New York Law Review

Tag: abortion

  • Lynch v. Rubino, 72 N.Y.2d 6 (1988): Liability for Negligent Advice Leading to Abortion Decision

    Lynch v. Rubino, 72 N.Y.2d 6 (1988)

    A physician can be held liable for medical malpractice when negligent advice places a patient in a position where she must choose between two undesirable options, leading to physical and emotional injuries, even if the patient’s ultimate decision involves an abortion.

    Summary

    Jacqueline Lynch sued her gynecologist, Dr. Rubino, for malpractice. After Rubino negligently told her she wasn’t pregnant and prescribed Provera, a drug known to cause birth defects, Lynch discovered she was indeed pregnant. Facing the risk of a deformed child, she chose to have an abortion, violating her moral beliefs. The court held that Rubino’s negligence put Lynch in a position where she suffered physical and emotional injuries from having to make this impossible decision. The court emphasized that this was not a case about injury to the fetus, but rather about the direct harm Lynch suffered from the negligent medical advice. The court found the decision to terminate the pregnancy was a foreseeable consequence of Rubino’s negligence, and not a superseding cause.

    Facts

    Jacqueline Lynch consulted Dr. Rubino because she missed her period and had negative home pregnancy tests. Dr. Rubino, after a visual examination but without blood or urine tests, told her she was not pregnant. He prescribed Provera, a hormonal drug. Lynch later learned from the pharmacist that Provera could cause congenital disabilities if taken during early pregnancy. Relying on Rubino’s advice, she took the drug. When she still didn’t menstruate, another gynecologist confirmed she was pregnant and warned her about Provera’s risks. Fearing birth defects, Lynch and her husband decided to terminate the pregnancy.

    Procedural History

    Lynch sued Rubino for malpractice, alleging that his negligence forced her to choose between risking a deformed child or having an abortion. The trial court dismissed the complaint for failure to state a cause of action. The Appellate Division affirmed, reasoning that the case involved injury to the fetus and that Rubino’s conduct was not the proximate cause of the abortion. The New York Court of Appeals modified the Appellate Division’s order by reinstating the malpractice claim.

    Issue(s)

    Whether a physician can be held liable for medical malpractice when negligent advice regarding a patient’s pregnancy status leads the patient to take a drug known to cause birth defects if taken during pregnancy, and subsequently, to terminate the pregnancy out of fear of those birth defects, thereby causing the patient physical and emotional injuries?

    Holding

    Yes, because the physician’s negligent diagnosis and treatment were the precipitating causes of the patient’s injuries, placing her in the position of having to choose between two objectionable alternatives, and that choice was a foreseeable consequence of the physician’s negligence.

    Court’s Reasoning

    The court reasoned that Lynch was not seeking damages for emotional distress resulting from injuries inflicted on the fetus, but for injuries she sustained as a direct result of Rubino’s negligence. The court emphasized that the breach of duty was Rubino’s failure to perform a pregnancy test before advising Lynch that she was not pregnant and prescribing a potentially harmful drug. The court stated that “it is the erroneous advice that she was not pregnant…which, plaintiff asserts, led to the actions directly causing her injuries: her ingestion of the dangerous drug and her decision to terminate the pregnancy to avoid the drug’s harmful effects.” The court distinguished this case from those where the plaintiff sought damages for injuries to a third person (the fetus). Regarding proximate cause, the court found that whether it was foreseeable that Lynch would choose to have an abortion after discovering she was pregnant and had taken the drug was a question of fact for the jury. The court stated: “That plaintiff made the very choice forced upon her by defendants’ negligence cannot insulate them from legal responsibility for such conduct.” The court applied the rule that an intervening act which is a normal consequence of the situation created by a defendant cannot constitute a superseding cause, absolving the defendant from liability. The court determined that the choice Lynch made was a direct result of the negligent medical advice.

  • Martinez v. Long Island Jewish Hillside Medical Center, 70 N.Y.2d 697 (1987): Negligent Infliction of Emotional Distress Based on Erroneous Medical Advice

    70 N.Y.2d 697 (1987)

    A physician’s negligent misdiagnosis and advice, which directly leads a patient to undergo a medical procedure that violates her deeply held beliefs, can be the basis for a claim of emotional distress damages, even in the absence of physical injury.

    Summary

    Carmen Martinez sued Long Island Jewish Hillside Medical Center for emotional distress. She had an abortion based on the defendant’s negligent genetic counseling, which erroneously indicated a high probability that her child would be born with severe birth defects. After the abortion, she learned the advice was wrong. Martinez, who morally opposed abortion except in extreme cases, claimed the erroneous advice and subsequent abortion caused her severe mental anguish. The Court of Appeals held that Martinez could recover for emotional distress because the distress resulted directly from the defendant’s breach of duty owed directly to her, and her affirmative action based on that breach.

    Facts

    Carmen Martinez, in her first trimester of pregnancy, sought genetic counseling from Long Island Jewish Hillside Medical Center to assess the impact of medication she took early in her pregnancy on the fetus. The medical center negligently advised Martinez that her baby would likely be born with microcephaly (small brain) or anencephaly (no brain). Based on this advice, Martinez, who held strong moral objections to abortion except in extraordinary circumstances, underwent an abortion. She later discovered the medical advice was incorrect, and the abortion was unnecessary.

    Procedural History

    Martinez sued Long Island Jewish Hillside Medical Center for emotional distress. The trial court ruled in favor of Mrs. Martinez. The Appellate Division reversed the trial court’s decision. The New York Court of Appeals reversed the Appellate Division’s order and remitted the case to the Appellate Division for consideration of the facts and other issues not reached on the initial appeal.

    Issue(s)

    Whether a patient can recover damages for emotional distress caused by undergoing a medical procedure (abortion) based on a physician’s negligent misdiagnosis and advice when that procedure violated the patient’s deeply held moral beliefs.

    Holding

    Yes, because the emotional distress was the direct result of the defendant’s breach of a duty owed directly to the plaintiff, and the plaintiff affirmatively acted upon the erroneous advice, resulting in the violation of her deep-seated convictions.

    Court’s Reasoning

    The Court distinguished this case from bystander emotional distress cases such as Tobin v. Grossman, where emotional harm stems from observing injury to a third person. Here, Martinez’s mental anguish stemmed directly from the defendants’ breach of a duty owed to her. The court emphasized that Mrs. Martinez’s emotional distress did not derive from what happened to the fetus, but from the psychological injury directly caused by her agreeing to an act that violated her firmly held beliefs, based on the erroneous medical advice.

    The court stated, “[H]er mental anguish and depression are the direct result of defendants’ breach of a duty owed directly to her in giving her erroneous advice on which she affirmatively acted in deciding to have the abortion. The emotional distress for which she seeks recovery does not derive from what happened to the fetus; it derives from the psychological injury directly caused by her agreeing to an act which, as the jury found, was contrary to her firmly held beliefs. Defendants’ breach of duty was the precipitating and proximate cause of that injury.”

    The dissent argued that the majority effectively created a new cause of action for negligent infliction of harm to an individual’s deep-seated beliefs, an expansion of tort law beyond established precedents. The dissent emphasized that while intentional infliction of emotional distress and negligently induced fear of physical injury were recognized causes of action, compensating emotional distress from guilt due to acting against one’s convictions based on negligent advice was unprecedented.