Schroeder v. Perkel

HANDLER, J.,

concurring in part, dissenting in part.

I join with the majority of the Court, as I did in Berman v. Allan, 80 N.J. 421, 434-446 (1979), in recognizing and extending relief available to the aggrieved parents in this type of medical malpractice case. However, I disagree with the majority, again as I did in Berman, first, for failing to appreciate fully the nature of the cause of action and the character and extent of the injuries of such parents; and second, for failing to recognize, independently, the injuries and right of redress of the infant plaintiff. In expressing my views separately, however, I want to emphasize that I strongly endorse the Court’s extension of its holding in Berman and its exposition of a rationale which, I believe, can more completely vindicate the interests of the victimized parents and child — the family — who have been wronged by the medical malpractice.

*73I

The wrongful conduct of a physician, in contexts such as are present here, is a tort to the entire family. A doctor’s wrongdoing, which directly leads to the otherwise avoidable conception and birth of a gravely congenitally handicapped infant, can be considered no less than a wrong to all who comprise the family unit. The Court itself recognizes that concept in this case, viz:

A family is woven of the fibers of life; if one strand is damaged, the whole structure may suffer. The filaments of family life, although individually spun, create a web of interconnected legal interests. This Court has recognized that a wrongdoer who causes a direct injury to one member of the family may indirectly damage another....
A physician’s duty thus may extend beyond the interests of a patient to members of the immediate family of the patient who may be adversely affected by a breach of that duty.
[Ante at 63, 64.]

This very thought was expressed in the dissenting opinion of Justice Jacobs in Gleitman v. Cosgrove, 49 N.J. 22, 50 (1967), who stated: “While the wrong was done directly to Mrs. Gleitman, in truth and reality it vitally affected her entire immediate family.” It was the germ of the dissenting opinion in Berman which emphasized that the physician’s malpractice against the parents “encompass[es] the child” and that the “breach of [the physician’s] duty affects both.” 80 N.J. at 444.

The nature of this tort is unique; it impacts upon an entire family, both individually and collectively, and causes suffering peculiarly affecting one and all. The Court in Berman recognized in some measure the familial nature of the tortious injury when it overruled Gleitman and gave primary emphasis, by way of damages, to the mental anguish and emotional suffering of the parents attributable to the “wrongful birth” of their child arising out of physician misconduct.

While agreeing with the Court in Berman, I deemed it important to underscore additional components of such parental grief — the “moral affront” — that is suffered by parents upon their realization that they have been deprived of free will or moral choice in connection with so vital a matter as whether to *74bring a handicapped child into the world. 80 N.J. at 439-440. Also, I explicitly recognized that the injury to familial relationships occasioned by this kind of medical negligence must entail an appreciation that the parents, by their mental and emotional anguish and their moral conflict, have been diminished in their role as parents — “impaired parenthood”. Id. at 440-441. I continue to believe that it is important to emphasize that these factors are a real dimension of parental suffering and an essential part of any award of damages for this kind of malpractice.

In this case, then, I readily join my colleagues in reversing the decision of the Appellate Division and remanding this matter to the trial court to enable the parents to recover for the special medical expenses entailed in the care of their child, Thomas, as well as mental and emotional damages, inclusive of the element of moral injury or harm.

II

I would also hold in this case that the child, whose parents lacked proper medical advice and were wrongfully deprived of the moral choice of whether to conceive or bear a genetically defective child, should be able to obtain damages from a delinquent physician to the extent the child shares the familial injuries and has suffered harm beyond that of the parents.

One aspect of the family tort is most clearly suffered by the child alone — that which is derived or flows from impaired parental capacity of the parents caused by physician dereliction. This harm to the child might be thought of as impaired or diminished childhood.

As I stated in my dissent in Berman,

Mental, emotional and moral suffering can involve diminished parental capacity. Such incapacity of the mother and father qua parents is brought about by the wrongful denial of a reasonable opportunity to learn of and anticipate the birth of a child with permanent defects, and to prepare for the heavy obligations entailed in rearing so unfortunate an individual. Such parents may experience great difficulty adjusting to their fate and accepting the child’s impairment as nature’s verdict. Wolfensberger & Menolascino, “A Theoretical Framework for the Management of Parents of the Mentally Retarded,” supra at 479. While *75some individuals confronted by tragedy respond magnificently and become exemplary parents, others do not. See, e. g., Becker v. Schwartz, 46 N.Y.2d 401, 413 N.Y.S.2d 895, 386 N.E.2d 807 (Ct.App.1978) in which the parents subsequently put their mongoloid child up for adoption, N. Y. Times, Feb. 17, 1979, at 23, col. 1. Individuals, suffering this form of parental incapacity or dysfunction are denied to a great extent the fuller joys, satisfaction and pride which comes with successful and effective parenting. This may endure for some time during the early developmental years of the child. [80 N.J. at 440-441]

The recognition of this cause of action is based upon the view that

[a]n adequate comprehension of the infant’s claims under these circumstances starts with the realization that the infant has come into this world and is here, encumbered by an injury attributable to the malpractice of the doctors ... [He suffers] a diminished childhood in being born of parents ... who, on ... account [of the malpractice] were less fit to accept and assume their parental responsibilities. [Id. at 442]

Yet, many courts and commentators have, understandably, betrayed wariness, if not skepticism, in treading this area, seemingly deterred or discouraged by concerns over causation, the riddle — self-imposed, I would add — of comparing non-life to life itself, and the problem of duplicating damages. See, e. g., Elliott v. Brown, 361 So.2d 546 (Ala.S.Ct.1978); Becker v. Schwartz, 46 N.Y.2d 401, 413 N.Y.S.2d 895, 386 N.E.2d 807 (1978) ; Speck v. Finegold, 268 Pa.Super. 342, 408 A.2d 496 (1979) ; Comment, 63 Marq.L.Rev. 611 (1980); Cohen and LaCava “Actions for Unwanted Births” For the Defense, Vol. 23, No. 5 (May 1981). Laudably, some courts and commentators, however, have started to accept the thesis that a child in this blighted family situation is entitled to some recovery for its own injuries. Curlender v. Bio-Science Laboratories, 106 Cal.App.3d 811, 165 Cal.Rptr. 477 (1980); Note, 53 Temple L.Q. 176, 187; Editorial, “ ‘Wrongful Life’ — the Label that Traps: Gleitman and Berman Revisited,” 107 N.J.L.J. 260 (May 26, 1981).

Part, certainly not all, of the difficulties encountered by courts in this area inhere in the language employed to describe and analyze the legal issues. The connotations conjured by the popular or handy reference, “wrongful life,” confuse and confound rather than enlighten. Whether the infant’s cause of action be called wrongful life or, somewhat more aptly, “dimin*76ished life,” is not the point. What is important is to recognize the existence of a form of suffering to the infant affecting the quality of its life, an incremental harm that adds to the great weight of the natural affliction it already bears. Courts, therefore, should not step into semantic quicksand or be trapped by labels that block insight into the rightness of this cause of action. Editorial, supra, 107 N.J.L.J. at 260.

As I stated in Berman v. Allan, supra, 80 N.J. at 441-446, the perceived analytical roadblocks to the recognition of infant recoveries based upon a diminished life or childhood, ante at 75, are, if not illusory, at least surmountable. First, recognizing the harm and measuring damages in terms of impaired childhood is based on a clear causal connection with the underlying tort. Diminished parental capacity, and its functional counterpart in the child — impaired childhood — to the extent they exist, are directly attributable to the deprivation of the parents’ moral choice, their resultant grief and anguish and their lessened ability to cope with the rearing of a defective child — all traceable to the malfeasance of the errant physician. Second, no measure of life versus non-life is required. Rather, an injury to the existing child is merely being recompensed. The action recognizes that the afflicted child “is here, [further] encumbered by an injury attributable to the malpractice of the doctors.” Id. 80 N.J. at 442. Finally damages awarded to the child need not be duplicative of those obtained by the parents. While the overall harm casts a pall upon the entire family, the injury to the child in the form of an impaired childhood is peculiar to the child and is analytically distinct from that harm suffered by the parents, although the two are interrelated. To the extent the child has suffered harm beyond that of the parents, damages to the child redress a separate wrong.

The identification and measure of damages for this cause of action, concededly, is elusive and complex, involving sensitive and subtle judgments. We have not hesitated to impose on fact finders tasks of comparable difficulty. E. g., Green v. Bittner, 85 N.J. 1 (1980); Portee v. Jaffee, 84 N.J. 88 (1980); Berman v. *77Allan, supra. Moreover, even where the pitfalls of measuring damages have been genuine, we have not refused to grapple with the complexities in order to recognize the justness and fairness of relief. Green v. Bittner, supra. We should not shrink from what is right in this case.

I believe that what I am urging as a cognizable cause of action on behalf of the hapless child in this situation is not inconsistent with the philosophy of the Court expressed in the case it decides today. The familial nature of the tort is acknowledged. We have given voice to the common understanding that the physician’s professional duty and responsibility, in treating a patient in matters involving procreation, pregnancy and childbirth, extend to that person not simply as an individual but as a member of a family whose entire welfare is bound up in the patient’s health and well-being.

Unfortunately, the Court has not seen fit to comment further upon this aspect of the case relating to the child’s cause of action, apparently because it does not view that claim as within the ambit of the issues on appeal. The infant’s claim, however, is fully implicated by the Court’s decision and reasoning and should be confronted.

While the plaintiffs, upon the dismissal of the fourth count of their complaint seeking damages for the infant Thomas, did not further challenge the adverse decision of the Appellate Division, this was fully understandable in light of the then-existing law expressed in Berman v. Allan, supra which appeared to foreclose such relief. Nevertheless, by our decision today, solely as a result of plaintiffs’ appeal, the Court has now come to recognize more completely the familial nature of the malpractice tort in the wrongful birth and life context. The Court’s conceptualization and definition of the tort, in my estimation, would readily encompass and accommodate a cause of action on behalf of the child. Plaintiffs in this suit should not be shorn of the deserved fruits of their diligent and successful efforts in achieving this result and in extending the frontiers of the law in this “chang*78ing landscape of family torts.” Ante at 71. The Court frustrates plaintiffs, however, because the technical and inadvertent state of the appellate pleadings does not explicitly present the infant’s claim. Since the matter comes to us on partial summary judgment and is now to be remanded for a full trial and adjudication upon the merits, I would allow plaintiffs leave to pursue all of their causes of action in light of the Court’s rationale as to the nature of the tortious injury.

Accordingly, on remand, I would reinstate the “diminished” or “wrongful” life claim on behalf of the infant as set forth in the fourth count of the complaint, as well as the claim for medical expenses sought in the third count allowed by this Court.

For reversal and remandment —Chief Justice WILENTZ and Justices SULLIVAN, PASHMAN, CLIFFORD, HANDLER and POLLOCK — 6.

For affirmance — Justice SCHREIBER — 1.