BAILII is celebrating 24 years of free online access to the law! Would you consider making a contribution?
No donation is too small. If every visitor before 31 December gives just £5, it will have a significant impact on BAILII's ability to continue providing free access to the law.
Thank you very much for your support!
[Home] [Databases] [World Law] [Multidatabase Search] [Help] [Feedback] | ||
Scottish Court of Session Decisions |
||
You are here: BAILII >> Databases >> Scottish Court of Session Decisions >> Holdich v Lothian Health Board [2013] ScotCS CSOH_197 (19 December 2013) URL: http://www.bailii.org/scot/cases/ScotCS/2013/2013CSOH197.html Cite as: 2014 GWD 10-182, 2014 SLT 495, [2013] CSOH 197, [2013] ScotCS CSOH_197 |
[New search] [Help]
OUTER HOUSE, COURT OF SESSION
|
|
|
|
A28/05
|
OPINION OF LORD STEWART
in the cause
RICHARD HOLDICH
Pursuer;
against
LOTHIAN HEALTH BOARD
Defenders:
________________
|
Pursuer: O'Brien QC, Love; Balfour & Manson (for Foot Anstey Sargent Solicitors, Exeter)
Defenders: Stephenson QC, D Ross; NHS Scotland Central Legal Office
19 December 2013
[1] This is a
case about the failure of one of the storage vessels in a sperm bank, otherwise
"a cryogenic storage facility". The facility was apparently owned and managed
by the defenders. I say "apparently" because this is not actually spelled out
in the written pleadings. The defenders are a statutory provider of health
services. In 1992 the pursuer, then aged 22, deposited three sperm
samples in the defenders' facility. He did this before having treatment for
testicular cancer which, he was advised, would, and which in fact did, make him
infertile. He deposited his sperm to preserve his chances of becoming a
father. The pursuer later married. In August 2001 the pursuer requested
his stored sperm so that he and his wife could try and have children by in
vitro fertilisation [IVF]. He was then told that there had been a
malfunction.
[2] The
malfunction involved a leak of the cooling medium, liquid nitrogen. Because of
the leak the temperature of the storage vessel rose for a period from minus 190o
C to minus 53o C. All of the pursuer's sperm was stored in
the affected vessel. The initial advice to the pursuer was that his samples
could have been damaged and should not be used. The apprehended damage reduces
the chances of conception and increases the risk of chromosomal abnormalities,
miscarriage and birth defects. After a period of discussion, during which
conflicting advice was offered, the pursuer decided not to proceed with IVF
using his sperm samples. He avers that his decision was a reasonable one. The
samples remain in cryostorage. The pursuer claims compensation from the
defenders for distress, depression and loss of the chance of fatherhood, all on
the basis that damage to his sperm samples was caused by the defenders'
negligence. The loss of the chance of fatherhood is characterised as "loss of
autonomy".
[3] The case
comes to me on the procedure roll for a debate on the defenders' preliminary
plea, the question being whether, as the defenders submit, the pursuer's
pleadings demonstrably fail to disclose a cause of action relevant in law, or
which could be relevant, for recovery of damages for distress, depression and
loss of autonomy. For present purposes I have to take the pursuer's averments pro
veritate. The defenders argue that even if all the facts averred by the
pursuer are proved he has failed to state a relevant case for compensation
under the heads claimed: the law does not compensate for mental injury, in
this case distress and depression, in the situation postulated by the pursuer; the
law does not generally compensate for "mere distress"; and the law does not
recognise "loss of autonomy" as a compensable head of claim. These are, it is
said, questions of "pure" law which can be decided on the pleadings without
proof of the facts. Parties agree that the Jamieson test applies, the
question being whether the action will necessarily fail, the onus being on the
defenders who seek dismissal at this stage [Jamieson v Jamieson 1952
SC (HL) 44 at 50 per Lord Normand].
[4] The pursuer's
case is presented primarily as a claim for mental injury consequential on
property damage in breach of contract et separatim, secondarily, as
a claim for "pure" mental injury in delict, that is on the basis of fault at
common law, et separatim, if somewhat faintly, as a novel type of
claim for damage to sperm, neither person nor property but something sui
generis, with consequential mental injury, again on the basis of
common law fault. The main issues include the following: is the pursuer's
mental injury consequent on bodily injury, is it "pure" mental injury or is it
mental injury consequent on damage to sperm characterised as moveable property
or something else sui generis; does damage to the sperm samples
constitute personal injury, is it damage to the pursuer's moveable property or
is it something else; did the act of handing over the samples for storage
effect a gratuitous contract of deposit for safekeeping, depositum, of
the pursuer's moveable property between the pursuer and the defenders;
is the question of the defenders' liability for the pursuer's mental injury to
be decided by contractual rules or by delictual rules? These are not just
categorisation controversies: how these issues are decided could make the
difference, I am told, between recovery of damages and non-recovery.
[5] I heard
legal argument on these issues over eight days ending on 17 May 2013 and
made avizandum. I have now decided to reserve the defenders'
preliminary plea and to allow parties a proof of their respective averments
before answering the questions of law. I take the view that the claim in delict
for "pure" mental injury caused by negligent out‑of‑body damage to
sperm is apt for proof and certainly cannot be rejected out of hand. If the
delictual case is to go to proof I think the property-contract case should be
remitted for probation too. Though I am not necessarily convinced that the property-contract
case as currently presented is sound in law, equally I am not convinced that,
if differently presented, it is bound to fail and, anyway, no additional
evidence will be required. A separate reason for allowing proof on all matters
is that the case raises questions of novelty and importance in a developing
area of law which demand to be answered after all the facts are known. I am
well aware that lots of books, book chapters and journal articles have been
written about the issues touched on in this opinion. Academics may be
irritated by the opinion's apparently narrow knowledge base and by my failure
to address the philosophical, ethical and policy considerations: but court
judgments are about particular disputes and have to be based on the arguments
and material presented. There are time constraints and funding constraints. In
the present case counsel on both sides have to be complimented on the
assistance they have given within these constraints.
Personal injury
claims for damage to gametes
[6] The
authorities to which counsel refer plainly show that the law has no difficulty
compensating mental injury and losses consequent thereon where the mental
injury is itself a consequence of or associated with negligently caused bodily
injury, even though the bodily component may be trivial. However, both sides
agree, rightly or wrongly, that the law as it stands is antagonistic to the
idea that damage to stored sperm can constitute bodily injury. I say "rightly
or wrongly" because no court in Scotland has actually ruled on the question; and
it is not obvious to me that a Scottish court would necessarily negative the
proposition. Would it be unreasonable to extend the concept of injury to
damage to viable bio‑matter produced or removed for the purpose of the
living subject's own reproduction or medical treatment? Clearly there is such
a thing as out‑of‑body treatment, for example high‑dose
radiation of cancerous organs removed to protect surrounding tissue. Thinking
of autologous grafts, transplants and transfusions, would it be far‑fetched
to deal with viable bio‑matter outside the body as part of the subject's
person? Would it do violence to the law? Would it run counter to current
norms of medical practice? Would it be inconsistent with the regulatory
regimes? Would it offend morality?
[7] This class
of bio‑matter includes ovarian tissue intended for re‑implantation
to facilitate conception in vivo. Would it then be unreasonable to
treat gametes, male or female, intended for in vitro fertilisation as
part of the subject's body, or possibly bodies in the case of unimplanted
embryos? In Yearworth the Court of Appeal noticed the German law theory
of the "functional unity" [eine funktionale einheit] of stored gametes
with the living body. The theory is a plausible one to my mind [Yearworth
& Ors v North Bristol NHS Trust (CA) [2010] QB 1 at § 21 per Lord
Judge CJ giving the judgment of the court; BGHZ 124, 52 (VI ZR 62/93),
09.11.1993 (key words, Schmerzensgeldanspruch, Vernichtung, Spermakonserve),
English translation in the web site of The University of Texas School of Law,
http://www.utexas.edu/law, Institute of Transnational Law, foreign law
translations University of Oxford, Institute of European and Comparative Law
and Professor B S Markesinis].
[8] The Court
of Appeal also stated: "Ancillary to the object of the later possible use of
the sperm is the need for its storage in the interim." As a matter of statutory
interpretation, effective cryostorage of semen is arguably a practice "designed
to secure that embryos are in a suitable condition to be placed in a woman"
and, on that view, cryostorage is a practice authorised in the course of
providing treatment services under the Human Fertilisation and Embryology Act 1990
["the 1990 Act"]. Thus it can be said that the 1990 Act envisages the
keeping of gametes for the subject's own reproduction as being, if not
treatment in itself, an activity which is ancillary to the provision of
treatment services; the statutory consenting regime follows the therapeutic
model; and there is a subtle indication that the legislature thinks of out‑of‑body
harm to gametes as injury giving rise, potentially, to tortious liability rather
than as property damage for which a contractual or contractual‑type
remedy might be available [Yearworth & Ors v North Bristol NHS
Trust (CA) [2010] QB 1 at § 45(f) per Lord Judge CJ giving the
judgment of the court; Human Fertilisation and Embryology Act 1990 s. 2,
sched 1 para 1 and sched 3; Human Fertilisation and Embryology Act 2008 Act
s. 44, inserting new section 1A in the Congenital Disabilities (Civil
Liability) Act 1976].
[9] I have to
confess that I do not have the same difficulty with the idea of functional
unity as the Court of Appeal did in Yearworth. The Court of Appeal
rather pushed the theory aside, stating that the 1993 decision of the
Bundesgerichtshof had been superseded by the repeal of section 847 (in
2002, I believe) and the substitution of a new section 253 of the German
Civil Code on "intangible damage" [immaterieller schaden]: but ―
I do not know ― is it possible that section 253 now gives
legislative effect to the 1993 decision? There is, however, no point in
discussing the pros and cons of functional unity on this occasion: pursuer's
counsel, junior and senior, categorically repudiate the idea that damage to
sperm samples could be injury to the pursuer's body, even in the alternative;
and so I have to judge the case, as it is presented, on the basis that it is
not a claim for bodily injury with consequential mental injury [Yearworth
& Ors v North Bristol NHS Trust (CA) [2010] QB 1 at §§
18―24 per Lord Judge CJ giving the judgment of the court].
Delictual claims for
"pure" mental injury
[10] Actionable
negligence has to involve fault, a breach of duty. The common law fault theory
depends on the neighbourhood principle: a duty of care is owed to persons who
are neighbours in law, to persons, that is, who are in a relationship of
proximity to the wrongdoer and within the reasonably foreseeable ambit of harm.
In cases of bodily injury proximity can be subsumed to the extent that
reasonable foreseeability alone appears determinative of the duty relationship.
Conversely, a duty to take care not to cause "pure" mental injury tends to be
recognised only where the proximity test is independently satisfied. "Proximity"
refers variously to the propinquity of the claimant to the harmful event in
time and space; to the relationship of the claimant, if not the original
victim, to the original victim; and to the connection of the claimant with the
alleged wrongdoer, for example through a pre‑existing contractual nexus
but certainly not limited to contractual situations. Other controls, not
necessarily determinative of the duty relationship, are designed to exclude
recovery for harm below a certain threshold of gravity and ― absent
foreknowledge of special susceptibility ― for remote and idiosyncratic
reactions: this is, I think, where the concepts of "nervous shock", "ordinary
fortitude" and "recognised psychiatric condition" fit in. Considerations of
"distributive justice", of what is "fair, just and reasonable" and whether
there has been "assumption of responsibility" by the wrongdoer are occasional
visitors to the debate [McLoughlin v O'Brian [1983] 1 AC 410; Alcock
v Chief Constable of South Yorkshire (HL (E)) [1992] 1 AC 310; Page
v Smith [1996] AC 155; McLoughlin v Grovers (A Firm) otherwise
McLoughlin v Jones (CA) [2002] QB 1312; Campbell v North
Lanarkshire Council & Anor 2000 SCLR 373; Anderson
v Christian Salvesen Plc 2006 SLT 815; Rothwell v Chemical
& Insulating Co Ltd & Anor (CA) [2006] ICR 1458 and ((HL)E) [2008] 1 AC 281].
[11] The
perceived complexities and anomalies of the law of damages in delict for "pure"
mental injury have been discussed for a number of years and are currently the
subject of consultation in advance of intended legislation. The Scottish Law
Commission has described the existing law as "unprincipled" and "as suffering
from defects and being in need of reform": I think, with respect, that "unprincipled"
is possibly going too far; and the question of "defects" is a matter on which
opinions differ. Nonetheless, true it is that "pure" mental injury claimants
present the court with two main challenges. The first challenge is to decide
whether their claims belong in the "sole victim" or "primary victim" category
and, for claims that do not, the second challenge is to decide whether the Alcock
control mechanisms for "secondary victims" are satisfied [Scottish Law
Commission, Report on Damages for Psychiatric Injury, Scot Law Com No
196 (HMSO, Edinburgh, 2004) §§ 1.4, 1.9, 3.5; The Scottish Government, Civil
Law of Damages: Issues in Personal Injury - a Consultation Paper (Edinburgh,
2012); Alcock v Chief Constable of South Yorkshire (HL (E))
[1992] 1 AC 310 at 406H-407B, 410G-411B per Lord Oliver of Aylmerton].
[12] Returning
to the case as presented, the pursuer avers: "The sperm was the property of
the pursuer"; and the claim is formulated, primarily, as one not of reparation
for mental injury in delict but as one of reparation for damage to moveable
property on the ground of breach of contract with consequential mental injury. If
the formulation seems startling, it is ― whether or not jurisprudentially
sound ― explicable. In the absence of "functional unity", the pursuer has
suffered no bodily injury as a result of the cryogenic debacle. He says that
he has suffered mental injury and he wants the law to give him redress. There
are apparently 20 other cases waiting in the wings in some of which
claimants say they have suffered not just mental injury but also financial loss
consequent on mental injury.
[13] The
pursuer's lawyers, including the solicitor who acted for the plaintiffs in Yearworth,
apparently see the combination of property and contract law as the pathway to
compensation for mental injury for two reasons, namely (1) because this
approach has the blessing, more or less, allowing for different terminology, of
the Court of Appeal of England & Wales in the Yearworth case; and
(2) because the Hadley v Baxendale rule for damages in breach of
contract is thought to be capable of accommodating the pursuer's claim for
compensation for mental injury without the need to grapple with the delictual proximity
test and additional control mechanisms. The property‑contract theory is
supported by Professor McBryde in an article on the implications of Yearworth
which has clearly influenced the pursuer's pleadings and argument [Hadley
v Baxendale (1854) 9 Ex 341; Yearworth & Ors v North
Bristol NHS Trust (CA) [2010] QB 1; W McBryde, "Contract law ― a
solution to delictual problems?" 2012 SLT (News) 45].
[14] As
Professor McBryde acknowledges, this way forward was signposted in the
2007 article by Edinburgh trainee solicitor Matthew Boyle. The article
was cited by Lord Hope of Craighead in the pleural plaques cases Rothwell
and Ors, particularly in connection with the Grieves claim for
anticipatory anxiety and depression where there was no actual bodily injury. Rothwell
and Ors was founded on in Yearworth at the first instance for a different
purpose. The learned district judge appears to have appreciated its true
significance, for he said in the last paragraph of his judgment: "If there had
been a contract... by the terms of which the defendants agreed to provide
facilities for maintaining viable sperm, then... it seems to me that the
claimants would be entitled to compensation" [M Boyle, "Contractual
remedies of employees at common law: exploring the boundaries", Jur Rev 2007,
2, 145 at 149―150; Rothwell v Chemical & Insulating &
Co Ltd [2007] 3 WLR 876 at § 59 per Lord Hope of Craighead,
also at § 7 per Lord Hoffman and at § 74 per Lord Scott
of Foscote; Yearworth & Ors v North Bristol NHS Trust, 12
March 2008, WL 5044430 at §§ 34, 159, 166].
Can you put a kilt on
Yearworth?
[15] The
defenders say that the pursuer is "trying to put a kilt on Yearworth",
something that cannot be done. Yearworth was about six cancer
patients who, prior to chemotherapy, had deposited sperm samples in the
cryostore at Southmead Hospital Fertility Unit, Bristol. Before use, the
samples thawed because of a freezer failure and, it was assumed, became
unviable. The claims were variously for mental injury, distress and loss of
the opportunity to become a father. "None of the claims", said the Court of
Appeal, "amounts to a paradigm case" [Yearworth & Ors v North
Bristol NHS Trust (CA) [2010] QB 1 at § 12 per Lord Judge CJ
giving the judgment of the court].
[16] On the
trial of preliminary issues at the first instance, District Judge Griggs
dismissed all six claims, holding inter alia that damage to sperm
stored for use by the providers did not constitute personal injury; that damage
to sperm did not constitute loss of property; and that if damage to sperm
constituted loss of property such loss did not found a claim for damages for
mental injury. The plaintiffs appealed. During the hearing in the Court of
Appeal, at the prompting of the bench, the plaintiffs amended their notices of
appeal to claim that their sperm samples were personal property, that there had
been "gratuitous bailment" of their sperm samples and that the defendants were
in breach of their undertakings to take care of the samples. The court also
allowed the plaintiffs to lodge copies of the storage requests, consent forms
and information leaflets. These had not been available to the learned district
judge.
[17] The Court
of Appeal held that damage to sperm did not constitute personal injury: but,
allowing the appeal, that the claimants had ownership of their sperm for the
purpose of their claims in tort and, as amended, bailment; that there had been
gratuitous bailment of the sperm to the defendants' storage unit; that the
bailment was closely akin to a contract having as its object fertility
preservation with peace of mind for the claimants; that there had been a
breach by the defendants as bailees of a specific promise to store the sperm at
minus 196o C; and that it was open to the claimants to recover
damages in bailment for reasonably foreseeable distress and mental injury. The
actions were remitted to the county court for determination of the remaining
issues [Yearworth & Ors v North Bristol NHS Trust (CA) [2010] QB 1 at 2C-3B, at §§ 56―60 per Lord Judge CJ giving the
judgment of the court].
[18] The
defenders cite the Encyclopedia for the proposition that a Scots lawyer
"is likely to be perplexed and bewildered by a book on the law of property in
England". It is important to know, according to the defenders, that "the
English law of bailment... is so fraught with principles peculiar to English
contract law and the proprietary torts that it cannot be equiparated with the
Scots law on the subject". The defenders point out, correctly, that bailment
can be "akin to contract" but is not a contract, whereas the nearest Scots
equivalent, deposit, is contractual; and that Yearworth does not
address either the question of the power of statutory health authorities to
make contracts with individual patients or the question of contractual intent. Both
questions arise in the present case. As will appear in what follows, the
defenders also criticise the reasoning in Yearworth on its own terms [The
Laws of Scotland: Stair Memorial Encyclopedia (Edinburgh, 1993) vol 18,
part I: General Law, §§ 2, 6; vol 8, Deposit, § 1, note 3].
[19] As to the
facts, the defenders submit that six facts determined the issue of liability in
bailment in favour of the Yearworth plaintiffs: but four of those facts
are absent in Mr Holdich's case. The four facts are as follows. In Yearworth
there was an express promise by the defendants to "look after" the sperm
"with all possible care"; in Yearworth the fertility unit held itself
out as able to deploy "special skill" in preserving sperm; in Yearworth the
defendants admitted a breach of its duty of care in tort and, by analogy, on a
hypothetical basis, a breach of duty of care in bailment; and in Yearworth
the defendants made and broke a particular promise to store the sperm at
minus 196o
C. It was the breach of the particular promise to store the sperm at
minus 196o C that persuaded the Court of Appeal that any damages
should be "more akin to that referable to breach of contract rather than to
tort" so that damages might properly include compensation for "mental distress"
[Yearworth & Ors v North Bristol NHS Trust (CA) [2010] QB 1
at §§ 6, 13, 25, 46―50, 56―59 per Lord Judge CJ giving the
judgment of the court].
[20] The pursuer
submits:
"It would be extraordinary and unfortunate if a man whose sperm was stored in Scotland had no right of action, whereas his brother in England did have the right in terms of Yearworth, all in the context of a United Kingdom-wide statute [the Human Fertility and Embryology Act 1990]."
As the defenders say, there are bound to be hard cases. There are hard cases under the 1990 Act as well. Evans was a hard case for the plaintiff which would have gone the other way in some jurisdictions [Evans v United Kingdom [2007] 1 FLR 1990].
Circumstances of
cryostorage in the present case
[21] The
pursuer in the present case avers that his samples were delivered on 18 March,
3 March and 1 April 1992. The pursuer does not further specify the
circumstances of the constitution of the claimed contract of deposit at that
time. No documentation relating to the storage of the pursuer's sperm in 1992
has been produced. The pursuer has tendered a pro forma relating to
another patient dated 12 February 1993 and an information leaflet which
may have been issued to patients around that time. Both documents have the
hospital's telephone number as 031 332 2525. The "031" area code was
superseded by the "0131" area code on 16 April 1995. The pro forma is
headed "Department of Surgery (Urology) - Infertility Clinic", is signed on
behalf of Mr T B Hargreave, consultant urological surgeon, and is
addressed to the patient's general practitioner. It informs the general
practitioner that his patient has been referred to the clinic by another
hospital for "long term sperm storage" and continues:
"This service is provided by our laboratory for patients in Scotland and is directly financed by the Scottish Home and Health Department. The service is designed for young men who are about to have cancer chemotherapy which is likely to sterilise... I enclose a copy of an explanatory leaflet I have given to your patient."
The information leaflet says nothing about consenting procedures. It assumes that the samples are intended for use by "you and your wife" and that insemination will be carried out in vivo, adding: "This does not hurt in any way and indeed some couples can learn to do the technique themselves." The leaflet says nothing about fertilisation in vitro.
[22] The long
term storage service is stated to be free. It is explained that the sperm are
stored in vials in liquid nitrogen. Answering the question "What if something
goes wrong with the storage?" the leaflet states:
"We cannot guarantee to keep samples stored in the event of strike action interrupting our supplies of liquid nitrogen or other civil disturbance. However we will always do our best to keep samples safely."
As to the duration of storage the leaflet states:
"We usually undertake to store samples for five years. At the end of that time we contact you to ask whether you wish the samples kept for longer. Sometimes we are unable to contact one of our patients at the end of the five year period and if this happens we will then dispose of the stored samples..."
Words that might be open to interpretation (had the document been agreed or incorporated in the pleadings as part of the pursuer's case) include "service", "undertake", "patients" and "wishes". Whether or not the document plays a direct part in the pursuer's case, it is not disputed that it is the defenders' information leaflet.
[23] The pursuer
avers that: "Continued storage was subject to the pursuer's consent." The
pursuer makes the following averment about a communication from the defenders
on an unspecified date:
"Mr Hargreave, a consultant urological surgeon, wrote to the pursuer on behalf of the defenders. He confirmed that they held three sperm samples in their long term storage bank. He informed the pursuer that the defenders intended to store the samples until 2024 but that they would enquire every five years as to whether he wished the samples to remain in continued storage. The pursuer was informed the defenders would not normally destroy sperm samples without his permission."
The significance of "2024" is not explained: but I note that the pursuer was born in 1969 and will be 55 in 2024, the age of 55 being effectively the statutory age limit for gamete retention in terms of the 1990 Act s. 14(3) as amended by the Human Fertilisation and Embryology (Statutory Storage Period) Regulations 1991/1540. The letter referred to by the pursuer has not been produced. The defenders refer to a letter of 21 April 1994, which may be the same document.
[24] The pursuer
was contacted in about March 1996. The defenders sent him an undated letter
signed on behalf of Mr Hargreave enclosing the "legal sperm storage form"
headed "HFEA(91)6 FORM OF CONSENT TO STORAGE AND USE OF SPERM AND EMBRYOS",
which the pursuer completed by ticking yes/no choice boxes as follows:
"1. USE
a. I hereby consent to the use of my sperm for the following purposes
i. in treating any partner of mine YES
ii. in treating others NO
iii. in any project of research NO
b. I hereby consent to the use of my sperm to fertilise egg(s) in vitro and to the use of embryo(s) developed from these egg(s) for the following purposes
i. in treatment of myself together with my partner YES [here the full name of the pursuer's wife was inserted in the space provided]
ii. in treating others NO
iii. in any project of research NO
STORAGE
I hereby consent to the storage of my sperm or embryo(s) developed in vitro from egg(s) fertilised with my sperm:
a. Storage period in years, Sperm Maximum [10 years] YES, Embryos Maximum [5 years] YES
b. If I die or become mentally incapacitated my sperm or the embryo(s) developed in vitro from egg(s) fertilised with my sperm should:
i. be allowed to perish, Sperm NO, Embryos NO
ii. continue in storage for purposes given in 1a. (for sperm) and 1b. (for embryos), Sperm YES, Embryos, YES
iii. continue in storage for other purposes, Sperm NO, Embryos NO"
The pursuer signed the form on 21 March 1996 and returned it. The defenders acknowledged receipt. A copy of the completed form is produced.
Is there a claim for
breach of statutory duty?
[25] The
defenders submit that there is no need to strive for a remedy for breach of
duty at common law, as the Court of Appeal did in Yearworth, because the
pursuer has a remedy for breach of statutory duty or, rather, had a remedy
which, unfortunately for the pursuer, the defenders say, is now time‑barred
and extinguished by prescription. This statutory duty argument was not advanced
in Yearworth.
[26] The
defenders argue that the 1990 Act s. 17(1)(c) provides the basis of a
remedy by way of breach of statutory duty. The provision enacts:
"17 The person responsible
(1) It shall be the duty of the individual under whose supervision the activities authorised by a licence are carried on (referred to in this Act as the "person responsible") to secure-
[...]
(c) that proper arrangements are made for the keeping of gametes and embryos ... "
The defenders submit that the provision is conceived in favour of individuals who have provided bio-matter for storage; and that failure to discharge the duty gives rise to civil liability. There is textbook support for this interpretation, so it is said [A Grubb (ed), I Kennedy and A Grubb, Medical Law, 3rd edn (London, 2000), 1308]:
"In our view, the 1990 Act is so emphatic in its commitment to the wishes of the gamete-providers that a court might well take the view that a private right of action should arise. The provisions of Sch 3 clearly contemplate gamete-providers as the beneficiaries of the obligations imposed upon licence-holders. The argument gains force from the fact that otherwise the aggrieved party might not have a remedy in law for breach of the terms of this Act."
[27] Since the
text book was written, the 1990 Act has been amended by the Human Fertilisation
and Embryology Act 2008 ["the 2008 Act"] which, by section 44,
inserts a new section 1A in the Congenital Disabilities (Civil Liability)
Act 1976. The effect of section 1A is to give a right of action to
disabled children for congenital disabilities resulting from "any act or
omission in the course of... [inter alia] the keeping...
outside the body of... the gametes used to bring about creation of the
embryo" [emphasis added]. The right of action is conferred where the
defendant would have been liable in tort to the parent or parents;
"and it is no answer that there could not have been such liability because the parent or parents concerned suffered no actionable injury, if there was a breach of legal duty which, accompanied by injury, would have given rise to the liability."
The defenders submit that the new provision recognises the potential civil liability to all affected persons of "the responsible person", whose duty it is to secure that "proper arrangements are made for the keeping of gametes" [emphasis added]. I have been offered no judicial or academic commentary on this wording though I do notice that it is taken from the original section 1, in which setting it is more immediately intelligible. The 1976 Act does not apply to Scotland for the reason that the Scottish Law Commission, almost 40 years ago, took the view that Scots law already accorded a right of action to live born children injured in the womb [Hansard HL Deb, 27 May 1976, vol 371, cols 356-87; Scottish Law Commission, Report on Liability for Antenatal Injury, Scot Law Com No 30, Cmnd 5371 (HMSO Edinburgh, 1973), §§ 8―21].
[28] I reject
the defenders' argument that the 1990 Act creates a private right of
action against, and imposes civil liability on "responsible persons" for breach
of statutory duty. Kennedy and Grubb may be correct that any handling of
gametes and embryos except in accordance with the informed consent provisions
of Schedule 3 could give rise to civil liability: but that is a different
matter; and it does not involve "responsible persons" as such. There is
nothing in the 1990 Act which suggests an intention to impose unqualified,
"non‑delegable" liability on individual clinicians such as Mr T B
Hargreave, consultant urological surgeon, who appears to have been the
"responsible person" in this case, for breach of section 17 obligations. Section 17
of the Act is part of the bundle of sections headed: "Grant, revocation and
suspension of licences." I read section 17 as imposing responsibility for
activities carried out under the licence as part of the regulatory scheme, the
sanction for non‑compliance being suspension or revocation of the
licence. Section 44 of the 2008 Act contains no reference to
"responsible persons" or breaches of obligations imposed on "responsible
persons" by the 1990 Act. For completeness defenders' counsel are unable
to tell me what is the nature of the interest which gives gamete‑providers
title or standing to sue on the statute, whether it is a matter of infringement
of a property right or a matter of personal injury or some other interest such
as being a gamete‑provider; and the defenders' pleadings contain not a
hint that the case should have been directed against their consultant
urologist.
The pursuer's property
theory
[29] As
stated above, the pursuer's case is founded primarily on the proposition,
following Yearworth, that the sperm samples are his property. The
pursuer submits that "the key to the analysis" is the division of the Roman law
into the law of persons and the law of property. (This alludes to the texts
which tell us: "The whole of the law... relates either to persons, or to things,
or to actions.") Senior counsel points to the pursuer's averment: "The sperm
was the property of the pursuer." Corporeal moveable property in Scots law
includes, according to Bell's Principles "all things which, being
themselves capable of motion or of being moved, may be perceived by the senses
― seen, touched, taken possession of..." According to Ms O'Brien QC,
senior counsel for the pursuer, sperm is perceptible by four of the five
senses. At the next stage of the argument "the key to the analysis" is said to
be "possession". The institutional writers evidence the reception into Scots
law of the Roman law doctrine of occupatio ― the constitution of
property by original possession. Stair says: "The first and most simple way
of constitution of property, is by the possession of things..." In Bell's Principles
we find:
"The original modes of acquisition depend either on the first effectual apprehension of the subject having no owner; or on a natural, accidental, or intentional change, by which a new subject of property is produced... As to things not hitherto appropriated, the general rule is, that they belong to the occupant; quod nullius est, fit occupantis. Shells, pearls, pebbles, or precious stones on the sea shore; animals ferae naturae, beasts, birds, fish,― fall under this rule."
The matter is elaborated by junior counsel for the pursuer by reference to Shetlanders capturing small whales by driving them into a bay and slaughtering them there. By depositing his ejaculate in a receptacle, then handing it over for storage, the pursuer was clearly taking possession of his sperm (and constituting it as his property by occupatio), or so it is said. There is text book support for the application of occupatio to separated body parts. The pursuer quotes Erskine's Institute to support the proposition that the statutory restrictions on the use of stored sperm and the limitations on use which are part of the supposed contract of deposit are perfectly compatible with a right of property:
"All rights which affect any subject are called by the Romans iura in re, and by us, real rights; and the sovereign or primary right is that of property; which is the right of using and disposing of a subject as our own, except insofar as we are restrained by law or paction..."
These propositions, together with the Yearworth analysis, are the essentials of the pursuer's property theory [J More (ed), J Dalrymple, Viscount Stair, The Institutions of the Law of Scotland, a new edition (Edinburgh, 1832), vol 1, II. i. 29 ― the pursuer gives the citation "II. i. 33", only part of which has been copied for my use: the full sentence in section 29 does not, I think, support the pursuer's argument; W Guthrie (ed), G Bell, Principles of the Law of Scotland, 10th edn, (Edinburgh, 1899), §§ 1285―1289; The Laws of Scotland: Stair Memorial Encyclopedia (Edinburgh, 1993) vol 18, part I: General Law, §§ 3, 5, 11, 540―544; M Earle and N Whitty, "Medical Law" in The Laws of Scotland: Stair Memorial Encyclopedia, Reissue (Edinburgh, 2006), § 346; J Nicholson (ed), J Erskine, An Institute of the Law of Scotland (Edinburgh, 1871), II. i. 1; Yearworth & Ors v North Bristol NHS Trust (CA) [2010] QB 1 at §§ 25-29, 45 per Lord Judge CJ giving the judgment of the court].
The defenders' no‑property
theory
[30] The
defenders' no‑property theory also goes back to the Romans. In Yearworth
Lord Judge CJ began the discussion by quoting a passage from the Digest
of Justinian, nodding in the direction of its deployment to such effect by
Lord Rodger in Bentham five years earlier. "Dominus membrorum
suorum nemo videtur: no‑one is to be regarded as the owner of his
own limbs, says Ulpian in D.9.2.13. pr." [Yearworth & Ors v North
Bristol NHS Trust (CA) [2010] QB 1 at § 30 per Lord Judge CJ
giving the judgment of the court; Regina v Bentham [2005] 1 WLR 1057 at § 14 per Lord Rodger of Earlsferry].
[31] The
defenders tell me that prior to the decision in Yearworth, subject to
one closely defined exception, no United Kingdom court had ever held that human
bio‑matter, living or dead, could be owned. The exception is where skill
and labour have been applied to alter the quality of the thing [Dobson v
North Tyneside Health Authority [1997] 2 WLR 596 and Reg v
Kelly [1999] QB 621] applying Doodeward v Spence (1908) 6 CLR 406]. Legislative policy is generally consistent with the no-property
principle. The Human Tissue (Scotland) Act 2006 s. 20 criminalises
commercial dealing in body parts for transplantation, as does the Human Tissue
Act 2004 s. 32 while preserving the common law "application of human
skill" exception. Gametes are excluded from the tissue enactments for the
reason that they are controlled by separate legislation. The defenders argue
that Parliament has had opportunities to address the property issue, to
innovate on the common law and to permit ownership but has not done so: see
the current human tissue statutes and the Human Tissue Act 1961, Human
Organ Transplants Act 1989, Human Fertilisation and Embryology Act 1990,
Human Fertilisation and Embryology Act 2008 and subordinate legislation. The
Evans case at first instance provides a helpful summary of the
background to the 1990 Act. The relief sought by Ms Evans in respect
of a claimed proprietary/ possessory interest in the embryos in terms of ECHR
protocol 1, article 1 was not granted [Evans v Amicus
Healthcare and Ors [2003] 4 All ER 903 at §§ 4(e) 16, 17].
[32] The
relevant legislation at all material times was the 1990 Act, now amended
by the 2008 Act. The defenders submit that the provisions and effect of
the 1990 Act supported by Human Fertilisation and Embryology Authority
[HFEA] Code of Practice 2001 are incompatible with the normal indiciae of
ownership: it cannot be said that the pursuer has "the right of using and
disposing of" the samples of his own sperm or that he has "the right of use,
enjoyment and abuse" of the samples. It is illusory to suggest that the
samples are owned by the pursuer or are his property. In this context it is
futile to ask whether living tissue is capable of being owned at common law: the
1990 Act prevents sperm submitted for storage from being owned and treated
as property. In this connection the defenders refer particularly to the
1990 Act ss. 4(1), 12(1)(e), 13(5), 14, 16, 17 (a)―(e), 23, 24,
schedule 2 and schedule 3; and to the HFEA Code of Practice (2001)
paragraphs 9.21―9.27; 10.2, 10.3, 10.15.
[33] Yearworth,
the defenders say, expressly elides the concepts of legal ownership and
possessory title. According to the defenders, the Yearworth approach is
an innovation on the common law or, as the Court of Appeal put it, a "re‑analysis"
of the common law's traditional approach. The Court of Appeal believed the
"easiest approach" would have been to apply the Doodeward-type "skill
and labour" exception, equating freezing with the application of skill and
labour. The defenders dispute this on two grounds: first, they submit, the
purpose of freezing is not to change the attributes of the thing but to
preserve its attributes; secondly, they say, the "skill and labour" approach
in the hands of the Court of Appeal begs the question of ownership since, as Doodeward,
Kelly and Dobson make clear, changing the attributes of a thing
by the application of skill and labour vests ownership of the new, different
thing in the craftsman or specificator, that is ownership transfers on
this hypothesis to the person who does the freezing [Yearworth & Ors v
North Bristol NHS Trust (CA) [2010] QB 1 at § 45(c) per Lord Judge
CJ giving the judgment of the court].
[34] The
defenders question how much support Professor Honoré's article on
ownership, cited at paragraph 28 of Yearworth, actually gives to
the Court of Appeal's property thesis [A M Honoré, "Ownership", in A
G Guest (ed), Oxford Essays in Jurisprudence (1961) ch v, 107]. According
to the defenders, Professor Honoré's article gives the impression that
there cannot be ownership without most if not all of the incidents of
ownership. The pursuer in contrast has none of Professor Honoré's
incidents of ownership, or at least none in an unqualified way. Even without
the intervention of the 1990 Act it is difficult to see what incidents he
enjoys. The Court of Appeal avoided quoting the passages about body parts at
pages 129 and 130 of the article. The passage at page 129, as
quoted in Yearworth at the first instance, is as follows [this is also
how the text is quoted in B Björkman and S O Hanson, "Bodily
rights and property rights", J Med Ethics, 2006 April; 32(4): 209-214: but
the photocopy - of the 1961 text in the Advocates Library apparently - produced
to me is different]:
"In other cases again, we speak not of having a thing but a right in or to something. Thus, a person does not either own or have his body or liberty, though perhaps he owns dead parts of his body such as his hair and nails. In general he has, instead, a right to bodily security or liberty, and a right to determine how parts of his body, such as his kidneys, are to be used during his lifetime if he chooses to forego their use or, being dead, no longer has use for them. Here the analogy with the ownership of a thing is tenuous. These rights are either inalienable or can be dealt with only by something in the nature of a gift."
Both texts include the key words, in relation to the subject's use of his or her own body parts: "Here the analogy with the ownership of a thing is tenuous." These key words were not quoted in Yearworth. The only one of Professor Honoré's eleven incidents of ownership founded on by the Court of Appeal, say the defenders, is "the right to use"; and that incident is severely circumscribed [Yearworth & Ors v North Bristol NHS Trust (CA) [2010] QB 1 at § 28 per Lord Judge CJ giving the judgment of the Court; Yearworth & Ors v North Bristol NHS Trust, 12 March 2008, WL 5044430 at §§ 61―63].
[35] The Court
of Appeal noticed two Californian decisions, Moore and Hecht. The
Court of Appeal apparently derived much assistance from Hecht; and Hecht
is founded on by the pursuer in the present case. The defenders in the present
case submit that the Californian decisions have to be treated with
caution for the reason that the cases were decided against a different common
law and statutory background. In Moore a clinician and a researcher
employed by the university medical centre had patented a cell line established
from bio-matter obtained, the plaintiff alleged, without his informed consent. The
Supreme Court of California, by a majority, dismissed the action insofar as
founded on conversion of personal property and allowed the action to proceed
insofar as based on breach of fiduciary duty and lack of informed consent
holding that
"the laws governing such things as human tissues, transplantable organs, blood, foetuses, pituitary glands, corneal tissue and dead bodies deal with human biological materials as objects sui generis rather than abandoning them to the general law of personal property."
The reference to "the laws governing such things" is a reference to various statutory provisions. The defenders in the present case submit that, similarly, in the United Kingdom, gametes are sui generis, have been subject to comprehensive statutory provision and are not subject to the general law. In Hecht a probate court, at the instance of the adult children of the deceased's former marriage, William Kane junior and Katharine Kane, granted an order for destruction of frozen sperm samples intended by the deceased to go to his "girlfriend" Deborah Hecht. On appeal in 1993 the California Court of Appeal, Second District, decided that the deceased's interest in his stored sperm fell within "the broad definition of property" in the California Probate Code s. 62: accordingly the California Court of Appeal vacated the order for destruction and remanded to the probate court to decide the question of testamentary validity [Moore v Regents of University of California, 51 Cal 3d 120; 793 P 2d 479; 271 Cal Rptr 146; Hecht v Superior Court, 16 Cal App 4th 836; 20 Cal Rptr 2d 275].
Discussion: property,
dispositional control and sui generis
[36] At
the time of the hearing I did not understand the significance of the pursuer's
submission about the mode of production of the pursuer's samples. I did not
understand why pursuer's junior counsel insisted that the property issue was
"fact sensitive"; and that allowing the evidence to be led would enable the
court to appreciate how the sperm samples had been produced. I guessed that
the production process involved masturbation and, frankly, I thought the
submission ridiculous. As I now understand it, the property theory advanced in
this case does actually depend on the gamete‑provider "capturing" his own
sperm: on this basis the particular way in which the sperm samples were
produced is an essential fact. Essential facts ought to be set out in the
pleadings. The pursuer's pleadings say nothing about how the samples were
produced. All the pleadings say is that the samples were delivered for
storage.
[37] I cannot be
persuaded that a theory which, as I now understand it, depends on the mode of production
of the sperm samples is a good one. Ideally, I should have thought, there
ought to be symmetry in the legal treatment of male and female gametes: but
the occupatio argument, as presented, has to be stretched too far if it
is to fit the harvesting and storage of female ova. Maybe the clinician in
such a case is to be characterised as an agent effecting occupatio on
behalf of the patient. On the other hand both parties seem to agree that there
is no contract in relation to the provision of treatment in terms of the
National Health Service (Scotland) Act 1978 ["the 1978 Act"] so that,
presumably, there is no scope for a contract of agency either. Pursuer's
senior counsel recognises this difficulty and simply asks me to confine my
decision, expressly, to male gametes: but what about sperm harvesting or sperm
retrieval, of which the Blood case is an example?
[38] I
understand that the mode of production, called electro-ejaculation in Blood,
involves the insertion of an electric probe into the rectum. Shocks are
administered, increasing in strength until ejaculation occurs. This may result
in retrograde ejaculation, that is, sperm being discharged into the subject's
bladder, where it is collected via a catheter. The similar case of L,
we are told, also involved orchidectomy, that is surgical castration,
authorised by court order. To whom does the sperm belong when these techniques
are used; and is it correct to postulate only permanently or terminally
comatose, dying subjects and dead subjects. The answer to the latter question
is "no" since the technique of electro-ejaculation is available for paraplegic
patients. What happens to ownership if the patient recovers consciousness,
say, or ceases to be paralysed? The ownership‑by‑original-possession
argument plays no part in the Yearworth reasoning; and I suspect that
pursuer's counsel, junior and senior, misunderstand the minimalist Yearworth
property theory, possibly because too anxious to address the criticism made
by the defenders [R v Human Fertilisation and Embryology Authority
Ex parte Blood [1999] Fam 151 at §§ 2 and 29; L v The
Human Fertilisation and Embryology Authority [2008] EWHC 2149 (Fam) (03
October 2008) at § 19; Yearworth & Ors v North Bristol NHS Trust
(CA) [2010] QB 1 at § 37 per Lord Judge CJ giving the judgment of
the court].
[39] Ulpian's
principle that no one should be regarded as owning his or her own body or body
parts is capable of being misunderstood. The principle does not mean ―
as Yearworth might suggest to the unwary ― that living human
bodies cannot be owned. On the contrary, as Ulpian emphasises, while the free
man has no action under the property-damage provisions of lex Aquilia
for injury to his own body he does have a remedy for injury to the slave who is
his property; the non‑ownership principle was not so entrenched that it
prevented the praetor (or an interpolator) from giving an action by analogy, actio
utilis, to the injured free man; and there were non‑aquilian remedies
or sanctions for the mutilated limbs and broken bones of free men. The
distinctions between free and slave, person and property, for these purposes,
were superseded in the Civil law. In Innes we find counsel pleading lex
Aquilia to support the claims of the unfortunate tenant farmer who fell
into an unfenced excavation designed to accommodate ― rich irony given
Edinburgh's notorious trade in cadavers ― the professor of anatomy's body
store. Ultimately the sources, Roman and Civil law sources and native Scots
law, merged and solatium came to be recognised as the head of damages
for pain and suffering arising from bodily injury as well as for hurt feelings
and other non‑patrimonial losses [D McKenzie and R Evans‑Jones,
"The Development of Remedies for Personal Injury and Death" in The Civil Law
Tradition in Scotland (Stair Society, Edinburgh, 1995), 277; Innes
v Magistrates of Edinburgh and Ors 1798 M 13189; ALSP, Faculty
Collection, 1797―1798, no 60; D.9.2.29.7; Allan v McLeish 1819
2 Murray's Jury Court Reports 158; D Walker, The Law of Delict in
Scotland, 2 edn rev (Edinburgh, 1981), 23; J Blackie, "Unity in Diversity:
The History of Personality Rights in Scots Law", in N Whitty and R Zimmermann
(eds), Rights of Personality in Scots Law: a Comparative Perspective (Dundee,
2009), ch 2].
[40] Paradoxically,
one anxiety attaching to the treatment of body parts as property is that it
will take us full circle back to Ulpian's frame of reference, back to an
acceptance that bodies can be commodities, back, in other words, to slavery. Another
anxiety is about the commodification of genes and genotypes: in Moore
the California Supreme Court denied the conversion remedy partly on the ground
that extending property claims to human bio‑matter would harm medical
research. On the other hand, of course, propertising genetic discoveries for a
period by patenting is an incentive to innovation [Moore v Regents of
University of California, 51 Cal 3d 120; 793 P 2d 479; 271 Cal Rptr
146; cf. Association for Molecular Pathology v Myriad Genetics Inc,
United States Supreme Court, issued 13 July 2013].
[41] At the end
of the day senior counsel for the pursuer accepts a number of the defenders'
criticisms. She distances herself from the phrase "transferrable right of
ownership" used by her junior though continuing to support the existence of a
"transferable right of possession"; she accepts that even if gametes are
"property", they cannot be transferred mortis causa notwithstanding
contrary views expressed in other jurisdictions in Bazley, Edwards
and Hecht; and she concedes that the cases of Dewar, Welsh,
Rothery, Kelly, Stevens, Herbert and Hecht turn
on specialities and, while interesting, do not support the proposition that
bio-matter not subject to the application of skill and labour is susceptible of
ownership at common law. I was not told whether stored gametes vest in the
trustee in bankruptcy, or are arrestable ad fundandam jurisdictionem:
but during the discussion of contracts of deposit, junior counsel for the
pursuer told me - without explaining why - that gametes have to be excepted
from the rule that deposited property is attachable for debt [Bazley v Wesley
Monash IVF Pty Ltd [2010] QSC 118; Jocelyn Edwards; Re the estate of
the late Mark Edwards [2011] NSWSC 478; Dewar v HM Advocate
1945 JC 5; R v Welsh [1974] RTR 478; R v Rothery
[1976] RTR 550; Reg v Kelly [1999] QB 621; Stevens v Yorkhill
NHS Trust 2006 SLT 889; commentary on the case of R v Herbert
in "'The Rape of the Lock': is it Larceny?", 25 J Crim L 163 (1961)].
[42] Hecht (1993)
influenced the Court of Appeal's thinking on the property question in Yearworth
and through Yearworth the property theory fed into the Queensland
decision in Bazley, then into the New South Wales decision in Edwards
and now the Western Australia decision in ex parte C [Re section 22
of the Human Tissue and Transplant Act 1982 (WA) ex parte C [2013] WASC 3].
Hecht (1993) turns out to have been one stage in ― I discover,
having checked simply to find out whether the decision noticed in the Court of
Appeal of England & Wales had been appealed ― a protracted litigation
which took the case to the Second District Appeal Court three times. The
after-story is noticed in a British Columbia case JCM v ANA 2012
BCSC 584 (not cited by counsel).
[43] In a sense
the Hecht story starts and ends with Parpalaix, the decision of a
French court in 1984, the earliest decision that I have seen cited about
disposition of stored gametes post mortem. Parpalaix was brought
to the notice of the Californian court through an American secondary source,
E D Shapiro and B Sonnenblick, "The Widow and the Sperm: the
Law of Post‑Mortem Insemination", 1 J Law & Health (1986-87) 229. Thanks
to the Judges' Library and the Taylor Law Library, University of Aberdeen, I
have a copy of the specific report from which the journal article was drawn. I
understand that the Parpalaix facts cannot be repeated since posthumous
insemination is now prohibited by French law [TGI Créteil, 1er août
1984 Parpalaix c/ Centre d'étude et de conservation du Sperme [CECOS]: Gaz
Pal 1984 (2e sem) 560; le loi 94-654 du 29 juillet 1994].
[44] One thing
that the American article makes abundantly clear, expressing the matter in
common law parlance, is that the Tribunal de Grande Instance de Créteil firmly
and expressly rejected the claim in "bailment" of the widow Corinne Parpalaix. The
tribunal refused to accept that stored sperm could be moveable property for the
purpose of the articles of the French Civil Code which govern "contracts of
deposit":
"Les règles du contrat de dépôt telles qu'elles sont définies par les art. 1915 et s[uivants] C[ode] c[ivil] ne peuvent s'appliquer à la présente espèce qui concerne non pas une chose tombant dans le "commerce" mais une sécrétion contenant le germe de la vie et destinée à la procréation d'un être humain." [The rules governing contracts of deposit as defined by article 1915 and following of the Civil Code cannot apply in this case which concerns not a commodity [cf. article 1128] but a body fluid which contains the seed of life destined for the creation of a human being.]
A determining argument was that, if deemed to be moveable property, the sperm would descend to the heirs, to be divided among them according to the laws of inheritance without any consideration for the procreative intentions of the deceased. (The tribunal spared itself from addressing the conundrum whether, subject to the Civil Code article 315, the nasciturus might inherit the property responsible for his creation.) The widow won on the basis that the pseudo‑deposit of the sperm involved a presumed stipulation that the sperm would be returned to the provider or to her for whom it was intended [à celle à qui le sperme était destiné]. As later happened in Blood, where reference was made to the Book of Common Prayer 1662, importance was attached to the fact of marriage, and to the traditional primary purpose of marriage, namely the procreation of children. M and Mme Parpalaix married two days before his death.
[45] The
mischief foreseen by the tribunal of Créteil came to pass in California. By
virtue of the decision in Hecht (1993) the probate judge on remand ruled
that the fifteen vials of cryostored sperm should be distributed as residual
"assets" in terms of the 20:40:40 scheme of arrangement entered into by the
girlfriend and the two children to settle the will contest, three vials to the
girlfriend and twelve to the children. When the first two attempts at
impregnation failed, the girlfriend appealed. In Hecht (1996) the
justices of the California Court of Appeal, Second District, qualified their
property theory, this time putting the word "property" in inverted commas and
holding:
"to the extent that this sperm is 'property' it is only 'property' for [the girlfriend]. As such it is not an 'asset' of the estate subject to allocation, in whole or in part, to any other person whether through agreement or otherwise."
Even the girlfriend could not give, sell or allow the use of the sperm by others, so that dispositional control is exercisable only once, that is at the instance of the provider. The justices returned for guidance to Parpalaix, stating, with approval, that: "This fundamental right [to procreate or not to procreate] must be jealously protected, and is not to be subjected to the rules of contracts". The development of the thinking in Hecht has been recognised in the British Columbia Supreme Court case of JCM [Hecht v The Superior Court of Los Angeles County, 50 Cal App 4th 1289 (1996), ordered not to be published in the Official Reports by the Supreme Court of California on 15 January 1997: see 1997 Cal LEXIS 131; JCM v ANA 2012 BCSC 584].
[46] Ultimately,
the theory of Parpalaix and Hecht seems to be that, in the
circumstances of those cases, the "right" of the provider in his stored sperm
is a highly circumscribed, non‑transferrable right of "dispositional
control" or "dispositional liberty". The wrong done according to Yearworth was
the "preclusion" by the health authority of the pursuer's "right to use" his
sperm for procreation. In reaching its conclusion on "ownership" in Yearworth
the Court of Appeal said:
"... we are fortified by the precise correlation between the primary, if circumscribed, rights of the men in relation to the sperm, namely in relation to its future use, and the consequence of the [hospital] trust's breach of duty, namely preclusion of its future use."
Accordingly, the defenders are correct in saying that Yearworth derives a property remedy from the "right to use", which is only one of Professor Honoré's list of eleven indiciae of ownership; and the pursuer is mistaken in thinking, apparently, that he has to demonstrate ownership in a global sense to be eligible for a Yearworth‑type remedy.
[47] Is it
accurate to say that the defendants' breach of duty "precluded the use by the
plaintiffs of their sperm"? Clearly not, since the problem is not that damaged
sperm cannot be used: the problem is that, when used, damaged sperm has
reduced procreative efficacy. Whether the Yearworth solution is
anything more than a semantic trick of the light which could apply equally
where people lose "the use" of "their" limbs is a matter for debate; saying
that six men have a "right to use" their sperm does not actually tell us
whether the "right" is a property right or a personality right; and, supposing
"the right to use" gametes is somehow different from "using" other parts and
products of the body, the broader question remains whether it is doctrinally
correct, or indeed a useful exercise, to classify stored sperm as "property",
even in the minimalist, Yearworth sense.
[48] Is it a
convenient fiction for the pursuer to say that the pursuer's right of property
is, to use Erskine's words, "restrained by law or paction"? On an alternative
view, the statutory regime masks the weakness of the property argument. The
value of Parpalaix and Hecht (1996) is that they offer
glimpses of how the law might regard stored sperm in the absence of a
regulatory overlay; and a possible conclusion is that the postulated property
right of gamete-providers is so attenuated that it is a distortion to describe
it as a right of property at all. I also wonder whether, if stored gametes are
really the property of the gamete‑provider, in some ample sense, it could
possibly be ECHR compliant, thinking of protocol 1, article 1, to
restrict the owner's rights so that virtually nothing is left of them [J
Nicholson (ed), J Erskine, An Institute of the Law of Scotland (Edinburgh,
1871), II. i. 1; D Carey Miller, Corporeal Moveables in Scots Law,
2nd edn (Edinburgh, 2005), § 1.12; cf Yearworth & Ors v
North Bristol NHS Trust, 12 March 2008, WL 5044430 at §§ 151―152].
[49] Possessory
remedies, interdict and delivery, are available for corpses and bio‑matter
separated from the body: but that fact of itself does not make the objects of
the remedies property; nor does the fact that for certain statutory purposes bio-matter
is to be treated as a "product". I do not say that bio-matter cannot be
property. The British Columbia Supreme Court case of JCM illustrates a
situation in which, on the arguments presented, I can see no private law
objection to treating stored sperm as property. The case is about a female
same‑sex couple who separated from a "spousal relationship" inadvertently
omitting to include thirteen cryostored, anonymous‑donor sperm straws in
their separation agreement. The sperm had been a joint purchase, costing the
parties approximately C$250 per straw. JCM and ANA had impregnated
themselves with some of the sperm; and a child was born to each of them. JCM
started a new spousal relationship with TL. TL wanted to have a child "with"
JCM using the remaining sperm straws so that "their" child would be
biologically related to "the children of JCM's relationship with ANA". ANA
wanted to have the sperm straws destroyed. The Honourable Madam Justice
Russell held that the sperm straws were property and ruled:
"I find that the remaining 13 gametes should be divided between the parties. Assuming it is not possible, or that it is impractical, to divide one sperm straw in half, I award seven sperm straws to the claimant, J.C.M., and six sperm straws to the respondent, A.N.A. J.C.M. will pay A.N.A. $125 for the extra one-half straw she is receiving. Should A.N.A. wish to sell her share of the gametes to J.C.M. that will be her prerogative. She may dispose of them as she wishes."
The question is, if stored gametes have to be labelled in terms of traditional categories, where should the line ― effectively the line of separation from the body ― be drawn between persons and property? [C v Advocate General for Scotland 2012 SLT 103; Dewar v HM Advocate 1945 JC 5 at 14 per Lord Moncrieff; Stevens v Yorkhill NHS Trust 2006 SLT 889 at §§ 59-61; A v National Blood Authority [2001] 3 All ER 289; JCM v ANA 2012 BCSC 584].
[50] An
interesting question was posed by Lady Justice Arden in Evans:
"Another approach might be that the father has some rights of property in his genetic material. But the question posed by this case is, why should he have any right of property in this regard since he would not have had any right of property if sexual intercourse had taken place in the normal course of events?"
Arguably separation from the body takes place not on ejaculation or harvesting but on renunciation by the gamete‑provider of his or her reproductive interest by simple abandonment, by sale or by donation and, if not previously, on death, if no continuing reproductive intention can be inferred. Senior counsel for the pursuer submits, I suspect correctly, that where gametes stored for research are damaged by third party negligence, the cryostorers must have a property‑damage remedy in delict, if not in contract, for any loss: but does this not serve to highlight the limitations of allowing a property‑damage remedy to gamete-providers claiming for mental injury? On the Yearworth analysis the remedy is guaranteed to work only where the action lies against the cryostorers qua bailees [Evans v Amicus Healthcare Ltd & Ors [2004] 2 FLR 766 at § 88 per Arden LJ].
[51] What
happens when the cryostore malfunction is caused, as senior counsel figures, by
careless outside contractors ― a possibility actually hinted at by the
defenders' pleadings in the present case ― without fault on the part of
the bailees? Yearworth left somewhat undecided the question whether
tortious property damage to stored gametes can found a claim for mental injury.
A more effective solution if the object is compensation - and compensation
seems to have been the object in Yearworth ― might well be the
"functional unity" theory of personal injury outlined above. If the theory
offers a satisfactory explanation in the situation described by the defenders'
information leaflet, namely where couples intend "to do the technique
themselves", it may be that there is no serious obstacle to extending its
application to situations where the technological input is greater. If gamete‑providers
are the primary victims of cryostore malfunction, the theory offers the
possibility of accommodating secondary-victim claims, claims for specified
gamete-receivers like Mrs Holdich in this case.
[52] Neither the
property‑bailment theory nor the personal-injury theory, as presently
understood by the courts, seems to offer a remedy for gamete‑receivers
like Mme Parpalaix and Ms Hecht should there be damage to the sperm
after the death of the provider. Is there something to be said for the
defenders' submission that stored gametes are sui generis? The pursuer
also argues, in an alternative submission, that if stored gametes are not
property they are sui generis. These submissions echo the words used by
the Archbishop of York, the Most Revd Dr John Habgood, commenting on the
embryo provisions during the passage of the bill which became the 1990 Act
[quoted in S Andrews and others (eds), Scottish Current Law Statutes
Annotated 1990, (Edinburgh, 1990), vol 3, 37-7]:
"'Conceptus' can bury the idea in the deepest obscurity of the Latin language and I put it forward as a purely neutral term meaning that which is the result of fertilisation up to the time of implantation... One of the difficulties in the debate is that embryology, to coin a phrase, is sui generis. We are constantly trying to apply distinctions which pertain in ordinary life but which do not actually apply in a particular respect. For example, lawyers try to put everything in one of two baskets; it is either a person or a thing. However there are entities which are neither persons nor things..."
"Neither persons nor things" fairly encapsulates, I think, the sui generis submission made, in different ways, by both sides. Is there any need to disambiguate the idea of "his" sperm, or "her" ova or "their" embryos? Accepting the ambiguity permits both personal‑type remedies and property‑type remedies, as appropriate and depending on the situation, without distorting the doctrinal framework. Damage and disputes over control and use are only two of the potential issues. Mistakes happen: the wrong person can end up as the gamete-receiver and embryos can be implanted in the wrong womb. There are succession issues, including, we must not forget, issues about succession to titles of honour and about "perpetuities", and family law issues, if "family" continues to be a meaningful idea. Perhaps we should agree to "resist the almost overwhelming temptation to use established conventional models" [P (Contact), Re [2012] 1 FLR 1068 at §§ 5 and 8]. The issue raised in the present case exists only because of a conjunction of circumstances, namely the possibility of storing gametes and the necessity of combining opposite-sex gametes for human reproduction ― but for how much longer? Senior counsel for the defenders draws my attention to the news report of "a breakthrough in human cloning by turning skin cells into early-stage embryos" [The Independent, 16 May 2013, 6]. I offer a tentative conclusion about the property theory at the end of the following sections which concern the contractual issue.
The statutory
framework for cryostorage and the scope for contracting
[53] The
pursuer characterises the sperm samples as property not as an end in itself but
for the purpose of arguing that the delivery of the samples and their acceptance
by the defenders for safekeeping constituted a gratuitous contract of deposit
between the parties. The threshold question is about the power of the
defenders as a statutory provider of health services to enter into contracts
with service users at all. The framework legislation is the National Health
Service (Scotland) Act 1978 ["the 1978 Act"]. Prima facie
when National Health Service [NHS] providers deliver services to users, they do
so in performance of their statutory functions and not on an individual
contract basis. My assessment of parties' respective positions is as follows: both
sides deny a doctor‑patient relationship, though for different reasons. The
pursuer wants it to be understood that cryostorage services are outside the
1978 Act because in that way it is easier to infer the existence of a
contract between the pursuer and the defenders and to impose contractual
liability for mental injury. The defenders on the other hand wish it to be
understood that cryostorage services are a 1978 Act function so that it is
easier for them to argue against contractual liability: but the defenders also
wish cryostorage to be characterised as something other than a patient‑treatment
function in terms of the 1978 Act because, as they see it, where there is
no "treatment", there is no "relationship of proximity" and it is easier for
them argue against delictual liability for "pure" mental injury.
[54] The
pursuer's primary position is that the defenders provide cryostorage services
in the exercise of powers given by the Human Fertilisation and Embryology Act 1990.
This must be wrong. The 1990 Act is a regulatory measure; the 1990 Act
regulates both private providers and statutory providers without distinguishing
between them; as enacted the 1990 Act does not mention the NHS at all; as
amended by the 2008 Act it mentions the NHS twice, then only in connection
with the protection of patient information in England & Wales; and there
is nothing in the 1990 Act as enacted or as amended that gives statutory
providers the power to provide fertility services or services ancillary to the
provision of fertility services ― certainly the pursuer does not point to
anything.
[55] The well‑publicised
variability of publicly‑funded fertility services from area to area
― some say "inequalities"― hints at a lack of clarity about the
statutory basis for provision. I have taken the liberty of looking at official
literature on the subject. None of the documents I have looked at gives a
clear‑cut answer. The Expert Advisory Group on Infertility Services in
Scotland (EAGISS) recorded in its report published in 2000 that: "The NHS
Executive and its Scottish counterpart have acknowledged that infertility
management represents a healthcare need." It is one thing to say that
something "represents a healthcare need" but quite another to say that it is
within the statutory remit of NHS Scotland to meet the need at tax‑payer
expense. The government's general duty in terms of section 1 of the
1978 Act is
"to promote a health service designed to secure (a) improvement in the physical and mental health of the people of Scotland, and (b) the prevention, diagnosis and treatment of illness, and for that purpose to provide or secure the effective provision of services..."
Between the "treatment of illness" and the "improvement of health" you might think that there is probably sufficient territory to accommodate both fertility services, at least in relation to the traditional NHS heterosexual-couple‑based model, and the storage of gametes, even if regarded as a separate activity. It is a question of definition. The non‑exhaustive statutory definition of illness is:
"'Illness' includes mental disorder within the meaning of [since 2003] section 328 of the Mental Health (Care and Treatment) (Scotland) Act 2003 and any injury or disability requiring medical or dental treatment or nursing".
[Evidence and Equity: A National Service Framework for The Care of Infertile Couples in Scotland (1999), 6; National Health Service (Scotland) Act 1978 ss. 1, 2 and 108, definition of "illness"; Mental Health (Care and Treatment) (Scotland) Act 2003 s. 328, definition of "mental disorder"].
[56] An official
report in 1993 stated:
"It became clear to the [Working Group of the National Medical Consultative Committee] that, apart from the very real personal and social difficulties and the overwhelming sense of failure, infertility should be regarded as a very real health problem for the affected couple. As such, and in the interests of society as a whole, we have concluded that every involuntarily fertile couple should be entitled... to receive diagnosis and treatment under the general provision of the National Health Service... Infertility is a disorder which merits planned investigation and treatment within the National Health Service."
The report also said:
"Cryopreservation of semen is widely available for men who are undergoing testicular surgery, irradiation or chemotherapy, and should be considered in every case as a matter of good practice."
The National Infertility Group 2013 reported as follows:
"11. Infertility is recognised across much of Europe as a disease state which can be treated by appropriate assisted reproductive technology. The World Health Organization (WHO) defines infertility as: 'Infertility (clinical definition): a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. 'The WHO defines health as '... a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.' Infertility, accordingly, is a source of diminished health and social well-being."
It follows that cryostorage as a "fertility preservation" strategy, to use current terminology, can, and could, in 2001, be understood as a treatment or as a service or activity ancillary to treatment [Scottish Office Home and Health Department, Infertility Services in Scotland [Edinburgh HMSO, 1993], foreword, summary, § 109; National Infertility Group Report (Scottish Government, 2013), § 3.1; WHO Revised Glossary on ART [Assisted Reproduction Technology] Terminology 2009, "infertility"; cf. National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012/ 2996, regs 7―9].
[57] It is not
entirely helpful that the defenders should have come into court apparently
unprepared to offer a clear idea of the statutory basis for their cryostorage
activities. In the third speech Mr Stephenson QC, senior counsel for the
defenders, submitted that the pursuer was in a therapeutic relationship with
the defenders' clinicians in 1992 during the time when he underwent cancer
treatment and that he formed a new doctor‑patient relationship in 2001
when he embarked, or attempted to embark on fertility treatment in England with
his wife. The pursuer was not in a doctor‑patient relationship during
the intervening period although the storage of his sperm by the defenders was
"relevant" to his future treatment. Senior counsel proposed that the storage
of gametes for fertility preservation should be understood as one of the "other
services" referred to in section 36(1)(c) of the 1978 Act:
"36 Accommodation and services.
(1) It shall be the duty of the Secretary of State to provide throughout Scotland, to such extent as he considers necessary to meet all reasonable requirements, accommodation and services of the following descriptions-
(a) hospital accommodation, including accommodation at state hospitals;
(b) premises other than hospitals at which facilities are available for any of the services provided under this Act;
(c) medical, nursing and other services, whether in such accommodation or premises, in the home of the patient or elsewhere."
While my preferred view aligns with Yearworth in thinking, contrary to the submissions on both sides of this case, that gamete cryostorage for cancer patients is ancillary to treatment, and therefore, in Scottish terms, part of the section 1 "general provision", I consider that Mr Stephenson's submission about section 36 is not unreasonable; and in any event his interpretation was not directly contested. I also note that the government is assumed, in terms of a provision not referred to by counsel, namely section 44 of the 1978 Act, to have the power to keep supplies of blood and other substances and parts of human bodies "for the purpose of, or in the course of providing, any service under this Act". I should mention in passing that the pursuer's samples are kept in the haematology unit cryostore.
[58] There is
consensus between parties to the extent that the pursuer argues that
cryostorage per se has nothing to do with the improving health or
preventing, diagnosing and treating illness; and that the storage element can
be severed from the fertility treatment element. The pursuer points out that
the defenders' cryostorage service was centrally financed; and that the service
was available for patients "throughout Scotland" rather than for patients only
from the defenders' area. The pursuer submits that general NHS provision for
prevention, diagnosis and treatment is entrusted to area health boards like the
defenders and that the defenders did not provide the storage service as a
health board for their specific area in terms of the legislation. I do not
think that these points controvert the defenders' argument. I think ―
there is a degree of opacity in the wording ― that the provision of
"other services" under section 36(1)(c) of the 1978 Act is not a
function which health boards were necessarily bound to exercise for their areas
in terms of the legislation [National Health Service (Scotland) Act 1978
ss. 1 and 2; Functions of Health Boards (Scotland) Order 1991/570].
[59] I believe
that at the time there were cryostores in three or four regional centres and
that not all health boards were able to provide facilities for the long‑term
storage of blood, body parts and other substances. I note that since 2008 it
has been, expressly, the function of the Common Services Agency of NHS Scotland
to
"exercise the functions of the Scottish Ministers under section 44 of the Act to provide supplies of human blood for the purposes of carrying out blood transfusion, or provide material which has come from a human body and consists of, or includes, human cells, and provide related services for the purpose of, or in the course of, providing any service in relation to the health service".
I do not know what the precise arrangements were between the government and the defenders and between the defenders and other statutory health entities in the period 1992 to 2001 for the provision of cryostorage services: but neither party argues that storing gametes was ultra vires of the defenders; and no one has taken the point that it is for the government or the Common Services Agency rather than the defenders as an area health board to answer the pursuer's claim. I conclude, on, I emphasise, the material and arguments presented to me, that the storage of the pursuer's sperm samples was a service provided by the defenders to the pursuer in exercise of the defenders' functions in terms of the National Health Service (Scotland) Act 1978 [National Health Service (Functions of the Common Services Agency) (Scotland) Order 2008/312 reg 2; National Health Service (Scotland) Act 1978 ss. 2(8), 10(8); cf. Goorkani v Tayside Health Board 1991 SLT 94].
[60] Moving then
to the pursuer's secondary argument, it is said that the 1978 Act allows
parties scope to regulate their relationship by contract. As between clinical
personnel and their patients the current orthodoxy is that, as a generality, no
contractual relationship exists. However, the possibility of contractual
arrangements has been recognised [R Mulherron, "Duties in Contract and
Tort" in A Grubb and others (eds), Principles of Medical Law (Oxford,
2011), chap 3, §§ 3.08―3.14; Reynolds v The Health First
Medical Group [2000] Lloyd's Rep Med 240; Dow v Tayside
University Hospitals NHS Trust 2006 SLT (Sh Ct) 141].
[61] According
to the pursuer, the present case can be distinguished from cases where the
statutory service provider is left with no choice but to provide the service; and
the absence of any need for contractual consideration in Scots law enlarges the
opportunities for statutory providers to contract. Health authorities do make
contracts daily, for example to settle court cases and to provide inoculation
to individuals for foreign travel. The defenders had a choice whether or not
to become fertilisation and embryology service providers. The 1996
consent form completed by the pursuer (above) demonstrates that the pursuer had
freedom to make stipulations for storage and use. The normal rules of contract
apply unless there is conflict with statutory functions. There is no conflict
between the common law duty of depositaries to keep the deposited property safe
and the duty on licence holders in terms of section 17 of the 1990 Act
"to secure... that proper arrangements are made for the keeping of gametes and
embryos ..." The pursuer submits that there are clearly gaps in the statutory
provisions which have to be filled by the common law and one of the gaps is the
legal relationship between gamete‑provider and cryostorer in respect of
the deposit and safekeeping of samples [Pfizer Corporation v Ministry
of Health [1965] AC 512 at 535E―536C per Lord Reid; Norweb
Plc v Dixon (DC) [1995] 1 WLR 636 at 642G―64C per Dyson
J; Wylie v Grosset and Another 2011 SLT 609 at § 20].
[62] The
defenders submit that the issue of a power to contract was not addressed in Yearworth
for the reason that bailment in English law is a non-contractual
relationship. The issue does arise in this case because the nearest Scots law
equivalent, deposit, is a contract. The suggestion of a contractual
relationship implies that the parties were at liberty to decide how the sperm
was to be held, used and disposed of whereas, in reality, the position was
quite the opposite. The whole exercise was subject to strict control in terms
of the 1990 Act and the HFEA code of practice. In any event the known
circumstances were such that they did not give rise to a contractual
relationship. The services to be provided by the defenders in terms of the
1978 Act are to be provided free of charge except insofar as there is
express provision to the contrary. The functions of health boards do not
include the power to conclude contracts with individual patients [National
Health Service (Scotland) Act 1978 ss. 1 and 2; Functions of
Health Boards (Scotland) Order 1991/ 570].
[63] Clearly,
say the defenders, health authorities are empowered to enter into contracts for
the acquisition of land, goods and services: but the delivery of
services is a different matter. Arrangements made by health authorities for
the delivery of their services by other health authorities are called "NHS
contracts" and it is enacted, notwithstanding the name, that "NHS contracts" must
not to be regarded as giving rise to contractual rights and liabilities. The
accepted wisdom is that health authorities do not provide services to patients
and other service users under contract. The no‑contract theory is based
on three principles, the first being the absence of a statutory power to
contract; the second being that statutory agencies, such as health boards,
which are legally obliged to do something are not free to contract to do that
thing; and the third principle being that patients and other service users do
not (in general) provide consideration for services received. [National Health
Service (Scotland) Act 1978 s. 17A; National Health Service (General
Medical Services Contracts) (Scotland) Regulations 2004/115; R Mulherron,
"Duties in Contract and Tort" in A Grubb and others (eds), Principles
of Medical Law (Oxford, 2011), chap 3, §§ 3.08―3.14].
[64] According
to the defenders the cases of Reynolds and Dow do not support the
contract theory. In Reynolds Simmons J held that any suggestion
that the parties intended to enter into the legal relations requisite to found
a contract was negated by the fact that the relationship between the plaintiff
and her general practitioners was a statutory one governed by the National
Health Service Act 1996. In Dow Sheriff Fletcher held that
ordinarily the relationship between a patient and her doctor providing
treatment in terms of the National Health Service (Scotland) Act 1978 is
non‑contractual; and that where the contrary is asserted for the purpose
of suing on breach of contract, a relevant case cannot be instructed without
specific averments about the nature and terms of the contract. The consent
form in the instant case, so the defenders say, is expressed to be a consent to
"treatment" and to storage for the purpose of "treatment" in accordance with
the 1990 Act Sch 3. The pursuer's averments, according to the defenders,
do not face up to the challenge of deriving an intention to contract outside
the public law regime in a situation where both parties were entitled to rely
on the regime in delivering and receiving the service. The contractual claim
is defective by reason of the fact that there is negligible specification of
the circumstances in which the claimed contract was concluded; and there is no
specification of the terms on which it was concluded. No intention to contract
or to enter into a contractual relationship can be inferred from the only circumstance
averred namely the acceptance of the semen for storage [Reynolds v The
Health First Medical Group [2000] Lloyd's Rep Med 240; Dow v Tayside
University Hospitals NHS Trust 2006 SLT (Sh Ct) 141].
[65] I think
that the defenders probably have the better argument on the statutory
provisions; and that the parties were not in a contractual relationship,
principally because the defenders were delivering a service mandated by the
1978 Act. In oral debate pursuer's senior counsel in fact conceded that
if the pursuer did fulfil the medical criteria, the defenders would have been
bound to offer him cryostorage of his semen. I do not deny that there are
areas in which contracts might well exist between statutory health providers
and service users. For example, I should be surprised if health authorities in
Scotland were to contest that they are depositaries in a contractual sense for
patients' belongings handed to their staff for safekeeping in accordance with
protocols.
Was there a contract;
and was it a contract of deposit?
[66] Assuming,
contrary to the foregoing that there was scope for contracting, did parties
actually contract and, if so, what kind of contract did they make? The pursuer
avers that the continued storage of his sperm samples after 21 March 1996
was subject to his consent; and he makes the terms of the HFEA consent form
(above) part of his written case. The pursuer suggests that the consenting
procedure badges the activity as a contractual one. Quite the contrary to my
mind: the consenting procedure, more than anything else, if that is all there
is by way of an exchange of words or wording, undermines the contract‑of‑deposit
theory. The pursuer's consent expresses the idea that he had a right not
to have his sperm stored; and the consent is not easily reconcilable with the
idea that the defenders had a contractual obligation to store his sperm, as
they would if they were contractual depositaries. The pursuer consented to the
storage of his sperm for a certain period. A practical correlative of this
time‑limited consent is that when the consent expires, the sperm must be
allowed to perish, which is exactly what happens under the HFEA scheme.
[67] Without
going too deeply into the matter the HFEA scheme could well represent,
predominantly if not exclusively, the idea of the gamete-provider's "right" to
procreative autonomy as opposed to an idea of property and contract; and it is
plausible that the scheme expresses and respects the primary, underlying
reality which exists, as in Parpalaix and Hecht (1996),
independently of the HFEA scheme. While it is true, as the pursuer submits,
that the absence of payment means that the arrangement was not a contract for
custody [locatio custodiae], it does not follow that it must therefore
have been a gratuitous contract of deposit [depositum] as opposed to the
delivery of a statutory service: to borrow Lord Reid's words, "any
resemblance... is only superficial" [Pfizer Corporation v Ministry of
Health [1965] AC 512 at 535E―536C per Lord Reid].
[68] Some
deference is due to what the parties thought they were doing. The defenders
draw attention to "the surprising conclusion" whereby the Court of Appeal in Yearworth
found "without hesitation" that there was bailment by the plaintiffs of
their sperm samples to the Southmead fertility unit, something which had never
occurred ― with or without hesitation ― to the plaintiffs
themselves. Indeed it was the court that prompted the plaintiffs' lawyers to
make submissions on bailment. In the present case I understand that the
property‑deposit claim did not emerge until after the second Yearworth
decision. I think the defenders are right to raise the question of
intention to contract. To whom did the pursuer deliver his samples; what did
the recipient or recipients say or do that supports the inference of an
intention to contract? Did that person or those persons have authority to
contract on behalf of the defenders? The pursuer offers to prove nothing at
all about the circumstances of the supposed contract.
[69] There is
also difficulty with the idea that any contract was one of deposit, correctly
so called. What the pursuer contends for is "a real contract of proper
deposit", "real" meaning relating to a res or thing, "proper" meaning
that the thing itself rather than an equivalent has to be restored. Deposit or
depositum, it is said, "is to be distinguished from consensual custody"
or locatio custodiae. The first point of distinction ― already
noticed ― is that deposit is a gratuitous contract, whereas custody is a
contract for reward. Another difference, intuitively, is that the obligation
of the depositary is essentially a passive one inferring liability to return
the thing entire, whereas the obligation of the custodier may well be in
addition an active one, to take reasonable care to "prevent injuries incident
to the situation" in which the thing is kept. Some confusion has crept in. Professor McBryde
puts the matter as follows:
"To summarise Bell's Principles (4th edn, para. 70), the obligations of the depositary are (1) not to use the subjects of deposit; (2) not to penetrate or disclose the secret of the deposit; (3) to restore the packet, casket etc. precisely as received; and (4) the subjects must be restored uninjured. Bells' editors somewhat confused the topic by mentioning reasonable care and negligence mainly under the influence of English authorities (10th edn, para. 212) but Bell did not do this. To him deposit was a contract of strict liability."
The 4th edition is the last edition published during Professor Bell's lifetime. I did question counsel as to why they were citing Guthrie's (10th edition) of the Principles but I am not sure that I got an answer. At one point I was referred to the treatment of gratuitous deposit (depositum) in the 10th edition while counsel quoted the text of some other, I suspect the 7th, edition [W McBryde, "Contract law ― a solution to delictual problems?", 2012 SLT (News) 45 at 47].
[70] Is there a
place for the contract of proper deposit in our law, recognising that it has
the characteristics of a primitive arrangement? I think there is: but I would
not be convinced that it entails, without additional stipulations, liability
for the loss of a thing with a tendency to escape or cause damage, or for the
deterioration of a perishable thing, or for the consequences of loss and
damage, as argued for by the pursuer in this case. Ignorance of the contents of
a package does not sit easily with liability for losses consequent on damage to
the contents. Again, the Romans are said to have qualified the liability of
the gratuitous depositary, restricting it to cases of dolus or culpa lata.
We have largely abandoned the categories of fault. In my view our law
should be slow to recognise a contract of deposit arising merely from the fact
of delivery and acceptance in relation to anything except uncomplicated,
inanimate and imperishable objects, as when Domitius, no capsarius being
in attendance, hands his clothes for safekeeping to the bath keeper. Surely it
is unreal to suppose that anyone would as a matter of contract
voluntarily undertake without payment to look after something that requires to
be stored at minus 190o C for years on end with potential liability
for the thing itself and consequential losses? In Yearworth at the
first instance the learned Judge Griggs envisaged that if there were a
storage contract it might well be fenced with exclusion clauses, by which, I
think, he also meant limitation clauses including possibly a liquidated damages
provision: this is what you find in commercial contracts for sperm cryostorage
[Digest of Justinian, D.1.15.3.5 and 16.3.1.8; W Guthrie (ed),
G Bell, Principles of the Law of Scotland, 10th edn (Edinburgh,
1899), §§ 210―212; W McBryde, The Law of Contract in
Scotland, 3rd edn (Edinburgh, 2007), §§ 9-52―9-59; The
Laws of Scotland: Stair Memorial Encyclopedia (Edinburgh, 1993) vol 8,
Deposit, §§ 1―3, 13, 14; Yearworth & Ors v North Bristol
NHS Trust, 12 March 2008, WL 5044430 at § 166].
[71] The
defenders say that the cases cited by the pursuer are not about the
constitution and existence of the contract, whatever: they are about
prescription, mode of proof, onus of proof and standard of care. In Central
Motors the contract for garaging and washing a motor car, taken and damaged
by a "bibulous joy rider" employed by the garage, was one of safekeeping for
reward (locatio custodiae) or hiring of storage and safe custody
(described as locatio operarum but correctly, perhaps, as described in
the report, locatio operis faciendi). Taylor is about the non‑return
of money; and the issue was as to the onus of proof. Copland is a case
in which a parish clerk asked a carter, as a favour, to take some cheques to
the bank in a neighbouring town and to bring back the proceeds in money. The
carter cashed the cheques and "lost" the money. The defenders submit that,
properly analysed, Copland is not, and was not decided as, a case of
gratuitous deposit. In Uprichard, where a shotgun was left for repair,
the sheriff principal said in terms: "... the present case is not one of
gratuitous deposit" [W McBryde, The Law of Contract in Scotland 3rd
edn (Edinburgh, 2009), §§ 9-52―9-59; Taylor v Nisbet 1901
4F 79 at 83 per Lord Young, at 87 per Lord Moncrieff;
Copland v Brogan 1916 SC 277; Central Motors (Glasgow) Ltd v
Cessnock Garage and Motor Co 1925 SC 796; Uprichard v J
Dickson & Son Ltd 1981 SLT (Sh Ct) 5 at 7; cf. Sinclair v Juner
1952 SC 35].
[72] According
to the defenders, none of these authorities supports the proposition that
depositing samples in a sperm bank for non‑restoration to the
gamete‑provider can give rise to a contract recognised by law as one of
gratuitous deposit. The pursuer argues that the concept of
"restoration" is flexible enough to include applying the property to some use
at the directions of the depositor. My opinion is that the impossibility of
restoration of the thing, were that to be absolutely the case, is not in itself
fatal where the thing is to be used or applied to the directions of the
depositor. There are circumstances in which cryostored sperm can still be made
available if not to the provider at least to the intended recipient for home
insemination [HFEA Code of Practice (2009) §§ 15.4, 15.5].
[73] An argument
which neither side is eager to make is that, if there be a contract, the
contract was one not for storage simpliciter but for storage and use (described
as "treatment") combined. Is there another difficulty? As I understand the
activities mentioned in the 1990 Act as amended and in the HFEA Code of
Practice, and also explained, to some extent, in the case law, sperm is not
cryostored in its "raw" state: each "sample" is prepared and re‑packaged
in a number of "vials" or "straws". If this be the case ― and evidence
might well clarify the point ― it suggests that any contract includes at
least an operis faciendi element. In the Central Motors case,
cited by the pursuer, the Lord President noticed the different incidents
of contracts of deposit, contracts for custody and contracts for labour and,
without expressing a concluded opinion, raised the question whether the law had
properly recognised the distinctions.
[74] My
understanding is as follows. Various types of contract have a safekeeping component.
Where the issue is about safekeeping, it is not generally necessary to observe
the distinctions between the types of contract. The essential point is that
the liability of the contractor for safekeeping is strict. Strict liability is
to be differentiated from absolute liability. Strict liability is prima
facie liability which admits of an exception, the exception being in this
context that the loss or damage is not caused by the fault of the contractor,
the onus being on the contractor. I had thought that part of the reason why
the pursuer wished to insist on a contract for safekeeping was to put the onus
on the defenders to explain how the samples could have been damaged without
fault on the part of the defenders. In oral debate senior counsel for the
pursuer denied this. Whether necessarily or unnecessarily, the pursuer makes
detailed averments of negligence on the defenders' part. Of course, in the
present case the issue may be one of risk rather than actual damage. My
provisional view is that where there is a breakdown, admitted or proved, of
specialist storage facilities involving a risk of damage, the evidential onus
in delictual claims readily transfers to the store operators in relation to
both absence of fault and absence of damage. An interesting argument, not
advanced by the pursuer in this case, is that even if there is no contract
between health service providers and service users, the latter are entitled to
the benefit of the employees' contractual obligations to their employers to
carry out the work with due care [Sinclair v Juner 1952 SC 35; R
v Sault
Ste Marie [1978] 2 SCR 1299; Rees v Darlington
Memorial Hospital NHS Trust [2004] 1 AC 309 at § 148 per Lord Scott of
Foscote].
[75] My conclusion
on the pursuer's property‑contract case is as follows. I am not
confident that it is bound to fail, although, as it has been presented at this
stage, it faces difficulties. I suspect that it could have been put on a
simpler footing, namely that any "thing", not being a living person, in
relation to which the possessory remedies of delivery and interdict are
available, is capable of being the subject matter of a contract for
safekeeping. Sperm in a container is such a "thing". This puts the emphasis on
the res as an object rather than as property. Even Yearworth, I
suspect, without professing knowledge of the law of England & Wales, goes
too far in pursuit of the property theory. Yes, I envisage that the pursuer in
the present case could insist on delivery of his samples to a licensed treatment
provider chosen by himself and his wife; and I envisage that he could invoke
the law to prohibit the application of his samples for an unconsented use, were
that threatened.
[76] Uncertainty
about the precise statutory basis for cryostorage of gametes by the NHS leaves
scope for a contractual argument. Consenting to safekeeping is not necessarily
inconsistent with contracting for safekeeping, just as consenting to medical
treatment need not be inconsistent with contracting for medical treatment, although
as the defenders correctly point out the there is a shortage of detail in the
pleadings, at this stage, to support the idea of contractual intention. The
availability of an analogous remedy in England & Wales must be at least
mildly persuasive in relation to the question whether the pursuer's property‑contract
case ought to be allowed to proceed to proof. If the delictual case is to go
to proof, there is an argument in expediency for allowing the property‑contract
case to go to proof too. As will appear from what follows, I take a positive
view of the relevancy of the delictual case.
The pursuer's
delictual case
[77] My
opinion is that the pursuer's delictual claim, that is the case in negligence
for damages for mental injury, is relevant for proof or at least not so
obviously irrelevant that it cannot be sent for proof before answer. On record
the defenders deny that they owed the pursuer a duty at common law to take
reasonable care in the storage of his sperm. In oral debate the defenders conceded,
and rightly so, that such a duty was incumbent on them. The defenders continue
to deny that they had a "duty to take reasonable care to prevent the pursuer
suffering psychiatric harm and loss of autonomy."
[78] The
pursuer's primary delictual case is for damage to his sperm as property. His
secondary case in delict is for damage to the sperm simply as sperm, something sui
generis, neither person nor property. The pursuer founds on a number of
cases to argue that the primary/secondary victim dichotomy applies to determine
the existence or otherwise of a duty relationship between parties who are not
in pre‑existing legal proximity; that the parties in the present case
were in legal proximity before and during the harmful event by virtue of the provision
by the defenders to the pursuer specifically and by name, whether in terms of a
contract or under statute, of a cryostorage service for fertility preservation;
that, if the primary/secondary victim distinction applies, the pursuer is a
primary victim; that, in either event, the duty relationship being admitted,
the outstanding liability questions, assuming negligence proved, are about the
nature of the pursuer's mental injury, causation, foreseeability and
remoteness; and that all outstanding questions are apt for determination once
evidence has been heard. The pursuer appears to concede that his claim for
distress is relevant only in connection with the contractual claim: but I do
not accept that, for the reasons given below [Attia v British Gas Plc
[1988] 1QB 304; Page v Smith [1996] AC 155 at
180F―181E, 182B―183C per Lord Browne-Wilkinson, at
184A―F, 187E―G, 188G―190F, 197E―H per Lord Lloyd
of Berwick; Barber v Somerset County Council at §§ 3―5,
14―22 per Hale LJ giving the judgment of the Court of Appeal;
approved (reversed on another point) [2004] ICR 457 at § 63 per Lord
Walker of Gestingthorpe with whom the majority concurred; Scottish Law
Commission, Report on Damages for Psychiatric Injury, Scot Law Com No
196 (Edinburgh, 2004), §§ 2.12, 3.5, 3.6; AB & Others v Tameside
& Glossop Health Authority & Anor [1997] PNLR 140; Farrell v
Avon Health Authority [2001] Lloyd's Rep Med 458; W and Ors v Essex
County Council [2001] 2 AC 592; McLoughlin v Grovers (A Firm)
otherwise McLoughlin v Jones (CA) [2002] QB 1312; In re Organ
Retention Group Litigation [2005] QB 506].
[79] Attia was
the sole authority relied on by the Yearworth plaintiffs for the
proposition that there can be liability for psychiatric injury arising from
negligent damage to property. In the present case Attia is the only
authority relied on by the pursuer for the same purpose. Mrs Attia
returned home to find her house ablaze. The fire was the fault of the
contractors who were installing central heating for her. Her claim was
dismissed on a preliminary issue raising the question whether she could recover
damages for "nervous shock". The Court of Appeal allowed her appeal and
remitted the case for trial holding that subject to proof of causation and
foreseeability Mrs Attia could recover damages for psychiatric injury [Yearworth
& Ors v North Bristol NHS Trust (CA) [2010] QB 1 at 4B―F,
at §§ 55 and 60 per Lord Judge CJ giving the judgment of the court;
Attia v British Gas Plc [1988] 1QB 304].
The defenders'
challenge to the delictual case
[80] The
defenders argue that if the pursuer's property and breach of contract case
fails then the claim based on negligence must fail. In all "pure" psychiatric
injury cases the primary/secondary victim dichotomy is relevant. Victims have
to be placed in one category or another so that it can be known whether the
secondary‑victim control mechanisms come into play. The pursuer does not
satisfy the criteria for secondary-victim liability. According to the
pursuer's averments the cryostore malfunction took place between 5 and
8 July 2001; by letter dated 11 December 2001 the defenders informed
the pursuer of the malfunction; by letter dated 5 March 2002 the pursuer
received advice from the defenders that his samples should not be used for IVF;
and thereafter the pursuer experienced "irritability, tearfulness, anger and
negative ruminations" and also "distress", which, on a sympathetic view of his
pleadings, developed in late 2002 or early 2003 into a depressive
disorder of two years duration. The alleged psychiatric injury does not
arise directly from damage to property; the claim in negligence cannot satisfy
the control mechanisms for secondary victims; and the claimed psychiatric
injury did not arise from shock. The pursuer did not have a "close tie of love
and affection" with the "injured party". The pursuer did not witness the
"accident" or the immediate aftermath. The pursuer did not have any direct
perception of the malfunction; and it is axiomatic that direct perception of
the distressing event is essential to found a claim for "pure" mental injury in
delict as a "secondary victim" [In re Organ Retention Group Litigation [2005] QB 506 at § 197; Alcock v Chief Constable of South Yorkshire (HL
(E)) [1992] 1 AC 310 at 400D―402D per Lord Ackner, at
407A―F, 411F―412B, 416D―417A].
[81] The
defenders submit that Attia is not a reliable guide: the outcome is
unknown; the case does not have a significant after‑history; and the
case pre‑dates the Alcock analysis. If you can allow for
equivalence between the Alcock "close ties of love and affection for a
family member" and the Attia "emotional attachment to the family home
and treasured possessions", then, the defenders accept, Attia does meet
the Alcock secondary‑victim test for "pure" psychiatric injury. This
is on the basis of two determining facts, namely (1) that Mrs Attia
was a witness to the harmful event (the fire in that case) and (2) that
Mrs Attia might have been physically injured. Equivalent facts are absent
from the present case. If the Alcock control mechanisms were not to
apply in property damage cases, the defenders say, you would have the anomaly
that it would be harder to get damages for mental injury arising from the death
of a close relative than it is to get damages for mental injury arising from property
damage.
[82] As to
whether the pursuer is a "primary victim", the defenders dispute that the
pursuer can be classed with mental-injury claimants harmed by negligent
provision of professional services, negligent decision-making and negligent
communication. In the Thameside & Glossop cases, once a decision
had been made to impart bad news to patients, namely that they had been exposed
to the risk of HIV infection, there was a duty of care to communicate the news
in such a way as not to cause or to aggravate psychiatric illness: but that
was a matter of admission, not a decision by the court. In Farrell,
another case from Southmead as it happens, nurses at a special care baby
unit mistakenly told the claimant that a premature baby fathered by him had died
an hour before. The corpse ― someone else's dead baby ― was
brought to him and he cradled it in his arms. The judge found that the event
caused "nervous shock" and contributed to the development of post‑traumatic
stress disorder [PTSD] so that damages should be awarded to the claimant as a
primary victim. In W and Others foster carers suffered psychiatric
illness including reactive depression and PTSD after discovering that their own
children had been sexually abused by a foster child wrongly placed with them by
the local authority. In an appeal against striking out the House of Lords held
that the law did not prevent the parents from being primary victims to whom the
local authority owed a duty of care not to cause psychiatric injury. The
hypothesis was that the illnesses were caused by the parents' feeling of
responsibility for their children's exposure to abuse. McLoughlin was
another appeal against striking out: the Court of Appeal held it to be arguable
that the contractual relationship of solicitor and client gives rise to a duty
of care not to expose the client to the risk of psychiatric injury which might
accompany wrongful conviction. A client who suffered because of a poorly
prepared defence that ignored his express instructions could be regarded as a
primary victim [Scottish Law Commission, Report on Damages for Psychiatric
Injury, Scot Law Com No 196 (Edinburgh, 2004), § 2.12; AB &
Others v Tameside & Glossop Health Authority & Anor [1997] PNLR 140; Farrell v Avon Health Authority [2001] Lloyd's Rep Med
458; W and Ors v Essex County Council [2001] 2 AC 592; McLoughlin
v Grovers (A Firm) otherwise McLoughlin v Jones (CA)
[2002] QB 1312; In re Organ Retention Group Litigation [2005] QB 506].
[83] The Organ
Retention decision is about the retention of pathology specimens removed post
mortem from dead children and subsequently disposed of without further
reference to the parents. In the three lead cases the claimants each claimed
for an adjustment disorder triggered by notification of the retention and
disposal of organs. Gage J found that organ retention consenting
procedures involve a continuing doctor‑patient relationship. His Lordship
held that doctor‑patient relationships are akin to contract; and that
parents who suffer mental shock from acquiring organ retention knowledge are
primary victims of any negligent failure to advise that their children's organs
may be removed and retained. The defenders submit that In re Organ
Retention was wrongly decided: describing the parents as "primary victims"
was a way of avoiding the Alcock controls; and in any event the facts
of In re Organ Retention are wholly dissimilar, partly because of the
continuing doctor‑patient relationship ― which does not exist in
the pursuer's case ― and partly because the claimants were "participants"
in the alleged harmful events, namely the consenting procedures [In re Organ
Retention Group Litigation [2005] QB 506 at §§ 67, 84, 109,
193―226].
[84] The
defenders submit that there cannot be compensation for "pure" psychiatric
injury unless the injury is induced by shock, by, that is "the sudden
appreciation by sight or sound of the traumatic event". In Cross Lord Macfadyen
held that the "nervous shock" control does not apply to primary victims. Cross
was an employers' liability case. According to the defenders, workers are
primary victims because they "participate" in the work of the enterprise and
because employers owe a duty of care to their workers to provide them with a
system of work which safeguards mental health as well as physical wellbeing. As
Lord Hoffman said in White, the breakdown of the employee in Walker
"was caused by the strain of doing the work which his employer had required him
to do" [Wood v Miller 1958 SLT (Notes) 49; Taylorson v Shieldness
Produce Ltd [1994] PIQR P329; Taylor v Somerset Health Authority
[1993] PIQR P262; Sion v Hampstead Health Authority [1994] 5
Med LR 170 (CA); Tredget and Tredget v Bexley Health Authority [1994] 5 Med LR 178; North Glamorgan NHS Trust v Walters [2003] PIQR P16; Cross v Highlands and Islands Enterprise 2001 SLT 1060 at
§§ 61―63; Walker v Northumberland County Council [1995] ICR 702; White and Ors v
Chief Constable of South Yorkshire [1999] 2 AC 455 at 505D―506A per
Lord Hoffmann].
Discussion: delictual
claims for mental injury
[85] The
defenders submit that while Yearworth may have approved the claim in
bailment, it did not unequivocally support the tort claims laid in negligence. This
is correct: but contrary to what the defenders imply, at this stage the point
is one in favour of the negligence claims, not against them. This is because Yearworth
was a trial of preliminary issues. On the trial of preliminary issues the
learned district judge dismissed the plaintiffs' claims determining among other
things that mental injury flowing from damage to sperm could not in principle
give rise to a claim for damages in tort. The Court of Appeal disagreed,
allowed the appeal on this and other points and remitted the case to the county
court. In other words the Court of Appeal decided that the tort claims were
not bound to fail. That is the view that I take of the pursuer's delictual
claims in the present case.
[86] I guess
that the jurisprudence in this area has been shaped in part by the fact that
the common law of England & Wales allows no compensation to family members
in death cases for grief and sorrow. The issue that has taxed the courts was
defined by Dillon LJ in Attia as follows:
"How far is it right that the law should allow a claim for damages against a wrongdoer, where the wrong done by the wrongdoer was primarily a wrong done to someone other than the claimant, and the claimant is a person of whom, at the relevant time, the wrongdoer had no knowledge and who may then have been far away from the scene of the wrongdoer's act?"
His Lordship went on to say, immediately, that the difficulty did not arise in Attia, because, given the pre‑existing relationship between Mrs Attia and British Gas Plc, there was "no problem of proximity". In similar vein Bingham LJ said:
"... there is in this case a special feature... , namely, a special relationship between the defendants and contractors and the plaintiff as occupant of a house in which they were working".
I think it is reasonably clear that the fact that Mrs Attia, not unexpectedly, witnessed the conflagration and the possibility ab ante that she herself might have been injured went to foreseeability rather than proximity [Attia v British Gas Plc [1988] 1QB 304 at 311H―312B and 313D per Dillon LJ, at 314D and 317B per Woolf LJ, at 318E-319E per Bingham LJ].
[87] The
defenders in the present case are mistaken about Attia and about how Attia
was analysed in Yearworth. The Court of Appeal in Yearworth
said this about Attia [at § 55]:
"In Attia v British Gas plc [1988] QB 304, D who was installing central heating in C's home, negligently set it on fire. For four hours C witnessed her home ablaze. This court held that, subject to proof of causation and foreseeability, she could recover for psychiatric injury sustained as a result of it. Bingham LJ, at p 320E, gave a different example of where recovery would lie, namely if
'... a scholar's life's work of research or composition were destroyed before his eyes as a result of a defendant's careless conduct, causing the scholar to suffer reasonably foreseeable psychiatric damage.'
It will be noted that the facts both of the Attia case and of Bingham LJ's different example are of injury sustained as a result of witnessing damage to property. It may be controversial to distinguish between the person who witnesses damage to his property and in consequence suffers psychiatric injury and the person who receives information about damage to it and suffers similarly. On the other hand the distinction does no more than to replicate what, for policy reasons, has been drawn in relation to the so-called secondary victim who foreseeably suffers psychiatric injury as a result of personal injury which the primary victim suffers, or to which he is exposed, as a result of the defendant's negligence: Alcock v Chief Constable of South Yorkshire Police [1992] 1 AC 310. At all events, in the light of what follows, there is no need for us to consider the distinction any further."
The defenders' submission characterises Mrs Attia as a "secondary victim": but clearly the Yearworth judges, assuming without deciding that an Alcock‑type framework was applicable, analysed Mrs Attia as a "primary victim" and saw the Yearworth plaintiffs as potentially eligible "secondary victims". Thus the example proposed by Bingham LJ might have been re‑worked to refer to the burning of Thomas Carlyle's manuscript of The French Revolution by John Stuart Mill's housemaid. The sage of Craigenputtock did not witness the event: but Mill offered him £200 compensation, worth approximately £25,000 in today's money.
[88] The Yearworth
analysis does not purport to be anything other than provisional. I remain
unconvinced, with respect, that the primary/secondary distinction has more than
illustrative value in cases where there is only one victim. The
primary/secondary issue should not arise in sole victim cases where the
allegation is of wrong done directly to the injured party's interests, where
the injured party's identity, as an individual or possibly as a member of a
class, is known in advance to the wrongdoer and where the wrongdoer has a duty
of care by virtue of pre‑existing legal proximity to safeguard the
interest in question.
[89] I also take
the view that the concept of "pure" mental injury is capable of being
misunderstood, as it has been in the present case. The idea derives from
analogy with "pure economic loss" in delict, that is economic loss not
consequent on property damage or personal injury. The descriptor "pure" tends
to be applied to all cases of mental injury not consequent on bodily injury
without necessarily recognising a distinction between cases where mental injury
is the result of a direct assault on the mind in the absence of pre‑existing
legal proximity, of which Page is an example, and cases where there is
pre‑existing legal proximity of which Attia is an example. It is
probably too late to change the terminology: but clearly the Attia type
is less "pure" than the Page type [Page v Smith [1966] AC
155; McLoughlin v O'Brian
[1983] 1 AC 410,
at 418A-423C per Lord Wilberforce].
[90] Observing
this distinction, as indeed the pursuer's written argument does, I understand
it now to be settled that damages for mental injury are recoverable to a
different extent in three types of delictual case, namely (1) usually
where mental injury is associated with bodily injury, (2) exceptionally
where mental injury is "pure" mental injury in the absence of a pre‑existing
relationship and (3) in a range of situations involving mental injury consequent
on wrongful harm to the claimant other than bodily injury, the unifying
principle being pre-existing legal proximity. "Wrongful harm" in this context
extends to include harm to the claimant's rights or other non-patrimonial
interests. Although the claim in the present case is formulated primarily as
one of damage to property, no value is attributed to the sperm; and no claim
is made for the damage to the sperm per se. The non‑patrimonial
interest is characterised by the pursuer as "procreative autonomy". The Yearworth
analysis focuses on the property aspect and does not consider in detail the
non‑patrimonial harm. The idea of "witnessing the event or its immediate
aftermath" is not readily applicable to non‑patrimonial harm or to
microscopic damage or to an appreciation of harm that develops over time, like
the appreciation, through discussion with experts, of the consequences of
thawing on stored gametes. I respectfully agree with the analysis of
Lord Macfadyen in Cross to the effect that "nervous shock",
such as may be produced by witnessing a harmful event, is not necessarily a
pre-requisite for compensable "pure" mental injury [McLoughlin v O'Brian
[1983] 1 AC 410,
at 423A-B per Lord Wilberforce; Cross v Highlands and
Islands Enterprise 2001 SLT 1060 at §§ 61-64].
[91] The
foregoing principles are illustrated - even if not always articulated - in the
cases of Attia, Tameside & Glossop, W and Ors, McLoughlin,
In re Organ Retention and Yearworth founded on by the
pursuer. Stevens is another case that supports the pursuer. In Stevens
temporary judge C J Macaulay QC declined to dismiss a claim for
damages for psychiatric injury by the mother of a deceased infant whose brain
had been removed post mortem and retained for research. The learned
temporary judge held that the unauthorised removal and retention of organs from
a dead body constitute a legal wrong for which damages are recoverable by way
of solatium in Scots law. The defenders in the present case submit that
the juridical basis for this type of claim lies in actio injuriarium,
the remedy for intentional affront to the person (iniuria): the claim
is not one for negligent damage to property (damnum). This is correct: Ulpian
describes mishandling of a corpse as an injury to the heirs actionable by them.
The point in the present context is that the defenders' submission does not
address the pursuer's secondary delictual claim which proceeds on the basis
that stored sperm is not property [AB & Others v Tameside
& Glossop Health Authority & Anor [1997] PNLR 140; Farrell v
Avon Health Authority [2001] Lloyd's Rep Med 458; W and Ors v
Essex County Council [2001] 2 AC 592; McLoughlin v Grovers (A
Firm) otherwise McLoughlin v Jones (CA) [2002] QB 1312; In
re Organ Retention Group Litigation [2005] QB 506; Stevens v Yorkhill
NHS Trust 2006 SLT 889; D M Walker, The Law of Delict in Scotland,
2 edn rev (Edinburgh 1981), 31―32; Digest of Justinian
D.47.10.1.4, also D.47.10.27].
[92] Stevens also
has a case laid in delict. The learned temporary judge decided that there was
sufficient on averment to infer legal proximity. This was notwithstanding the
absence of a doctor‑patient relationship between the parent and the
clinician who carried out the autopsy-consenting procedure. In this way Stevens
reaches the same conclusion as In re Organ Retention by a slightly
different route, the common feature being proximity. The decision in Stevens
argues against the proposition that there has to be a therapeutic nexus before
there can be an ongoing duty relationship in a healthcare setting. Going
further - though it is unnecessary to do so - I should have thought that if
legal proximity were to exist anywhere outside contractual and doctor-patient
relationships, there is as good an argument for its existence between statutory
cryostorage providers and individual service users trusting to the cryostore for
fertility preservation as anywhere else. I reject the defenders' contention
that a therapeutic doctor-patient relationship is the sine qua non of
proximity between health service providers and service users. I note that in Farraj
(a case not cited by counsel) Swift J held that a private third-party
laboratory in contract to provide cell‑culturing services to a statutory
health authority owed an independent duty of care to the plaintiff patients [Stevens
v Yorkhill NHS Trust 2006 SLT 889 at §§ 22, 67, 72, 77-82; Farraj
v King's Healthcare NHS Trust [2006] PIQR P29].
[93] I also
reject the defenders' argument that "participation" is determinative, as in the
"participation" of workers in the work of the enterprise, or the
"participation" of parents in post mortem consenting procedures or,
hypothetically, the "participation" of gamete-providers in cryostore
breakdowns. "Participation" is a strained way of rationalising the type of
cases that involve pre‑existing legal proximity by equating claimants in
those cases with secondary‑victim claimants who are witnesses to the
"traumatic event or its immediate aftermath". The determining factor is rather
that claimants are involved with alleged wrongdoers in a relationship that
gives rise to a duty of care not to cause reasonably foreseeable harm. On
averment the pursuer in the present case was in that sort of relationship with
the defenders, as the defenders now concede [cf. In re Organ Retention Group
Litigation [2005] QB 506 at §§ 196-199; Hunter v British Coal
Corporation and Anr [1999] QB 140 at 162B-H per Hobhouse LJ
dissenting; Taylor and another v A Novo (UK) Ltd [2013] 3 WLR 989 at §§ 25‑28 Lord Dyson MR with whom the other members
of the Court of Appeal agreed].
[94] That being
so, the question is not whether the defenders in the present case owed a duty
to avoid causing mental injury: the question is whether mental injury to the
pursuer was reasonably foreseeable by the defenders as a consequence of any
breach by them of their duty of care. This is, in principle, a question of
fact to be reserved, as it was in Yearworth, for answer after the
evidence has been heard [Yearworth & Ors v
North Bristol NHS Trust (CA) [2010] QB 1 at §§ 54, 55 and 60 per Lord Judge
CJ giving the judgment of the court].
[95] The issue
at this stage is whether the pursuer's averments taken pro veritate are
apt to support the conclusion. The pursuer avers:
"[The defenders] knew or ought to have known [the pursuer] was about to undergo cancer treatment that would render him infertile. They knew or ought to have known, as was obvious, that the storage of sperm was undertaken to provide peace of mind to the pursuer and to preserve his ability to father children. They knew or ought to have known, as was obvious, that knowledge that the sperm was safely stored was likely to provide the pursuer with comfort when he was undergoing treatment for cancer and thereafter once rendered infertile. They knew or ought to have known, as was obvious, that the ability to father children is a deeply personal matter affecting the pursuer's freedom to make decisions about his future family life and integral to his personal autonomy. They knew or ought to have known that if the sperm were to be damaged the pursuer would lose the opportunity to proceed with treatment without additional risk. They knew or ought to have known that if the samples were damaged to the extent there was DNA damage it would be unlikely the samples could be used to effect conception and live birth, even if the pursuer elected to use them. They knew or ought to have known that in the event of such damage the pursuer was likely to suffer loss, injury and damage including psychiatric harm and loss of autonomy, as in fact occurred..."
It would be safe to say that most of the foregoing propositions are axiomatic. If authority be required it can be found in Evans and Yearworth. In Evans in the Court of Appeal Arden LJ said:
"Infertility can cause the woman or man affected great personal distress. In the case of a woman, the ability to give birth to a child gives many women a supreme sense of fulfilment and purpose in life. It goes to their sense of identity and to their dignity."
The averments which do not state the obvious are relevant for proof; and it may be that the proof will be filled out by reference to the thinking of health professionals about the purpose of fertility preservation by cryostorage at the material dates. During the oral debate that I heard, there was virtually no discussion of the third‑stage tests for the imposition of liability in delict for "pure" mental injury, namely "assumption of responsibility", "fair, just and reasonable" and "distributive justice". I assume that, if these tests have a bearing, the defenders are content to discuss their application after the evidence is out [Evans v Amicus Healthcare Ltd [2005] Fam 1 at § 81 per Arden LJ; Yearworth & Ors v North Bristol NHS Trust (CA) [2010] QB 1 at 4B―F, at §§ 10, 53, 57 per Lord Judge CJ giving the judgment of the court].
Damages for
"distress"
[96] In
Evans Arden LJ stated that infertility causes "great personal
distress" (above). The defenders tell me that it is trite that damages for
"mere distress" and "mere anxiety" are not recoverable in delict. In McLoughlin
Lord Bridge said: "The common law gives no damages for the emotional
distress which any normal person experiences when someone he loves is killed or
injured." In Page Lord Lloyd said:
"Shock by itself is not the subject of compensation, any more than fear or grief or any other human emotion occasioned by the defendant's negligent conduct. It is only when shock is followed by recognisable psychiatric illness that the defendant may be held liable."
In the present case the pursuer submits that damages for the distress that he suffered are recoverable as part of his contractual claim but are irrecoverable if his claim lies in delict. The defenders naturally agree. I can understand how the pursuer has come to form this view: but I believe it to be mistaken. On averment, it seems to me, the claim is not necessarily for damages for "mere distress" [McLoughlin v O'Brian [1983] 1 AC 410 at 431G-H per Lord Bridge of Harwich; Page v Smith [1996] AC 155 at 189G per Lord Lloyd of Berwick].
[97] In Yearworth
five of the six claimants alleged that they had suffered "not merely mental
distress but a psychiatric injury, namely a mild or moderate depressive
disorder". The claim of the sixth claimant, Christopher
Waddleton, was described as follows:
"The sixth man alleges that, as a result of the loss of his sperm, he has suffered mental distress and that, inasmuch as it remains unclear whether he has recovered his natural fertility, his distress has continued to date and may well continue in the future. He does not, however, allege that he has also suffered a psychiatric injury."
The Court of Appeal noted that damages for distress are recoverable for breach of contracts which "are not purely commercial but which have as their object the provision of enjoyment, comfort, peace of mind or other non-pecuniary, personal or family benefits". The court held that bailment of sperm samples came within the same principle so that all the claimants including Mr Waddleton would in principle be entitled to compensation for psychiatric injury and "actionable distress" [Yearworth & Ors v North Bristol NHS Trust (CA) [2010] QB 1 at §§ 11, 56 and 57 per Lord Judge CJ giving the judgment of the court].
[98] It
has been doubted whether in Scots law, in spite of dicta to the
contrary, there is a threshold for actionable mental injury in delict: but in
any event I think it is reasonably clear that the judicial outlook is now
sufficiently flexible to recognise that distress can be the precursor of more
serious mental symptoms. Where the line is to be drawn between distress and
mental illness "is a matter for trial". Distress by itself may be compensable
where professional negligence is proved. In the present case the averments
about apparently sub‑clinical mental symptomatology do not require to be
read as forming the subject matter of a standalone claim. Accordingly I must
conclude that the pursuer's averments about "irritability, tearfulness,
negative ruminations and distress" preceding "a depressive disorder" are not so
obviously irrelevant that they should be excluded from probation, even assuming
the claim is one only for damages in delict [R White and M Fletcher, Delictual
Damages (Edinburgh, 2000), 42-43; McLoughlin v O'Brian [1983] 1 AC 410 at 433A-C per Lord Bridge of Harwich; Attia v British
Gas Plc [1988] 1QB 304 at 311D per Dillon LJ, at 316F-G per
Woolf LJ; McLoughlin v Grovers (A Firm) otherwise McLoughlin
v Jones (CA) [2002] QB 1312 at § 29 per Brooke LJ,
at § 51 per Hale LJ].
Claim for "loss of
autonomy"
[99] The
debate has left me uncertain as to the nature of the dispute around the
pursuer's "loss of autonomy" claim. Pursuer's senior counsel is insistent that
"loss of autonomy" must be recognised as a separate head of damages and that
compensation for loss of autonomy cannot be "rolled up" under the heading of solatium.
I suspect that this is an attempt to outflank a perceived requirement to prove
that the pursuer's sperm was of reasonable quality and that he would have had a
better than 50 per cent chance of becoming a father if the sperm had been
released undamaged: but I really do not know. The pursuer founds on the cases
of McFarlane, Parkinson, Briody and Rees [McFarlane
v Tayside Health Board 2000 SC (HL) 1 at 15H-16A per Lord Steyn,
at 44H-45A; Parkinson v St James & Seacroft University Hospital
NHS Trust [2002] QB 266 at §§ 56-63, 66-69, 73, 89, 93 per Hale LJ;
Briody v St Helens and Knowsley AHA [2002] QB 856 at § 18 per
Hale LJ; Rees v Darlington Memorial Hospital NHS Trust [2004] 1 AC 309 at §§ 8-10 per Lord Bingham, §§ 17 per Lord Nicholls
of Birkenhead, §§ 123-126 per Lord Millett, at § 148 per
Lord Scott of Foscote].
[100] Scots law
has recognised negligently caused sterility as a loss for which solatium
is recoverable in claims for bodily injury. In the case of Goorkani the
patient was prescribed treatment for an eye condition which rendered him
infertile. Lord Cameron of Lochbroom held that the patient should have
been warned of the risk and awarded damages of £2,500 as solatium for
"the loss of self esteem, the shock and anger at the discovery of his
infertility together with the frustration and disruption which ignorance and
the sudden shock of discovery brought to the marital relationship". His
lordship said: "Plainly any award cannot include any element for the loss of
ability to father children." The reason was that the pursuer had failed to
prove that it was standard practice back in 1981 to offer sperm banking before
treatment began. In McEwan the patient was rendered practically sterile
as a secondary consequence of negligent surgery. Lord Matthews was
persuaded that solatium should be assessed as a whole and not under a
series of separate heads. His Lordship awarded £65,000 for among other things
the inability of the pursuer to add to his family or at least his very great
difficulty in doing so [Goorkani v Tayside Health Board 1991 SLT
94; McEwan v Ayrshire & Arran Acute Hospitals NHS Trust [2009] CSOH 22].
[101] The
defenders argue that the only authority for a "loss of autonomy" award is Rees;
and that Rees, though a decision of the House of Lords, is
not binding on this Court. According to the Lord Justice‑Clerk in Dalgliesh:
"no legal issue in Scots law should be held to be governed by a House of
Lords decision in an English appeal, unless the point in issue is based on
legislation which has equal applicability and force in both countries, or has
been decided by an authoritative and binding court to be exactly the same and
have the same legal significance in both countries." Rees, it is said,
has not been followed or even discussed by any Scottish court; it is the
decision of a bare majority; the reasoning of the four Lords of Appeal in the
majority was not identical; and the powerful dissent of three members of the seven-man
Appellate Committee, including the only Scots judge, Lord Hope of Craighead,
means that it would be unsafe to apply the ratio of Rees beyond
identical fact situations - see for example Lord Steyn at paragraphs 41 to
44. The purpose of the award in Rees, so the defenders say, was
to compensate by a "conventional award" for something that could not otherwise
- since the decision in McFarlane - be compensated for, namely
the upbringing costs of live-born children in "wrongful conception" and
"wrongful birth" cases. Thus a "Rees award" was not considered
applicable in the Less case where the pregnancy resulted in a
stillbirth. There is no authority for a "loss of autonomy" award in "wrongful
sterility" cases; and in any event wrongfully‑caused sterility is already
compensated for by awards of solatium [Rees v Darlington
Memorial Hospital NHS Trust
[2004] 1 AC 309; Dalgliesh
v Glasgow Corporation 1976 SC 32 at 52 per Lord Justice‑Clerk
(Wheatley); McFarlane v Tayside Health Board 2000 SC (HL) 1; Less
v Hussain [2013] Med LR 383].
[102] On what I
have heard, the defenders' argument is the better one: but I do not need to do
anything about it since the pursuer's averment of "loss of autonomy" is not per
se irrelevant. It is as capable of forming part of a claim for solatium
as it is of supporting a standalone claim, so that there is no reason to
prevent the averment from going to proof: it can be left to the ultimate
decision maker to decide whether a separate award should be made. In deference
to the arguments I have heard, I offer some observations. There is a possible
contradiction in the pursuer asserting on the one hand that stored sperm is
property and in claiming on the other hand "loss of autonomy" in respect of
the, let us assume, destruction of the sperm. Compensation for "loss of
autonomy" does not look like a proprietary remedy. "Autonomy" in this context
seems to be a personality right. See the discussion of "personal autonomy" by
the Strasbourg court in Pretty. In McFarlane Lord Millett, in a
minority of one, stated that there should be entitlement to "general damages"
for "loss of autonomy". Lord Millett was the only one of the majority in Rees
to use the phrase "loss of autonomy" to describe the loss which the
"conventional award" was intended to compensate: he meant the award to
compensate for denial of the right of adult individuals to limit the size of
their families rather than to compensate for upbringing costs. In Parkinson
Hale LJ, as she then was, said that the right of physical autonomy, that is
"the right to make one's own choices about what will happen to one's own body"
is included in "the right to bodily integrity". Her Ladyship described a
wrongful pregnancy as "a severe curtailment of personal autonomy". She
appeared to equate parental responsibility with "an infringement of personal
autonomy". In Rees in the Court of Appeal, referring to the financial
burden and other responsibilities, Hale LJ added: "the principal
detriment suffered by anyone who becomes a parent against their will is the
legal and factual responsibility to look after and bring up the child" [Pretty
v United Kingdom (2002) 35 EHRR 1; McFarlane v Tayside Health
Board 2000 SC (HL) 1 at 44I per Lord Millett, cf. at 16A per Lord
Steyn; Rees v Darlington Memorial Hospital NHS Trust
[2004] 1 AC 309 at §§
123, 125 per Lord Millett; Parkinson v St James &
Seacroft University Hospital NHS Trust
[2002] QB 266 at §§
56-63, 66-69 per Hale LJ; Rees v Darlington Memorial Hospital
NHS Trust [2003] QB 20 at § 21 per Hale LJ].
[103] Parkinson
was a case about wrongful conception. Briody, in contrast,
decided less than three months after Parkinson, was a case
where clinical negligence had deprived a young woman of her uterus and thus her
ability to bear children, though not of the possibility of implanting her
biological embryos conceived in vitro with her partner's sperm in a
surrogate womb. In Briody, Hale LJ said that for a young woman to
be deprived of the chance of having children is "a very serious loss of
amenity": she did not say it is "a very serious loss of autonomy"; and
she also appeared to say, if I understand correctly, that the "very serious
loss of amenity" should be reflected in an enhanced award of general damages,
not in a separate award [Briody v St Helens and Knowsley AHA (Claim
for Damages and Costs)
[2002] QB 856 at § 18
per Hale LJ].
[104] It is also
the case, as mentioned above, that from the early 19th century solatium
has come to be recognised as the common law head of damages in Scotland for
all non‑patrimonial loss whether represented by damage to rights and
interests, personal affront or personal injury, whether caused on purpose or
negligently. Thanks to the intervention of statute and for a number of practical
reasons we have become used to the splitting of damages including, in some
circumstances, non‑patrimonial awards, into various heads: but as Lord Hope
carefully explained in Rees, awarding the sort of conventional sum
proposed by the majority breaks the common law rule as to non-patrimonial
damages and, if it were intended to compensate patrimonial loss, the rule as to
patrimonial damages as well. I would say, with respect, that while giving the
appearance of judicial correctness, the "conventional award" is actually a cap on
damages (cf. the statutory damages caps increasingly used in other
jurisdictions for malpractice claims in particular and personal injury claims
in general.) I cannot think why, unless there is a concern about difficulties
of proof, the pursuer in the present case wants to take the "conventional
award" route. As it happens, I am not at all sure that the thinking of the
majority in Gregg about "loss of a chance" would necessarily apply in a
wrongful sterility claim [Rees v Darlington Memorial Hospital NHS
Trust
[2004] 1 AC 309 at §
73 per Lord Hope of Craighead; eg Caps on Damages, American
Medical Association (AMA, 2012) at www.ama-assn.org; Civil Liability Act 2002
(New South Wales) (as amended); Gregg v Scott [2005] 2 AC 176].
Conclusion
[105] For
the reasons given I shall reserve the defenders' preliminary plea, their first
plea‑in‑law, and allow a proof before answer to parties of their
respective averments without excluding any matter from probation. I shall
reserve all questions of expenses.