Greco v. United States

Supreme Court of Nevada
893 P.2d 345 (1995)

ELI5:

Rule of Law:

Under Nevada law, a mother has a medical malpractice claim against a physician whose negligence in prenatal diagnosis denies her the opportunity to terminate a pregnancy of a severely deformed fetus. However, the child born with such defects has no cognizable 'wrongful life' claim.

Facts:

Sundi A. Greco received prenatal care from physicians at Nellis Air Force Base in Nevada.
During her pregnancy, these physicians allegedly failed to perform, or negligently performed and interpreted, prenatal medical tests.
Due to this alleged negligence, the physicians did not discover that Greco was carrying a fetus with severe defects.
Greco was not informed of the fetus's condition, which deprived her of the opportunity to lawfully terminate the pregnancy.
Greco gave birth to her son, Joshua, who was born with numerous severe congenital defects, including spina bifida, hydrocephaly, and paraplegia.
Joshua's conditions result in permanent physical and mental disabilities, requiring extraordinary and lifelong medical and custodial care.

Procedural Posture:

Sundi A. Greco, individually and on behalf of her son Joshua, filed a medical malpractice suit against the United States of America in the United States District Court for the District of Maryland.
The United States moved to dismiss the complaint for failure to state a cause of action under Nevada law.
Finding no controlling precedent in Nevada state court decisions, the U.S. District Court certified questions of law to the Supreme Court of Nevada for resolution.

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Issue:

Under Nevada law, does a physician's negligent failure to timely diagnose severe fetal defects, which denies the mother her right to terminate the pregnancy, give rise to a valid medical malpractice claim for the mother and a 'wrongful life' claim for the child?

Opinions:

Majority - Springer, J.

Yes, as to the mother's claim; No, as to the child's claim. A mother has a valid medical malpractice claim, but a child does not have a cause of action for wrongful life. The mother's claim is not a novel 'wrongful birth' tort but a standard medical malpractice action based on a physician's breach of the standard of care. The physician's negligence caused a cognizable injury: the loss of the mother's legally protected right to choose whether to carry a severely deformed fetus to term. This injury is distinct from the birth of a healthy child, which is not a legally cognizable harm. The damages flowing from this injury include the extraordinary medical and custodial expenses for the child's lifetime of dependency and the mother's emotional distress, without an offset for the 'benefits' of parenthood. The court rejects the child's 'wrongful life' claim because it would require the judiciary to make an impossible comparison between a life with severe impairments and the 'utter void of nonexistence,' a calculation the law is not competent to perform.

Concurring-in-part-and-dissenting-in-part - Shearing, J.

I concur that the mother has a valid malpractice claim, but dissent from the denial of the child's cause of action. The impaired child should be allowed a 'wrongful life' cause of action to recover the extraordinary expenses attributable to the impairment. The court should not become mired in the philosophical difficulty of comparing life to nonexistence, but should instead focus on the public policy objectives of tort law: compensating injured parties and deterring future wrongful conduct. The reality is that the child exists and suffers due to the physician's negligence. Allowing the child to sue directly ensures that the ability to recover the crushing burden of extraordinary expenses does not depend on the 'wholly fortuitous circumstance of whether the parents are available to sue.'

Analysis:

This decision establishes a significant precedent in Nevada by recognizing a mother's cause of action for negligent prenatal diagnosis, which the court carefully frames within traditional medical malpractice doctrine rather than creating a new 'wrongful birth' tort. This approach solidifies the legal injury as the deprivation of the right to choose abortion, directly linking malpractice to the loss of a constitutional right. By allowing recovery for extraordinary lifelong care costs and emotional distress without an offset, the court provides a robust remedy for parents. The firm rejection of the child's 'wrongful life' claim aligns Nevada with the majority of U.S. jurisdictions, reinforcing the legal principle that courts are incapable of valuing impaired life against nonexistence, thereby setting a clear limit on the scope of tort liability in this area.

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