Court Opinion

ID: 9743966
Source: CourtListenerOpinion
Date Created: 2023-08-26 21:51:14.499836+00
Date Added: 2024-06-11T07:24:45.987526
License: Public Domain

Liacos, C.J.
(dissenting). I disagree with the court’s conclusion that a hospital employer violates no public policy when it fires an employee for alerting supervisors to matters detracting from good patient care. The court has construed *477far too narrowly the public policy exception to the doctrine of employment at will. Moreover, in demanding a statutory basis for public policy, the court has relinquished to the Legislature its role in shaping the common law. I dissent.
It is well-established that “an at-will employee has a cause of action for wrongful discharge if the discharge is contrary to public policy.” DeRose v. Putnam Management Co., 398 Mass. 205, 210 (1986).1 We have perceived clear violations of public policy when an employer terminates an employee for: (1) asserting a legal right, see Smith-Pfeffer v. Superintendent of the Walter E. Fernald State Sch., 404 Mass. 145, 149 (1989) (citing example of filing a workers’ compensation claim); (2) doing what the law requires, see Hobson v. McLean Hosp. Corp., 402 Mass. 413, 416 (1988) (enforcing safety laws); and (3) refusing to do what the law forbids, see DeRose, supra at 210 (giving false testimony at trial). In addition, we have established “legal redress in certain circumstances for employees terminated for performing important public deeds, even though the law does not absolutely require the performance of such a deed.” Flesner v. Technical Communications Corp., 410 Mass. 805, 810-811 (1991) (cooperating with ongoing government investigation).
*478“[T]he Achilles heel of the [public policy exception] lies in the definition of public policy.” Palmateer v. International Harvester Co., 85 Ill. 2d 124, 130 (1981). It is a proper rolé of the courts to construe the boundaries of “public policy” and thereby develop common law remedies available to at-will employees who are terminated. Cf. Schofield v. Merrill, 386 Mass. 244, 245, 247-248 (1982) (based on social values and customs, and lack of community consensus, court refused to abolish “common law rule that a landowner is not liable to an adult trespasser for injuries resulting from the landowner’s negligence”). I find it disturbing, therefore, that the court would relinquish this role, by requiring a statutory basis for public policy. The court reads Flesner too narrowly. In that case, we provided relief because the plaintiff was fired for performing an important public deed, not because the plaintiff was acting in accordance with a legislatively determined public policy. The court also declines to say whether public policy arises from such nonstatutory sources as regulations or the ethical codes of private professional organizations. It thus defers unduly to the Legislature in defining the contours of the public policy exception. This deferral in the realm of common law is inappropriate. The court must determine the boundaries of public policy, by looking not only to statutory law, but also to administrative law, judicial opinions, and even professional codes of conduct (where those codes serve a public interest, not merely the interests of the profession). See Pierce v. Ortho Pharmaceutical Corp., 84 N.J. 58, 72 (1980).
In the instant case, the court should begin by acknowledging the undisputable public interest in the provision of good medical care by hospitals. We have long recognized that hospitals “conduct enterprises greatly affected with a general public interest.” Springfield Hosp. v. Commissioner of Pub. Welfare, 350 Mass. 704, 709 (1966). The Legislature clearly shares our concern with patient care.2 In general, hospitals *479are heavily regulated. See, e.g., G. L. c. 111, § 51 (1990 ed.) (requirement of license from Department of Public Health). Hospitals must have provisions in their by-laws “for reporting conduct by a health care provider that . . . might be inconsistent with or harmful to good patient care or safety.” G. L. c. 111, § 203 (a) (1990 ed.). Under G. L. c. 111, § 70E (1990 ed.), patients possess a multitude of rights — for example, the right to reasonably prompt responses to requests, to background data on their physicians and the hospital, to information on their treatment, and in some cases, on all alternative treatments —that promote good care by empowering patients. Collective bargaining between health care facilities and their nursing and nonprofessional employees is also subject to statutory control, “in the interests of preserving the continuity and improving the quality of health care within the commonwealth.” G. L. c. 150A, § 1 (1990 ed.). In addition, many administrative rules and regulations are concerned with the provision of good patient care. See, e.g., 244 Code Mass. Regs. § 3.02 (3) (f) (1986) (requirement of Board of Registration in Nursing that nurses “collaborate, communicate and cooperate as appropriate with other health care providers to ensure quality and continuity of care”).
Given the public interest in good patient care, it must be the public policy of the Commonwealth to protect, if not encourage, hospital employees who perceive and report detriments to patient care. Only when problems are identified can they be adequately addressed; an employee’s failure to report perceived detriments to patient care may allow the problems to persist. A hospital employer therefore violates public policy when it fires an employee for trying to improve the quality of patient care. Cf. Hobson, supra at 416 (violation of public policy to terminate employee for enforcing law). That an employer may deter other employees from reporting *480problems (for fear of losing their jobs) inhibits the provision of good patient care and offends the public interest.
The plaintiff was terminated for reporting problems affecting patient care to a private, national, supervisory organization.3 According to her, these problems were causing lowered morale among nurses and conflicts between physicians and nurses, which in turn affected the quality of patient care.4 As the plaintiff’s comments concerned issues affecting patient care, the case does not involve a matter internal to the hospital over which the public has no concern. See Mello v. Stop & Shop Cos., 402 Mass. 555, 560-561 (1988). Furthermore, unlike the situation in Smith-Pfejfer, supra at 151, the plaintiff raised concerns over employee relationships, not over hospital policy. The plaintiff was not terminated for contributing to the hospital’s problems, nor for refusing to accept her supervisor’s method of addressing the problems; she was fired for reporting the problems to appropriate accreditation authorities. Such a termination offends the public interest and is actionable. I dissent.

A majority of other States have adopted the public policy exception. See, e.g., Foley v. Interactive Data Corp., Al Cal. 3d 654, 665 (1988); Palmateer v. International Harvester Co., 85 Ill. 2d 124, 128 (1981); Pierce v. Ortho Pharmaceutical Corp., 84 N.J. 58, 71 (1980). But see Murphy v. American Home Prods. Corp., 58 N.Y.2d 293, 300-302 (1983) (rejecting the public policy exception).
In addition to the public policy exception, we have developed another exception to the employment-at-will doctrine. Employment contracts contain an implied covenant of good faith and fair dealing, which limits the conditions under which employment may be terminated. See Fortune v. National Cash Register Co., 373 Mass. 96, 102 (1977). We have limited the application of this exception to cases in which an employer fires an employee and thereby deprives him or her of bonuses, commissions, or wages. See id.; Gram v. Liberty Mut. Ins. Co., 384 Mass. 659 (1981). As the plaintiff here “does not claim that she was terminated to avoid paying her expected future compensation or expected benefits . . . [Fortune and Gram] are inapplicable.” Smith-Pfeffer v. Superintendent of the Walter E. Fernald State Sch., 404 Mass. 145, 150 n.4 (1989).

The court states that there is no statutory basis for the public policy allegedly violated by the defendant. It has reviewed only those statutes *479requiring nurses and others to report cases of abuse and neglect, whereas I refer to a broader range of statutes reflecting a concern over the quality of patient care.

The court does not address the defendants’ contention that there was insufficient evidence to support a jury finding of termination in retaliation for critical comments. A review of the evidence in the light most favorable to the plaintiff, see ante at 470, reveals the following: The plaintiff received excellent evaluations; her supervisor was upset when he learned that a survey team would visit the hospital, and he questioned whether the plaintiff had instigated the visit; the plaintiff criticized the hospital to the survey team, and her statements were made known to the defendant; the supervisor made a comment suggesting that the hospital would terminate the employment of those who made criticisms, and he admitted that the comment might have referred to the plaintiff; the supervisor refused to talk to the plaintiff after he learned of her statements and refused to acknowledge her presence. Based on this evidence, the jury clearly were warranted in concluding that the plaintiff’s termination was due to her critical comments.

The problems did not have to amount to abuse or neglect of patients in order to raise an issue of public concern.