I.
Seventeen years ago in Dillon v. Legg (1968) 68 Cal.2d 728 [69 Cal.Rptr. 72, 441 P.2d 912, 29 A.L.R.3d 1316], California became the first American jurisdiction to hold that a mother could recover for the emotional distress she experienced when she witnessed the negligent infliction of death or injury to her child even though she was not within the physical zone of danger. (See Nolan & Ursin, Negligent Infliction of Emotional Distress: Coherence Emerging from Chaos (1982) 33 Hastings L.J. 583.) The Dillon court rejected the “hopeless artificiality” of the zone-of-danger rule (68 Cal.2d at p. 733) and emphasized the primary importance of foreseeability in establishing liability.1 (Id., at pp. 739-740.)
However, the court cautioned that since duty is inherently intertwined with foreseeability, this issue “must necessarily be adjudicated only upon a case-by-case basis. We cannot now predetermine defendant’s obligation in every situation by a fixed category; no immutable rule can establish the extent of that obligation for every circumstance of the future.” (68 Cal.2d at p. 740, italics added.)
Dillon set forth certain guidelines for determining the foreseeability question: “(1) Whether plaintiff was located near the scene of the accident as *182contrasted with one who was a distance away from it. (2) Whether the shock resulted from a direct emotional impact upon plaintiff from the sensory and contemporaneous observance of the accident, as contrasted with learning of the accident from others after its occurrence. (3) Whether plaintiff and the victim were closely related, as contrasted with an absence of any relationship or the presence of only a distant relationship. ” (68 Cal.2d at pp. 740-741.)
What has followed in Dillon's wake is confusion rather than clarity. The Dillon guidelines have been strictly and mechanically applied. This has led to arbitrary, inconsistent and inequitable results antithetical to principles enunciated in Dillon.
A review of the cases is illustrative. First, consider the Court of Appeal decisions which have strictly construed the second Dillon guideline. In Hathaway v. Superior Court (1980) 112 Cal.App.3d 728 [169 Cal.Rptr. 435], a six-year-old boy was electrocuted by touching an evaporative cooler while playing outside. His mother and father, who were inside the house, came out after their son’s playmate told them something was wrong with their child. They rushed outside to see him lying in a puddle of water by the cooler in a “dying state,” gagging and spitting up. Efforts to revive him failed. (Id., at pp. 730-731.)
The Court of Appeal held that the parents did not state a cause of action under Dillon because they did not satisfy the second “requirement.” (112 Cal.App.3d at p. 734.) The parents “did not sensorily perceive the injury-causing event, that is, the actual contact between the electrically charged water cooler and [their child], but saw only the results of the contact (the injuries) after the accident was over.” (Id., at p. 736.) The court was confident that its strict application of the second Dillon “requirement” followed a “steady flow of Court of Appeal cases.” (Id., at p. 734.)
Parsons v. Superior Court (1978) 81 Cal.App.3d 506 [146 Cal.Rptr. 495, 5 A.L.R.4th 826] is one example in that “flow.” There, the plaintiffs, who had been following a car in which their two daughters were passengers, came upon the wreckage of the car. They realized instantly that their daughters were either dead or dying. The father left his car and reached the wreckage “before the dust had settled.” (Id., at pp. 508-509.) Nevertheless, the Court of Appeal held that since the parents did not see, hear or otherwise sensorily perceive the injury-producing event, the second Dillon “requirement” had not been met. (Id., at p. 512.)2
*183These cases are hard to reconcile with other Court of Appeal decisions which have taken a more flexible view. For example, in Nazaroff v. Superior Court (1978) 80 Cal.App.3d 553 [145 Cal.Rptr. 657], the mother of a three-year-old boy sought recovery after witnessing her son being pulled from a swimming pool. The mother had been looking for her son when she heard a neighbor scream, “It’s Danny.” She ran to the pool and saw a neighbor pull Danny out and give him mouth-to-mouth resuscitation. Three days later, the boy died. (Id., at pp. 557, 559.)
Even though the mother arrived on the scene after the accident, the Court of Appeal permitted recovery. Observing that Dillon “creat[ed] [not] parameters but merely guidelines” (80 Cal.App.3d at p. 562), Nazar off characterized the issue as whether emotional distress had resulted from the “contemporaneous observation of the immediate consequences of the defendants’ negligent act,” and concluded that there were triable issues of fact for the jury. (Id., at p. 566.)
Similarly, in Archibald v. Braverman (1969) 275 Cal.App.2d 253 [79 Cal.Rptr. 723], the plaintiff’s 13-year-old son sustained severe injuries as the result of a gunpowder explosion. Within moments of the actual explosion, the mother appeared at the scene in an effort to render aid. When she saw his injuries, she suffered severe fright, shock and mental illness.
The Court of Appeal reversed a summary judgment for the defendants, concluding that all three Dillon factors had been satisfied. (275 Cal.App.2d at p. 256.) As to the second factor, the court noted that “[a] plaintiff claiming damages for emotional trauma as a result of injury to a third party must either be present at the time of the accident [citation] or the shock sustained by the plaintiff must be fairly contemporaneous with the accident rather than follow when the plaintiff is informed of the whole matter at a later date. [Citation.] Manifestly, the shock of seeing a child severely injured immediately after the tortious event may be just as profound as that experienced in witnessing the accident itself. Consequently, the shock sustained by the mother herein was ‘contemporaneous’ with the explosion . . . .” (Ibid., italics added.)
*184There is no principled way to reconcile these cases. Why should the parents in Hathaway and Parsons, who arrived on the scene moments after the crucial event, have been denied recovery, when the parents in Nazaroff and Archibald, who also arrived moments after the accident, have been permitted recovery? Was the emotional distress suffered by the parents in the former cases any less reasonably foreseeable than the emotional distress suffered by the parents in the latter cases? The arbitrary distinctions drawn in cases such as Hathaway and Parsons lead to inequitable and unjust results.
Other inconsistent results are caused by this rigid, narrow construction of the second Dillon guideline. For example, compare Justus v. Atchison (1977) 19 Cal.3d 564 [139 Cal.Rptr. 97, 565 P.2d 122] with Austin v. Regents of University of California (1979) 89 Cal.App.3d 354 [152 Cal.Rptr. 420]. Both cases involved plaintiff-fathers who were present in the delivery room when their children died during birth due to the defendants’ alleged negligence. In Justus, the court denied recovery since the father’s shock occurred after the doctor informed him that the baby had just died. (19 Cal.3d at p. 585.) However, in Austin, the court permitted recovery since the father “learned of the death by his own observation . . . .” (89 Cal.App.3d at p. 358.) Surely, these results are irreconcilable.3
Cases addressing the third Dillon factor—“[w]hether plaintiff and the victim were closely related, as contrasted with an absence of any relationship or the presence of only a distant relationship” (68 Cal.2d at p. 741)—further illustrate the morass that has developed. Dillon spoke only in terms of a close relationship, yet lower courts have read in a close blood or marriage relationship as a threshold requirement for recovery. Again, arbitrary distinctions, inequities and inconsistencies are the result of these mechanical applications.
*185Drew v. Drake (1980) 110 Cal.App.3d 555 [168 Cal.Rptr. 65] is another illustration. There, the plaintiff sustained emotional distress when she witnessed an automobile collision involving her “de facto spouse” with whom she had lived continuously for three years. Construing the third Dillon guideline to require a “family relationship” between the plaintiff and the decedent, the Court of Appeal observed, “[t]o allow persons standing in a ‘meaningful relationship’ (to use a contemporary colloquialism) to recover for emotional distress resulting in physical injury would abandon the Dillon requirement that ‘[t]he courts . . . mark out the areas of liability, excluding the remote and unexpected. ’ ...” (Id., at pp. 557-558.)
In a sharply worded dissent, Justice Poché chastised the majority for drawing a “bright line distinction” between those persons formally married and those not and for rewriting the third Dillon guideline “to require a formal marriage relationship.” (110 Cal.App.3d at p. 558.) “We are told that unchurched . . . relationships cannot be close and that the tortfeasor could not foresee that his victim would have a close relationship with a person to whom she was not formally married. ... [t] I do not believe that this no marriage-no recovery rule is what the California Supreme Court meant when it ordered the courts of this state to carefully analyze on a case-by-case basis what the ordinary person should have foreseen.” (Id., at pp. 558-559.)4
Trapp v. Schuyler Construction (1983) 149 Cal.App.3d 1140 [197 Cal.Rptr. 411] further illustrates how the courts have narrowly construed this guideline. The plaintiffs were two children who witnessed the drowning of their first cousin and constant playmate in a swimming pool negligently maintained by the defendant. Despite the presence of a relationship analogous to that between siblings, the Court of Appeal held that a close relationship “does not include friends, housemates, or those standing in a ‘meaningful relationship.’” (Id., at p. 1142.)
The Court of Appeal for the Fifth District recently concluded that the third Dillon guideline requires a strict construction. (Kately v. Wilkinson (1983) 148 Cal.App.3d 576 [195 Cal.Rptr. 902].) There, a mother, Kately, her 14-year-old daughter, Rebecca, and the daughter’s best friend, Rhonda, described as a “filial member” of the family, were involved in a water skiing accident. Kately was the owner and operator of the boat. While Rhon*186da was water skiing, the boat’s steering wheel locked because of an alleged defect. While Rebecca looked on, the boat collided with Rhonda, causing severe injuries. Rhonda, who was still alive, was pulled back into the boat. However, “because of the locked steering column, Kately was unable to operate the boat. Kately and Rebecca were compelled to sit with Rhonda in her badly mutilated condition as the boat circled in the water. Rhonda died as a result of her injuries.” (Id., at p. 580.) Witnessing these fatal injuries, Kately and Rebecca suffered emotional stress.
The Court of Appeal concluded that Kately’s and Rebecca’s relationship with Rhonda was “not a family relationship but one akin to a family relationship because of friendship and past associations . . . .” (Kately, supra, 148 Cal.App.3d at p. 579.) Although aware of several out-of-state cases which suggested a more liberal construction of the third Dillon guideline, the court observed that the California courts “which have been called upon to construe the Dillon guidelines as they relate to foreseeability, when the satisfaction of one or more of them was less than absolute, have construed them strictly.” (Id., at p. 584.)5
As these cases so aptly illustrate, confusion and inconsistency are the result of a strict construction of the Dillon guidelines. The courts have woven a web of arbitrary rules having little or no relation to the reasonable foreseeability of a plaintiff’s emotional distress.
However, this deplorable state of the law does not stop with Dillon and its progeny. This court’s decision in Molien v. Kaiser Foundation Hospitals (1980) 27 Cal.3d 916 [167 Cal.Rptr. 831, 616 P.2d 813, 16 A.L.R.4th 518] added another layer of confusion upon an already “analytically complex regime of arbitrary rules restricting recovery for foreseeable emotional distress” (Nolan & Ursin, supra, 33 Hastings L.J. at p. 587).
In Molien, this court permitted a husband to recover for emotional distress resulting from the misdiagnosis of his wife for syphilis. Faced with a factual situation which did not fit neatly into the Dillon mold, Molien recognized that Dillon's general foreseeability principles controlled and reaffirmed that foreseeability was the “critical inquiry” in determining a defendant’s liability. (27 Cal.3d at pp. 922-923.)
Since the plaintiff-husband was not a bystander, the Dillon guidelines were not applicable. However, Molien permitted recovery since the risk of harm to the husband was “reasonably foreseeable.” The court characterized the husband as a “direct victim.” (Id., at p. 923.)
*187As several commentators and courts have observed, this “direct victim” test is nothing more than reasonable foreseeability in disguise. (See, e.g., Andalon v. Superior Court (1984) 162 Cal.App.3d 600, 609 [208 Cal.Rptr. 899]; Wiggins v. Royale Convalescent Hospital (1984) 158 Cal.App.3d 914, 922-923 [206 Cal.Rptr. 2] (dis. opn. of Sonenshine, J.); Accounts Adjustment Bureau v. Cooperman (1984) 158 Cal.App.3d 844, 848-849 [204 Cal.Rptr. 881]; Nolan & Ursin, supra, 33 Hastings L.J. at p. 603; Note, Negligent Infliction of Emotional Distress: New Horizons After Molien v. Kaiser Foundation Hospitals (1981) 13 Pacific L.J. 179, 189.)
Yet that test, too, has spawned confusion. For example, in Andalon v. Superior Court, supra, 162 Cal.App.3d 600, the Court of Appeal permitted the parents of a child born with Down’s Syndrome to recover for emotional distress resulting from the alleged negligent prenatal care to the mother. The court concluded that both parents were “direct victims,” since the mother was a party to the contract with the defendant-doctor and the father was a “direct beneficiary of [the] tort-duty imposed by virtue of the doctor-patient relationship.” (Id., at p. 611.)
In Accounts Adjustment Bureau v. Cooperman, supra, 158 Cal.App.3d 844, the Court of Appeal permitted the parents of a two-year-old child to maintain an action against a psychologist for emotional distress allegedly caused by the defendant’s misdiagnosis of their child. Relying on Molien, the court held that “[i]t would be pure fiction to believe that a negligent diagnosis of a two-year-old could not foreseeably cause parents serious emotional distress. A two-year-old has no one but parents to be distressed. Parents having sole responsibility for their child can be direct victims of their child’s misdiagnosis.” (Id., at pp. 848-849.)
A similar expansive reading of Molien’s direct victim analysis occurred in Sesma v. Cueto (1982) 129 Cal.App.3d 108 [181 Cal.Rptr. 12]. There, a mother and father suffered emotional distress as a result of alleged medical negligence resulting in the stillbirth of their child. The court permitted the mother to go to trial as a direct victim since the mother’s “emotional distress could have been personally and directly sustained in her own right, as contrasted to injury sustained in her ‘bystander’ capacity as a prospective mother distressed at injury inflicted upon her unborn fetus.” (Id., at p. 115, fn. omitted.) The court further held that Molien “supports the conclusion that . . . the father [] may be able to show that he is a ‘direct victim’—if not percipient witness—of negligent acts giving rise to infliction of serious emotional distress.” (Id., at p. 116.)
However, in Cortez v. Macias (1980) 110 Cal.App.3d 640 [167 Cal.Rptr. 905], the Court of Appeal strictly construed Molien’s direct victim require*188ment. There, a mother sued for negligent infliction of emotional distress caused by the negligent diagnosis and treatment of her infant son. The court recognized that “[t]he language in Molien is sufficiently broad ... to permit similar reasoning to be applied to the facts of the case before us.” (Id., at p. 649.) Nevertheless, the court applied the Dillon guidelines and denied recovery because the mother’s shock did not result from a contemporaneous observance of the negligent conduct but from the news of her child’s death moments later. (Id., at p. 650.)6
Wiggins v. Royale Convalescent Hospital, supra, 158 Cal.App.3d 914 also illustrates a strict construction of Molien's direct victim limitation. There, the court denied recovery to a wife who sued a hospital for emotional distress arising from the negligent care of her husband who was seriously hurt when he fell from his hospital bed because of the defendant’s failure to raise the bed’s safety rails. The court was not persuaded that the case fell within the ambit of Molien, concluding that the wife was not a direct victim since her emotional distress derived solely from her husband’s injuries. (Id., at pp. 917-918.)
In a persuasive dissent, Justice Sonenshine concluded that the wife was a direct victim under Molien. (158 Cal.App.3d at p. 923.) “It is easily predictable that negligent care of one’s elderly and infirm spouse would produce emotional distress. This is particularly true in the context of this case. Wife herself is elderly and was unable to personally fulfill her spousal obligations of comfort and care. She thus entrusted her husband’s care to defendants. Any negligent abuse of that responsibility would have a direct effect on her.” (Ibid.)
In Kately v. Wilkinson, supra, 148 Cal.App.3d 576, the Court of Appeal applied a flexible direct victim analysis. Although Dillon would not permit recovery (see ante, at p. 185), the court held that under Molien, mother and daughter were direct victims. (148 Cal.App.3d at pp. 587-589.) The manufacturer and seller of the boat “should reasonably have foreseen that Kately, as the purchaser and an operator of the defective boat, would suffer emotional distress when the boat malfunctioned and killed or injured another human being.” (Id., at pp. 587-588.) “The user of a defective product is not a mere bystander but a primary and direct victim of the product defect *189. . . .” (Id., at p. 588.) Moreover, in view of a statute which required that the skier be under constant surveillance, the court held that “it was foreseeable that [the daughter] would suffer emotional distress from witnessing injury to the skier for whom she was the responsible observer ....’’ (Id., at pp. 588-589.)
Kately is particularly representative of the confusion that has followed Dillon and Molien. Faced with a compelling factual situation in which emotional distress was manifestly foreseeable, the court reached a just result. But that result was obscured by a strict reading of the Dillon guidelines and a flexible direct victim analysis.
Taken together, Dillon and Molien reduce to the following: if a plaintiff is a “direct victim,” then a “pure” foreseeability test applies to determine liability for negligent infliction of emotional distress. However, if the plaintiff is a “bystander,” the three Dillon criteria are invoked. (See Diamond, Dillon v. Legg Revisited: Toward a Unified Theory of Compensating Bystanders and Relatives for Intangible Injuries (1984) 35 Hastings L.J. 477, 494-495; Note, Negligent Infliction of Emotional Distress: Reconciling the Bystander and Direct Victim Causes of Action (1983) 18 U.S.F. L.Rev. 145, 152.)
It may be asked whether the distinction between a direct victim and a bystander is sufficiently clear to justify application of different tests. (See Andalon v. Superior Court, supra, 162 Cal.App.3d at pp. 608-609.) Why, for example, should plaintiffs such as Mr. Molien be permitted recovery while plaintiffs who fall within the ambit of the Dillon bystander scenario be denied recovery simply because they fail to satisfy all of the Dillon guidelines?
One commentator has aptly summarized the state of negligent infliction of emotional distress law after Dillon and Molien: “[C]ourts have applied the Dillon guidelines mechanically, viewing them as strict preconditions to recovery. This mechanical application has led to the erection of arbitrary limitations on recovery bearing little relation to the principles of foreseeability espoused so forcefully in Dillon. While in some instances mental distress is compensated, other equally foreseeable mental injuries are not. The result is feast or famine for the plaintiff depending on the fortuities of time, location, or characterization of the plaintiff as ‘direct’ or ‘indirect.’ ” (Diamond, supra, 35 Hastings L.J. at p. 478, fns. omitted.)
II.
Instead of providing the clear guidance that is sorely needed in this area of the law, the majority mechanically apply the Dillon guidelines.7 Despite *190their reaffirmation that the guidelines should be treated as such (maj. opn., ante, at p. 170), even the majority convert the guidelines into strict “requirements.” (See id.., at p. 165 & fn. 6.) They also narrowly construe Molierís direct victim analysis, virtually limiting Molien to its facts.
The majority properly reject the “sudden occurrence” requirement which had been read into the second Dillon guideline. Their rejection is premised on the arbitrariness of that requirement. (Maj. opn., ante, at p. 168.) However, the rule they propose—that recovery is permitted “when there is observation of the defendant’s conduct and the child’s injury and contemporaneous awareness the defendant’s conduct or lack thereof is causing harm” (id., at p. 170)—is equally arbitrary.
While this rule obtains the correct result here, such will not always be the case. Liability should not hinge on the observation of the defendant’s wrongdoing. Certainly, the foreseeability of emotional shock from seeing a loved one die or suffer injury does not always depend on whether the plaintiff observes the defendant’s conduct or is “contemporaneously aware” that such conduct is causing the harm.
Under the majority’s rule, any parent who arrives on the scene after an accident will not be permitted recovery. For example, a parent who is present with a child when a doctor administers an incorrect dosage which results in the child’s death will be permitted recovery, while a parent who is asked to wait in an adjoining room while the doctor administers the same fatal dosage will not.
This court should not replace one arbitrary limitation with another, thereby perpetuating artificial distinctions which result in inequitable and unfair rulings. Instead, this court should embrace the foreseeability principles espoused in both Dillon and Molien. Both of those decisions emphasized that foreseeability of the risk was the critical element in determining liability. (Molien, supra, 27 Cal.3d at p. 922; Dillon, supra, 68 Cal.2d at p. 740.) Both recognized that “ [i]n order to limit the otherwise potentially infinite liability which would follow every negligent act, the law of torts holds defendant amenable only for injuries to others which to defendant at the time were reasonably foreseeable.” (Id., at p. 739, italics added; Molien, supra, at p. 922.) Both instructed that liability had to be determined on a case-by-case basis and that “no immutable rule” could establish the extent of that liability for every circumstance in the future. (Dillon, supra, at p. 740; Molien, supra, at p. 923.)
Just as Dillon condemned the “hopeless artificiality” of the zone of danger rule (68 Cal.2d at p. 733), denounced “artificial abstractions which bar *191recovery contrary to the general [principles of tort law]” (id., at p. 747) and rejected “ ‘mechanical rules of thumb’ ” which are at variance with those general principles (id., at p. 746), this court should reject the “mechanical rules of thumb” created by a rigid application of the Dillon guidelines and condemn the “hopeless artificiality” of the direct victim/bystander distinction. Just as Molien held that the defendant owed the plaintiff a duty to exercise care in that case “[b]ecause the risk of harm . . . was reasonably foreseeable” (27 Cal.3d at p. 923), this court should reaffirm that simple holding.
Dillon and Molien compel the conclusion that reasonable foreseeability is the appropriate test for determining whether a defendant is liable for the negligent infliction of emotional distress. Any other reading of those cases creates artificial distinctions and arbitrary limitations which in the end produce unjust results and mass confusion.
By embracing reasonable foreseeability to determine a defendant’s liability, this court would conform the emotional distress area to all other areas of negligence law, thereby honoring its admonition in Dillon that there is “no good reason why the general rules of tort law, including the concepts of negligence, proximate cause, and foreseeability, long applied to all other types of injury, should not govern the case now before us.” (68 Cal.2d at p. 746.) The test of reasonable foreseeability “facilitates rational risk spreading and correlates liability with the risks that the defendant should expect.” (Diamond, supra, 35 Hastings L.J. at p. 500.) Most importantly, it provides a principled basis for determining liability.
Other courts, notably in England and Hawaii, have held that reasonable foreseeability is the appropriate test for determining a defendant’s liability in these cases. In McLoughlin v. O’Brian (1982) 2 All Eng.Rep. 298, plaintiff’s husband and three minor children were involved in an automobile accident caused by the defendants’ negligence. One of the plaintiff’s children was killed instantaneously and her husband and two other children were severely injured. At the time of the accident, the plaintiff was two miles away at home. She was informed of the accident about an hour later and was driven to the hospital. There, she saw the injured, bedraggled members of her family and heard that her two-year-old daughter had been killed. As a result, plaintiff suffered severe shock, organic depression and a change of personality. (Id., at pp. 300-301.)
The House of Lords reversed both lower courts which had denied plaintiff’s claim and held that she had stated a cause of action for emotional distress. Relying in part on Dillon, McLoughlin concluded that “common law principle requires the judges to follow the logic of the ‘reasonably *192foreseeable test’ so as, in circumstances where it is appropriate, to apply it untrammelled by spatial, physical or temporal limits. Space, time, distance, the nature of the injuries sustained and the relationship of the plaintiff to the immediate victim of the accident are factors to be weighed, but not legal limitations, when the test of reasonable foreseeability is to be applied.” (McLoughlin, supra, 2 All Eng.Rep. at p. 311.)
Since Lord Bridge’s opinion in McLoughlin is particularly instructive, I would like to quote from it at length. He concluded that there were no policy considerations sufficient to justify limiting the liability of negligent tortfeasors, who have caused emotional distress, by some narrower criterion than that of reasonable foreseeability. (Id., at pp. 319-320.) “A policy which is to be relied on to narrow the scope of the negligent tortfeasor’s duty must be justified by cogent and readily intelligible considerations, and must be capable of defining the appropriate limits of liability by reference to factors which are not purely arbitrary.” (Id., at p. 319.) “[T]o draw a line by reference to any of [the Dillon\ criteria must impose a largely arbitrary limit of liability. . . . [Ijnjustice would be wrought by any such hard and fast lines of policy as have been suggested.” (Ibid.)
Lord Bridge concluded that “this is an area of the law of negligence where we should resist the temptation to try yet once more to freeze the law in a rigid posture which would deny justice to some who, in the application of the classic principles of negligence . . ., ought to succeed, in the interests of certainty, where the very subject matter is uncertain and continuously developing, or in the interests of saving defendants and their insurers from the burden of having sometimes to resist doubtful claims. I find myself in complete agreement with [Justice] Tobriner . . . that the defendant’s duty must depend on reasonable foreseeability and—‘must necessarily be adjudicated only upon a case-by-case basis. We cannot now predetermine defendant’s obligation in every situation by a fixed category; no immutable rule can establish the extent of that obligation for every circumstance of the future.’ ” (2 All Eng.Rep., at p. 320, italics added.)
The courts of Hawaii have taken similar stands. In recognizing the tort of negligent infliction of emotional distress, the court in Rodrigues v. State (1970) 52 Hawaii 156, 52 Hawaii 283 [472 P.2d 509], held that liability in such cases would be determined “most justly by the application of general tort principles.” (Id., at p. 520.) Liability may be found where it was reasonably foreseeable that serious mental distress to the plaintiff could result from the defendant’s conduct. (Id., at pp. 520-521.)
Rodrigues was reaffirmed four years later in Leong v. Takasaki (1974) 55 Hawaii 398 [520 P.2d 758, 94 A.L.R.3d 471]. There, the court held that *193“when it is reasonably foreseeable that a reasonable plaintiff-witness to an accident would not be able to cope with the mental stress engendered by such circumstances, the trial court should conclude that defendant’s conduct is the proximate cause of plaintiff’s injury and impose liability on the defendant for any damages arising from the consequences of his negligent act.” (Id., at p. 765.) The court noted that the Dillon guidelines “should not be employed by a trial court to bar recovery but should at most be indicative of the degree of mental stress suffered.” (Id., at p. 766.)8
Most recently, in a unanimous decision, the Hawaii Supreme Court reaffirmed the principles espoused in Rodrigues and Leong. In Campbell v. Animal Quarantine Station, Etc. (1981) 63 Hawaii 557 [632 P.2d 1066], the court upheld an award of damages for emotional distress suffered when the plaintiffs’ dog died as a result of the defendants’ negligence in transporting the dog to a private veterinarian hospital. None of the plaintiffs saw the dog die nor did any of them see its deceased body. They were informed of the dog’s death by telephone the following day. (Id., at p. 1067.)
The court found that Rodrigues and Leong were dispositive. (632 P.2d at p. 1068.) Reaffirming the view that the Dillon guidelines “should be utilized to determine the genuineness and degree of mental distress, rather than to bar recovery,” the court indicated that there is no requirement that the tortious event be witnessed by the plaintiffs. (Id., at p. 1069.)9
*194The posture taken by the courts of England and Hawaii supports the conclusion that reasonable foreseeability should play the primary role in determining a defendant’s liability in such cases. As both jurisdictions recognized, the Dillon guidelines should be used as mere factors for the jury’s consideration rather than as hard and fast requirements for recovery.10
Opponents of such an approach will undoubtedly proclaim that it will open the floodgates and result in unlimited liability. But as the majority observe, quoting from Dillon, “ ‘ “[We] should be sorry to adopt a rule which would bar all such claims on grounds of policy alone, and in order to prevent the possible success of unrighteous or groundless actions. Such a course involves the denial of redress in meritorious cases, and it necessarily implies a certain degree of distrust, which [we] do not share, in the capacity of legal tribunals to get at the truth in this class of claim.” ’ ” (Maj. opn., ante, at p. 171, citations omitted.)
Addressing a related argument in Rodrigues, the Hawaii Supreme Court recognized that its decision “does shift a part of the burden of administering claims of mental distress inordinately assumed by the courts to juries.” (472 P.2d at p. 521, fn. 8.) However, “[a]s in other mental tort cases, the jury, representing a cross section of the community is in a better position to consider under what particular circumstances society should or should not recognize recovery for mental distress. . . . Moreover, the jury is no less ‘without restraint’ under the ‘reasonable man’ standard we have established *195than in innumerable other negligence cases where a ‘reasonable man’ standard and general tort principles are applied and where the preliminary issue of whether the case presents questions on which reasonable men would disagree is for the court.” {Ibid.)
Dillon itself indicated that the concept of reasonable foreseeability “limit[s] the otherwise potentially infinite liability which would follow every negligent act ... .” (68 Cal.2d at p. 739.) Dillon also observed that “we cannot let the difficulties of adjudication frustrate the principle that there be a remedy for every substantial wrong.” {Ibid.) In the face of the present confusion that exists in this area of the law, these statements should not be ignored.
Moreover, the Molien court, like the Hawaii court in Rodrigues, limited recovery to claims of serious mental distress. (Molien, supra, 27 Cal.3d at p. 930; Rodrigues, supra, 472 P.2d at p. 520.)11 That limitation, employed with the reasonable foreseeability principle, adequately limits the class of potential claims. (Nolan & Ursin, supra, 33 Hastings L.J. at pp. 609-615; Kelley v. Kokua Sales and Supply, Ltd., supra, 532 P.2d at pp. 677-678 (dis. opn. of Richardson, C. J.).) “[T]he seriousness criterion adequately protects against fraud, trivial claims, and unlimited liability by requiring severe and debilitating harm.” (Nolan & Ursin, supra, 33 Hastings L.J. at p. 620.)
It is also instructive to take note of Hawaii’s experience. In its most recent decision, the Hawaii Supreme Court pointed out that “[sjince our holding in Rodrigues, there has been no ‘plethora of similar cases’; the fears of unlimited liability have not proved true.” (Campbell, supra, 632 P.2d at p. 1071.)12
III.
The Dillon guidelines originally envisioned as aids in determining reasonable foreseeability have been transformed into rigid, threshold requirements for recovery. Arbitrary, inconsistent and inequitable results are the rule. The Molien “direct victim” scheme, at least as construed by the majority, *196only adds another layer of confusion. The majority’s reasoning simply perpetuates the problem.
The answer lies in a careful reading of the grounds on which Dillon and Molien rest. An individual who suffers emotional distress, regardless of whether he or she is a “direct victim” or a “bystander,” should be able to recover damages if (1) the emotional distress was reasonably foreseeable and (2) the distress suffered was serious. The concepts of reasonable foreseeability and serious injury, employed together, adequately protect against unlimited liability and provide a principled basis for determining it. Dillon should remain a guidepost to assist the trier of fact in determining liability.
As Justice Tobriner stated so eloquently, “Legal history shows that artificial islands of exceptions, created from the fear that the legal process will not work, usually do not withstand the waves of reality and, in time, descend into oblivion. . . . [fj No good reason compels our captivity to an indefensible orthodoxy.” (Dillon, supra, 68 Cal.2d at pp. 747-748.)13
Dillon embraced the concepts of negligence, proximate cause and foreseeability, but condemned “artificial abstractions” which bar recovery contrary to the general rules. Also, it recognized that “ ‘mechanical rules of thumb which are at variance with these principles do more harm than good.’ [Citation.]” (68 Cal.2d at pp. 746-747.)
See also Ebarb v. Woodbridge Park Assn. (1985) 164 Cal.App.3d 781 [210 Cal.Rptr. 751] (recovery denied to sister who observed brother’s body floating in a spa 20 minutes *183after he drowned when his arm became encased in drain at bottom of spa); Madigan v. City of Santa Ana (1983) 145 Cal.App.3d 607 [193 Cal.Rptr. 593] (recovery denied to parent and stepparent who arrived at scene within 15 minutes after collision killing their son); Arauz v. Gerhardt (1977) 68 Cal.App.3d 937 [137 Cal.Rptr. 619] (recovery denied to mother who arrived at scene within 5 minutes after collision injuring her son); Powers v. Sissoev (1974) 39 Cal.App.3d 865 [114 Cal.Rptr. 868] (recovery denied to mother who saw injured 5 Vi-year-old daughter 30 to 60 minutes after the accident); Deboe v. Horn (1971) 16 Cal.App.3d 221 [94 Cal.Rptr. 77] (recovery denied to wife summoned to emergency room where she observed totally paralyzed husband).
Also illustrative is Johnson v. Superior Court (1981) 123 Cal.App.3d 1002 [177 Cal.Rptr. 63], There, a mother suffered emotional distress resulting from a medically caused stillbirth. The court initially attempted to apply the Dillon guidelines, but finally recognized “the difficulty of fitting a medically caused stillbirth neatly into the Dillon mold.” {Id., at p. 1007.) In recognizing a cause of action, the court concluded that “[i]t is nonetheless patently clear that a mother forms a sufficiently close relationship with her fetus during pregnancy so that its stillbirth will foreseeably cause her severe emotional distress. . . . The solution to the problem lies not in contorting Dillon to cover a situation which it was not designated to fit, but in recognizing that the emotional distress arising from the sensory impact of the death of the child is compensable as part of the mother’s cause of action for malpractice to herself.” (Ibid.) A more liberal reading oí Dillon and a focus on the reasonable foreseeability of the serious emotional distress would have prevented such a strained analysis. (See post, at pp. 190-191.)
Negligent misdiagnosis and treatment cases are in their own state of disarray. (Compare Mobaldi v. Regents of University of California (1976) 55 Cal.App.3d 573 [127 Cal.Rptr. 720], with Jansen v. Children’s Hospital Medical Center (1973) 31 Cal.App.3d 22 [106 Cal.Rptr. 883] and Hair v. County of Monterey (1975) 45 Cal.App.3d 538 [119 Cal.Rptr. 639].)
A recent Court of Appeal decision has reached a result contrary to the Drew majority. In Ledger v. Tippitt (1985) 164 Cal.App.3d 625 [210 Cal.Rptr. 814], the court concluded that an unmarried cohabitant could sue for emotional distress suffered from witnessing the stabbing death of her lover. The court noted that “ ‘[t]he law should find more than pity for one who is stricken by seeing that a loved one has been critically injured or killed.’ [Citation.]” (Id., at p. 647.)
The Court of Appeal permitted recovery on another theory. (See post, at p. 188.)
One commentator has observed that “[wfithin months after the Molien decision, California appellate courts began struggling to apply the ‘standards and guidelines’ of that case to the facts of their respective cases. Despite the supreme court’s reminder in Molien to determine liability on a case-by-case basis, lower courts have already reverted to strict adherence to the Dillon standards.” (Note, Molien v. Kaiser Foundation Hospitals: California’s New Tort of Negligent Infliction of Serious Emotional Distress (1982) 18 Cal. Western L.Rev. 101, 118, fn. omitted.)
Compare the majority’s treatment of Mrs. Ochoa with their treatment of Mr. Ochoa. (See maj. opn., ante, fn. 6.)
The Hawaii Supreme Court retreated somewhat from the forceful views expressed in Rodrigues and Leong in Kelley v. Kokua Sales and Supply, Ltd. (1975) 56 Hawaii 204 [532 P.2d 673]. There, the court denied recovery where a grandfather living in California suffered a fatal heart attack when informed by telephone that his daughter and granddaughter had been killed and another granddaughter seriously injured as a result of an automobile accident in Hawaii. To limit a defendant’s liability, the Kelley court required that plaintiffs be located within a reasonable distance from the scene of the accident. (Id., at p. 676.) The court held that the defendants could not reasonably foresee the consequences to the grandfather since his location from the scene of the accident was “too remote.” (Ibid.)
In a strongly worded dissent, Chief Justice Richardson, the author of Rodrigues and Leong, chastised the majority for drawing a line that “arbitrarily forecloses plaintiff’s claim for negligent infliction of mental stress.” (532 P.2d at p. 678.) He reminded the majority that in prior decisions, the court “saw fit to repose its trust in the trier of fact to separate the ‘meritorious from the feigned’ in accordance with traditional tort principles . . . .” (Ibid.) “It follows from our established case law that a negligent wrongdoer is liable for the consequences of his act. It is thus a deliberate policy decision that as between an innocent plaintiff and a negligent wrongdoer, that the latter must bear the loss. ...[!] Confining liability to a specific sphere of contemporaneity, as proposed, is all too inflexible. In effect the majority reinstates a scheme of arbitrary distinctions as to where liability ends that we expressly rejected in Rodrigues. The artificiality of the majority’s position is too readily apparent.” (Ibid.)
An increasing number of other out-of-state decisions are permitting recovery for emotional distress in situations where the Dillon guidelines are not explicitly satisfied. (See, e.g., Ferriter v. Daniel O’Connell’s Sons, Inc. (1980) 381 Mass. 507 [413 N.E.2d 690, 11 A.L.R.4th 518] [permitted recovery by a mother and children for emotional distress from *194witnessing husband-father in a hospital after he had sustained quadriplegic injuries in a work-related accident; the Massachusetts Supreme Judicial Court stated that “[a] plaintiff who rushes onto the accident scene and finds a loved one injured has no greater entitlement to compensation for that shock than a plaintiff who rushes instead to the hospital. So long as the shock follows closely on the heels of the accident, the two types of injury are equally foreseeable.” (Id., at p. 697.)]; Dziokonski v. Babineau (1978) 375 Mass. 555 [380 N.E.2d 1295] [permitted recovery for a mother’s wrongful death where mother suffered severe shock and died from a resulting heart attack while she was a passenger in the ambulance that was carrying her daughter to the hospital; daughter had been run over due to the defendant’s negligence and mother who lived in the vicinity had arrived on the accident scene and had witnessed her injured daughter lying on the ground]; Portee v. Jaffee (1980) 84 N.J. 88 [417 A.2d 521] [permitted recovery by a mother who did not see original accident in which her young son was trapped between the outer door of a moving elevator and the wall of the shaft, but who was summoned to the scene and witnessed the agonizing slow death of her son from crushing injuries as police unsuccessfully sought to free the child]; Mercado v. Transport of New Jersey (1980) 176 N.J.Super. 234 [422 A.2d 800] [permitted recovery by a mother who learned of the accident minutes after it happened, went to scene and saw her injured son in the street]; General Motors Corp. v. Grizzle (Tex.App. 1982) 642 S.W.2d 837, [permitted recovery by a mother who arrived at scene moments after the accident].)
Two other jurisdictions have reached a similar conclusion. (See Jaensch v. Coffey (1984) 54 Austl. Argus L.R. 417; Paugh v. Hanks (1983) 6 Ohio St.3d 72, 6 Ohio B.R. 114 [451 N.E.2d 759].) For an excellent discussion proposing full recovery for reasonably foreseeable emotional distress injuries, see Bell, The Bell Tolls: Toward Full Tort Recovery for Psychic Injury (1984) 36 U.Fla. L.Rev. 333.
“[Sjerious mental distress may be found where a reasonable man, normally constituted, would be unable to adequately cope with the mental stress engendered by the circumstances of the case.” (Rodrigues, supra, 472 P.2d at p. 520; Molien, supra, 27 Cal.3d at p. 928; see also Dillon, supra, 68 Cal.2d at p. 740 [“ ‘Under general principles recovery should be had in such a case if defendant should foresee fright or shock severe enough to cause substantial injury in a person normally constituted.’”].)
I recognize that Hawaii has imposed one arbitrary requirement to limit liability since its decision in Rodrigues. (See Kelley v. Kokua Sales and Supply, Ltd., supra, 532 P.2d at p. 676; but see id., at p. 678 (dis. opn. of Richardson, C. J.), ante, at p. 193, fn. 8.)
I also dissent from the majority’s conclusion that plaintiffs have not pleaded facts sufficient to state a cause of action for intentional infliction of emotional distress. (See maj. opn., ante, at p. 165, fn. 5.) The majority apparently rely on the view that the defendant must act with “the purpose of causing the plaintiffs emotional distress.” (Ibid.) To support that view, the majority cite cases involving threats and insults.
In my view, this situation more closely resembles cases involving unauthorized autopsies, where liability has been found even in the absence of a claim that the defendant acted with the purpose of causing emotional distress. (See, e.g., Huntly v. Zurich General A. & L. Ins. Co. (1929) 100 Cal.App. 201 [280 P. 163].)
A cause of action for intentional infliction of emotional distress may rest upon outrageous conduct by the defendant which is in “reckless disregard” of the probability of causing emotional distress. There does not have to be an intent to cause such distress. (See Newby v. Alto Riviera Apartments (1976) 60 Cal.App.3d 288, 296 [131 Cal.Rptr. 547], disapproved on another point in Marina Point, Ltd. v. Wolfson (1982) 30 Cal.3d 721, 740-741, fn. 9 [180 Cal.Rptr. 496, 640 P.2d 115, 30 A.L.R.4th 1161].) “A defendant’s conduct is in reckless disregard of the probability of causing emotional distress if he has knowledge of a high degree of probability that emotional distress will result and acts with deliberate disregard of that probability or with a wanton disregard of the possible results.” (BAJI No. 12.77 (6th ed. 1977); see also Rest.2d Torts, § 46, com. i.) Given the lack of response by the defendants in the face of the severity of the symptoms exhibited by the decedent and the repeated pleas of Mrs. Ochoa, plaintiffs have pleaded facts sufficient to state a cause of action for intentional infliction of emotional distress.
It is also interesting to note that the majority conclude that plaintiffs stated facts sufficient to state a cause of action under 42 United States Code section 1983 which requires plaintiffs to state facts which show that defendants’ medical care was “woefully inadequate” and thus resulted in the infliction of cruel and unusual punishment. (See maj. opn., ante, at pp. 176-177.) If defendants’ conduct may have amounted to cruel and unusual punishment, does it not satisfy the “reckless disregard” test for an intentional infliction of emotional distress cause of action? Methinks there is an inconsistency here.