P.2d 954; Procanik by Procanik v. Cillo (1984), 97 N.J. 339, 478 A.2d 755; Harbeson, 98 Wash.2d 460, 656 P.2d 483. Minimizing the issues of cognizable injury and calculation of damages requiring comparison to nonexistence (We need not become preoccupied, however, with these metaphysical considerations, Procanik, 97 N.J. at 353, 478 A.2d at 763), these concerned and thoughtful decisions, like that of our Court of Appeals in this case, emphasize public policy considerations such as the alleviation of financial burdens, Turpin, 31 Cal.3d at 239, 182 Cal. Rptr. at 348, 643 P.2d at 965; respond[ing] to the call of the living for help in bearing the burden of their affliction, Procanik, 97 N.J. at 353, 478 A.2d at 763; and foster[ing] societal objectives of genetic counseling and prenatal testing, and discourag[ing] malpractice, Harbeson, 98 Wash.2d at 481, 656 P.2d at 496. However, we believe that such considerations of public policy are better suited to legislative than judicial determination. Persuaded that the generally prevailing view is better reasoned and more consistent with established principles of tort law, we conclude that life, even life with severe defects, cannot be an injury in the legal sense. Azzolino, 315 N.C. at 109, 337 S.E.2d at 532. Damages for wrongful life are not cognizable under Indiana law. Seeking to avoid application of this majority view rejecting wrongful life claims, Cowe insists that he has made no claim that he should not have been born, nor that nonexistence is preferable to his life. Brief of Appellant (to the Court of Appeals) at 17. He expressly disavows any claim that but for the negligent conduct of another he would have been aborted. Brief in Opposition to Defendant's Petition to Transfer at 8. Apart from the separate claim of negligent prenatal care, discussed below, the gravamen of Cowe's remaining Count IV claim is that Forum's negligence impinged upon his right to be born to a mother who chose to conceive him, to carry him to birth, to appreciate his existence and provide some minimum level of care for him. Appellant's Brief in Opposition to Defendant's Petition to Transfer at 10. Melanie Meredith's disabilities preexisted his conception and are not alleged to have been caused by the defendant. Cowe argues that it is the unavoidable loss of maternal care beginning at the instant of his birth, and not the fact of his birth, of which he complains. We do not find this distinction to be significant. To ascertain whether Cowe's birth circumstances may constitute cognizable harm, the determinative issue is causation. An essential element in a cause of action for negligence is the requirement for a reasonable connection between a defendant's conduct and the damages which a plaintiff has suffered. W. Prosser & W. Keeton, The Law of Torts § 41 at 263-66 (5th ed. 1984). This element requires, at a minimum, causation in fact  that is, that the harm would not have occurred but for the defendant's conduct. The but for analysis presupposes that, absent the tortious conduct, a plaintiff would have been spared suffering the claimed harm. Cowe's claim essentially argues that, due to the defendant's negligence, he was born to the wrong mother. However, if his biological mother had been a person other than the unfortunately incapacitated Melanie Meredith, there would be no Jacob Cowe. The only way the plaintiff could have been spared the burden of having been born to a mother incapable of providing care and support is not to have been born at all. To the extent that the defendant's conduct caused the plaintiff such suffering, it also caused the plaintiff's existence. Here we cannot find that but for Forum's alleged negligence Cowe would have been spared the asserted harm, the absence of affection and support of his biological mother, because Cowe would not have even existed without Forum's said conduct. Because the considerations involved in assessing damages for Jacob Cowe's birth to an incapacitated mother are parallel to those associated with determining wrongful life damages for children conceived with congenital defects, the recovery sought by Cowe is likewise not cognizable. Thus while the plaintiff here seeks to distinguish his claim from the traditional wrongful life case, the same considerations are present which have led a majority of jurisdictions, now including Indiana, to hold that wrongful life damages are not cognizable. We therefore conclude that no cause of action is stated in plaintiff's Count IV claim to the extent that it seeks damages for the defendant's negligence in failing to protect his mother from rape thereby causing his birth to parents incapable of care and support. Summary judgment was properly entered as to this issue.