The general rule in Iowa is emotional distress damages are not recoverable in torts, “absent intentional conduct by a defendant or some physical injury to the plaintiff”.  Miranda v. Said, 836 N.W.2d 8, 14 (Iowa 2013).  This rule recognizes there is no duty in tort law to avoid causing emotional damages.  Id.  The duty to exercise ordinary care to avoid causing emotional harm is recognized only when supported by the nature of the relationship between the parties and the nature of the acts engaged in by the defendant within the context of the relationship.  Id.  Emotional distress damages are available only in situations which involve both a close nexus to the action at issue and extremely emotional circumstances.  Miranda, 836 N.W.2d at 24.  Damages for emotional distress which arise out of acts that invade an interest protected by tort law are recoverable only if the claimed emotional distress naturally ensues from the acts complained of.  Id. 

When the tort involves willful or unlawful conduct, rather than negligence, recovery of mental distress damages has been allowed despite a lack of injury in a variety of different factual situations.  See, e.g., Kraft v. City of Bettendorf, 359 N.W.2d 466, 471 (Iowa 1984) (false arrest); Blakeley v. Estate of Shortal, 236 Iowa 787, 791-93, 20 N.W.2d 28, 31 (1945) (act of suicide in plaintiff’s kitchen); Holdorf v. Holdorf,  185 Iowa 838, 842, 169 N.W. 737, 738-39 (1919) (willful assault); Johnson v. Hahn, 168 Iowa 147, 149, 150 N.W. 6, 6 (1914) (repeated solicitation to commit adultery); Watson v. Dilts, 116 Iowa 249, 252, 89 N.W. 1068, 1069 (1902) (encounter with a nighttime trespasser in the home); Chicago, R.I. & Pac. R.R., 77 Iowa 54, 58-9, 41 N.W. 564, 565 (1889) (wrongful ejection from a train); Stevenson v. Belknap, 6 Iowa 96, 103-05 (1858) (seduction); see also Craker v. Chicago & Northwestern R.R., 36 Wis. 657, 677-79 (1875) (recovery allowed for injured feelings where a conductor kissed a female passenger against her will).

The  question of whether damages for emotional distress are recoverable in a given tort depends on the theory of recovery in each type of action.  In cases grounded on negligence where there is no duty to exercise ordinary care to avoid causing emotional harm, recovery is generally denied for the infliction of mental distress without an accompanying physical injury.  Consequently, this court has approved the dismissal of an action where the only damage claimed was the mental distress caused by the negligent telephoning of truthful information by violent and profane language. Kramer v. Ricksmeier, 159 Iowa 48, 51, 139 N.W. 1091, 1091-92 (1913).

In Oswald v. LeGrand, negligent conduct of a doctor and hospital staff within a physician-patient relationship was found especially likely to cause severe emotional distress when the conduct was specifically directed at the plaintiff.  Oswald v. LeGrand, 453 N.W.2d 634, 639 (Iowa 1990).  An exception to the general rule exists when the nature of the relationship between the parties is such that there arises a duty to exercise ordinary care to avoid causing emotional harm.  Id.  In Oswald, the Iowa Supreme Court held that liability for emotional injury should attach to the delivery of medical services.  Id.  For example, in Meyer, the birth of a child involves the matter of life and death evoking such “mental concern and solicitude” that the breach of a contract incident thereto “will inevitably result in mental anguish, pain, and suffering.”  Meyer v. Nottger, 241 N.W.2d 911, 920 (Iowa 1976).  Other authorities are in accord with the Iowa Supreme Court.  See Geibel v. U.S., 667 F. Supp. 215, 220 (W.D. Pa. 1987) (recognizing malpractice claim for emotional distress based on injury induced by physician through “words or actions” as well as direct injury from therapeutic and diagnostic measures); Taylor v. Baptist Medical Center, 400 S.2d 369, 374 (Ala. 1981) (recognizing exception to denial of recovery for purely mental anguish where duty “so coupled with matters of mental concern or solicitude, or with the feelings of the party to whom the duty is owed, that a breach of that duty will necessarily or reasonably result in mental anguish or suffering”).