Court Opinion

ID: 9688032
Source: CourtListenerOpinion
Date Created: 2023-08-24 16:58:10.560328+00
Date Added: 2024-06-11T18:18:34.480324
License: Public Domain

O’Connell, P.J.
(dissenting). The majority concludes that the “lost opportunity to survive” rationale, *513as enunciated in Falcon v Memorial Hosp, 436 Mich 443; 462 NW2d 44 (1990), and repudiated in MCL 600.2912a(2); MSA 27A.2912(1)(2), should be extended to include the “lost opportunity to have an abortion.” I disagree. No appellate court in this nation has expended the Falcon rationale to the “lost opportunity to have an abortion.”
There exists no reasonable justification for applying the lost opportunity doctrine to the present case where, first, that doctrine has been applied only to situations involving death or physical harm, and, second, where the doctrine as a whole has been expressly superseded by statute. Because I do not believe that the lost opportunity doctrine should apply to the present case, I would find that plaintiff failed to meet her burden of proving that any malpractice on the part of defendant “more likely than not” caused her loss of opportunity to obtain an abortion. Accordingly, I would affirm the order granting summary disposition of the issue of proximate causation. In light of this, I would find it unnecessary to reach the issue whether Michigan continues to recognize a cause of action for wrongful birth where a child is bom with birth defects.
i
On May 10, 1992, plaintiff gave birth to a son suffering from Down’s syndrome (trisomy 21). On December 17, 1992, she filed suit against defendant, contending that defendant had been both directly and vicariously hable for the failure of her physician to perform a particular prenatal test that might have detected that her son would suffer from the chromosomal disorder. Had the test been performed and had the test *514accurately disclosed the affliction, she avers that she would have had an abortion. Because the alleged malpractice of defendant foreclosed her opportunity to terminate the pregnancy, she sought damages to compensate her for the incremental cost of raising a handicapped child and for her pain and suffering.
As relevant to the instant appeal, defendant moved for summary disposition, alleging that plaintiff had failed to present legally sufficient evidence with respect to proximate causation. The prenatal test in issue, maternal serum alpha-fetoprotein (msafp) screening, is an indirect method of detecting, among other things, the possibility that the fetus will suffer from Down’s syndrome. While alpha-fetoprotein occurs normally in pregnant women, an abnormally low concentration of the serum during the second trimester of pregnancy is associated with Down’s syndrome. Expert testimony on deposition established that msafp screening will detect Down’s syndrome in approximately twenty-five percent to thirty percent of the cases in which the syndrome will ultimately be manifested. Defendant argued, in short, that, because the msafp screening failed to detect Down’s syndrome more than fifty percent of the time, the chance of detection was legally insufficient to have caused plaintiff’s lost opportunity to obtain an abortion. The circuit court granted defendant’s motion, and plaintiff now appeals as of right.
H
In Falcon, supra, p 453, our Supreme Court ruled that a patient deprived of an opportunity to survive because of a physician’s malpractice could recover pro rata in tort from that physician, even where the *515opportunity lost afforded less than a fifty percent chance of “achieving a better result,” i.e., survival. 1 In that case, a physician failed to insert an intravenous line in a situation in which it was alleged that the standard of care called for such insertion. Had the physician inserted the line, the plaintiffs decedent would have had a 37.5 percent chance of surviving. Because the physician did not, the plaintiffs decedent was deprived of this chance of survival, and died. The Court held that this deprivation of a substantial opportunity to survive was actionable despite the fact that the decedent would have had less than a fifty percent chance of “a better result” had the procedure been performed.
The Falcon decision was, however, both a limited and short-lived holding. As clarified in Justice Boyle’s concurrence, p 473, the Falcon Court was
called upon to decide the viability of a claim for “lost opportunity” only where the ultimate harm to the victim is death. Thus any language in the lead opinion suggesting that a similar cause of action might lie for a lost opportunity of avoiding lesser physical harm is dicta. Whether the social and policy factors which justify compensation for a lost chance of survival would justify recovery for the loss of a chance to avoid some lesser harm is a question for another day.
*516Our Legislature immediately rejected the substantial opportunity doctrine, and the doctrine and the reasoning of Falcon were soon superseded by statute. MCL 600.2912a(2); MSA 27A.2912(1)(2). Thus, the substantial opportunity doctrine was the law in Michigan only briefly. Nevertheless, in Weymers v Khera, 210 Mich App 231, 236; 533 NW2d 334 (1995), lv gtd 451 Mich 898 (1996), this Court extended the rule of law established in Falcon (in the limited number of still-viable causes of action arising before the effective date of the legislation nullifying Falcon) to situations involving physical harm. This Court stated:
We hold that the loss of a substantial opportunity to avoid physical harm is harm distinct from the underlying injury for which tort law should allow recovery in proportion to the extent of the lost opportunity, provided that the negligence of the defendant, more probably than not, caused the loss of opportunity. [210 Mich App 236.]
The Falcon holding was thereby extended beyond situations involving the loss of a substantial opportunity for survival to “the loss of a substantial opportunity to avoid physical harm.”2 This was done despite the fact that the Falcon decision declared itself to be a limited holding and the fact that the Legislature had repudiated the substantial opportunity doctrine.
in
Plaintiff asks that this Court further extend the reasoning of Falcon to situations involving the loss of an *517opportunity to obtain an abortion. I would decline to do so.
At issue in the present case is proximate cause.3 The element of proximate cause encompasses two distinct aspects: cause in fact and so-called “legal cause.” Skinner v Square D Co, 445 Mich 153, 162-163; 516 NW2d 475 (1994). In general, to establish cause in fact, a plaintiff must demonstrate that “it is more likely than not that the conduct of the defendant was a cause in fact of the [injury].” Id., p 165, quoting Mulholland v DEC Int’l Corp, 432 Mich 395, 416; 443 NW2d 340 (1989), in turn quoting Prosser & Keeton, Torts (5th ed), § 41, p 269. The phrase “more likely than not” is a precise term denoting a probability of greater than fifty percent. Falcon, supra, p 450.
Here, plaintiff has failed to present evidence that defendant’s failure to perform MSAFP screening for plaintiff “more likely than not” deprived her of the opportunity to have an abortion. Plaintiff’s expert stated that, at best, the procedure had roughly a thirty percent chance of detecting that plaintiff’s son would suffer from Down’s syndrome. The chance that the test would not have detected Down’s syndrome was greater than two in three. Therefore, because this probability was less than fifty percent, plaintiff was unable to demonstrate that the lack of msafp screening “more likely than not” deprived her of the opportunity to have an abortion.
*518However, to demonstrate proximate cause in the present case, plaintiff relies on the moribund exception to the general rule that a defendant’s actions must be more likely than not the cause of a plaintiff’s alleged injuries, that adopted in Falcon. Falcon is applicable to the present cause of action, despite the fact that that decision is no longer good law, because the action arose before the enactment of MCL 600.2912a(2); MSA 27A.2912(1)(2). Plaintiff argues that her situation is indistinguishable from that in Falcon. As in Falcon, the instant defendant failed to take a certain action. In Falcon, the victim of this inactivity was deprived of the opportunity to survive. Here, the victim was deprived of an opportunity to obtain an abortion. Because recovery was allowed in Falcon, it is contended that recovery should be allowed in the present case.
Thus, we must determine whether the rule of law established in Falcon — that recovery may be predicated on the “loss of a substantial opportunity” for survival, as extended to physical injury by Weymers, even where the opportunity lost is less than fifty percent — applies to the loss of the opportunity to obtain an abortion. As made clear in both Falcon, supra, pp 458-461, and Weymers, supra, pp 236-239, this is a question of policy; it invokes not the cause-in-fact aspect of proximate cause, but the “legal cause” component. Therefore, we must determine whether the policy justifications advanced in Falcon and Weymers apply with equal force in the present context.
IV
While plaintiff does not address the public policy aspects of extending Falcon to the present case, *519defendant devotes the bulk of its brief on appeal to the subject. Defendant argues that “Michigan public policy favors life over abortion.” Defendant is correct.
The Supreme Court of the United States has declared that there is a constitutional right to privacy. Roe v Wade, 410 US 113; 93 S Ct 705; 35 L Ed 2d 147 (1973). This right to privacy “protects the woman from unduly burdensome interference with her freedom to decide whether to terminate her pregnancy.” Maher v Roe, 432 US 464, 473-474; 97 S Ct 2376; 53 L Ed 2d 484 (1977). However, this right to privacy “implies no limitation on the authority of a State to make a value judgment favoring childbirth over abortion.” Id., p 474. For example, “[f]or public policy reasons, the state may choose to eliminate benefits that it previously offered,” such as the public funding of abortion. Doe v Dep’t of Social Services, 439 Mich 650, 678; 487 NW2d 166 (1992). Michigan refuses to publicly fund an abortion unless the abortion is necessary to save the life of the mother. Id.; MCL 400.109a; MSA 16.490(19a). Our state’s public policy is manifested in numerous other ways. See, e.g., MCL 333.17014(f) and (h); MSA 14.15(17014)(f) and (h). “[E]ven the Roe Court acknowledged that the state has an ‘important and legitimate interest... in protecting the potentiality of human life.’ ” Doe, supra, p 666, quoting Roe v Wade, p 162.
However, defendant’s argument is not wholly transferable to the present context. While the reasoning of Falcon was somewhat elusive in that it failed to succinctly summarize the public policy upon which it was based and failed to address competing policy considerations, the gist of its holding appears in section vi, p 461. Falcon involved a pregnant woman who *520gave birth to a healthy, normal baby, but immediately after delivery suffered complications that led to her death. Her physician failed to perform a procedure that had a 37.5 percent chance to save her life. The Falcon Court concluded that public policy favored recovery in that situation because
[w]omen gave birth to children long before there were physicians or hospitals or even midwives. A woman who engages the services of a physician and enters a hospital to have a child does so to reduce pain and suffering and to increase the likelihood of her surviving and the child surviving childbirth in a good state of health even though the likelihood of the woman and child not surviving in good health without such services is far less than fifty percent. That is why women go to physicians. That is what physicians undertake to do. That is what they are paid for. They are, and should be, subject to liability if they fail to measure up to the standard of care. [Id., p 461.]
The Court concluded that recovery should be allowed, despite the fact that only a 37.5 percent chance existed that the decedent would have survived had malpractice not occurred. Id., p 470. Thus, the Falcon Court gave its approval to a lowered threshold of proof of causation in cases involving the loss of the opportunity to survive.
From this passage, one may deduce that the policy considerations advanced by the Falcon decision concerned a patient’s reliance on a physician to undertake measures meant to prevent death or physical harm, or at least to lessen the possibility that these exigencies would come to pass. Even where one has less than a fifty percent chance of suffering death, in Falcon, or physical harm, in Weymers, one engages the services of a physician to lessen that chance still *521further. A physician, it was held, should not be immunized from liability merely because one seeking treatment had, upon arrival, less than a fifty percent chance of suffering death, Falcon,, supra, or physical harm, Weymers, supra, where the physician through malpractice fails to lessen the possibility of the adverse consequence.
Turning, then, to the present case, I fail to see how the policy considerations articulated in Falcon and extended in Weymers would be furthered by allowing plaintiff to proceed in the absence of evidence that defendant’s inaction “more likely than not” deprived her of the opportunity to obtain an abortion. First, and most significantly, plaintiff did not suffer death or physical injury; she “suffered” the birth of a healthy child with Down’s syndrome. The alleged injury before this Court differs in kind from those considered in Falcon and Weymers. To apply the reasoning of those cases to the present context would constitute not an extension, but a wholesale grafting, of this reasoning to a distinct area of tort law. Second, as stated by the United States Supreme Court in Harris v McRae, 448 US 297, 325; 100 S Ct 2671; 65 L Ed 2d 784 (1980), “[a]bortion is inherently different from other medical procedures, because no other procedure involves the purposeful termination of a potential life.”
Therefore, I would conclude that the reasoning of Falcon and Weymers does not apply where a plaintiff has not suffered death or physical injury. Because plaintiff suffered neither of these, the “lost opportunity” doctrine does not apply. Thus, plaintiff had the burden of presenting evidence that defendant’s alleged breach “more likely than not” caused her *522alleged injuries, that defendant’s inaction was more than fifty percent the cause of her inability to obtain an abortion. She has presented no such evidence. Therefore, summary disposition was appropriate.
v
On cross appeal, defendant contends that the circuit court erred in denying defendant’s prior motion for summary disposition pursuant to MCR 2.116(C)(8). In that motion, defendant argued that Michigan recognizes no cause of action for “wrongful birth” where the alternative would have been abortion. The term “wrongful birth” “is a shorthand name given to actions brought by the parents of a child bom with severe defects against a physician (or other responsible party) who negligently fails to inform them in a timely fashion of the risk that the mother will give birth to such a child, effectively precluding an informed decision as to whether the pregnancy should be avoided or terminated.” Proffitt v Bartolo, 162 Mich App 35, 40; 412 NW2d 232 (1987). Defendant submits that given the absence of binding precedent on the subject and Michigan’s public policy disfavoring abortion, the circuit court should have granted its motion for summary disposition.
There are persuasive arguments to be made both in favor of and in opposition to defendant’s position. In defendant’s favor, this Court has recognized that “all human life is presumptively valuable.” Rouse v Wesley, 196 Mich App 624, 631; 494 NW2d 7 (1992). We are aware of no court decision applying Falcon-type reasoning in the present context. See, e.g., Simmons v West Covina Medical Clinic, 212 Cal App 3d 696; 260 Cal Rptr 772 (1989). Additionally, we have stated *523that “the courts of this state should not be the forum of the unbecoming spectacle of parents, in an effort to maximize recovery, presenting evidence of how little affection they have for their children or disparaging the value of their children.” Rouse, supra, p 631. One would be hard pressed to conceive of a situation more unbecoming than a parent testifying under oath that had the parent been given more information, the parent would have aborted the child underlying the suit. However, working to defendant’s detriment, it would appear inconsistent to allow some recovery for malpractice resulting in the birth of a healthy, normal child, see Rinard v Biczak, 177 Mich App 287; 441 NW2d 441 (1989), while disallowing recovery for the birth of a healthy, abnormal child, or an unhealthy, abnormal child.
However, I would defér deciding this issue because it is not necessary to the resolution of this case. Regardless of whether such a cause of action exists, the outcome of the present appeal would be the same.
I would affirm.

 Our Legislature has since rejected the reasoning set forth in Falcon. In the wake of Falcon, MCL 600.2912a; MSA 27A.2912(1) was amended to provide that “[i]n an action alleging medical malpractice, the plaintiff cannot recover for loss of an opportunity to survive or an opportunity to achieve a better result unless the opportunity was greater than fifty percent.” Falcon is, thus, applicable only to causes of action arising before the effective date of the amendment of MCL 600.2912a; MSA 27A.2912(1). The present case involves such an action.

 The legislation nullifying the Falcon holding also nullified the Weymers holding, except in those causes of action arising before the effective date of the legislation.

 We assume arguendo that defendant was under a duty to provide msafp screening and that defendant breached that duty by failing to offer the test. We are aware that at the time this cause of action arose there existed divergent views concerning the applicable standard of care.