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Schirmer v. Mt. Auburn Obstetrics & Gynecologic Associates, Inc.
Citations: 108 Ohio St. 3d 494; 844 N.E.2d 1160Docket: No. 2004-0296
Court: Ohio Supreme Court; March 2, 2006; Ohio; State Supreme Court
Parents of a child born with disabilities due to alleged negligent genetic counseling or failure to diagnose a fetal defect may pursue legal action under medical malpractice principles, specifically for costs incurred during pregnancy and birth. However, they cannot recover consequential economic or noneconomic damages related to the care and rearing of the child. In the case at hand, Helen and Richard Schirmer filed a lawsuit against multiple defendants for medical negligence and lack of informed consent, claiming inadequate monitoring of Mrs. Schirmer’s pregnancy prior to the birth of their son, Matthew, in 1997. They cited Mrs. Schirmer’s chromosomal condition, which posed risks for birth defects, and alleged that the defendants failed to perform and interpret diagnostic tests correctly, leading to Matthew’s diagnosis of Trisomy 22, a severe genetic disorder. The Schirmers contended that had they been properly informed about the risks, they would have chosen to terminate the pregnancy. Their claims for damages included costs of pregnancy and delivery, costs for raising a disabled child, and emotional and physical injuries resulting from the challenges of caring for Matthew. After extensive trial court proceedings, an agreed entry recorded various stipulations and entered judgment. The Schirmers dismissed their claim for damages related to the pregnancy and delivery pain of their child, Matthew. The court granted defendants’ motions to dismiss the remaining claims due to failure to state a cognizable claim, asserting that Ohio law does not permit recovery for consequential economic or noneconomic damages in wrongful-birth actions. The trial court adopted a "limited damages" rule, allowing only damages for pregnancy and delivery pain. The dismissal of these claims led to the dismissal of the Schirmers' complaint for lack of legally recoverable damages. On appeal, the appellate court partially affirmed and reversed the trial court's decision, recognizing a close causal link between medical negligence and the genetic harm to the Schirmers’ child, thus stating a valid medical claim. Damages were limited to additional economic expenses incurred in raising a disabled child, excluding noneconomic damages, which the court deemed impermissible as they involve weighing the value of existence versus nonexistence. The case is now before the court following the Schirmers’ discretionary appeal and the defendants’ cross-appeal, both of which challenge the validity of the "wrongful birth" tort in Ohio and the associated damages. The document also outlines three categories of prenatal torts: wrongful pregnancy (costs of an unplanned child post-negligent sterilization), wrongful birth (costs associated with raising an impaired child due to negligent genetic counseling), and wrongful life (claims by impaired children arguing they were harmed by being born). The court has previously rejected wrongful life claims. The Schirmers claim wrongful birth, while defendants contend it is merely a derivative of a wrongful life claim. They reference Wilson v. Kuenzi, where Missouri courts ruled against both wrongful life and wrongful birth claims, stating that the causation for wrongful birth is more remote than for wrongful life since parents seek damages for the child's injury. The court highlighted that parental recovery for expenses arises from the negligence causing the child's injury, thus making the parents' claim derivative. If the child lacks a valid claim for injury, the parents' collateral loss claim must also fail. However, the authors of this document reject this reasoning, proposing that causation should focus on the pregnancy rather than the child's life. They characterize the parents' injury as a lost opportunity to terminate the pregnancy, framing it as a medical malpractice claim instead of wrongful birth or life. The discussion notes the potential confusion caused by labeling claims as wrongful life or birth, suggesting that such cases should be analyzed under medical negligence principles. For medical negligence, four elements must be proven: duty, breach, damages, and proximate causal relationship. The appellate court found that the Schirmers sufficiently alleged the duty and breach, which are not contested in this case. Damages in this case revolve around the evolution of prenatal tort cases in Ohio. In *Johnson v. Univ. Hosp. of Cleveland*, the court ruled that damages for child-rearing expenses cannot be awarded in wrongful pregnancy actions, citing public policy that the birth of a healthy child cannot be considered an injury to parents. Subsequently, in *Hester v. Dwivedi*, the court addressed a wrongful life claim where a child born with defects argued for compensation due to her birth. The court noted that recognizing such a claim would imply that nonexistence (abortion) would be preferable to life with disabilities, contradicting the value of life as upheld in precedent. The court emphasized that determining the value of life versus nonexistence falls into moral and philosophical realms rather than judicial. The Schirmers, in their case, assert damages not based on their child's existence but on their own suffering as parents due to the alleged failure to provide critical test results. This aligns with the court’s prior commentary in *Hester*, which acknowledged that parents could claim injury for being deprived of the choice to terminate a pregnancy based on undisclosed fetal abnormalities. The appellate court determined that consequential economic damages for the costs associated with raising a disabled child, compared to those for a non-disabled child, are not recoverable. This conclusion is based on the absence of a tort that would establish direct responsibility for the child's condition, as the mother claimed she would have terminated the pregnancy had she known of the disability. The court emphasized that the case centers on the comparison between existence and nonexistence, not life versus impaired life, and reiterated that the law does not permit damages based on this valuation. Consequently, the appellate court's judgment regarding consequential economic damages was reversed. However, the court acknowledged that damages related to pregnancy and delivery expenses are recoverable when negligent medical care affects informed decision-making during pregnancy. This aligns with previous rulings that limit damages in wrongful-birth cases to costs directly associated with the continuation of the pregnancy and the birth of the child. The court also clarified that while consequential economic and noneconomic damages lack a causal link to the defendants’ alleged negligence, damages for pregnancy and birth-related costs do have a sufficient causal connection to allow for recovery. Alicia Hester could not establish facts supporting her claim for damages against the appellee doctors, as they neither caused her spina bifida nor could have treated her mother or her to prevent her condition. The only injury linked to the doctors' breach of duty was Patricia Hester's loss of the opportunity to make an informed decision about continuing the pregnancy. Similarly, in the Schirmers’ wrongful-birth claim regarding their son Matthew, who had a condition determined at conception, the defendants did not cause or prevent his condition. The only injury recognized was Mrs. Schirmer's loss of the chance to decide about terminating the pregnancy. The court clarified that the abortion debate was not at issue, affirming that medical negligence affecting parental decision-making regarding pregnancy could be actionable. Consequently, parents of an unhealthy child born due to negligent genetic counseling or failure to diagnose may pursue medical malpractice claims for costs incurred from the pregnancy and birth. However, since the Schirmers voluntarily dismissed their claims for such damages, they are barred from recovering any associated injuries. The court dismissed their claims for consequential economic and noneconomic damages, reversed the appellate court's ruling on recoverable costs beyond ordinary child-rearing expenses, affirmed the denial of noneconomic damages, and reinstated the trial court's dismissal of the case. The judgment was supported by varying concurrences and dissents among the justices.