Court Opinion

ID: 9617552
Source: CourtListenerOpinion
Date Created: 2023-08-22 04:57:35.661595+00
Date Added: 2024-06-11T18:04:14.142123
License: Public Domain

Shearing, J.,
with whom Rose, J. joins,
concurring in part and dissenting in part:
*416I agree with the majority that a mother should have a malpractice claim against professionals who negligently fail to make a timely diagnosis of fetal defects. However, I would also allow the impaired child a cause of action, with the measure of damages being the extraordinary expenses attributable to the child’s impairment.
In this case, Joshua was born with congenital defects which result in his suffering paraplegia with no sensation from the hips down and permanent fine and gross motor retardation and mental retardation. It is clear that he will require extraordinary care throughout his life.
This case is not a traditional malpractice claim in which a medical professional directly causes a patient to suffer injuries. In order to find any causation from the medical professional’s failure to test for abnormalities, one must accept the proposition that if Joshua’s mother had been informed of the condition of the fetus, she would have had a therapeutic abortion and Joshua would never have been born.
Courts have had a great deal of difficulty in dealing with the moral implications of compensating parents or a child for that child’s birth, when the plaintiffs’ claim is essentially that they would all be better off had the child never been born. One reason the issue of compensation is so knotty is that it runs counter to our conception of the preciousness of human life.
This court has held that the birth of a normal healthy child is not “a ‘wrong’ or the type of injurious consequences for which society should, through its courts, as a matter of public policy, give reparation.” Szekeres v. Robinson, 102 Nev. 93, 97, 715 P.2d 1076, 1078 (1986). This court then went on to state “[o]ur decision to disallow tort actions for the birth of a normal child . . . simply holds that one cannot recover in tort for such an event because the constituent element of a negligence tort, namely damages, is not present here.” Id. at 97-98, 715 P.2d at 1079. The question in this case is whether the birth of a seriously impaired child constitutes “damages” within the contemplation of our tort law.
The majority, along with other courts, rejects the impaired child’s cause of action after wrestling with the question of whether damages exist when that determination requires the comparison of the value of an impaired life to the value of no life at all. The majority quotes Becker v. Schwartz, 386 N.E.2d 807 (N.Y. 1978), in which the New York Court of Appeals stated:
Whether it is better never to have been born at all than to have been born with even gross deficiencies is a mystery more properly to be left to the philosophers and the theologians. Surely the law can assert no competence to resolve the *417issue, particularly in view of the very nearly uniform high value which the law and mankind has placed on human life, rather than its absence. Not only is there to be found no predicate at common law or in statutory enactment for judicial recognition of the birth of a defective child as an injury to the child; the 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?
There is also a second flaw. . . . The very allegations of the complaint state that had the defendant not been negligent, the infant’s parents would have chosen not to conceive, or having conceived, to have terminated rather than to have carried the pregnancy to term, thereby depriving the infant plaintiff of his or her very existence. Simply put, a cause of action brought on behalf of an infant seeking recovery for wrongful life demands a calculation of damages dependant upon a comparison between the Hobson’s choice of life in an impaired state and nonexistence. This comparison the law is unequipped to make.
Id. at 812. Other courts have echoed the distress expressed by the Becker court in denying this cause of action. See Azzolino v. Dingfelder, 337 S.E.2d 528 (N.C. 1985).
However, not all courts have taken the view that these difficulties are so great as to overcome the public policy objectives of tort law — to compensate injured parties and to deter future wrongful conduct. In Turpin v. Sortini, 643 P.2d 954 (Cal. 1982), the California Supreme Court quoted with approval a lower court opinion which stated:
“The reality of the ‘wrongful life’ concept is that such a plaintiff exists and suffers, due to the negligence of others. It is neither necessary nor just to retreat into meditation on the mysteries of life. We need not be concerned with the fact that had defendants not been negligent, the plaintiff might not have come into existence at all. The certainty of genetic impairment is no longer a mystery. In addition, a reverent appreciation of life compels recognition that plaintiff, however impaired she may be, has come into existence as a living person with certain rights.”
Although it is easy to understand and to endorse these decisions’ desire to affirm the worth and sanctity of less-than-perfect life, we question whether these considerations alone provide a sound basis for rejecting the child’s tort action. To begin with, it is hard to see how an award of *418damages to a severely handicapped or suffering child would ‘disavow’ the value of life or in any way suggest that the child is not entitled to the full measure of legal and nonlegal rights and privileges accorded to all members of society.
Id. at 958, 961-62 (quoting Curlender v. Bio-Science Laboratories, 165 Cal. Rptr. 477, 488 (Ct. App. 1980)).
The California Supreme Court went on to hold that both the child and the parents had a cause of action. However, the court rejected the parents’ claim for general damages and allowed only the claim for medical expenses and extraordinary expenses for specialized teaching, training and equipment required because of the impairment. Id. at 966.
The New Jersey Supreme Court has taken a similar approach, stating in Procanik by Procanik v. Cilio, 478 A.2d 755 (N.J. 1984):
The philosophical problem of finding that such a defective life is worth less than no life at all has perplexed not only Justice Schreiber, but such other distinguished members of this Court. . . . We need not become preoccupied, however, with these metaphysical considerations. Our decision to allow the recovery of extraordinary medical expenses is not premised on the concept that non-life is preferable to an impaired life, but it is predicated on the needs of the living. We seek only to respond to the call of the living for help in bearing the burden of their affliction.
Sound reasons exist not to recognize a claim for general damages. Our analysis begins with the unfortunate fact that the infant plaintiff never had a chance of being born as a normal, healthy child. Tragically, his only choice was a life burdened with his handicaps or no life at all. The congenital rubella syndrome that plagues him was not caused by the negligence of the defendant doctors; the only proximate result of their negligence was the child’s birth.
The crux of the problem is that there is no rational way to measure non-existence or to compare non-existence with the pain and suffering of his impaired existence. Whatever theoretical appeal one might find in recognizing a claim for pain and suffering is outweighed by the essentially irrational and unpredictable nature of that claim. Although damages in a personal injury action need not be calculated with mathematical precision, they require at their base some modicum of rationality.
Underlying our conclusion is an evaluation of the capability of the judicial system, often proceeding in these cases through trial by jury, to appraise such a claim. Also at work *419is an appraisal of the role of tort law in compensating injured parties, involving as that role does, not only reason, but also fairness, predictability, and even deterrence of future wrongful acts. In brief, the ultimate decision is a policy choice summoning the most sensitive and careful judgment.
We believe that the interests of fairness and justice are better served through more predictably measured damages — the cost of the extraordinary medicad expenses necessitated by the infant plaintiffs handicaps. Damages so measured are not subject to the same wild swings as a claim for pain and suffering and will carry a sufficient sting to deter future acts of medical malpractice.
Id. at 763.
The approach of the California and New Jersey courts is sound. These courts refuse to become mired in philosophical discussions of the meaning and value of life, and focus on compensating injured parties and deterring future wrongful conduct.
Our knowledge in the fields of genetics and obstetrics has grown dramatically, with far-reaching consequences for human life. It is clear that responsive treatments and the counseling necessitated by those treatments will develop in accordance with our ever-increasing capability to test and diagnose. It would, therefore, be anomalous for medical practitioners in these fields to be immune from liability for wrongful conduct or for departing from accepted professional standards. Unquestionably the public policy behind tort law supports compensating impaired children and their parents for the special damages resulting from impairment when the negligence of the medical professional results in the birth of the impaired child.
Although this court has stated that the public policy in Nevada is that birth of a normal healthy child is not a legally compensable damage, this court has also recognized that the value of an impaired life is not always greater than the value of non-life. See McKay v. Bergstedt, 106 Nev. 808, 801 P.2d 617 (1990). In addition, the legislature has recognized this fact in setting forth the policy of this state concerning the deprivation of life-sustaining procedures. NRS 449.535-,690 (“Withholding or Withdrawal of Life-Sustaining Treatment”). In these statutes, the legislature made clear that a person may choose not to sustain life. The underlying policy recognizes that, in some situations, non-life may be preferable to an impaired life; further, the policy recognizes that each individual has the right to make his or her determination as to the relative value of life and non-life.
Some courts have distinguished, as does the majority, between *420the wrongful birth action of the parents and the wrongful life action of the child. There is certainly logical justification for this approach under traditional tort concepts. The wrongful life action presents problems regarding duty, causation and damages. However, I agree with the New Jersey court which stated in Procanik by Procanik:
Law is more than an exercise in logic, and logical analysis, although essential to a system of ordered justice, should not become a instrument of injustice. Whatever logic inheres in permitting parents to recover for the cost of extraordinary medical care incurred by a birth-defective child, but in denying the child’s own right to recover those expenses, must yield to the injustice of that result. The right to recover the often crushing burden of extraordinary expenses visited by an act of medical malpractice should not depend on the “wholly fortuitous circumstance of whether the parents are available to sue.”
478 A.2d 755, 762 (N.J. 1984) (quoting Turpin v. Sortini, 643 P.2d 954, 965 (Cal. 1982)). I would allow the child the cost of the extraordinary expenses attributable to the impairment. The claims of the child and the parents are mutually dependent; it would be unfair to deny compensation to the child if the parent or parents are not available to make their claim. While there can be no duplication of recovery, either action should lie.