Mason v. Western Pennsylvania Hospital

HESTER, Judge,

concurring and dissenting:

Although I agree that this case must be remanded for trial, it is on the issue of potential damages recoverable by appellant that I must part company with the majority. The instant case is, of course, factually similar to the situations examined in Speck and Stribling: an allegedly negligent sterilization procedure resulted in the birth of a child contrary to the parent’s wishes. The distinguishing hallmark of the instant case is that the child here was born healthy— there are no defects or deformities, no crippling hereditary diseases as attended both children in our former opinions. Despite the absence of post-natal complications in the child, the majority allows appellant to recover the full cost of rearing the child offset by the “child’s aid, comfort, and society during the parent’s life expectancy.” At 1370. Because this holding goes far beyond that which we approved in Speck, and because of the speculative verdicts the “benefit rule” will generate and the unwise public policy fostered thereunder, I dissent.1

*377A number of courts have considered “wrongful birth”2 suits in the context of the healthy and the unhealthy newborn and have reached varying results. On one side of the spectrum are those courts which place no apparent limit on the amount of damages recoverable for the wrongful birth of a healthy child, including damages incident to the rearing and support of the child. Thus, in Custodio v. Bauer, 251 Cal.App.2d 303, 59 Cal.Rptr. 463, 27 A.L.R.3d 884 (1967), the court held that the parents of an unplanned, normal child could recover from the physicians involved all damages proximately caused by a negligently performed sterilization, in accord with normal tort principles:

The mental suffering attendant to the unexpected pregnancy because of the complications which may or may not result, the complications that do result, and the delivery of a child are all foreseeable consequences of the failure of the operation .... Where the mother survives without casualty there is still some loss. She must spread her society, comfort, care protection and support over a larger *378group. If this change in the family status can be measured economically it should be as compensable as the former losses.

251 Cal.App.2d at 323-4, 59 Cal.Rptr. at 476 (footnote omitted); accord, Ziemba v. Sternberg, 45 App.Div.2d 230, 357 N.Y.S.2d 265 (1974); Rivera v. State, 94 Misc.2d 157, 404 N.Y.S.2d 950 (1978); Betancourt v. Gaylor, 136 N.J.Super. 69, 344 A.2d 336 (1975); cf. Bowman v. Davis, 48 Ohio St.2d 41, 356 N.E.2d 496 (1976).

On the other side of the spectrum are those jurisdictions which deny all damages when the alleged negligence leads to the birth of a normal child. Illustrative of these cases is Rieck v. Medical Protective Co., 64 Wis.2d 514, 219 N.W.2d 242 (1974). There, the alleged negligence was the failure of the doctor to timely inform the parents of the fact of the mother’s pregnancy, the complaint averring that had the parents been so informed, they would have elected an abortion. The court denied the plaintiff’s claim for the costs of rearing the child:

To permit the parents to keep their child and shift the entire cost of its upbringing to a physician who failed to determine or inform them of the fact of pregnancy would be to create a new category of surrogate parent. Every child’s smile, every bond of love and affection, every reason for parental pride in a child’s achievements, every contribution by the child to the welfare and well-being of the family and parents, is to remain with the mother and father. For the most part, these are intangible benefits, but they are nonetheless real. On the other hand, every financial cost or detriment-what the complaint terms “hard money damages”—including the cost of food, clothing and education, would be shifted to the physician who allegedly failed to timely diagnose the fact of pregnancy. We hold that such result would be wholly out of proportion to the culpability involved, and that the allowance of recovery would place too unreasonable a burden upon physicians, under the facts and circumstances here alleged.

*37964 Wis.2d at 518-19, 219 N.W.2d at 244-5. (footnote omitted).3

To a similar effect are Terrell v. Garcia, 496 S.W.2d 124 (Tex.Civ.App.1973)4; Shaheen v. Knight, 11 Pa.D. & C.2d 41 (1957); cf. Ball v. Mudge, 64 Wash.2d 247, 391 P.2d 201 (1964).

Between the two extremes of unlimited recovery and no recovery lay several intermediate approaches allowing some, but not boundless, damages for the wrongful birth of a healthy child. Many courts now adopt the so-called benefits rule of the Restatement (Second) of Torts, § 920.5 These courts allow recovery of the cost of rearing a healthy child during its minority, but require that damages be offset by any benefits accruing to the parents by virtue of the child’s birth.

In keeping with the “same interest” limitation of Restatement, Torts, § 920, supra, and its underlying purpose to prevent unjust enrichment, the trier of fact will be required to reduce [rearing] costs by the value of the *380child’s aid, comfort, and society which will benefit the parents for the duration of their lives.

Sherlock v. Stillwater Clinic, Minn., 260 N.W.2d 169, 176 (1977) (footnote omitted). Accord, Troppi v. Scarf, 31 Mich. App. 240, 187 N.W.2d 511 (1971); Anonymous v. Hospital, 33 Conn.Sup. 126, 366 A.2d 204 (1976); cf. Green v. Sudakin, 81 Mich.App. 545, 265 N.W.2d 411 (1978). Still other courts limit recovery to pregnancy related costs and expenses and the pain and suffering attendant thereto. “Damages based upon hospital and medical costs attending [the mother’s] unwanted pregnancy, as they affect her person, have little to do with the child’s right to life and its concomitant expenses of upbringing and education.” Wilczynski v. Goodman, 73 Ill.App.3d 51, 63, 29 Ill.Dec. 216, 225, 391 N.E.2d 479, 488 (1979). These courts thus deny recovery for the costs of the child’s upbringing, but allow damages for pain and suffering incident to the pregnancy, loss of consortium during the relevant time period, and the medical costs of the sterilization and unplanned pregnancy. Wilczynski, supra; accord, Coleman v. Garrison, 327 A.2d 757 (Del.Super.1974), aff’d., 349 A.2d 8 (Del.1975); cf. Bushman v. Burns Clinic, 83 Mich.App. 453, 268 N.W.2d 683 (1978).

I have carefully considered the thoughtful approaches to the damages issue taken by these several courts and am not unmindful that whatever avenue is finally chosen will inevitably be colored with notions of public policyrand a sensitivity to the conflicting and legitimate interests of the parents, doctors, and child involved.6 Nevertheless, I am persuaded that the first approach above discussed, that of allowing virtually unlimited damages for the wrongful birth of a healthy child, must be rejected. To allow the parents to keep the child, while shifting the entire cost of its upbringing to the physician, would amount to a windfall to the parents and would impose upon the doctor an intolerable financial burden totally out of proportion to the degree of culpability involved. Moreover, I do not subscribe to the *381theory that the life of a healthy child can be considered a “damage” to the parents, notwithstanding the assertions in Custodio v. Bauer, supra, that “the birth of a child may be something less than [a] ‘blessed event’ ”. 251 Cal.App.2d at 321, 59 Cal.Rptr. at 475. Accordingly, I cannot embrace a rule of damages which would extend a doctor’s malpractice liability to the point where he is responsible for providing long term economic support for an otherwise healthy child who is wrongfully born. See, Note, U.Pgh.L.Rev. 550, 558 (1978).

Similarly, to impose no damages upon the physician is also an unacceptable result. Such a ruling would provide the medical profession with unwarranted immunity in those cases where the patient seeks to avoid pregnancy. The practical affect of this position would allow tortious conduct by a physician in such cases to be totally uncompensable. “As Justice Rutledge said . . . immunity tends to foster negligence while liability tends to induce care and caution.” Flagiello v. Pennsylvania Hospital, 417 Pa. 486, 505, 208 A.2d 193, 202 (1965) (Musmanno, J.); Speck, supra, 268 Pa.Super. 353, 408 A.2d at 501-2; Feldman, Pa.Trial Guide, § 342 (1978). I am thus unwilling to extend immunity to the physician in this case.

It would seem, then, that an intermediate approach to the damages question is a more desirable response than either of the two extremes. As I have stated, many courts including now this Court, espouse use of the benefits rule of the Restatement (Second) of Torts § 920, but I decline to do so. To allow the jury to consider the satisfaction, joy, and companionship of a child as mitigation of damages against the costs of rearing the child would generate speculative verdicts as there is no firm basis upon which to calculate a dollar amount. “Who can place a price tag on a child’s smile or the parental pride in a child’s achievement?” Terrell v. Garcia, 496 S.W.2d 127, 128 (Tex.Civ.App.1973). Indeed, the Court today does not suggest any concrete rule by which the jury will ascertain a dollar amount representing the child’s “benefit” to appellant. In cases where a jury has far more guidance than is provided under today’s holding, we have *382•nonetheless found verdicts to be a product of speculation and conjecture. See, e. g. Gordon v. Trovato, 234 Pa.Super. 279, 338 A.2d 653 (1975). While it is true that mere uncertainty as to the amount of damages will not preclude recovery, Pugh v. Holmes, 486 Pa. 272, 405 A.2d 897 (1979), it is also clear that the jury must have an intelligent understanding of how damages should be calculated. Stated another way, damages may not be based on guess or speculation. Feldman, Pa.Trial Guide, § 34.2 (1978). The benefits rule, while allowing reasonable certainty in computing the cost of rearing a child, would then countenance a rule of mitigation based upon conjecture and sheer guesswork. I am not willing to embark on such an unchartered course in this Commonwealth without providing our juries with at least some guidance in reaching a principled verdict.

I thus conclude that the final alternative above discussed, that of awarding pregnancy-related costs, to be the most appropriate measure of damages. Such costs will be readily ascertainable and not subject to speculation; moreover, placing limits on the sums recoverable avoids the evils of a windfall to the parents at the enormous expense of the physician. Further, the rule I would adopt is more consonant with the very real expenses attendant to the injury suffered and the obvious difficulties stemming from the unexpected pregnancy of the woman. Thus, should appellant establish liability at trial, I would hold that she be entitled to recover for the pain and suffering and mental anguish incident to the pregnancy and the costs and expenses incurred as a result of the pregnancy.7

CERCONE, President Judge, and HOFFMAN, J., join in this concurring and dissenting opinion.

. It has been observed, most appropriately, that the principle controversy in negligent birth control actions revolves around the question of whether the physician must bear the cost of raising and educating the child. See, Wilczynski v. Goodman, 73 Ill.App.3d 51, 62, 29 Ill.Dec. 216, 224, 391 N.E.2d 479, 487 (1979); Note, Wrongful Conception; Who Pays for Bringing Up Baby?, 47 Fordham L.Rev. 418 *377(1978); Note, Recovery of Child Support for “Wrongful Birth”, 47 Tul.L.Rev. 225 (1972).

. As explained in Speck, wrongful birth and wrongful life are generic terms suggesting “factually divergent wrongs.” Id., 268 Pa.Super. 353, 408 A.2d at 502. In both kinds of cases:

“The plaintiff alleges that the child’s very existence is wrongful in that, had the physician diagnosed the mother’s disease that resulted in the child’s deformity and informed her of the risk of having a deformed child and of termination of the pregnancy as an alternative, the child would not have been born deformed. The distinction between a wrongful life action and a wrongful birth action is that that former is brought by the child, whereas the latter is brought by the parents. Wrongful conception cases are primarily distinguishable from both wrongful life and wrongful birth cases in that the parents in the latter cases want a healthy child, whereas in wrongful conception cases the parents do not want a child at all. Wrongful conception differs in that the cause of action arises at the time of the unwanted conception that is proximately caused by the acts of the physician.”

Note, 47 Fordham L.Rev. 418, 419 (1978); Note, 25 Wayne L.Rev. 961, 967-8 (1978), thus, although this case may more appropriately be labelled as one for wrongful conception, Sherlock v. Stillwater Clinic, Minn., 260 N.W.2d 169 (1977) or even wrongful pregnancy, Bushman v. Burns Clinic, 83 Mich.App. 453, 268 N.W.2d 683 (1978), I will retain, for convenience, the wrongful birth nomenclature.

. Rieck was distinguished in Dumer v. St. Michael’s Hospital, 69 Wis.2d 766, 233 N.W.2d 372, 83 ALR 2d 1 (1975) (failure to diagnose rubella), where the unwanted child was bom with congenital defects. Damages in this situation were recoverable but “limited to those expenses which they have reasonably and necessarily suffered, and will to a reasonable medical certainty suffer in the future by reason of the additional medical, hospital and supportive expense occasioned by the deformities of the child as contrasted to a normal, healthy child.” 69 Wis.2d at 776, 233 N.W.2d at 377.

. As did the Wisconsin court, Texas has similarly drawn a distinction between the wrongful birth of a healthy child. Thus, in Jacobs v. Theimer, 519 S.W.2d 846 (Tex.1975), a deformed child was born following the alleged negligence of the physician to diagnose rubella in the mother. The Court distinguished the healthy newborn situation in Terrell v. Garcia, supra, and authorized recovery of expenses reasonably necessary for the care and treatment of the child’s impairment.

. Sec. 920 provides:

“Where the defendant’s tortious conduct has caused harm to the plaintiff or to his property and in so doing has conferred upon the plaintiff a special benefit to the interest which was harmed, the value of the benefit conferred is considered in mitigation of damages, where this is equitable.”

. Indeed, one court has observed that “any solution is a selection of a lesser evil.” Bushman, supra, 83 Mich.App. 453, fn. 3, 268 N.W.2d 683, fn. 3 (1978).

. In her complaint, appellant did not request recovery for the cost of the tubal ligation or for loss of consortium. See, Coleman, supra.