8 N.E.2d 760 (1937)
The case involved a Defendant who was mentally insane and Plaintiff, a registered nurse, who was hired to care for Defendant. One day, Defendant struck Plaintiff in the head with the leg from a dressing table. Plaintiff brought an action for battery against Defendant.
In reversing the trial court’s directed verdict in favor of Defendant, the Massachusetts Supreme Court held that Defendant’s action of striking Plaintiff was intentional and she should be held responsible for her action notwithstanding the fact that she was insane.
The court conceded, however, that imposition of intentional tort liability upon insane individuals “rested more upon grounds of public policy and upon what might be called a popular view of the requirements of essential justice than upon any attempt to apply logically the underlying principles of civil liability to the special instance of the mentally deranged.” Those grounds included:
- To give the insane defendant’s guardians, who presumably have an interest in conserving the defendant’s estate, an incentive to be careful in their supervision of her;
- Persons who are financially able, even though mentally disordered, out to pay for the damage they cause just as they ought to pay for their own support;
- It would be unjust to allow mentally disordered persons to continue to enjoy their wealth while their victims bear the burden of the injury; and
- Courts are reluctant to import into tort law the difficulties that have attended administration of the insanity defense in criminal law.
Gioia v. Ratner, No. 1477-CV-00676 (Mass Super. Ct. 7/19/2016):
The seminal case, McGuire v. Almy, 297 Mass. 323, 8 N.E.2d 760 (1937), concerned a claim for assault and battery. The plaintiff, a private duty nurse hired to care for a mentally disabled person in her home, was injured when the patient struck her in the head with a piece of furniture. Justice Qua stated the general rule and noted that it had been “criticized severely” as inconsistent with “modern theory that liability in tort should rest upon fault.” Id. at 327. Nonetheless, he held that in the circumstances “where an insane person by his act does intentional damage to the person of another, he is liable for that damage in the same circumstances in which a normal person would be liable.” Id. at 328.5. He explained:
This means that in so far as a particular intent would be necessary in order to render a normal person liable, the insane person, in order to be liable, “must have been capable of entertaining that same intent and must have entertained it in fact.” The law will not inquire further into his peculiar mental condition with a view toward excusing him if it should appear that delusion or other consequences of his affliction has caused him to entertain that intent or that a normal person would not have entertained it. Id.
The rule imposing liability without fault for torts committed by a mentally disabled person is generally justified on the following policy grounds: First as between two innocent persons, the one whose act caused the injury should bear the loss; Second, the rule avoids difficult evidentiary problems inherent in attempting to estimate the existence and extent of a person’s mental deficiency; Finally, imposing liability encourages those responsible for incompetent people to provide care for them so as to avoid injury to others. See Note, Rejecting the Logic of Confinement Care Relationship and the Mentally Disabled Under Tort Law, 109 Yale L.J. 381, 386-92 (1999-2000).
The issue whether an insane person is civilly liable for intentional or negligent acts causing injury to others has not been directly addressed by the Supreme Judicial Court since McGuire was decided. Several courts which have addressed the issue have deviated from the general rule in the case of institutionalized mentally disabled patients (typically advanced Alzheimer’s patients) unable to control or appreciate the consequences of their conduct who caused injury to caregivers who were employed care for them. Courts have reasoned that it is unfair to charge the defendant with a duty of care to prevent injury to the plaintiff that arises from the very risk of harm the plaintiff and her employer were hired to prevent. This exception commonly referred to as the “caretaker exception” has also been justified on the grounds that public policy favors imposing the risk on the employer who is “in the best position to protect against the risks to the provider rooted in the very reason for the treatment.” Herrle, 53 Cal.Rptr. 2d at 719.