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2) Wrongful Birth

Wrongful birth refers to the claim brought by the parents of a congenitally disabled child against a health-care professional on the ground that her negligent advice or treatment prevented them from avoiding conception or of terminating the pregnancy. Some cases involve pre- conception negligence in the course of genetic testing or counselling. In H.(R.) v. Hunter, [Note 32: (1996), 32 C.C.L.T. (2d) 44 (Ont. Gen. Div.).] for example, the defendant physician failed to inform the plaintiff that there was a genetic risk that her male children might develop Duchenne muscular dystrophy. Both of her sons developed the disease. Other cases involve post-conception negligence such as the failure to warn mothers of the risk of fetal abnormality from post-conception illnesses, the failure to test for fetal abnormalities, or the failure to interpret test results accurately. A good illustration of post-conception negligence is found in Arndt v. Smith, [Note 33: Above note 27.] discussed above, where the defendant physician failed to tell the plaintiff of the risk that chickenpox contracted after conception posed to her fetus. Arndt also addressed the importance of causation in these cases. The plaintiff must establish that, if the defendant had not been negligent, a reasonable person in her particular circumstances (the modified objective test) would have prevented the pregnancy or terminated it as the case may be. The plaintiff's action in Arndt failed on that ground. [Note 34: See Mickle v. Salvation Army Grace Hospital (1998), 166 D.L.R. (4th) 743 (Ont. Gen. Div.) for a discussion of the difficulties of determining cause-in-fact in wrongful birth cases.]

The primary head of damage in wrongful birth cases is the increased costs and special expenses of caring for a handicapped child, [Note 35: 1 It is not yet clear if a claim for ordinary child-raising costs can also be made; see section D(4), "Wrongful Pregnancy," in this chapter.] but the award may also include the loss of income suffered by the parental caregiver and general damages to both parents for emotional suffering. The claim of the father is wholly derivative, standing or falling with that of the mother.

3) Wrongful Life

The wrongful life action has not been recognized by any Canadian court. [Note 36: See Jones (Guardian ad litem of) v. Rostvig (1999), 44 C.C.L.T. (2d) 313 (B.C.S.C.); and Lacroix (Litigation Guardian of) v. Dominique, [1999] 12 W.W.R. 38 (Man. Q.B.).] It is the companion action of the child to the parents'wrongful birth claim. The plaintiff child's contention is that, had the defendant given his mother timely warning of the risk of congenital abnormality, she would have chosen either not to have had a child or, if the negligence was after conception, to have terminated her pregnancy. In either case, the plaintiff would not have been born and he would have been spared a life burdened by physical or mental incapacity, pain, and suffering. As in the case of wrongful birth, there is no suggestion that the defendant caused the plaintiff's disability. The plaintiff never had a chance of being born free of congenital disability. The plaintiff's claim is that he should never have been born at all. Claimants in wrongful life actions in the United States commonly seek recovery for future care costs and non-pecuniary damages for pain and suffering and for an impaired childhood flowing from the chronic sorrow and psychological grief suffered by some parents upon the birth of a handicapped child. [Note 37: See Procanik v. Cillo, 478 A.2d 755 (N.J. 1984).]

It is unlikely that Canadian courts will entertain wrongful life claims in the near future. There are many technical and policy objections to them and this has led to a rejection of these claims in all common law jurisdictions other than a few American states. The primary technical problem relates to the assessment of damages. Damages in negligence are designed to restore the plaintiff to the position that he would have been in if the negligence had not taken place. In wrongful life claims this gives rise to a profound and unanswerable philosophical and theological conundrum. If the defendant had exercised care, the plaintiff would not be in existence. A comparison between the state of non-existence and the plaintiff's current state is clearly not justiciable on conventional principles.

Policy factors also dictate great caution. There is a risk that the recognition of a wrongful life claim will devalue the sanctity of life in general, and the plaintiff's life in particular. A finding of liability may be interpreted as a finding that the plaintiff's life is a legally recognized loss and that he would be better off dead. Recognition of the action would also produce some uncertainty. It is not clear, for example, if the plaintiff's claim depends upon the manifestation of catastrophic disabilities or whether more minor disabilities may also give rise to the action.

Those American judges who favour the wrongful life action emphasize competing policy factors, including the need for deterrence against negligent physicians, the plaintiff's great need for adequate future care compensation, [Note 38: Those American courts that favour the wrongful life action often restrict damages to extraordinary expenses necessitated by the birth defect.] and the desirability of allocating the plaintiff's losses to the best loss distributor. These factors are, perhaps, more compelling in jurisdictions without public health care and with less well-developed social assistance programs.

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