Lead Opinion
The opinion of the court was delivered by
This is a medical malpractice wrongful birth action brought in the United States District Court for the District of Kansas by John and Nicole Arche against the United States of America, Department of the Army. Chief Judge Earl E. O’Connor of the United States District Court has certified the following questions for resolution by this court pursuant to the Uniform Certification of Questions of Law Act, K.S.A. 60-3201 et seq.:
1. Does- Kansas law recognize a cause of action for the wrongful birth of a permanently handicapped child?
2. If Kansas does recognize such a cause of action, what is the extent of damages which may be recovered upon proper proof?
A discussion of three types of related malpractice torts is helpful in our analysis of the certified questions. These torts — wrongful pregnancy, wrongful life, and wrongful birth — have evolved because of advances in technology and the recognition of a woman’s right to prevent conception or to terminate a pregnancy. See generally Speck v. Finegold,
In the tort of wrongful pregnancy, parents who have taken medical steps to prevent pregnancy bring suit, for damages caused by a child nevertheless being bom, even if that child is born healthy. See Bruggeman v. Schimke,
“[W]e are not concerned here with an unsuccessful sterilization proceeding followed by the birth , of a mentally retarded or physically handicapped child. Our concern here is only with , items of damages claimed when it is alleged that a sterilization procedure was negligently performed,. and thereafter, a normal, healthy child was bom to the ‘sterilized’ parent.”
The tort of wrongful life constitutes an action brought by an impaired child, whereby the child alleges that, but ;for the defendant’s negligent advice or treatment, the child would hot have
The tort of wrongful birth differs from the tort of wrongful life in that the suit is brought by the parents, who claim they would have avoided conception or terminated the pregnancy had they been properly advised of the risks or existence of birth defects to the potential child. See Bruggeman,
Twenty courts in other jurisdictions have recognized the action. State court opinions recognizing the action include: Lininger v. Eisenbaum,
Arizona, California, and Utah have sometimes been cited as states recognizing the action, but the issue has not been clearly presented and determined in those states. See Walker by Pizano v. Mart,
Defendants cite three decisions in which courts have refused to recognize wrongful birth actions: Wilson v. Kuenzi,
Wilson,
Azzolino,
We note that the Minnesota Supreme Court has upheld the constitutionality of a statute prohibiting wrongful birth claims. Hickman v. Group Health Plan, Inc.,
Gleitman v. Cosgrove,
During the next twelve years, two major changes occurred: The ability to detect birth defects in útero greatly increased, and the United States Supréme Court recognized a woman’s right to obtain an abortion. Roe v. Wade,
These changes caused the New Jersey Supreme Court to reject its former reasoning and recognize a cause of action for wrongful birth in Berman v. Allan,
A plaintiff must prove three elements to prevail in a medical malpractice action in this state:' “(1) that a duty was owed by the physician to the patient; (2) that the duty was breached; and (3) that a causal connection existed between the > breached’duty and the injury sustained by the patient.” Wozniak v. Lipoff,
Under Kansas law, if it were determined ‘‘that the child would be born with physical or mental défect,” Nicole Arche could'have chosen to have an abortion. K.S.A. 21-3407. Roe v. Wade,
• In recognizing a cause of action for wrongful birth in this state, we assume that the child is severely and permanently handicapped. By handicapped, we mean, in this context, that the child has such gross deformities, not medically correctable, that the child will never be able to function as a normal human being. We further assume that there is negligence on the part of the defendants; that the gross defects of the child could have been determined by appropriate testing prior to birth; that defendants owed plaintiffs a duty to perform such tests; and that no such tests were offered or performed, or if performed, were negligently performed.
The remaining question to be answered is the extent of damages which are to be allowed. Formulas for damages in wrongful birth cases vary widely. See generally University úf Ariz. v. Superior Court,
In Gleitman v. Cosgrove,
Twelve years later, however, in Berman v. Allan,
Almost all cases allowing the action now allow those expenses caused by the child’s handicaps. See, e.g., Robak v. United States,
Wrongful birth plaintiffs typically desire a child and plan to support the child. Such support is, of course, the obligation of all parents. It is therefore reasonable to deny those normal and forseeable costs which accrue to all parents. See Smith v. Cote,
We next must consider whether plaintiffs in a wrongful birth suit may recover for emotional distress. Some courts have held that parents may recover for emotional distress suffered as the consequence of witnessing the birth of an impaired child and the consequent stress of raising such a child. See Blake v. Cruz,
The rule in Kansas is that plaintiffs can sustain a cause of action for negligent infliction of emotional distress caused by the injuries of a third party only if they were witnesses to the occurrence which caused the injury. Smelko v. Brinton,
We next determine whether the “benefit rule” should be applied to reduce the damages payable by the defendant. The benefit rule requires that any special benefits to the plaintiffs from having a child should be offset against the damages caused by the defendant’s negligence. The rule has usually been applied against damages for emotional distress or damages for the general costs of raising a child. See Note, Wrongful Birth: Who Owes What to Whom and Why?, 40 Wash. & Lee L. Rev. 123, 137 (1983). The rule may be necessary where damages for emotional distress are allowed, to take into account those positive emotions
. In discussing the benefit rule in wrongful birth actions, the Colorado court in Lininger v. Eisenbaum,
The final question to be determined, concerning allowable damages, is over what period of time such expenses may be recovered. Those courts presented with the issue of whether expenses may be compensated beyond the age of the child’s, majority have generally found that they may where the child will be incapable of self-support. See Phillips v. U.S.,
The court in Garrison by Garrison v. Medical Center of Delaware, Inc.,
Legal scholars find it doubtful that there was a duty by parents to support their children under earliest common law in England and in this country. See Comment, The Parental Duty to Support Disabled Adult Children, De Paul L. Rev. 245, 245-47 (1960). Rather, the duty was believed to be only a moral one unless dictated by statute. See Annot., Parent’s Obligation to Support Adult Child,
Ry the twentieth century, however, the majority of American courts repudiated this view, and held that, regardless of statute, parents are under a legal as well as a moral duty to support their children. See cases cited in 9 De Paul L. Rev. at 247 n.8; Annot., Postmajority Disability as Reviving Parental Duty to Support Child, 48 A.L.R:4th 919; Annot.,
Courts still varied at first, however, in their view of the extent to which this duty existed. Some courts held that, in the absence
Other courts held the duty continued where the child remained incompetent, under the rationale that the adult child remained as helpless as an infant. The primary foundation for the imposition of a common-law duty of support is that children are incompetent to support themselves; where the foundation remains, the duty remains. See Crain v. Mallone,
These jurisdictions finding a legal duty of support were split by various restrictions put on the continuing obligation by some of the courts. Some courts required that the adult child be incapacitated at the time of reaching majority. See Crain,
We have held that a parent has a common-law duty of support extending as long as the child is so incapacitated as to be unable to maintain and support himself or herself. See In re Estate of Glass,
In Sheneman v. Manring,
The father’s guardian appealed, arguing the daughter was no longer a member of her father’s household. We accepted this exception as part of the old common law, but found that support was properly mandated by the broad equity powers granted the
Courts often relied on “poor laws” requiring contribution by parents, grandparents, or even more distant relatives to the support of indigent incompetent children or adults. See generally Comment, 9 De Paul L. Rev. at 246. The courts nevertheless often found means to enforce a common-law obligation of support where such poor laws were not in existence or were inapplicable.
Such was the case in Prosser v. Prosser,
The father argued there was no statutory authority for requiring support. We noted, however, that the action was not brought under the authority of a statute, but .
“brought to enforce the common law duty of a parent to provide for the support and maintenance of his children. It is a generally accepted rule that where a child on becoming of age is in such a feeble and dependant condition, physically or mentally, as to be unable to support himself the parental obligations and duties toward such a child remain unchanged.” 159 Kan. at 653 .
We cited Sheneman v. Manring,
The final Kansas case we must consider is In re Estate of Glass,
The decedent, Lucy Glass, was the mother of two adult incompetent children who were committed to the Osawatomie State Hospital. She left a will in which she left no bequests or devises to these two children. During the probate proceedings, the State filed a timely petition for allowance of its demand against the Glass estate for the maintenance,, care, and treatment of the two adult incompetent children up to the date of Mrs. Glass’s death. The executor objected, contending that the State’s claim abated and did not survive decedent’s death. Both the probate and district courts sustained this objection. This court held that the claim survived. We reversed the district court and remanded the cause for further proceedings.
We discussed our prior holdings in Sheneman and Prosser, and said:
“[A] parent has a common law duty to provide support and maintenance for his minor children and that such duty extends and remains unchanged to a child who, on becoming of age, is in such feeble and mental condition physically and mentally as to be unable to maintain and support itself.”175 Kan. at 250 .
The executor argued that the demand was.based wholly on G.S. 1949, 59-2006 (1951 Supp.), which provided in part:
“The following shall be bound by law to support persons committed to or received as patients at the state hospitals . . . : Spouses, parents and children. . . . The state department of social welfare may recover the sum of twelve dollars ($12) per week as compensation for the maintenance, care and treatment of a patient in a state hospital . . . from any person bound by law to support such person . . . .”
We did not agree with the executor’s argument and held that there is a nonstatutory (or common-law) duty, as well as a statutory duty, upon the parent to support an adult incompetent child.
The Kansas Legislature, in 1907, in an act “concerning lunatics, insane persons, idiots, imbeciles, distracted persons, feeble-minded persons, drug habitues, and habitual drunkards,” provided:
“The following relatives shall be bound by law to provide for and support [persons admitted to state hospitals]: The husband for the wife and the wife for the husband, the parent for his or her children, and children for their parents.” L. 1907, ch. 247, § 33.
That act, later codified as R.S. 1923, 39-233, was repealed in 1939 upon the complete revision of our probate code. See L. 1939, ch. 180, § 280. G.S. 1935, 59-2006 (1939 Supp.), however, (later codified, as amended, as K.S.A. 59-2006, [Corrick]) continued the liability of parents for the support of their incompetent children in the following language:
“The following shall be bound by law to support persons adjudged to be insane: Spouses, parents, and children. . . . The state may recover the sum of five dollars per week, to be applied on the maintenance, care and treatment of a patient in a state hospital, from . . . any person bound-by law to support such person.”
The amount which the state could recover from persons bound by law to support patients was increased in 1965 to the sum of twelve dollars per week. L. 1965, ch. 349, § 1.
The following legislature reduced the list of persons whose duty it is to support patients in state hospitals. See L. 1967, ch. 474, § 1. Thereafter, only spouses and parents of minor children are bound by law to support patients in state hospitals. The current statute imposes such a duty only upon “[a] person’s spouse and the parents of a person who is a minor.” K.S.A. 1989 Supp. 59-2006(a). The basic rate of charge for patients in state hospitals is
Thus, under the statute, parents of incompetent adult children are not bound by law to support such children if they are patients in state hospitals. On the other hand, if we apply our “common-law” rule as expressed in Sheneman, Prosser, and Glass, parents are bound by law to support their incompetent adult children if the children are cared for at home, are patients in private institutions, or are anywhere except in state institutions. Such a ruling would create an inconsistency in our law and an incongruous situation.
It is a matter of common knowledge that the cost of medical and psychiatric care and treatment has risen to astronomical heights since the legislature fixed the amounts recoverable for patient care in state hospitals at five or even twelve dollars a week. For that reason, most people carry hospital and medical insurance. Even the most liberal coverage, however, is sometimes insufficient to cover catastrophic illnesses. Children are sometimes covered under their parents’ hospital and medical plans past minority and through their normal college years; beyond that, children may not be insured under their parents’ health insurance policies, but must have their own insurance.
Considering the realities of present-day insurance practices and hospital, medical, and surgical costs, should a parent be responsible for those expenses for his or her adult child? Consider a parent of middle age and average circumstances whose adult child suddenly becomes incompetent. Should the parent, under the “common law” of Kansas, be legally responsible for the care and treatment of that adult child?
Consider also parents, such as the plaintiffs in this action, who have the misfortune to give birth to a child who suffers gross deformities and has no hope of ever becoming a normal, self-supporting adult. Should the parents of that child be legally responsible for the continuing support and maintenance of that child after it reaches majority? Or should the State assume that responsibility, once the child becomes an adult? The Kansas Legislature has faced that precise issue and has determined that
K.S.A. 77-109 provides as follows:
“The common law as modified by constitutional and statutory law, judicial decisions, and the conditions and wants of the people, shall remain in force in aid of the General Statutes of this state . . . .”
As we have seen, under the earliest common law a parent was not responsible for the care of an adult incompetent child. That common-law rule was modified by our earlier decisions and by statutory law. Then, in 1967, the legislature reinstated the early common-law rule that a parent would not be liable for the support, care, and maintenance of an adult incompetent child who was in a state hospital. After careful study, and in light of the economic realities of our present society, we conclude that we should follow the lead of the Kansas Legislature and modify our decisional law. Accordingly, we hold that a parent is no longer required by law to provide support for an adult incompetent child in this state. Recovery in this case, then, may be had only for the period of time of the child’s life expectancy or until the child reaches the age of majority, whichever is the shorter period.
Finally, we must voice a concern that has not been briefed by the parties and is outside the scope of the questions certified to us. This concern is the possible unjust use of any damage award received by parents in a wrongful birth case.
We note that the plaintiffs in Becker v. Schwartz,
Damages are to be based on those extra expenses caused by the child’s disabilities. It would be unjust for the parents to be able to recover such damages and escape the expenses.
These concerns, and many others, could be avoided through the use of a reversionary trust. In Robak v. United States,
In Robak, the court based the award on the life expectancy of a healthy child, confident that the parents would not thereby receive a windfall because of the use of the reversionary trust. In some instances, this would be a reasonable calculation. In other circumstances, an award based on a normal lifespan would be contrary to medical knowledge. In Curlender v. Bio-Science Laboratories,
In summary: In response to Question No. 1, we hold that the tort of wrongful birth is recognized in Kansas. In response to Question No. 2, we hold that damages may be recovered for those costs which would not be incurred but for the child’s disability. These costs may be calculated on the basis of the child’s specific life expectancy or until the child reaches the age of majority, whichever is the .shorter period.
Concurrence Opinion
concurring: I concur-in the majority opinion. The majority, however, does not go far enough in its effort to protect any damage award from possible unjust use. The majority reasons that the use of the funds is “outside the scope of the questions certified to us.” I disagree. We should judicially craft this new claim so that its characteristics require: (1) any sums recovered as damages by the parents for wrongful birth to be placed in a reversionary trust for the use and benefit of the child; and (2)
We should mandate the two conditions into the claim for wrongful birth. If we have the authority to recognize the claim, we have the authority to determine its character. The trial court’s discretion may be relied upon for establishing the mechanics of the reversionary trust-fiduciary relationship concept on an individual case basis.
The majority cites Blake v. Cruz,
The majority also discusses Robak v. United States,
We have determined that the loss period for the recovery of damages terminates at the time the child reaches majority. The “loss period” represents the time frame for the determination of parent compensation for the wrongful birth condition of the child which has resulted, or will result, due to the negligence of the defendant.
A review of the pretrial order in the instant action reflects the atypical relationship between the plaintiff parents’ claim and the child whose condition provides the basis of the claim. The $10,000,000 claim of special damages of John and Nicole Arche (parents) for the care of their daughter Andrea born April 6, 1987, is stated as:
Loss of earning capacity (loss of income and benefits) $1,000,000.00
Medical supplies 400,000.00
Physical therapy, occupation therapy, speech therapy, and. miscellaneous therapy 1.750.000.00
Attendant care and therapy 2.300.000.00
Mother care 300.000.00
Rehabilitation services and care 1.000.000.00
Special education services 1,500,000.00
Medical care 750.000.00
Home remodeling and furnishings 250.000.00
Orthotic and miscellaneous supplies 250.000.00
Communication equipment and training 500.000.00
As I read Robak, the trial court suggested the reversionary trust.
The reversionary trust concept addresses three concerns that merit our consideration. It assures first, that the child will be adequately cared for; second, that the parents will be properly compensated for the additional wrongful birth expenses during the “loss period”; and third, if the child does not survive the “loss period,” that the parents are not compensated for expenses they never incurred. In Robak, as in the instant case, the defendant is the United States. Any judgment will be paid by the nation at large. In many other cases the defendant may be an individual health care provider.
We have denied a claim brought by a child for wrongful life. Bruggeman v. Schimke,
The juxtaposition between the substantive law of wrongful birth, as a new tort, and the damage award for that tort is unique. The claim is by the parents, for the parents, based on the special needs of the child. The typical case involving a claim for future expense arising from personal injuries to a minor is controlled by Stone v. City of Pleasanton,
The anomalous relationship between a plaintiff and an award in a wrongful birth case brings the use of any funds recovered within our province. We determine the substantive case law of torts in Kansas. If we are to recognize the new tort of wrongful birth, as I feel we should, we can define its characteristics.
