Court Opinion

ID: 9752056
Source: CourtListenerOpinion
Date Created: 2023-08-28 17:32:16.781366+00
Date Added: 2024-06-11T07:27:05.850157
License: Public Domain

CAPPY, Justice,
dissenting.
The majority finds that an action for wrongful death1 and survival2 can be maintained on behalf of triplets that were “born alive” but were unable to sustain life because of their premature birth. In reaching this conclusion the majority asserts that the lower courts which refused to allow this cause *162of action have taken the decision in Amadio v. Levin, 509 Pa. 199, 501 A.2d 1085 (1985) and “turned it on its head.” (Majority opinion at p. 602). To the contrary, I assert that it is the majority here which now turns Amadio on its head. Further, I reject the majority’s assertion that “interjecting the concept of viability into a situation where a child [is] born alive confuses the issue.” (Majority opinion at p. 602). As I find viability to be the issue I am compelled to dissent.
The facts in this case reveal that Mrs. Hudak was under the care of the defendant physicians for infertility. In January of 1983 she was found to be carrying triplets. On April 10, 1983, at which point the fetuses were between 20 to 23 weeks gestational age, Mrs. Hudak went into premature labor. The following day the triplets were delivered by cesarean section. Within 20 minutes, attempts at resuscitation being unsuccessful, two of the triplets were pronounced dead in the delivery room. The third triplet was resuscitated and placed on a respirator. Life support was removed ten hours later and the third triplet was pronounced dead. The parties stipulated that at the time of delivery the triplets were incapable of sustained life outside the womb thus, they were not viable.3
The question now before this Court is whether a cause of action for wrongful death and survival can be brought against the defendant physicians on behalf of the non-viable triplets. The majority concludes that as the triplets were “live born” the question of viability is immaterial and thus would allow the present action to proceed. Considering the impact of this Court’s recent decision in Amadio regarding the question of viability in relation to the wrongful death and survival actions in Pennsylvania, I cannot accept the conclusion of the majority.
Amadio specifically overruled Scott v. Kopp, 494 Pa. 487, 431 A.2d 959 (1981); Marko v. Philadelphia Transportation *163Company, 420 Pa. 124, 216 A.2d 502 (1966); and Carroll v. Skloff, 415 Pa. 47, 202 A.2d 9 (1964). Scott, Marko, and Carroll held that a cause of action under the wrongful death and survival statutes could only be brought on behalf of a fully formed infant born alive. Amadio expanded the parameters of the wrongful death and survival actions by recognizing a cause of action thereunder on behalf of a stillborn viable infant. The impact of Amadio was to alter the line of demarcation in such actions by expanding the right to bring an action on behalf of those infants who were “viable” — capable of sustaining life outside the womb — so as to effectuate the remedial purpose of the cause of action.
By abandoning the former arbitrary “live birth” requirement, we feel a liberal construction of the wrongful death and survival statutes will be accomplished. No longer will we sanction a legal doctrine that enables a tortfeasor who causes death to escape full liability, while rendering one whose wrongdoing is less severe in its consequences answerable in a wrongful death or other negligence action merely because his victim survives birth.
Amadio, 509 Pa. at 205, 501 A.2d at 1088 (citation omitted).
The decision in Amadio began a new era under the wrongful death and survival acts in Pennsylvania. The rationale for departing from our previous line of cases was set forth in the majority opinion:
Upon thorough review of our prior holdings, the change in the attitude of our sister states permitting these actions, and Appellants’ arguments that medical knowledge has advanced since we first formulated our position against the maintenance of these actions, we conclude that the time has arrived for us to join our twenty-eight sister states and the District of Columbia and recognize that survival and wrongful death actions lie by the estates of stillborn children for fatal injuries they received while viable children en ventre sa mere.
Amadio, 509 Pa. at 203, 501 A.2d at 1086-87 (footnote omitted; emphasis added).
*164In reaching this conclusion, the previous objections to expanding the right to bring a wrongful death and survival action — i.e: double damages to the parents; failure of the statute to speak to a fetus as an “individual”; problems with proof of causation and damages; authority in other jurisdictions; and the inability of a fetus to inherit property — were overcome by the majority in Amadio.
In surmounting these obstacles, the majority in Amadio relied upon the great weight of authority in other jurisdictions and the advances in medical knowledge. I note that little has changed either in our sister states or within the medical field since Amadio that would justify the sudden abandonment of viability as a prerequisite to bringing a survival action.
At the time Amadio was written, twenty-eight jurisdictions recognized a cause of action for a viable fetus. Since Amadio, the number has risen to thirty-four jurisdictions, excluding Pennsylvania.4 We recognize that in those jurisdictions, as viability was the key factor, the question of live birth was not an issue. Very few cases have been considered where a nonviable fetus is born alive. The majority does correctly note that a cause of action has been recognized in those jurisdic*165tions which have been faced with the unusual situation, as presented herein, where the non-viable fetus is born alive.5 The majority advocates that we permit a cause of action whenever there are signs of a live birth, regardless of viability. I find no justification for extending the wrongful death cause of action to a non-viable fetus.
The other factor cited by the majority in Amadio in reaching its conclusion was the advancement in medical knowledge. The Amadivo Court was concerned with the ability of medical technology to sustain the viable fetus outside the womb. This factor is the one most often cited by the jurisdictions which permit a cause of action for wrongful death of a viable fetus.6 The fallacy in attempting to expand this reasoning beyond the considerations in Amadio, however, is that little has actually changed in the medical determination of the demarcation of viability since the trimester approach created in Roe v. Wade, 410 U.S. 113, 93 S.Ct. 705, 35 L.Ed.2d 147 (1973).
The United States Supreme Court in Roe stated “the fetus becomes ‘viable,’ that is, potentially able to live outside the mother’s womb, albeit with artificial aid ... at about seven months (28 weeks) but [viability] may occur earlier, even at 24 weeks.” Id. at 160, 93 S.Ct. at 730 (footnote omitted). Present medical technology recommends that it is futile to expect *166the survival of a fetus of less than 23 weeks gestational age. Botkin, Delivery Room Decisions for Tiny Infants: An Ethical Analysis, 306 Clinical Ethics (Winter 1990); Avery, Considerations on the Definition of Viability, 206 New England J.Med. (Jan. 23, 1975).
There have been no significant advances in medical technology that would justify abandoning viability as the point at which a fetus can expect to exist separate from its mother or to logically support granting a cause of action to a non-viable fetus. Thus, the rationale offered in Amadio for recognizing a wrongful death cause of action on behalf of a viable fetus does not support the position advocated by the majority in the instant case.
Although it is a most difficult decision, I must dispute the rationale of the majority, and insist that if a fetus is to be granted a cause of action under the Pennsylvania wrongful death act, such cause of action can be extended only to a viable fetus. For the reasons set forth herein, I must respectfully, yet emphatically, dissent.

. 42 Pa.C.S. § 8301(a).

. 42 Pa.C.S. § 8302.

. Although it is clinically possible for a non-viable infant to show signs of life as recognized by a layman, i.e., heartbeat, breathing, brain-wave activity, it is medically accepted that a non-viable infant lacks sufficient lung tissue to permit survival. Botkin, Delivery Room Decisions for Tiny Infants: An Ethical Analysis, 306 J. Clinical Ethics 307 (Winter 1990).

. The jurisdictions which recognize a cause of action for a viable fetus are: Simmons v. Howard University, 323 F.Supp. 529 (D.D.C., 1971); Eich v. Town of Gulf Shores, 293 Ala. 95, 300 So.2d 354 (1974); Summerfield v. Superior Court, 144 Ariz. 467, 698 P.2d 712 (1985); Hatala v. Markiewicz, 26 Conn.Supp. 358, 224 A.2d 406 (1966); Worgan v. Greggo & Ferrara, Inc., 50 Del. 258, 128 A.2d 557 (1956); Volk v. Baldazo, 103 Idaho 570, 651 P.2d 11 (1982); Chrisafogeorgis v. Brandenberg, 55 Ill.2d 368, 304 N.E.2d 88 (1973); Britt v. Sears, 150 Ind.App. 487, 277 N.E.2d 20 (1971); Dunn v. Rose Way, Inc., 333 N.W.2d 830 (Iowa 1983); Hale v. Manion, 189 Kan. 143, 368 P.2d 1 (1962); Mitchell v. Couch, 285 S.W.2d 901 (Ky.1955); Danos v. St. Pierre, 402 So.2d 633 (La.1981); Mone v. Greyhound Lines, Inc., 368 Mass. 354, 331 N.E.2d 916 (1975); O’Neill v. Morse, 385 Mich. 130, 188 N.W.2d 785 (1971); Pehrsonv. Kistner, 301 Minn. 299, 222 N.W.2d 334 (1974); Terrell v. Rankin, 511 So.2d 126 (Miss.1987); O’Grady v. Brown, 654 S.W.2d 904 (Mo.1983); White v. Yup, 85 Nev. 527, 458 P.2d 617 (1969); Wallace v. Wallace, 120 N.H. 675, 421 A.2d 134 (1980); Salazar v. St. Vincent Hospital, 95 N.M. 150, 619 P.2d 826 (App.) writ quashed by 94 N.M. 806, 617 P.2d 1321 (1980); DiDonato v. Wortman, 320 N.C. 423, 358 S.E.2d 489 (1987); Hopkins v. McBane, 427 N.W.2d 85 (N.D.1988); Stidam v. Ashmore, 109 Ohio App. 431, 167 N.E.2d 106 (1959); Evans v. Olson, 550 P.2d 924 (Okla.1976); Libbee v. Permanente *165Clinic, 268 Or. 258, 518 P.2d 636 (1974); Miccolis v. AMICA Mutual Insurance Co., et al., 587 A.2d 67 (R.I.1991); Fowler v. Woodward, 244 S.C. 608, 138 S.E.2d 42 (1964); Matter of Certification of a Question of Law From U.S. Dist. Court, Dist. of South Dakota, Southern Division, 387 N.W.2d 42 (S.D.1986); Nelson v. Peterson, 542 P.2d 1075 (Utah 1975); Vaillancourt v. Medical Center Hospital of Vermont, Inc., 139 Vt. 138, 425 A.2d 92 (1980); Moen v. Hanson, 85 Wash.2d 597, 537 P.2d 266 (1975); Baldwin v. Butcher, 155 W.Va. 431, 184 S.E.2d 428 (1971); Kwaterski v. State Farm Mut. Auto Ins. Co., 34 Wis.2d 14, 148 N.W.2d 107 (1967).

. Finding that the question of viability creates additional difficulties in determining causation, two jurisdictions steadfastly refuse to discuss the issue where the non-viable fetus is bom alive. See Group Health Assoc., Inc. v. Blumenthal, 295 Md. 104, 453 A.2d 1198 (1983); Endresz v. Friedberg, 24 N.Y.2d 478, 301 N.Y.S.2d 65, 248 N.E.2d 901 (1969).

. The jurisdictions which recognize a cause of action at the point that a fetus is viable rely heavily upon the well reasoned dissent of Justice Boggs, in Allaire v. St. Luke’s Hospital, 184 Ill. 359, 366-69, 56 N.E. 638, 640 (1900). See also cases cited supra, note 4.