Viccaro v. Milunsky

Citations: 551 N.E.2d 8; 406 Mass. 777

Court: Massachusetts Supreme Judicial Court; March 1, 1990; Massachusetts; State Supreme Court

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The case involves the Viccaros, who consulted Dr. Milunsky regarding the genetic risk of ectodermal dysplasia before conceiving their second child, Adam, who was born with the condition. The Viccaros relied on the physician's assurances that there was no risk of genetic disorders. After Adam's birth, they sought damages for extraordinary expenses related to his care, emotional distress, and loss of companionship and services of a healthy child. The Supreme Judicial Court of Massachusetts addressed two certified questions regarding the legal basis for the Viccaros’ claims against the physician for negligent preconception counseling. 

The court confirmed that Massachusetts law recognizes a cause of action for negligent preconception genetic counseling. It also acknowledged that parents can recover extraordinary medical and educational expenses related to a child's congenital disorder, as established in various precedents. However, the court did not express a definitive position on emotional distress damages or ordinary child-rearing expenses. The decision highlights the legal framework for parents seeking damages associated with the birth of a child affected by genetic disorders due to negligent medical advice.

In the case of Schroeder v. Perkel, the court established that recovery is permitted for incremental medical costs and expenses necessary for the care of a child's physical impairment. Subsequent cases affirmed that extraordinary medical, educational, and related expenses attributable to a defective condition are recoverable, along with emotional distress of parents, which may be offset by any emotional benefits from the child's birth. Recovery for additional medical expenses due to a child's deformities is also recognized. 

Contrarily, North Carolina and Missouri cases, such as Azzolino v. Dingfelder, indicate no recovery for postconception negligence leading to the birth of a child with Down's syndrome, while Jackson v. Bumgardner allows for liability for preconception negligence resulting in the birth of a healthy child. Gallagher v. Duke University outlines liability for preconception negligence resulting in an impaired child, and Wilson v. Kuenzi found no liability for failing to advise on amniocentesis.

The court agrees that the Viccaros can recover extraordinary expenses related to caring for their child, Adam, and may also recover future expenses if they remain liable for his support upon reaching adulthood, as Massachusetts law dictates parental responsibility for adult children with impairments. The emotional distress suffered by the Viccaros due to the defendant's negligence is also recoverable. However, their claim for the loss of companionship of a normal child is unsupported, as the defendant is not liable for Adam's genetic disease.

The court confirms the existence of a cause of action for the parents but does not address all financial burdens associated with raising Adam. It affirms the Viccaros' right to recover for extraordinary medical needs and potentially for expenses incurred after Adam's majority, but lacks sufficient information to determine the parents' right to recover lost wages due to caregiving responsibilities.

Damages in this context should typically be calculated based on the fair market value of necessary extraordinary services, with parents' lost wages potentially serving as a recovery measure in unique situations. Parents may recover for emotional distress and any physical harm stemming from that distress, but this recovery is subject to offsets for emotional benefits derived from their first child and from Adam's existence. There is no basis for the Viccaros to seek recovery for the loss of Adam’s companionship, nor do they present a compelling argument for damages related to the loss of Adam's services as a normal child. 

Regarding the question of whether Massachusetts recognizes a wrongful life claim for a child born with a genetic defect due to negligent genetic counseling, the answer is negative. The reasoning is that allowing such a claim presents logical inconsistencies, as the child would not have been born without the alleged negligence. The prevailing legal principle across the country is that a physician cannot be held liable to a child born as a result of their negligence. While some jurisdictions permit recovery for extraordinary expenses incurred due to hereditary defects, the general rule remains that no emotional damages are awarded in these cases. Prior relevant cases reinforce this position, including the Payton v. Abbott Labs case, where recovery for physical or emotional damages was denied under similar circumstances.

The court asserts that a provider responsible for a plaintiff's existence should not be held liable for the unavoidable collateral consequences of that existence, particularly regarding a child's birth with a genetic disease. It argues that a physician accused of negligence leading to a child's existence cannot be deemed in breach of duty for the resulting unfortunate consequences, like pain, suffering, and emotional distress. However, it acknowledges that some jurisdictions permit recovery for extraordinary expenses related to a child's genetic condition. As long as the parents can recover those costs, the child does not need a separate cause of action. The opinion notes uncertainty regarding the child's life expectancy and future self-sufficiency, and while it suggests potential liability for extraordinary care expenses post-parents' death, it clarifies that this specific case does not raise that issue. The dissenting opinion agrees with the main findings regarding the child's claims but contests the notion of allowing parents to recover damages for the birth of a child with genetic defects, citing fairness to defendants and public policy concerns. The dissent emphasizes the difficulties and societal implications of quantifying the costs associated with raising a normal child, arguing against allowing such recoveries due to the potential harm to families and the reverence for human life.

The author maintains that the fundamental principles governing the case remain consistent, regardless of the challenges faced in raising a child with impairments compared to a typically developing child. The judge accepted the complaint's allegations regarding Amy's family history of ectodermal dysplasia, a serious genetic condition. The claims presented by the Viccaros are categorized as "wrongful birth," where parents assert that negligent actions by a healthcare provider led to the birth of a child with a genetic defect. In contrast, "wrongful life" claims are made by the child themselves. The text emphasizes that the core issue is the physician's negligence rather than the circumstances of birth or conception. 

The key legal questions certified include whether Massachusetts recognizes a cause of action for wrongful birth based on negligent genetic counseling, and if so, what damages are recoverable. Specific inquiries involve the recovery of financial burdens related to raising the child, expenses for special needs, compensation for extraordinary care provided by parents, and damages for emotional distress and physical injuries. The Viccaros indicate they do not seek compensation for all financial burdens associated with raising the child and do not argue for damages related to the loss of the child's services.