dissenting,
with whom KELLEHER, Justice, joins.I believe that the time has come to abandon the rule that denies all recovery for negligently inflicted emotional injury when that injury lacks any physical manifestation. Accordingly, I would answer the certified questions in the negative.
I recognize that a majority of other states follow the physicalmanifestation rule. See Prosser and Keeton, The Law of Torts, § 54 at 364 (5th ed. 1984). I also recognize, however, that a growing number of states have rejected that rule. E.g., Molien v. Kaiser Foundation Hospitals, 27 Cal. 3d 916, 616 P.2d 813, 167 Cal. Rptr. 831 (1980); Rodrigues v. State, 52 Haw. 156, 472 P.2d 509 (1970); see also Taylor v. Baptist Medical Center, Inc., 400 So. 2d 369 (Ala. 1981); Montinieri v. Southern New England Telephone Co., 175 Conn. 337, 398 A.2d 1180 (1978); Culbert v. Sampson’s Supermarkets, Inc., 444 A.2d 433 (Me. 1982); Bass v. Nooney Co., 646 S.W.2d 765 (Mo. 1983); Johnson v. Supersave Markets, Inc., 211 Mont. 465, 686 P.2d 209 (1984); James v. Lieb, 221 Neb. 47, 375 N.W.2d 109 (1985); Portee v. Jaffee, 84 N.J. 88, 417 A.2d 521 (1980); Schultz v. Barberton Glass Co., 4 Ohio St. 3d 131, 447 N.E.2d 109 (1983); Sinn v. Burd, 486 Pa. 146, 404 A.2d 672 (1979); St. Elizabeth Hospital v. Garrard, 730 S.W.2d 649 (Tex. 1987); cf. Barnhill v. Davis, 300 N.W.2d 104 (Iowa 1981) (bystander related to victim within second degree of consanguinity must have reasonable belief that victim would be seriously injured); Chappetta v. Bowman Transportation, Inc., 415 So. 2d 1019 (La. Ct. App. 1982) (liability limited to foreseeable or reasonably anticipated emotional injuries).
Courts generally cite three reasons for insisting on the physical-manifestation rule. They hold that nonapparent-emotional distress is usually of a temporary and trivial nature, a state that a person can easily feign or imagine. Furthermore the courts perceive the requirement of a negligent defendant’s compensating a plaintiff for a purely mental disturbance to be unfair. See Prosser and Keeton, § 54 at 360-61; Restatement (Second) Torts, § 436A, comment b (1965). No limit would exist to circumscribe a defendant’s liability. Courts also base their reluctance to abrogate the rule on the fear that allowing such claims would instigate an excessive number of lawsuits. The majority opinion in the instant case, relying on D’Ambra v. United States, 114 R.I. 643, 656, 338 A.2d 524, 530-31 (1975), reasons that physical symp-tomatology is necessary to make “some reasonable relation of nexus” between the negligence and claimed injury, to provide predictability, and to allow ease of administration. My colleagues emphasize the difficulty of proving emotional injury. Although these concerns have some validity, they present no insurmountable obstacle; and I am persuaded that the court can *900address them in a manner that would permit recovery for serious and genuine emotional injury.
The argument that physical symptoms guarantee the sincerity of a plaintiff’s claim fails for several reasons. First, although a claimant can also feign or imagine physical injuries, courts have not found either to be a sufficient reason to deny all such claims. Rather, courts have traditionally relied on the adversary process, with the perspicacity of its jurors and trial judges, to eliminate false claims. I maintain that the system is equally capable of distinguishing between fraudulent and genuine emotional injuries, particularly if trial courts have clear standards with which to examine such claims.
Better guarantors of authenticity than physical manifestation may exist. “It is entirely possible to allow recovery only upon satisfactory evidence and deny it when there is nothing to corroborate the claim, or to look for some guarantee of genuineness in the circumstances of the case.” Prosser and Keeton, § 54 at 361. The issue should be viewed as a matter of adequate proof. Physical manifestation of emotional trauma may provide one factor in establishing the existence of an emotional injury, but a prima facie case does not require such manifestation. See, e.g., Versland v. Caron Transport, 206 Mont. 313, 671 P.2d 583 (1983). To avoid compensating trivial emotional injuries, the court might, for example, require that the emotional trauma result from either death or serious injury to the victim and that the bystander share a marital or familial relationship with the victim. Thus when a plaintiff can establish that a defendant’s negligence has caused emotional distress, in circumstances in which a reasonable person would have reacted similarly, the plaintiff should be allowed some financial remuneration. Assessing emotional injury in terms of what a reasonable person would experience in the circumstances of the case should allow juries not only to discriminate between true and false claims but also to evaluate the severity of the emotional harm. See Comment, Negligent Infliction of Emotional Distress: A Proposal for a Recognized Tort Action, 67 Marq. L. Rev. 557, 598-99 (1984).
The circumstances in Wargelin v. Sisters of Mercy Health Corp., 149 Mich. App. 75, 385 N.W.2d 732 (1986), provide an example of circumstances indicative of genuine emotional distress. In that case parents became aware during labor that their child’s fetal heartbeat had decelerated. Despite Ms. Wargelin’s repeated requests for her doctor’s presence, the nurse failed to summon him. Although the bluish-gray child had not begun to breathe, the delivering intern apparently did not realize that the child had been stillborn. The intern therefore presented the infant to the mother as if it were a healthy baby. At that point the supervising physician grabbed the baby and unsuccessfully attempted resuscitation.
In the ensuing action for the negligent infliction of emotional and mental distress, the court held that the cumulative effect of all of these events was sufficient to bring the action before the jury and “sufficient to cause a parent to suffer emotional and mental distress.” Wargelin, 149 Mich. App. at 88, 385 N.W.2d at 738. The court established a foreseeability standard for similar cases.
In evaluating mental suffering in the absence of any physical injury, the court could require plaintiffs to present expert psychological evidence. To establish a claim for the negligent infliction of emotional distress, the Hawaii Supreme Court stated:
“The physician or psychiatrist must rely on the plaintiff’s testimony, the context in which the trauma occurred, medical testing or any physical ramifications, the psychiatrist’s knowledge of pain and disability likely to result from such trauma, and even the framework of human experience and common sense to determine the amount of pain resulting naturally as a response to defendant’s act, and whether it is beyond the level of stress with which a reasonable man may be expected to cope.” Leong v. Takasaki, 55 Haw. 398, 413, 520 P.2d 758, 767 (1974).
*901The requirement of foreseeable-emotional distress also counters the third argument above, the perceived unfairness of requiring a negligent defendant to compensate a plaintiff for a purely mental disturbance. I am of the opinion that in most instances serious emotional injury will produce some physical effects. See Prosser and Keeton, § 54 at 362. Although intentional infliction of emotional distress may warrant recovery because of the defendant’s extreme behavior, “the justification for tort recovery for [negligently inflicted] emotional distress is * * * not so strong. However, even where the claim is founded on only negligence, the level and reasonableness of the emotional distress must be assessed.” Payton v. Abbott Labs, 386 Mass. 540, 581, 437 N.E.2d 171, 193-94 (1982) (Hennessey, C.J., dissenting). Whether a person manages not to exhibit physical symptoms does not affect the authenticity of a traumatic-emotional injury. Contrary reasoning could lead a court to the anomalous result of rewarding a person for his or her weakness. In essence, it would encourage claimants to feign physical symptoms of nervous disorder.
The following reasoning supports this argument:
“The requirement is over inclusive because it permits recovery for mental anguish when the suffering accompanies or results in any physical impairment, regardless of how trivial the injury. More importantly, the requirement is under inclusive because it arbitrarily denies court access to persons with valid claims they could prove if permitted to do so. Molten v. Kaiser Foundation Hospitals, 27 Cal. 3d 916, 929, 616 P.2d 813, 820, 167 Cal. Rptr. 831, 838 (1980).
“Additionally, the requirement is defective because it ‘encourages extravagant pleading and distorted testimony.’ Id. To continue requiring proof of physical injury when mental suffering may be equally recognizable standing alone would force ‘victim[s] to exaggerate symptoms of sick headaches, nausea, insomnia, etc., to make out a technical basis of bodily injury upon which to predicate a parasitic recovery for the more grievous disturbance, the mental and emotional distress * * * endured.’ Magruder, Mental and Emotional Disturbance in the Law of Torts, 49 Harv. L. Rev. 1033, 1059 (1963).” St. Elizabeth Hospital, 730 S.W.2d at 652.
Other areas of the law in which “mere” emotional injury is fully compensated clarify the incongruity of the majority’s position. One commentator, for example, stated:
“[Tjhere is no requirement that a plaintiff whose privacy has been invaded or who has been defamed show some physical manifestation of his injury to recover. In fact, until the United States Supreme Court’s 1974 decision in Gertz v. Robert Welch, Inc., [418 U.S. 323, 94 S.Ct. 2997, 41 L.Ed.2d 789 (1974)], a plaintiff was generally allowed to recover for intangible, essentially psychic harm to his reputation without offering proof of any damage whatsoever. Such psychic harm has long been the core of several intentional torts, such as assault, false imprisonment and obviously, intentional infliction of emotional distress.” Bell, The Bell Tolls: Toward Full Tort Recovery for Psychic Injury, 36 Univ. Fla. L. Rev. 333, 407 (1984).
The court in Corgan v. Muehling, 167 Ill. App. 3d 1093, 118 Ill.Dec. 698, 522 N.E.2d 153 (1988), further illustrates the irrationality of the majority’s position. There the plaintiff brought a claim for negligent infliction of emotional distress against the defendant psychologist for engaging in sexual relations with her during treatment. The court refused to apply the physical-manifestation restriction of the Illinois bystander rule. The court reasoned:
“Nor can there be any rational justification for our courts to mandate that in order to qualify for damages in a psychologist or social worker malpractice case a patient exhibit physical manifestations of his or her emotional trauma suffered at the hand of therapists who are qualified to minister to their needs only in cases of mental or emotional malaise, especially since * * * such an injury, ‘though difficult to prove, may be as real *902as that type of injury which can be proven with mathematical certainty.’ ” Corgan, 167 Ill. App. 3d at 1102, 118 Ill.Dec. at 704, 522 N.E.2d at 159 (quoting Omer v. Edgren, 38 Wash. App. 376, 381, 685 P.2d 635, 638 (1984)); see also Rowe v. Bennett, 514 A.2d 802, 806 (Me. 1986) (“because of the nature of the psychotherapist-patient relationship, an action may be maintained by a patient for serious mental distress caused by the negligence of his therapist despite the absence of [physical symptoms and] an underlying tort”).
Courts that have abandoned the physical-manifestation rule have adequately addressed the remaining arguments. The court in James v. Lieb, 221 Neb. 47, 58, 375 N.W.2d 109, 117 (1985), for example, noted that experience in other states has shown that their courts have not been overwhelmed with litigation in this area; they have been able to place limits on liability; and the cost to society has not been unbearable. See also Schultz v. Barberton Glass Co., 4 Ohio St. 3d at 133, 447 N.E.2d at 111-12.
In Curtis v. State Department for Children and Their Families, 522 A.2d 203 (R.I. 1987), this court reiterated that an action for the intentional infliction of emotional distress will not lie where the plaintiffs neither present evidence of physical effects nor proffer any evidence of a defendant’s outrageous or extreme conduct. I disagree with the majority’s interpretation of that opinion. Although the Curtis opinion refers to older cases that required physical symptomatology of emotional injury, its holding pertains to the necessity of proving extreme and outrageous conduct. Such conduct eliminates the need for a physical manifestation.
Section 46 of the Restatement of Torts states that “[o]ne who by extreme and outrageous conduct intentionally or recklessly causes severe emotional distress to another is subject to liability for such emotional distress * * The form of the certified questions before this court indicates the outrageous circumstances of the instant action. The parents were
“present throughout and participated in [their] daughter’s traumatic * * * delivery, * * * saw and heard the devastating results of the negligence of the attending obstetrician and experiences and will continue to experience the constant stress inherent in caring for a child who has suffered nearly total devastation of her mind and body * *
In this situation the traumatic events virtually guaranteed a stressful reaction. Accordingly, I reject that requirement for both the intentional- and negligent-infliction-of-emotional-distress causes of action.
In summary, I believe that spurious claims and excessive damages can be avoided. By setting strict standards of proof, scrutinizing carefully the circumstances of each case, relying on expert psychological testimony, and utilizing a reasonable-person standard, courts can filter out all but the most serious, genuine claims of emotional distress. Accordingly, for those cases that fall within these guidelines, I would permit recovery. For these reasons, I respectfully dissent.