The "eggshell plaintiff" revisited: causation of mental damages in civil litigation.

The legal concept of the " eggshell plaintiff, " when explaining the causation of a plaintiff's claimed psychological injury, may be an archaic and a misleading paradigm. The " thin skull " or " eggshell plaintiff " rule—often described as the " defendant takes the victim as found " —protects the rights of individuals whose preexisting fragility makes them particularly susceptible to injury. This rule provides that when a defendant's tortious conduct causes harm that, due to the person's preexisting physical or mental condition, is of a greater magnitude or different type than might reasonably be expected, the defendant is liable for all harm caused by the tortious conduct. Plaintiffs must demonstrate that the defendant's alleged conduct was the cause of, or at least a substantial contributing factor to, the harm.[1] However, relying substantially upon this rule in cases alleging intentional or negligent infliction of emotional distress leads the trier of fact to ignore other important contributing and preexisting causes of the plaintiff's claimed damages. When a plaintiff has a preexisting condition, it is necessary to distinguish between emotional distress caused by the defendant's tortious conduct and emotional distress that would have developed regardless of the defendant's actions due to the natural course and history of the plaintiff's preexisting mental illness. Making an accurate differential diagnosis of mental disorders and assigning causation requires a comprehensive independent evaluation of the plaintiff. Often, the presentation of testimony by treating psychiatrists, psychologists, or other mental health professionals confuses, rather than clarifies, issues related to causation. Their role is to help the patient understand, cope with, and hopefully modify his or her behavior. Empathizing with the patient's point of view is the cornerstone of the psychotherapeutic relationship. According to the Hippocratic