Court Opinion

ID: 9689203
Source: CourtListenerOpinion
Date Created: 2023-08-24 18:24:35.322685+00
Date Added: 2024-06-11T18:18:46.063529
License: Public Domain

Mackenzie, P.J.
(dissenting). The question presented in this case is whether medical malpractice allegedly committed against the mother of a child not yet conceived gives rise to a negligence cause of action in favor of the child if, after conception, the malpractice committed against the mother causes injury to the child during gestation. More specifically, the issue is whether an obstetrician/ gynecologist owes a duty to a yet-to-be-conceived child not to breach the duty of care he owes to the unconceived child’s mother. I would answer in the negative.
"Duty” comprehends whether a defendant is under any obligation to the plaintiff to avoid negligent conduct. Moning v Alfono, 400 Mich 425, 437; *278254 NW2d 759 (1977). It is essentially a question whether the relationship between the actor and the injured person is such that there arises a legal obligation on the actor’s part for the benefit of the injured person. Moning, supra, pp 438-439. The question whether there is the requisite relationship giving rise to a duty depends in part on foreseeability — whether it is foreseeable that the actor’s conduct may create a risk of harm to the victim. Moning, supra, p 439.
In this case, defendants’ alleged wrongful conduct took place when they were treating the mother prior to the child’s conception. Clearly, defendants owed a duty to the mother to treat her in accordance with professional standards. However, when defendants’ alleged wrongful conduct took place, there was no relationship between defendants and the child upon which to predicate a duty owed to the child for the simple reason that the child did not exist. The majority appears to maintain that the child’s conception was foreseeable and that this foreseeability gives rise to defendants’ duty to the child. That reasoning is flawed. Under Moning, the question is whether it is foreseeable that the defendant’s conduct may create a risk of harm to the plaintiff, not whether it is foreseeable that the plaintiff will exist. Under the majority’s logic, all persons would be deemed to foresee, and thus owe a duty to, the future children of all other persons.
By not vaccinating the mother for rubella, the foreseeable risk of harm in this case was that the mother would contract the illness. The "victim” of defendants’ conduct was the mother, not the yet-to-be-conceived child. Of course, it was possible that the mother would be pregnant when that risk turned into reality — pregnancy is almost always a possibility in a woman of childbearing years. That *279possibility is not enough to create a legal duty in defendants to the gestating child, however. It was equally possible that the mother would contract rubella while not pregnant. The creation of a legal duty does not rise or fall on the serendipities of when the risk of harm materializes, but on the existence of a relationship between the actor and the plaintiff. Again, there was no such relationship in this case.
The majority’s holding, that one may owe a duty to unconceived children, exposes to liability not only the medical profession but also parents-to-be and the general public for their conduct prior to a plaintiffs conception. Suppose, for example, that a thirteen-year-old boy becomes involved in drug abuse and ten years after stopping use of drugs fathers an infant with birth defects resulting from the earlier drug use. Under the majority’s holding and Plumley v Klein, 388 Mich 1; 199 NW2d 169 (1972), abrogating parental immunity, the child might well be able to maintain an action against the father for injuries sustained as a result of the father’s drug abuse ten years before conception. Or suppose that a thirteen-year-old girl is struck while crossing a street by a negligently driven automobile, sustaining fractures to her pelvis. At age thirty-three, she gives birth to an infant who sustains prenatal injuries from a malformation in the mother’s pelvis caused by improper healing of the fractures. Under the majority’s holding, it would be possible for the injured infant to maintain an action against the person who drove the automobile twenty years earlier. See Preconception tort — The need for a limitation, 44 Mo L R 143 (1979).
The majority’s holding also creates the potential for exposure to liability well beyond the twenty-year period of the previous hypothetical. Suppose, *280for example, that a hospital staff physician negligently administers medication to a four-year-old girl and the drug alters the girl’s chromosome structure. At age thirty-five she gives birth to a daughter whose chromosome structure is damaged by the alteration in the mother’s chromosomes, but the damage is undetected because no outward deformity appears. At age thirty-two, the daughter gives birth to a child suffering from a deformity resulting from the damage to the chromosome structures of the mother and grandmother. Under the majority holding, the deformed infant could quite possibly maintain an action against the hospital which two generations earlier provided the drug to the infant’s grandmother. With the tolling of the statute of limitations for infancy, this cause of action would be maintainable eighty-one years after the offending drug was administered. See Preconception Tort, supra.
Yet another difficulty with the majority’s holding is that it inherently creates for a woman’s doctor a conflict of interest as between his patient and the patient’s yet-to-be-conceived children. This conflict of interest problem was well-articulated by the majority in Albala v City of New York, 54 NY2d 269; 429 NE2d 786 (1981):
[I]t is worth noting that the recognition of a cause of action under the circumstances of this case would have the undesirable impact of encouraging the practice of "defensive medicine”. A physician faced with the alternative of saving a patient’s life by administering a treatment involving the possibility of adverse consequences to later conceived offspring of that patient would, if exposed to liability of the magnitude considered in this case, undoubtedly be inclined to advise against the treatment rather than risk the possibility of having to recompense a child born with a *281handicap. Accordingly, society as a whole would bear the cost of our placing physicians in a direct conflict between their moral duty to patients and the proposed legal duty to those hypothetical future generations outside the immediate zone of danger. [54 NY2d 274.]
Finally, and perhaps more fundamentally, it appears to me that the cause of action plaintiffs are asserting is not a negligence claim, but one of medical malpractice. This Court has defined medical malpractice as
the failure of a member of the medical profession, employed to treat a case professionally, to fulfill the duty to exercise that degree of skill, care and diligence exercised by members of the same profession, practicing in the same or similar locality, in light of the present state of medical science. [Sexton v Petz, 170 Mich App 561, 565-566; 428 NW2d 715 (1988), quoting Adkins v Annapolis Hospital, 116 Mich App 558, 564; 323 NW2d 482 (1982), and Cotton v Kambly, 101 Mich App 537, 540-541; 300 NW2d 627 (1980), lv den 411 Mich 1033 (1981).]
Plaintiffs’ reliance on the recommendations of the American College of Obstetricians and Gynecologists as an indicator of defendants’ misfeasance strongly suggests a malpractice claim. Plaintiffs are alleging no more than that defendants failed to properly discharge their professional duties, which resulted in Andrea Monusko’s injuries. See Sexton, supra. In medical malpractice cases, however, the physician’s duty to render services within the applicable standard of care arises from the patient-physician relationship; the term "malpractice” denotes a breach of the duty owed by one rendering professional services to a person who has contracted for such services. See Malik v William Beaumont Hospital, 168 Mich *282App 159, 168; 423 NW2d 920 (1988), citing Rogers v Horvath, 65 Mich App 644, 646-647; 237 NW2d 595 (1975), lv den 396 Mich 845 (1976). Here, a patient-physician relationship existed between the mother and defendants. The yet-to-be-conceived child in no sense contracted for defendants’ rendition of preconception services to her future mother. Because the child seeks to recover for the injuries inflicted upon her which resulted from the alleged malpractice committed upon her mother when defendants failed to meet the professional standards of the American College of Obstetricians and Gynecologists, she has failed to state a cause of action. Compare Malik, supra.
The cause of action recognized by the majority requires the extension of traditional tort concepts beyond reasonable bounds. Defendants owed no duty to Andrea Monusko on these facts. Accordingly, I would reverse.