Academic journal article Missouri Law Review

The Constitutionality of Caps: Upholding Missouri's Right to Jury Trial and the Non-Economic Damages Debate

Academic journal article Missouri Law Review

The Constitutionality of Caps: Upholding Missouri's Right to Jury Trial and the Non-Economic Damages Debate

Article excerpt

Watts v. Lester E. Cox Medical Centers, 376 S.W.3d 633 (Mo. 2012) (en banc)


Imagine a loved one who, through no fault of their own, suffers from the terrible consequences of a medical professional's negligence. Picture a family member who is left paralyzed, unable to ever independently walk or move below the waist again, who will spend most of his or her remaining years sitting in a bed or chair. Imagine the pain and suffering, emotional anguish, physical impairment, and loss of capacity to enjoy life that this person will face on a daily basis. Now imagine that for the rest of this person's life, the most he or she will be able to recover in non-monetary damages from the negligent medical professional is $350,000, no matter how negligent the care or severe the mental anguish. (1) Until a Supreme Court of Missouri decision in July 2012, (2) this was not an imaginary situation, but a very real problem facing hundreds (3) of Missouri patients and families.

Tort reform is an issue within the health care industry that has seen attention both at the state and national level. (4) One aspect of tort reform involves capping damages in medical malpractice claims. (5) Missouri has capped damages since 1986 through Missouri Revised Statutes chapter 538, "Tort Actions Based on Improper Health Care." (6) Within its various sections, chapter 538 includes limits on non-economic damages, (7) how and when damages are paid, the requirement of affidavits by health care professionals confirming merits of the lawsuit, (9) immunity from civil liability for certain health care professionals, (10) and venue for certain actions against health care providers. (11) Under Missouri Revised Statutes section 538.210, a $350,000 non-economic damage cap was in place in 2012 when Watts v. Lester E. Cox Medical Centers was decided. (12)

After a 4-3 decision by the Supreme Court of Missouri that declared the $350,000 statutory cap unconstitutional, supporters of tort reform predicted "dire consequences" for the future of the health care system. (13) Nationwide, supporters of non-economic caps claimed a medical malpractice "crisis" had unfolded, resulting in doctors moving their practices to states with lower malpractice insurance rates, turning away high-risk patients and engaging in "defensive medicine" to avoid potential malpractice lawsuits. (14) Physicians and other health care representatives blamed excessive, frivolous lawsuits and high plaintiff payouts for the rise in malpractice premiums. (15) In contrast, those who opposed the statutory cap celebrated the Watts decision, claiming Missourians had their "constitutional rights restored." (16) Nationally, plaintiffs' lawyers and patient advocates claimed states "unconstitutionally restrict[ed] access to the courts" and limited redress of injury when legislators capped damages. (17) Because caps limited recovery at a certain amount regardless of extent or type of injury, plaintiff advocacy groups alleged patients were "squeezed out of a system designed to give them full redress" for the harm they suffered. (18)

This split in opinion raises important questions. Should caps on non-economic damages be constitutional in Missouri? Just how much do non-economic caps affect medical malpractice insurance premiums and the health care system overall? Are caps a fair solution to rising costs of health care or just a quick fix solution to a much more damaged system? This Note will discuss these questions and others involving the constitutionality of caps on non-economic damages and the policy issues that surround this controversial topic.

This Note argues that the Watts decision appropriately invalidated the statutory limits on economic damages, finding non-economic caps on damages unconstitutional. Part II of this Note analyzes the facts and holding of Watts. Part III examines previous constitutional challenges to Missouri Revised Statutes chapter 538 and how the court interpreted constitutional language to reach its decision. …

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