From: | Sandy Steel <as730@cam.ac.uk> |
To: | 'Robert H Stevens' <robert.stevens@ucl.ac.uk> |
CC: | 'Neil Foster' <neil.foster@newcastle.edu.au> |
obligations@uwo.ca | |
Date: | 09/04/2009 23:57:54 UTC |
Subject: | RE: Causation/Loss of chance in medical cases |
Thanks for the response.
So we agree that
(i) Loss of chance represents an epistemic uncertainty regarding some state
of the world.
I also agree that
(ii) ""Negligence in the air" isn't enough to prove a wrong". (There are
however three interrelated concepts under the "no negligence in the air"
idea: that the tortious aspect of the conduct must be a factual cause of
some harm; that the harm is not pre-empted; and that (roughly) the harm is
within the risk: Wright (1985) Cal.L.Rev)
So turning to the proposed explanation of the cases where the law imposes
liability for loss of chance:
"Negligence "in the air" isn't enough to prove a wrong. You need to be able
to show that it was your rights which were violated, which the patient can
do as against the doctor who has assumed responsibility towards her, but
those who live in the vicinity of the chemical factory cannot"
But the no "negligence in the air" point does not map onto the point that
loss-of-chance liability can be explained by instances where there has been
a rights-infringement and loss-of-chance damages are awarded as
consequential losses. (Obviously, the negligence in the air point (in its
first two meanings) is an application of the principle that the right must
have been infringed: but the principle is obviously broader, applying
outside negligence, and outside wrongs which require causation of some harm,
e.g. trespass). I don't see why an "assumption of responsibility" meets the
negligence in the air point, it does not establish (absent a contract) an
infringement of right where the duty imposed by the assumption of
responsibility is breached (it does not establish causation)
If the response to that is: well, that shows how flimsy the distinction is
between bringing the claim in contract and tort for loss of a chance, then
we can't say that liability is "explained" by where there is an infringement
of right since we acknowledge in the response that that is a distinction
(between bringing in contract where we have a nominal breach and
infringement of rights and tort where we don't) without a difference.
And if we then say, more substantively, that "assumption of responsibility"
explains recovery for pure economic loss, and recovery for loss of chance of
avoiding economic loss, and recovery for loss of chance of avoiding physical
injury then we are, I think, pushing it a little. Though as I said, some
subscribe to a view along those lines : Goldberg and Zipursky in the article
I cited; and Perry (1995, ed. Owen, Philosophical Foundations of Tort). But
this line still leads to the problem of why recovery should ever be more
than proportionate in this context. If we say in principle C should recover
in full where he can show D wronged him on the BoP, then do we treat the
loss-of-chance claim as a subsidiary claim? I don't think this is met by
Rob's point, elaborated in his Torts and Rights (2007), that we have to
distinguish with regard to Smith v. Leech Brain between an infringement of
right and the quantification of consequential loss. I think this distinction
can be accommodated by a better concept of causation, like NESS, which
relegates Baker v. Willoughby/Jobling-like problems to valuation of damages.
But I don't see why putting this doctrinally as matter of damages should
hide the fact that damages are reduced to account for the probability that
due to a non-tortious factor it might have happened anyway.
Secondly, Rob wrote:
"The last point [whether consequential damages had to be proved in the US to
be reasonably likely to occur] is an issue of remoteness and is the same in
England. Where you seek recovery for consequential loss you have to satisfy
Hadley v Baxendale."
I would be wise not to disagree with that! But I didn't mean to dispute
anything about remoteness. It is one thing whether damages are too remote
(whether they are not within Hadley limbs (1) and (2)). It is another thing
whether, even if they are not too remote, what standard of proof will be
applied in determining whether the defendant caused them. In the US, I
think, one must show with regard to future loss (and past loss - no weird
distinctions based on third parties' actions as far as I know) that the type
of damage is reasonably foreseeable (remoteness), but also that is more
likely than not that the D caused it. Whereas in England, one can claim for
the loss of chance of obtaining some past/future benefit. That effectively
means that a lower standard of proof is applied to some future loss (one can
obtain damages for a harm less than 50% likely to occur).
Finally, sorry for rambling on, but one last point. I disagree with the
conclusions Rob draws from his analysis of the factory-chemical example:
"If I negligently release a noxious chemical which 100,000 people inhale, if
25 years later there are 150 cases of lung cancer when without the release
there would have been only 100, all of those who suffer from the disease can
show that I have caused them to lose the chance of avoiding the disease but
none can show that I have injured/wronged them as on the balance of
probabilities each would have suffered the disease anyway".
Ex ante, Rob argues, the risk exposure each of the 100,000 suffers is
1/2000. Ex post, only the 150 who suffer actually lose a chance of 1/3:
"Only the 150 people who develop the disease suffer a lost chance (1/3) of
avoiding the cancer they have". This is supposed to show that the increased
risk of avoiding harm in the future is not the same as the loss of chance of
avoiding a harm.
This is true, but it is only true because we have more data when we know
that the 150 people have suffered cancer; we have a better idea as to the
probability that the defendant has caused the individual C's harm. We know
that 100 were doomed anyway and that 50 got cancer through the D's agency.
We do not know who belongs in which class. It is therefore impossible to say
that all those who suffer the cancer "actually" lost a chance (Rob does not
use this word, but it is a contrast implied in his analysis)- some of them
didn't - they were doomed: all we have is just a better approximation for
each of the 150 that the defendant caused their cancer. There would thus be
no inconsistency for the law to award damages for loss of chance before the
harm actually occurs: some people are doomed; some are not. We are in
exactly the same situation when the harm occurs; we just have better
probabilities.
I'll be amazed if anyone makes it to the end of this,
Cheers,
Sandy