delivered the opinion of the court:
Plaintiffs, Janice and Thomas Siemieniec, brought suit individually and on behalf of their son Adam against defendants, Lutheran General and Michael Reese Hospitals and two physicians. They allege that although they consulted with defendant physicians about whether a prospective child of theirs could be born a hemophiliac, they were assured by defendants that the possibility of this happening was at “low risk.” Adam subsequently was born with hemophilia.
The four-count, verified complaint seeks damages for extraordinary medical expenses Janice and Thomas will incur in caring for Adam’s condition as well as for negligent infliction of emotional distress, and damages for extraordinary expenses Adam will incur for treating his condition after he reaches adulthood. Answers were filed by the various defendants. The circuit court denied defendants’ subsequently filed motions to dismiss the complaint but recognized that issues of law were presented concerning which there were substantial grounds for differences of opinion. Three questions were certified for review by this court under Supreme Court Rule 308 (87 Ill. 2d R. 308) which contemplate whether: (1) the parents have a cause of action for the extraordinary medical expenses of the hemophiliac child during his minority; (2) the parents have a cause of action for negligent infliction of emotional distress; and (3) the child has a cause of action on his own behalf for extraordinary medical expenses during the age of majority. We have rearranged the order of the questions for purposes of analysis and review.
The pertinent facts alleged in the complaint follow. For the purpose of the motions to dismiss they must be taken as true. (Wilczynski v. Goodman (1979),
The complaint also alleged that defendants were under a duty to render competent diagnostic and consultive services which was breached by failure to adequately inform Janice about various types of hemophilia, for one of which, factor IX, there is no reliable test, and by failure to inquire adequately into her own health background. Plaintiffs, individually in counts I and II, seek to recover from defendants the extraordinary medical expenses that they will incur during their son’s minority and for their emotional distress. Counts III and IV, brought by Janice and Thomas on Adam’s behalf, seek recovery from defendants for the extraordinary medical expenses that he will incur as an adult.
I
Defendants contend that parents cannot maintain an action for “wrongful birth” under Illinois law, arguing that Adam’s parents do not have a cause of action for the extraordinary medical expenses incurred during his minority. It should be observed at once that nowhere in their complaint do Janice and Thomas assert that they are seeking damages for wrongful birth. Their sole claim for damages is for the extraordinary expenses they anticipate as a result of Adam’s impaired physical condition. In any event, the sole authority for defendants’ argument is the supreme court’s decision in the consolidated cases of Cockrum v. Baumgartner and Raja v. Tulsky (1983),
It is useful here to distinguish between “wrongful pregnancy” cases, such as Coekrum, and “wrongful birth” cases, such as the case before us. In a wrongful-pregnancy action, the alleged injury to the parent is the birth of the unplanned or unwanted, but usually normal and healthy, child, resulting from the negligence of a doctor or other health care provider in performing an abortion, sterilization, or in filling a prescription for contraceptives, whereas, in a wrongful-birth action, the injury usually claimed is the birth of a seriously handicapped or diseased child whose birth might have been prevented except for the negligence of those charged with prenatal testing, genetic prognosticating and counseling parents as to the likelihood of giving birth to a physically or mentally impaired or abnormal child. 2 Although in each instance suit is brought by the parents, the resultant effects of the subject birth are usually dramatically different. Not to be confused with the foregoing is still another type of action known as “wrongful life,” brought by parents on the child’s behalf, claiming that because of defendant’s negligence his adult life will be burdened with an impaired existence occasioned by the abnormal or unusual health condition with which he must live. We will treat this issue in part III of this opinion.
The utility in keeping the concepts described above separate and distinct for analytical purposes lies in the appropriate resolutions of questions of duty, asserted violations of that duty, proximate causes of the injuries sustained, and damages cognizable as a result of such injuries, with public policy as the frame of reference.
Although defendants acknowledge that Cockrum involved a healthy child, they argue the applicability of its rationale to the case at bar for the following reasons: the Cockrum court’s declaration that the “benefit of life should not be outweighed by the expense of supporting it” (Cockrum v. Baumgartner (1983),
The economic relief sought in the present case is related solely to the physical defects with which Adam was born, allegedly as a result of negligent advice, and the extraordinary, unanticipated expenses which Janice and Thomas, his parents, will incur as a result thereof, a matter standing distinctly apart from the issue raised in Cockrum: whether the birth of a normal, healthy, but unwanted child can be considered as compensable damages to his parents because of anticipative costs incurred in his ordinary upbringing involving no extraordinary expenses, which the supreme court answered in the negative in Cockrum, as did this court in Wilczynski v. Goodman (1979),
Considering the concerns of our supreme court in Cockrum, a wrongful-pregnancy action, we note that the first problem, the speculative nature of damages, does not apply here. This is not only because the action is not based upon wrongful pregnancy as in Cockrum, involving philosophical and ontological issues weighing the value, if any, of no existence with no attendant expenses, versus a normal, healthy existence with the usual expenses of raising an unplanned or unwanted child. Here, Janice and Thomas accept Adam’s existence and are willing to expend whatever funds are necessitated for ordinary upbringing. They seek only the extraordinary expenses of treating Adam’s hemophilia, which is well within the methods of proof employed in personal injury cases. See, e.g., Jacobs v. Theimer (Tex. 1975),
The concern in Cockrum, that the child will discover that it was not wanted is unwarranted here. The Siemieniecs have asserted that they did want a child; they only sought to avoid burdening their child with a hemophiliac condition. The Cockrum court’s desire to avoid placing the undue burden of rearing costs on a defendant also need not be considered in the instant case. Plaintiffs here do not seek to have defendants pay ordinary costs incurred for raising Adam, but rather liabilities that will be incurred for his extraordinary medical expenses. (Cf. Wilczynski v. Goodman (1979),
In wrongful-birth settings, as contrasted to wrongful-pregnancy cases, courts in other jurisdictions have acknowledged a causal link between a physician’s failure to diagnose or inform parents of potential birth defects and injury to the parents’ interests. Harbeson v. ParkeDavis, Inc. (1983),
In Illinois, the appellate court recently recognized such an action brought by parents of a child bom with Tay-Sachs disease, permitting the recovery of medical and associated expenses in Goldberg. As anticipated with this disease, the child there died during his infancy, however, leaving a somewhat different question, since damages would be incurred for a relatively short time by virtue of the disease involved. Continuing damages for extraordinary expenses for a prospectively much longer period of time is at issue in the case sub judice. In an earlier case, Doerr v. Villate (1966),
Our supreme court in Cockrum may well have suggested that the case of a child handicapped with a genetic disease might be treated differently than a claim emanating from wrongful pregnancy. For example, the court emphasized the normalcy and healthiness of the child when it identified the issue as “whether plaintiffs may recover as damages the costs of rearing a healthy child.” (Cockrum v. Baumgartner (1983),
One of the duties required of a physician toward his patient is to disclose accurately the nature and risks of treatment which the patient is advised to undergo. (Fure v. Sherman Hospital (1978),
II
Plaintiffs here also assert a cause of action for negligent infliction of emotional distress. Defendants maintain that such an action has no basis in Illinois and they note that case law historically has barred recovery for negligent infliction of emotional distress unless there was a contemporaneous physical impact or injury suffered by plaintiff. (Braun v. Craven (1898),
We believe that Rickey is controlling in a negligence setting. Although it is conceivable that Janice and Thomas could formulate a cause of action for “physical injury or illness” referred to in Rickey v. Chicago Transit Authority (1983),
Accordingly, we must hold in answer to certified question No. 2 that, absent allegations and proof of intentional and outrageous conduct, or that plaintiffs were at high risk to themselves of physical impact resulting in their physical injury or illness by reason of the emotional distress caused by a defendant’s negligence, they have no cause of action for emotional distress damages. Cf. Goldberg v. Ruskin (1984),
III
Lastly, we consider Adam’s action on his own behalf for extraordinary medical expenses which he expects to incur during his majority. It should be noted at the outset that Adam does not claim any damages other than those reflected in out-of-pocket extraordinary expenditures, unlike Zepeda v. Zepeda (1963),
A number of other jurisdictions have rejected similar causes of action. (Elliott v. Brown (Ala. 1978),
Recently, however, the supreme courts of New Jersey, Washington and California have permitted children to pursue actions limited to recovery for extraordinary expenses to be incurred in managing and treating genetic diseases. (Procanik v. Cillo (1984),
In Illinois, our supreme and appellate courts have considered whether an infant has the right to be bom whole and have concluded that such a right exists. (Renslow v. Mennonite Hospital (1977),
“This court has long recognized that a duty may exist to one foreseeably harmed though he be unknown and remote in time and place. (Wintersteen v. National Cooperage & Woodenware Co. (1935),361 Ill. 95 , 103. See generally Skinner v. Anderson (1967),38 Ill. 2d 455 .) Also, derivative actions, such as those of a husband or parent for the loss of the wife’s or child’s services, demonstrate that the law has long recognized that a wrong done to one person may invade the protected rights of one who is intimately related to the first. (See Dini v. Naiditch (1960),20 Ill. 2d 406 .) In these cases, because of the nature of the relationship between the parties harmed, the law recognizes a limited area of transferred negligence. Prosser, Palsqraf Revisited, 52 Mich. L. Rev. 1, 20-22 (1953).
The cases allowing relief to an infant for injuries incurred in its previable state make it clear that a defendant may be held liable to a person whose existence was not apparent at the time of his act. We therefore find it illogical to bar relief for an act done prior to conception where the defendant would be liable for this same conduct had the child, unbeknownst to him, been conceived prior to Ms act. We believe that there is a right to be born free from prenatal injuries foreseeably caused by a breach of duty to the child’s mother.
The extension of duty in such a ease is further supported by sound policy considerations. Medical science has developed various techniques which can mitigate or, in some cases, totally alleviate a child’s prenatal harm. In light of these substantial medical advances it seems to us that sound social policy requires the extension of duty in tMs ease.” (Emphasis added.)
In our opinion, the health care providers involved in the present case could have reasonably foreseen that one’s life would be impaired by being bom with hemophilia, at least to the extent of requiring extraordinary treatment with concomitant expenses. The duty to properly advise the parents of such a possibility was the responsibility of defendants here. The failure to fulfill that duty, if proved, affected not only the child’s parents, but, as demonstrated in Renslow, even more profoundly affected the child, Adam, himself. Procanik v. Cillo (1984),
With respect to defendants’ argument, that they were not the cause of the disease, but that they merely failed to reveal the real possibility of its existence, it is possible that defendants’ alleged breach of duty could be found to have resulted in the birth of a child who has been diagnosed as a factor IX hemophiliac and whose medical care is estimated to exceed that which is anticipated for the care for a normal, healthy child. Since it is here alleged that had Janice known of this she would have aborted his birth, the proximate causation may be proved to the satisfaction of the fact finders upon trial. See, e.g., Harbeson v. Parke-Davis, Inc. (1983),
Defendants insist, however, that recognition of Adam’s cause of action would require measuring the value of impaired life with nonexistence, which is better left to philosophers and the legislature.
3
Further, they urge that recognition of his claim would disavow the sanctity of life, contrary to our pro-life abortion statute and to the supreme court's position in Cockrum, if not our own position in Wilczynski. (See also Berman v. Allan (1979),
The action articulated on Adam’s behalf claims a real rather than a theoretical injury. It is definable by recognized tort standards and seeks recompense only for extraordinary expenses, not damages for being bom impaired as against the value of not being born at all. (See, e.g., Procanik v. CilLo (1984),
In our opinion, what Adam seeks are not damages for “wrongful life”; plainly, he seeks the same legal rights for redress of otherwise cognizable damages that every other person possesses. The anomaly inherent in allowing parents to recover damages in wrongful-birth cases involving impaired life, but denying recovery by the handicapped child of the same damages (see, e.g., Speck v. Finegold (1981),
“If such a distinction were established, the afflicted child’s receipt of necessary medical expenses might well depend on the wholly fortuitous circumstance of whether the parents are available to sue and recover such damages or whether the medical expenses are incurred at a time when the parents remain legally responsible for providing such care.
Realistically, a defendant’s negligence in failing to diagnose an hereditary ailment places a significant medical and financial burden on the whole family unit. Unlike the child’s claim for general damages, the damage here is both certain and readily measurable. Furthermore, in many instances these expenses will be vital not only to the child’s well-being but to his or her very survival. (See Schroeder v. Perkel, supra,432 A.2d 834 , 841.) If, as alleged, defendants’ negligence was in fact a proximate cause of the child’s present and continuing need for such special, extraordinary medical care and training, we believe that it is consistent with the basic liability principles of Civil Code section 1714 to hold defendants liable for the cost of such care, whether the expense is to be borne by the parents or by the child. As Justice Jacobs of the New Jersey Supreme Court observed in his dissenting opinion *** in Gleitman v. Cosgrove, supra,227 A.2d at page 703: ‘While the law cannot remove the heartache or undo the harm, it can afford some reasonable measure of compensa-
tion towards alleviating the financial burdens.’ ”
We conclude, in answer to the third certified question, that the child has a cause of action on his own behalf for extraordinary medical expenses during his majority.
In summation, the circuit court decision is affirmed as to its denial of defendants’ motions to dismiss plaintiffs’ complaint seeking extraordinary medical expenses associated with Adam’s hemophiliac condition during his minority and adulthood; we reverse the circuit court’s denial of defendants’ motions to dismiss Janice and Thomas’ action for negligent infliction of emotional distress; and we remand the case for trial.
Affirmed in part, reversed in part and remanded.
STAMOS, P.J., and BERLIN, J., concur.
Notes
For purposes of general and descriptive information only, hemophilia is a hereditary blood clotting disorder which affects mostly males. It is caused by the deficiency or inactivity of coagulation factors needed for blood clotting. It occurs in different levels of severity. Hemophilia A, sometimes called “classic hemophilia,” is due to deficiencies in clotting factor VIII and is the most common type, accounting for 70-80% of hemophilic patients. Hemophilia B, sometimes called “Christmas disease” (named after the first family found to have this condition), is due to a deficiency in clotting factor IX, which accounts for another 10-15% of the patients. Merieux Institute, Inc., Changing Concepts No. 2 Genetic Counseling in the Hemophilias (1978); Miller & Lubs, The Inheritance of Hemophilia 2 (1980).
See Phillips v. United States (D.S.C. 1981),
Some of the more interesting case debates on this subject have been recorded and analyzed in legal literature; e.g., Capron, Tort Liability in Genetic Counselling, 79 Colum. L. Rev. 618, 647-60 (1979); Persky, Wrongful Life: The Dawning of a New Cause of Action in Illinois?, 71 Ill. B.J. 594 (1983); Annot., 83 A.L.R.Sd 15 (1978); Comment, “Wrongful Life”: The right Not to be Born, 54 Tul. L. Rev. 480, 494-97 (1980). We need not tarry with these considerations in view of our perspective of the case at bar.
