## Facts

- On Christmas morning 1986, a vehicle collision occurred in Tunica County, Mississippi, involving vehicles driven by Ray James Munn and Trudy E. Algee.
- Ray James Munn’s wife, Elaine Munn, suffered severe injuries, including multiple rib and pelvic fractures, a lacerated chest artery, and a retroperitoneal hematoma causing major blood loss.
- At the hospital, Elaine Munn told medical staff she was a Jehovah’s Witness and would not accept blood transfusions.
- As her condition worsened, physicians sought consent from Ray James Munn for a transfusion; he refused and also refused reinfusion of her own blood.
- Elaine Munn died during surgery from loss of blood; medical testimony indicated she likely would have lived if transfusions had been given.
- Ray James Munn sued Algee in federal court under diversity jurisdiction, both individually (for his own injuries) and as administrator of Elaine Munn’s estate, and on behalf of Mississippi statutory wrongful-death beneficiaries.
- In the district court, Southern Health Plan, Inc., d/b/a IPA Apple Plan, intervened as a plaintiff seeking reimbursement for medical expenses it paid (it was not a party in the Fifth Circuit caption).
- Before trial, the district court granted partial summary judgment limiting damages, ruling that Mississippi’s avoidable-consequences (mitigation) doctrine could apply to the post-accident refusal of transfusions and barring proof of damages based on the hypothetical scenario that Elaine Munn accepted blood and survived.
- Algee admitted negligence, and the district court directed a verdict for plaintiffs on liability; the jury tried damages and the effect of the transfusion refusal.
- The jury awarded Ray James Munn $241.44 for his medical expenses and awarded Elaine Munn’s estate $20,411.67 (including $10,000 for pain and suffering).
- On the wrongful-death claim, the jury found Elaine Munn would not have died had she accepted transfusions and awarded the wrongful-death beneficiaries no damages.
- The district court denied Munn’s motion for a new trial, and Munn appealed to the Fifth Circuit raising constitutional, evidentiary, and state-law damages issues.

## Issues

1. Whether Mississippi’s avoidable-consequences doctrine permits a jury to deny wrongful-death damages when death likely would have been prevented by a post-accident blood transfusion that the decedent refused for religious reasons.
2. Whether admitting evidence and argument about the Munns’ Jehovah’s Witness beliefs and refusal of transfusions, and instructing the jury on mitigation based on that refusal, violated the Free Exercise Clause.
3. Whether the district court erred by preventing Munn from presenting damages evidence based on the scenario in which Elaine Munn accepted transfusions and lived.
4. Whether the “eggshell skull” rule required the defendant to bear full wrongful-death damages despite the decedent’s religiously motivated refusal of treatment.
5. Whether the district court committed reversible error in related evidentiary rulings, jury instructions, and denial of a new trial.

## Decision

- The Fifth Circuit affirmed the judgment for Algee in all respects as to the challenged rulings and the resulting verdict, leaving intact the awards to Munn and the estate and the zero award to wrongful-death beneficiaries.
- The court held that applying Mississippi’s avoidable-consequences doctrine to a refusal of medical treatment did not violate the Free Exercise Clause, even if the refusal was based on religious belief, because the rule is neutral and generally applicable.
- The court upheld admission of evidence about the Munns’ Jehovah’s Witness beliefs and refusal of transfusions, concluding the evidence served a nonreligious purpose: explaining why treatment was declined and helping the jury decide whether death was reasonably avoidable for damages purposes.
- The court rejected the attempt to use the eggshell-skull rule to shift wrongful-death damages to the tortfeasor based on the decedent’s post-injury treatment choice, declining to expand the doctrine beyond its usual application to preexisting physical conditions without direction from Mississippi courts.
- The court approved the district court’s limitation on damages proof, including exclusion of evidence of what Elaine Munn’s damages would have been had she accepted blood and survived, as consistent with Mississippi’s damages rules and the mitigation framework.
- The Supreme Court denied certiorari. 

## Legal Principles

- Mississippi’s avoidable-consequences doctrine limits recovery for harm that could have been prevented by reasonable post-injury medical care; it addresses the amount of damages after the defendant’s negligence, not whether the defendant caused the accident.
- A plaintiff’s refusal of treatment may be considered in deciding whether later harm (including death) was reasonably avoidable and therefore not compensable as an element of damages.
- A neutral, generally applicable tort-damages rule may be applied even when it has an incidental effect on religious conduct; the Free Exercise Clause is not violated merely because religiously motivated choices reduce recoverable damages.
- Evidence about religious belief may be admissible when offered for a secular, case-related purpose—such as explaining refusal of treatment and informing the mitigation/damages inquiry—rather than to attack or punish religion.
- The eggshell-skull rule generally concerns preexisting physical vulnerability; absent state-law direction, it does not automatically convert a post-injury refusal of treatment into full wrongful-death liability for the original tortfeasor.
- A court may exclude damages proof based on a hypothetical survival scenario when, under the governing damages rules and the mitigation theory submitted to the jury, those hypothetical losses are not recoverable.

## Conclusion

In *Munn v. Algee*, the Fifth Circuit affirmed a verdict that awarded limited damages to the husband and the decedent’s estate but no wrongful-death damages after the jury found the decedent likely would have survived had she accepted blood transfusions. The court held that Mississippi’s avoidable-consequences doctrine could be applied to a religiously motivated refusal of treatment without violating the Free Exercise Clause, approved admission of evidence about the Jehovah’s Witness refusal for the damages inquiry, declined to extend the eggshell-skull doctrine to that post-injury choice, and upheld exclusion of damages evidence premised on the decedent’s hypothetical survival.


Munn v. Algee, 924 F.2d 568 (5th Cir. 1991), cert. denied, 502 U.S. 900 (1991)