John FASSOULAS, et al., Petitioners,
v.
John R. RAMEY, et al., Respondents.
Supreme Court of Florida.
Arnold R. Ginsberg of Horton, Perse & Ginsberg, and Hawkesworth & Schmick, Miami, for petitioners.
Riсhard A. Sherman, Fort Lauderdale, and Wicker, Smith, Blomqvist, Tutan, O'Hara, McCoy, Graham & Lane, Miami, for respondents.
PER CURIAM.
This cause is before the Court on a decision certified by the Third District Court of Appeal as passing upon a question of great public importance. We have jurisdiction. Art. V, § 3(b)(4), Fla. Const. The issue in this case concerns the scope of damages in a "wrongful birth" negligence suit.
Plaintiffs, Edith and John Fassoulas, were married and had two children, both of whom had been born with severe congenital abnormalities. After much consideration, they decided not to have any more children due to thе fear of having another physically deformed child and the attendant high cost of medical care. They then decided that John would undergo a vasectomy. This medical procedure was performed in January 1974 by defendant, Dr. Ramey. However, due to the negligence of the defendant in performing the operation, in giving medical advice concerning residual pockets of sperm, and in examining and judging the viability of sperm samples, Edith twice became pregnant and gave birth to two children. The first of these, Maria, was born in November 1974 and had mаny congenital deformities. Roussi, the *823 second of the post-vasectomy children and the fourth Fassoulas child, was born in September 1976 with a slight physical deformity which was corrected at birth; he is now a normal, healthy child.
The plaintiffs sued Dr. Ramey and his clinic in tort based on medical malpractice for the two "wrongful births." They sought as damages Edith's past and future lost wages, her anguish and emotional distress at twice becoming pregnant, her loss of the society, companionship and consortium of her husband, John's mental anguish and emotional distress, his loss of the society, companionship and consortium of his wife, medical and hospital expenses and the expenses for the care and upbringing of the two new children until the age of twenty-one.
At trial, the jury found in favor of the plaintiffs, finding the defendants 100% negligent with reference to Maria and 50% negligent with reference to Roussi. The plaintiffs were found to be comparatively negligent as to the birth of Roussi. Damages were assessed in the amount of $250,000 for the birth of Maria and $100,000 for the birth of Roussi, the latter sum being reduced to $50,000 because of the plaintiffs' comparativе negligence.
Upon appeal, the district court affirmed as to liability but affirmed in part and reversed in part as to damages. Ramey v. Fassoulas,
WHETHER THE PARENTS OF A CHILD, WHO IS BORN AS A RESULT OF A NEGLIGENT VASECTOMY, ARE ENTITLED IN A "WRONGFUL BIRTH" NEGLIGENCE SUIT TO PAST AND FUTURE DAMAGES FOR THE CARE AND UPBRINGING EXPENSES OF THE SUBJECT CHILD AS AGAINST THE TORTFEASOR PHYSICIAN WHO NEGLIGENTLY PERFORMED THE VASECTOMY?
This question is the sole issue for our consideration in this cause; the issue of liability was not appealed to us and for the purposes of this proceeding, liability has been conceded. For the reasons expressed herein, we answer the question as did the district court, holding that ordinary rearing expenses for both a normal and defective child are not recoverable, and only the special expenses associated with raising a defective child to the age of majority are recoverable.[1] We thus approve the decision of the district court below.
The rule in Florida is that "a parent cannot be said to have been damaged by the birth and rearing of a normal, healthy child." Public Health Trust v. Brown,
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 fathеr. 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... . We hold that such result would be wholly out of proportion to the culpability involved....
Rieck v. Medical Protective Co.,
The same rеasoning forcefully and correctly applies to the ordinary, everyday expenses associated with the care and upbringing of a physically or mentally deformed child. We likewise hold as a matter of law that ordinary rearing expenses for a defective child are not recoverable as damages in Florida.
We agree with the district court below that an exception exists in the case of special upbringing expenses associated with a deformed child. See Moores v. Lucas,
We approve the decision of the district court below that remanded the instant proceeding to the trial court for a new trial on damages only. With respect to the issue certified to this Court relating to rearing expenses, the trial court will comply with the views heretofore expressed in this opinion. As to the remaining consequential damages that went to the jury, i.e., pain and suffering, lost wages and medical expenses, these were not appealed by the defendants, and we do not address them.
It is so ordered.
ALDERMAN, C.J., and BOYD, OVERTON and McDONALD, JJ., concur.
EHRLICH, J., dissents with an opinion with which ADKINS and SHAW, JJ., concur.
EHRLICH, Judge, dissenting.
I believe the opinion of the district court below, Ramey v. Fassoulas,
A brief recitation of the history of this developing area of tort law is necessary in order to show the foundation of my viewpoint. See generally Comment, Busting the Blessing Balloon: Liability for the Birth of an Unplanned Child, 39 Alb.L. Rev. 221 (1975); Note, Remedy for the *825 Reluctant Parent: Physicians' Liability for the Post-Sterilization Conception and Birth of Unplanned Children, 27 U.Fla.L. Rev. 158 (1974); Note, Sterilization and Family Plаnning: The Physician's Civil Liability, 56 Geo.L.J. 976 (1968).
The first case to consider the rights of parents after an unsuccessful sterilization operation was Christensen v. Thornby,
This "blessing" dicta was seized upon in Shaheen v. Knight, 11 Pa. D. & C.2d 41 (Pa. 1957). There, in a case of first impression, the court held that a contract to perform a non-therapeutic sterilization operation was not invalid as against public policy even when the reason for the procedure was solely for the purpose of family planning. The court refused to award damages, however, because of the "blessing" that the newborn child, the couple's fifth, would bring to them. "To allow damages in a suit such as this would mean that thе physician would have to pay for the fun, joy and affection which plaintiff Shaheen will have in the rearing and educating of this, defendant's [sic] fifth child." 11 Pa. D. & C.2d at 45-46. "He wants to have the child and wants the doctor to support it. In our opinion to allow such damages would be against public policy." Id. at 46. Additionally, the court noted that the parents were not willing to give the child up for adoption, although "[m]any people would be willing to support this child were they given the right of custody and adoption." Id.
Further cases followed this line of reasoning of allowing a сause of action for wrongful conception or wrongful birth[1] but denying recovery as a matter of law on public policy grounds. For example, Terrell v. Garcia,
The Florida district court decisions relied upon by the majority opinion fall into this category of denying damages as a matter of law on the basis of public policy considerations. In Public Health Trust v. Brown, the issue was only the scope of damages associated with the birth of a healthy child, not an unhealthy one. The court denied the costs of rearing the child because of the "simple proposition,"
The instant decision at the district court level relied heavily upon Public Health Trust for its analysis and public policy holding. It analogizes to the law in wrongful death cases in support of its position, pointing out that the recoverable elements of damage are not offset by child rearing expenses, overlooking all the while that those elements of damage are spelled out and controlled entirely by statute and that except for the death statute itself, there would be no cause of action or recoverable damages. It opines that its holding aligns itself with "some of the most fundamental values of our culture which has long honored the institution of the family and cherished the inestimable worth of children."
These opinions substitute wise-sounding platitudes for any earnest and frank examination of the relevant issues involved. To deny plaintiffs who have been wronged their just relief based upon alleged "humane ideals" and not to grant relief on the basis of long recognized and well accepted tort principles is unjust and unfair. As the dissent in Public Health Trust so aptly noted,
[T]he result reached by the majority in the name of humaneness is, unwittingly, inhumane. I see nothing humane in denying a parent the wherewithal which might savе a child from deprivation or, in many cases, abject poverty. I see nothing humane in a rule of law that could enhance the already dire need of parents and existing siblings. I see nothing humane in a decision which effectively immunizes physicians from their negligence and victimizes a mother who sought to relieve herself and her family from the additional burden of another child.
The line of cases denying relief as a matter of law on public policy grounds that the Florida district courts have adhered to are eroding away and no longer represеnt a majority position. See Hartke v. McKelway,
*827 [W]e are not persuaded that public policy considerations can properly be used to deny recovery to parents of an unplanned ... child of all damages proximately caused by a negligently performed sterilization operation. Analytically, such an action is indistinguishable from an ordinary medical negligence action where a plaintiff alleges that a physician has breached a duty of care owed to him with resulting injurious consequences.
Sherlock v. Stillwater Clinic,
Contraception, conjugal relations, and childbirth are highly charged subjects. It is all the more important, then, to emphasize that resolution of the case before us requires no intrusion into the domain of moral philosophy. At issue here is simply the extent to which defendant is civilly liable for the consequences of his negligence... . [W]e go no further than to apply sеttled common-law principles.
The use of various birth control methods by millions of Americans demonstrates an acceptance of the family-planning concept as an integral aspect of the modern marital relationship, so that today it must be acknowledged that the time-honored command to "be fruitful and multiply" has not only lost contemporary significance to a growing number of potential parents but is contrary to public policies embodied in the statutes encouraging family planning.
Stillwater v. Sherlock Clinic,
To say that for reasоns of public policy contraceptive failure can result in no damage as a matter of law ignores the fact that tens of millions of persons use contraceptives daily to avoid the very result which the defendant would have us say is always a benefit, never a detriment. Those tens of millions of persons, by their conduct, express the sense of the community.
Troppi v. Scarf,
Turning specifically to the issue of damages, whereas the minority of courts hold as a matter of law that there can be no recovery because of the "blessings" of a child, the mоdern majority of courts make use of what is known as the Benefits Rule. Restatement (Second) Of Torts § 920 *828 (1979)[3] recognizes a right of recovery but requires mitigation of damages where the interest harmed has also been benefitted. Two points are clearly germane. First, while it may be difficult to ascertain damages, it is not impossible.[4] "While we recognize that the dollar value of the benefits to be offset is difficult to assess, we have routinely allowed recovery for the loss of aid, comfort, and society in wrongful death actions where similar problems of prоof are presented." Sherlock v. Stillwater Clinic,
It may, indeed, be difficult to "place a price tag on a child's smile." But there is no support for the conclusion that the task cannot be performed... .
In any event, the fact that the extent of damages may be difficult to ascertain should not cause the courts to throw up their hands in frustration. Even the dice player who is faced with the admittedly difficult task of rolling a "10" is afforded the opportunity to roll the dice. If he fails, he loses, but the dice are not snatched from his hand with the explanation that the "point" is too difficult to make.
Terrell v. Garcia,
Second, the very strength of the Benefits Rule is its flexibility in case-by-case adjudication.
The essential point, of course, is that the trier must have the power to evaluate the benefit according to all the circumstances of the case presented. Family size, family income, age of the parents, and marital status are some, but not all, the factors which the trier must consider in determining the extent to which the birth of a particular child represents a benefit to his parents. That the benefits so conferred and calculated will vary widely from cases to case is inevitable.
Troppi v. Scarf,
One point needs to be emphasized concerning the mitigation of damages. I take issue with the language in Public Health Trust that the parents are overwhelmingly benefitted by the birth of the unplanned child and that, "[s]peaking legally, this may *829 be deemed conclusively presumed by the fact that a prospective parent does not abort or subsequently place the `unwanted' child for adoption." Public Health Trust,
It has often been said that hard cases make bad law. I am afraid that the majority opinion does just that. A look at the instant facts supports this conclusion. John and Edith Fassoulas already had two children and both were born with severe medical problems. They could not afford the medical bills arising out of the treatments required. This was partly a function of the high cost of the medical bills and partly a function of the unemployment of John himself because of ill health. The two decided upon the solution of a vasectomy, both for the stated еconomic reason and for the reason of their fear that any further children might also be born with defects. They went to Dr. Ramey for the vasectomy but the operation was negligently performed. Thereupon occurred what can only be described as a comedy of errors. The fact that the operation was not successful was not apparent to anyone at the time. Edith soon became pregnant but all concerned thought that the cause was Dr. Ramey's negligent instructions to the couple about how long to wait before resuming intercourse and how long to use birth control because of the presence of residual pockets of sperm. In any event, Maria made her appearance nine months later and was congenitally deformed. She had a short neck, an abnormal shaping of the skull, a skin irregularity that was described as fish-like and scaly in appearance, a heart murmur, hypertension, and malformations of the hands. The very result that John and Edith wished to avoid by having the vasectomy was thus visited upon them, clearly a foreseeable consequence of Dr. Ramey's negligence. Time passed. Dr. Ramey once again erred in his professional conduct, this time by negligently confusing sperm viability with sperm motility in his examination of John's sperm samples. John and Edith were told that John was sterile when in fact he was not. Believing that Maria was born because of the residual sperm pockets extant after the initial operation and that John was now sterile, the couple resumed sexual relations. Again, there resulted a surprise, this time Roussi's birth. Though born with minor infirmities, these were corrected and Roussi can bе considered a normal child. But now, instead of having only two children with physical infirmities, John and Edith have a total of four children, three with *830 infirmities and one without. There are now medical bills for three deformed children; John is still out of work; and Edith has to quit work in order to care for the four children. All are now on welfare. While Edith and John testified that they love their two unplanned children greatly, (and what parent would not?), they have clearly been wronged by the negligent physician. Can it fairly be said as a matter of law that they have not been damaged by Roussi's birth? Is it fair to say as a matter of law that the non-extraordinary expenses associated with rearing Maria are not recoverable? I think not.
"It is no answer to say that a result which claimant specifically sought to avoid, might be regarded as a blessing by someone else." Rivera v. State,
Dr. Ramey did not do Edith and John a favor. That is what this Court should hold. Since it did not, I must dissent.
ADKINS and SHAW, JJ., concur.
NOTES
[1] The district court opinion stated that "Maria was born mentally retarded,"
Notes
[1] The instant case is technically and properly a "wrongful conception" action, and not a "wrongful birth" or "wrongful life" action. See Sherlock v. Stillwater Clinic,
The distinction between a wrongful life action and a wrongful birth action is that the 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 nоt want a child at all.
Note, Wrongful Conception: Who Pays for Bringing Up Baby?, 47 Fordham L.Rev. 418, 418 n. 7 (1978).
[2] "This child is not to be thought of as unwanted or unloved, but as unplanned." Jackson v. Anderson,
[3] § 920. Benefit to Plaintiff Resulting from Defendant's Tort
"When the defendant's tortious conduct has caused harm to the plaintiff or his property and in so doing has conferred a special benefit to the interest of the plaintiff that was harmed, the value of the benefit conferred is considered in mitigation of damages, to the extent that this is equitable."
Restatement (Second) of Torts § 920. "It should be emphasized that the benefits rule involves a question of mitigation after the determination of damages, not a balancing proсess to determine their existence." Note, Wrongful Conception: Who Pays for Bringing Up Baby?, 47 Fordham L.Rev. 418, 432 n. 110 (1978).
[4] "[D]ifficulty in determining the amount to be subtracted from the gross damages does not justify throwing up our hands and denying recovery altogether." Troppi v. Scarf,
[5] "The right to have an abortion may not be automatically converted to an obligation to have one." Ziemba v. Sternberg,
[6] "[T]he parents of an unplanned ... child may feel, and properly so, that whether they wanted the child or not is beside the point once the child is born and that they have an obligation to rear the child as best they can rather than subject him to rearing by unknown persons." Troppi v. Scarf,
