Case Title: State v. Southard

Citation: 

Docket Number: S055463

State: oregon

Court: Oregon Supreme Court

Date: 2009-10-01T00:00:00Z

Document:
FILED: September 30, 2009
IN THE SUPREME COURT OF THE STATE OF OREGON
STATE OF OREGON,
Respondent
on Review,
v.
KERMIT EUGENE SOUTHARD,
Petitioner
on Review.
(CC
04FE0347ST; CA A128253; SC S055463)
En Banc
On review from the
Court of Appeals.*
Argued and
submitted September 17, 2008.
Anne Fujita Munsey,
Senior Deputy Public Defender, Salem, argued the cause and filed the brief for
petitioner on review.  With her on the brief was Peter Gartlan, Chief Defender,
Office of Public Defense Services.
Anna M. Joyce,
Assistant Attorney General, Salem, argued the cause and filed the brief for
respondent on review.  With her on the brief were Hardy Myers, Attorney
General, and Mary H. Williams, Solicitor General.
KISTLER, J.
The decision of the
Court of Appeals is reversed.  The judgment of the circuit court is reversed,
and the case is remanded to the circuit court for further proceedings.
*Appeal from
Deschutes County Circuit Court, Stephen N. Tiktin,
Judge. 214 Or App 292,
164 P3d 351 (2007).
KISTLER, J.
The question in this
case is whether a medical diagnosis of child sexual abuse is admissible
scientific evidence.  The trial court ruled that it is.  After considering
testimony regarding that diagnosis, as well as other evidence that defendant
had abused his girlfriend's two children, a jury convicted defendant of three
counts of sodomy.  The Court of Appeals affirmed the trial court's judgment
without opinion.  State v. Southard, 214 Or App 292, 164 P3d 351
(2007).  We allowed defendant's petition for review and now reverse the Court
of Appeals decision and the trial court's judgment.
Defendant moved in
with his girlfriend, her five-year-old son, and her three-year-old daughter.(1) 
Afterwards, defendant's girlfriend (mother) was incarcerated for possessing
controlled substances, and the state placed her children initially with their
maternal grandmother and later with a foster mother.  Both mother and the
foster mother noticed that the then six-year-old boy began engaging in actions
that concerned them.  They reported
"that [the boy] had been caught on several occasions
with his pants pulled down and trying to get other kids to kiss his penis. 
Foster Mom described multiple incidents of [his] touching other kids on their
bare bottoms.  Additionally, [he] would frequently expose himself to adults and
children in and out of the home.  Mom and Foster Mom shared that [he]
frequently grabs his groin area stating that his balls are sticking.  Mom and
Foster Mom feel this is a habit that has developed for [him]."
While visiting his
maternal grandmother, the boy disclosed that defendant made him suck
defendant's penis and that defendant had made the boy's younger sister do the
same thing.  After hearing that information, grandmother spoke with the
children's mother, who in turn called the foster mother.  She recommended that
mother call the Department of Human Services and the police.  Those agencies
referred both children to the KIDS Center, a nationally accredited medical
facility in Deschutes County that examines children to determine whether they
have been sexually or physically abused.
In determining
whether abuse has occurred, the KIDS Center follows statewide interviewing and
medical procedures as well as guidelines established by the American Professional
Society on the Abuse of Children.  Specifically, a team consisting of a social
worker and a physician examine each child who is referred to the center.  The
social worker receives information from the referring agency and also takes a
history from the child's parents or caregiver.  After reviewing that history,
the social worker conducts a videotaped interview with the child, and the
physician conducts a medical examination to see if there is physical evidence
of abuse.
In conducting the
interview and the medical examination, the social worker and physician ask
open-ended questions to avoid suggesting an answer.  They also tell the child
at the beginning of the interview that "it's okay to correct us, it's okay
to say, 'I don't know,' it's okay to say, 'I don't remember.'"  The center
follows that protocol because, "[o]therwise, kids won't do that, and
they'll acquiesce to possibly what the adult would suggest."  The
interview is videotaped and peer-reviewed to ensure that the interviewer is
asking appropriate, nonsuggestive questions and also to ensure that the
interviewer is not "using certain gestures or head motions that [suggest a
particular] answer."  Based on the child's history, the interview, and the
medical examination, the social worker and the physician consult with each
other, and the physician diagnoses whether sexual abuse has occurred.  Another
member of the KIDS Center then reviews their data and conclusion.  In some
cases, the center consults with other state and national organizations in
making a diagnosis.
In this case, the doctor
who examined the boy diagnosed him as having been sexually abused.  The doctor
who examined the girl was unable to diagnose whether she also had been sexually
abused.  In the course of reaching those conclusions, a social worker spoke
with the boy's mother and foster mother, who reported the behaviors (noted
above) that had concerned them.  The social worker also interviewed the boy,
who told her that defendant "made [him] suck on [defendant's]
private."  The boy described other details about the sexual activity and
said that "it would stop when his mom came home."  He "described
seeing [his sister] sucking on [defendant's] private and recalled that
[defendant] 'peed on [his sister].'"  He added that his sister
"sucked on [defendant's] private 'a lot more times more than I did,
because he told her to.'"  The interviewer spoke with the girl, who denied
that any sexual contact had occurred.
A physician then
conducted medical examinations of each child, which did not reveal any physical
evidence of sexual abuse.  Dr. Largent, the director of the KIDS Center, later
testified that the absence of physical evidence was not surprising.  She
explained that the type of sexual contact that the boy reported "doesn't
leave any physical marks most of the time, nothing that we [can] see." 
The social worker and physician accordingly considered the boy's statements to
them, as well as the history that they had received from the boy's mother and
foster mother, in determining whether sexual abuse had occurred.  In deciding
whether to credit the boy's reports of abuse, they considered whether the boy
had used age-appropriate terms to describe the abuse, whether he had provided
specific details, and whether the events that he described were consistent with
other historical facts.  They also considered whether the behaviors that the
mother and foster mother had reported were consistent with the reported abuse. 
Having considered those factors, the physician diagnosed the boy as having been
sexually abused.
The state charged
defendant with two counts of sodomy regarding the boy and one count of sodomy regarding
the girl.  Before trial, the defendant filed a motion in limine to
preclude the state from introducing "any diagnosis of 'sex abuse' on the
groun[d] that such evidence is 'scientific evidence' under OEC 702 and must be
subject to the foundational requirements for such evidence."  The trial
court held a pretrial hearing to resolve defendant's motion.  In addition to
the evidence set out above, the state offered evidence at the pretrial hearing
that a diagnosis of sexual abuse is generally accepted within the medical
community, that there are numerous published, peer-reviewed studies verifying
the techniques that the KIDS Center uses to elicit and evaluate the
information, and that the KIDS Center follows established guidelines in
evaluating the information that it receives.
After considering
that evidence, the trial court ruled that the diagnosis of sexual abuse was
admissible.  At trial, a physician from the KIDS Center testified that, after
consulting with the social worker who had interviewed the boy and the director
of the KIDS Center, she had diagnosed the boy as having been sexually abused. 
The state also introduced other evidence that defendant had abused the
children, and the jury found him guilty of three counts of first-degree sodomy
(two counts regarding the boy and one count regarding the girl).  The Court of
Appeals affirmed the resulting judgment without opinion.  We allowed
defendant's petition for review to consider whether, under the circumstances
presented here, a diagnosis of sexual abuse is admissible scientific evidence. 
On review, both
parties agree that a doctor's diagnosis of child sexual abuse is scientific
evidence.  Because the diagnosis "possesses the increased potential to
influence the trier of fact as [a] scientific assertio[n]," the scientific
principles on which the diagnosis rests must meet a minimum level of scientific
validity for the diagnosis to be admissible.  State v. Marrington, 335
Or 555, 561, 73 P3d 911 (2003).  The parties disagree, however, whether the
diagnosis in this case meets that minimum level.  Defendant argues that, without
physical evidence of abuse, a diagnosis of child sexual abuse is too unreliable
and not sufficiently verifiable to be considered scientifically valid.(2) 
The state responds that doctors frequently make diagnoses based solely on the
history that a patient provides and that the scientific principles on which the
diagnosis in this case rests are well established.
The parties' debate
invokes familiar principles.  Over the past 25 years, this court has
considered, in a series of cases, when scientific evidence will be admissible
in both civil and criminal proceedings.  See, e.g., Marcum v.
Adventist Health System/West, 345 Or 237, 193 P3d 1 (2008); Jennings v.
Baxter Healthcare Corp., 331 Or 285, 14 P3d 596 (2000); State v. Brown,
297 Or 404, 687 P2d 751 (1984).  To be admissible, scientific evidence must
meet three criteria:  It must be relevant, OEC 401; it must possess sufficient
indicia of scientific validity and be helpful to the jury, OEC 702; and its
prejudicial effect must not outweigh its probative value, OEC 403.  Marcum,
345 Or at 243; Jennings, 331 Or at 301.
Much of the focus in
our cases has been on the second step in the analysis -- determining when
scientific evidence possesses sufficient indicia of scientific validity to be
admissible under OEC 702.(3) 
And we think that, logically, that is the first question that we must answer in
this case.  If the diagnosis possesses sufficient indicia of scientific
validity to be probative and thus admissible, then there can be little doubt
that the diagnosis is relevant here; the state charged defendant with two
counts of sodomy regarding the boy, and the diagnosis makes it more likely that
the charged crimes had occurred.  See State v. Cox, 337 Or 477, 485, 98
P3d 1103 (2004) ("Evidence is relevant if it increases or decreases, even
slightly, the probability of the existence of any material fact in issue"). 
Similarly, we cannot determine, under OEC 403, whether the probative value of
the doctor's diagnosis is substantially outweighed by the risk of unfair
prejudice without first determining the validity of the diagnosis, which bears
on its probative value.  See Brown, 297 Or at 438 (following that
sequence).
Accordingly, we
begin with the question whether the evidence possesses sufficient scientific validity
to be admissible, and we base our decision on the record that the parties
developed below.  In Brown, this court rejected the notion that general
acceptance within the relevant scientific community is the sole criterion for
determining whether scientific evidence is admissible.  297 Or at 416.  Rather,
general acceptance is only one of several factors that bear on the
admissibility of scientific evidence.  See id. at 417 & n 5 (listing
seven primary and 11 additional factors);(4)
State v. O'Key, 321 Or 285, 306, 899 P2d 663 (1995) (adding four factors
set out in Daubert v. Merrill Dow Pharmaceuticals, 590 US 579, 113 S Ct
2786, 125 L Ed 2d 469 (1993)).(5)
Not all of the
factors that the court identified in Brown and O'Key will
necessarily apply in a given case, nor has the court required that all or even
a majority of the applicable factors be satisfied for evidence to be
admissible.  See Marcum, 345 Or at 248 ("The basis for establishing
the scientific validity of a differential diagnosis will vary depending on the
type of injury"); Jennings, 331 Or at 306-09 (ruling that a
differential diagnosis that ruptured silicone implants caused the plaintiff's
neurological disorder was admissible even though the diagnosis did not satisfy
several listed factors).  As with many multi-factor tests, the answers that the
Brown analysis has produced have tended to be case specific.
In undertaking that
inquiry in this case, we note that a diagnosis of child sex abuse differs from
other medical diagnoses.  Most medical diagnoses provide jurors with
information that is beyond their common experience; the diagnoses identify the
occurrence of a complex medical condition, determine its cause, or predict the
future resolution of the condition.  See Marcum, 345 Or at 245-46 (diagnosis
that gadolinium exposure caused the plaintiff's vasospastic disorder); Jennings,
331 Or at 309-10 (diagnosis that ruptured silicone breast implants caused the
plaintiff's neurological disorder).  A diagnosis of child sex abuse, however,
determines whether conduct (an act of sexual abuse by another person) has
occurred; the conduct is not complicated, and the ability to determine its
occurrence often is a matter within a lay person's competence.  In this case,
for example, if a lay person were to credit the boy's statements that defendant
made him and his sister engage in oral sex, then it follows that the children
were sexually abused.  It also follows that the doctor's ultimate conclusion in
this case -- that sexual abuse had occurred -- did not turn on an abstruse
matter of science; rather, it turned primarily on the sort of credibility determination
that lay jurors ordinarily make.(6)
In determining
whether the diagnosis possesses sufficient indicia of scientific validity to be
admissible, we begin by identifying the methodology that the KIDS Center used
to make its diagnosis.  See Jennings, 331 Or at 305 (explaining that, in
determining whether a doctor's opinion regarding causation was admissible
scientific evidence, "we focus on [the doctor's] methodology, not on his
conclusions").  As noted, the KIDS center uses a standardized three-part
process to diagnose child sex abuse.  First, the KIDS center takes the child's
history from the parent or caregiver, other family members, and medical
documents.  Second, the center conducts a videotaped interview of the child,
followed by a physical exam.  The primary purpose of the physical exam is to
find physical signs of abuse, but the doctor continues to ask questions of the child
during the exam.  Finally, after completing the interviews and processing any
lab results, the doctor and the social worker make a diagnosis as a team using
guidelines created by the center and other national researchers. 
Taking a history
from family members or caregivers is neither novel nor unusual.  Gathering a
patient's history from those sources is a standard feature of medicine relied
upon by doctors to diagnose a wide variety of conditions.  To be sure, the
inferences that an expert draws from that history (and the principles that the
expert uses to draw those inferences) may be subject to challenge.  In this
case, the boy's history disclosed instances of sexualized behaviors, and the
doctor explained that research had shown a strong correlation between the
behavior that the boy exhibited and sexual abuse.(7)  Defendant,
however, did not challenge at trial the research on which the doctor relied to
identify that correlation, and we see nothing in the first step in the
methodology that the KIDS Center used (taking a patient's history) that would
cause us to question the scientific validity of its diagnosis.
The second procedure
that the KIDS Center used -- interviewing the patient -- is also a standard
component of a medical diagnosis.  Interviewing a patient is often the only way
for psychologists, psychiatrists, and other doctors to gather sufficient information
to diagnose (and treat) a variety of conditions.  Largent explained that
interviewing children presents special problems, and the KIDS Center has
several procedures in place to enhance the accuracy of those interviews.  All the
interviewers follow the Oregon Interviewing Guidelines, a statewide guideline
for questioning children about abuse.(8) 
The guidelines that the interviewers follow are based on generally accepted
techniques for interviewing children and have been the subject of extensive
peer-reviewed literature.
The KIDS Center also
conducts a medical examination to look for evidence that either confirms the
reported abuse or provides alternative explanations for certain physical
phenomena.  In this case, the results of the medical examination were neutral. 
The examination revealed no physical evidence of abuse; however, as Largent
explained, the type of abuse that the boy reported is unlikely to leave any
physical evidence -- a proposition that defendant also does not challenge.  We
conclude that, in interviewing the patient and conducting the medical
examination, the KIDS Center employs valid, scientifically accepted
methodologies.
Finally, the KIDS
Center seeks to determine, based on the child's history, the interview, and the
medical examination, whether the child has been sexually abused.  Because there
was no physical evidence of sexual abuse in this case, the KIDS Center based
its diagnosis on:  (1) the boy's reported behaviors and (2) its determination
that the boy's reports of sexual abuse were credible.  As noted, defendant did
not challenge at trial the scientific validity of the research showing a
correlation between sexual abuse and the types of behaviors that the boy
exhibited.  And the kinds of considerations that the KIDS Center used to
determine whether to credit the boy's statements are standard fare in assessing
credibility.  Largent explained that, in evaluating the boy's credibility, the
KIDS Center considered whether the words that the boy used to describe the
abuse were appropriate for a child his age, whether the reports were detailed,
whether the details were consistent with other historical facts, and the
circumstances under which the boy first reported the abuse.  In evaluating the
data that it gathered, the KIDS Center followed nationally accepted protocols
for diagnosing child abuse.
Considering the
totality of the procedures that the KIDS Center used and based on the record
developed in this case, we conclude preliminarily that the KIDS Center's
diagnosis has sufficient indicia of scientific validity to be admissible.  The
experts were all qualified, the techniques used are generally accepted, the
procedures rely on specialized literature in the field, and the procedures used
are not novel.  Furthermore, the KIDS center follows numerous safeguards to
enhance objectivity and increase the accuracy of the final diagnosis.
Defendant, for his
part, recognizes that a diagnosis of child sexual abuse is admissible
scientific evidence when physical evidence corroborates the doctor's
conclusion.  He argues, however, that, without physical evidence of abuse, a
diagnosis of child sexual abuse is too unreliable to be admissible.  Defendant's
argument proves too much.  If physical evidence were a necessary prerequisite
of a scientifically valid medical diagnosis, trial courts would be hard pressed
to admit any diagnosis of mental capacity, mental suffering, or even illnesses
like migraines that have no visible outward manifestation.  Indeed, the rule
that defendant advances would preclude introducing some of the most traditional
and important forms of scientific evidence in criminal trials, such as expert
testimony to prove insanity.  The limitation that defendant urges would impose
an arbitrary restriction on the admission of expert medical testimony.
Defendant argues additionally
that the lack of "falsifiability" of the studies relied upon by the
doctors at the KIDS center makes the diagnosis invalid.  The thrust of
defendant's argument is that, without controlled experimentation and the
elimination of independent variables to verify the accuracy of results, the
conclusions that the national studies have drawn are not scientifically valid. 
Ethical concerns, however, counsel against the sort of controlled
experimentation that defendant would require as a basis for admitting a medical
diagnosis of sexual abuse, see State v. Perry, 347 Or ___, ___ P3d ___ (2009)
(decided this date) (slip op at 3 n 3) (so stating), and the absence of this
factor does not automatically make a scientific conclusion invalid.  See id.
at ___ (slip op at 17 ) (recognizing that proposition); Brown, 297 Or at
428 (holding that polygraph results were admissible under OEC 401 and OEC 702
even though their "falsifiability" could not be tested).(9) 
Where science cannot ethically provide such an indicator, we are required to
look more closely at other factors that offset the unavailability of that
indicator.  See Perry, 347 Or at ___ (slip op at 17) (stating
proposition).
After considering
the methodologies that the KIDS Center used to diagnose child sexual abuse, we
conclude that the diagnosis possesses sufficient indicia of scientific validity
to be admissible.(10) 
Put differently, we cannot say that, based on this record, a diagnosis of child
sexual abuse is "bad science" that should be excluded automatically
as scientifically invalid.  See O'Key, 321 Or at 306 ("[A] trial
court should exclude 'bad science' in order to control the flow of confusing,
misleading, erroneous, prejudicial, or useless information to the trier of
fact.").
Although we agree
with the trial court that the diagnosis is scientifically valid, scientific
validity is not the end of the inquiry.  To be admissible, the evidence also
must be relevant, and its probative value must not be substantially outweighed
by the danger of unfair prejudice.  Marcum, 345 Or at 243.  We turn to
those issues.  As noted above, the doctor's diagnosis is relevant.  Whether sexual
abuse has occurred is a material fact in proving a charge of sodomy, and the
doctor's diagnosis that the boy had been sexually abused increased the
probability of that fact's occurrence.  See Cox, 337 Or at 485 (stating
standard for relevance).  The remaining question is whether, under OEC
403, the probative value of the diagnosis "is substantially outweighed by
the danger of unfair prejudice, confusion of the issues, or misleading the
jury, or by considerations of undue delay or needless presentation of
cumulative evidence."  See Brown, 297 Or at 438-39 (restating the
terms of OEC 403). 
This court faced a
similar issue in Brown.  297 Or at 438-42.  It began by explaining that,
based on its assessment of the scientific validity of polygraph evidence, that
evidence had "some probative value."  Id. at 438.  It then
noted that, in the context of polygraph evidence, the risk of prejudice stemmed
from the fact that "the trier of fact may be overly impressed or
prejudiced by a perhaps misplaced aura of reliability or validity of the
evidence, thereby leading the trier of fact to abdicate its role of critical
assessment."  Id. at 439.  Among other things, the court noted that
the tendency to give polygraph evidence undue weight could cause jurors to
abdicate their traditional role of assessing the credibility of witnesses.  Id.
at 440-41, 440 n 31.  Balancing that and other concerns against the probative
value of polygraph evidence, the court concluded that the reasons for excluding
that evidence far outweighed its probative value.  Id. at 442.(11)
Although the
calculus differs slightly between this case and Brown, we reach the same
conclusion that the court did in Brown.  In determining the probative
value of the doctor's ultimate conclusion of sexual abuse, we note that her diagnosis
did not tell the jury anything that it was not equally capable of determining on
its own.  As noted above, whether defendant caused the boy to engage in oral sex
(and thus sexually abused him) does not present the sort of complex factual
determination that a lay person cannot make as well as an expert.  If the jury
credited the boy's reports of oral sex (which he recounted to his grandmother,
the staff at the KIDS Center, and the jury at trial), then it necessarily
follows that he was sexually abused.  And, while the staff at the KIDS Center
are experienced professionals, the criteria that the staff used to decide
whether to credit the boy's testimony are essentially the same criteria that we
expect juries to use every day in courts across this state to decide whether witnesses
are credible.(12) 
Because the doctor's diagnosis in this case did not tell the jury anything that
it was not equally capable of determining, the marginal value of the diagnosis
was slight.
The risk of
prejudice, however, was great.  The fact that the diagnosis came from a
credentialed expert, surrounded with the hallmarks of the scientific method,
created a substantial risk that the jury "may be overly impressed or
prejudiced by a perhaps misplaced aura of reliability or validity of the evidence." 
Brown, 297 Or at 439.  As in Brown, the diagnosis is particularly
problematic because the diagnosis, which was based primarily on an assessment
of the boy's credibility, posed the risk that the jury will not make its own
credibility determination, which it is fully capable of doing, but will instead
defer to the expert's implicit conlcusion that the victim's reports of abuse
are credible.  See id. at 440-41 (reasoning that polygraph evidence
could effectively take over the jury's traditional function of judging the
credibility of witnesses).  In our view, the risk of prejudice substantially
outweighs the minimal probative value of the diagnosis.
Other jurisdictions
have held, in a related context, that a doctor's diagnosis of sexual abuse is
not helpful to the jury under FRE 702 (or those jurisdictions' counterparts to
that rule) and thus is not admissible.  Those courts have concluded that a
medical diagnosis on the "ultimate issue of sexual abuse" does not
tell the jury anything that it is not capable of determining without expert
assistance.  See United States v. Whitted, 11 F3d 782, 785 (8th
Cir 1993) ("Because jurors are equally capable of considering the evidence
and passing on the ultimate issue of sexual abuse * * *, a doctor's opinion
that sexual abuse has in fact occurred is ordinarily neither useful to the jury
nor admissible."); United States v. Charley, 189 F3d 1251, 1264-69
(10th Cir 1999) (following Whitted); State v. Iban C., 275 Conn
624, 639, 881 A2d 1005 (2005) (a specific diagnosis of child sex abuse did not
assist the jury because "this type of assessment was well within the
jurors' capabilities and understanding and did not require a separate
conclusion from [an expert] that sexual abuse had taken place"); Atkins
v. State, 243 Ga App 489, 496-95, 533 SE2d 152 (2000) (holding that experts
cannot opine that abuse did in fact occur); State v. Batangan, 71 Haw
552, 558, 799 P2d 48 (1990) ("[C]onclusory opinions that abuse did occur
and that the child victim's report of abuse is truthful and believable is of no
assistance to the jury, and therefore, should not be admitted.").
As we understand
those decisions, they rest on the proposition that the degree to which the
diagnosis advances the jury's ability to evaluate the evidence is minimal and that
the risk that the jury will defer to the expert's assessment outweighs whatever
probative value the diagnosis may have.  As Mueller and Kirkpatrick explain, 
"Where the issue and subject are ones lay jurors can
appreciate and evaluate by applying common knowledge and good sense, admitting
expert testimony seems the wrong thing to do and may warrant reversal if it is
likely to dissuade the jury from exercising its own independent judgment or if
it effectively takes over the jury's traditional function to judge the
credibility of witnesses."
Christopher B. Mueller & Laird C. Kirkpatrick,
3 Federal Evidence § 7:9, 810-13 (3d ed 2007) (footnote omitted).  In
essence, those courts have balanced the probative value of the diagnosis
against the risk of prejudice and held, as we do, that the diagnosis is not
admissible.
Our holding today is
narrow.  The only question on review is whether a diagnosis of "sexual
abuse" -- i.e., a statement from an expert that, in the expert's
opinion, the child was sexually abused -- is admissible in the absence of any
physical evidence of abuse.  We hold that where, as here, that diagnosis does
not tell the jury anything that it could not have determined on its own, the
diagnosis is not admissible under OEC 403.  We do not consider, and our
decision today does not resolve, whether any subsidiary principles that inform
that diagnosis are themselves admissible.  This court has recognized that, depending
on the foundation and the purpose for which the testimony is offered, expert testimony
regarding aspects of child sexual abuse with which a lay person ordinarily
would not be familiar may be admissible.  See Perry, 347 Or at ___ (slip
op at 20) (evidence that some children who have been abused may delay
disclosing abuse is admissible to disprove a claim that delay in reporting
demonstrates that no abuse occurred); State v. Middleton, 294 Or 427, 440,
657 P2d 1215 (1983) (Roberts, J., concurring) (noting the existence of
well-qualified experts and a significant body of research on intrafamilial
sexual abuse and reasoning that this information is not known to the average
juror and is thus admissible).  Other courts have recognized that, given a
proper foundation, experts may tell jurors the results of their research on
abused children when those results would be helpful to the jury; however, those
same courts have held that an expert's ultimate conclusion that a child has or
has not been sexually abused is not admissible.  See Charley, 189 F3d at
1264-65 (summarizing cases).
We accordingly hold
that, in these circumstances, the trial court erred in admitting the diagnosis
of sexual abuse.  The state has not argued that the admission of that evidence
was harmless, and our review of the record confirms that the state reasonably
has declined to make that argument.
The decision of the
Court of Appeals is reversed.  The judgment of the circuit court is reversed,
and the case is remanded to the circuit court for further proceedings.
1. On
review, defendant challenges the trial court's pretrial ruling that a diagnosis
of sexual abuse is admissible, and we take the facts from the evidence brought
out at the pretrial hearing.  Most of those facts are not disputed.  To the
extent that a dispute exists, we state the facts consistently with the trial
court's ruling.
2. Defendant
does not argue that sexual abuse is not a condition recognized within the
medical community, nor does he argue that doctors do not diagnose and treat
that condition.  Rather, he acknowledges that, if there were physical evidence
of abuse, a doctor could testify regarding his or her diagnosis of sexual
abuse.
3. OEC
702 provides:
"If scientific, technical or other
specialized knowledge will assist the trier of fact to understand the evidence
or to determine a fact in issue, a witness qualified as an expert by knowledge,
skill, experience, training or education may testify thereto in the form of an
opinion or otherwise." 
4. The
seven primary factors listed in Brown are:  (1) the technique's general
acceptance in the field; (2) the expert's qualifications and stature; (3) the
use that has been made of the technique; (4) the potential rate of error; (5)
the existence of specialized literature; (6) the novelty of the invention; and
(7) the extent to which the technique relies on the subjective interpretation
of the expert.  297 Or at 417.
5. The
four factors listed in O'Key overlap, to some degree, with the seven
factors set out in Brown.  They are:  (1) whether the theory or technique
can and has been tested; (2) whether the theory or technique has been subject
to peer review; (3) the known or potential rate of error; and (4) the degree of
acceptance in the relevant scientific community.  321 Or at 303-04.
6. We
recognize that, in diagnosing sexual abuse, a doctor may draw on subsidiary
principles from the medical and social sciences.  In this case, for example,
the doctor relied on the way that children typically express themselves to
determine whether the boy had been coached or was using his own words to
describe his experience.  She also noted a strong correlation between the boy's
reported behaviors and sexual abuse.  Finally, she noted that the fact that the
boy had not reported the abuse immediately did not necessarily mean that he had
not been abused.  Defendant did not challenge at trial the validity of those
subsidiary principles; rather, he aimed his attack solely at the diagnosis
itself -- the doctor's ultimate conclusion that the boy had been sexually
abused.  We limit our discussion to the testimony that defendant challenged.
7. Largent
was careful to say that the behaviors that the boy exhibited (asking other
children to "kiss" his penis and the like) did not necessarily
establish that the boy had been sexually abused.  Rather, she testified only
that research showed a strong correlation between sexual abuse and those types
of behaviors.
8. The
KIDS center also uses the Oregon Medical Guidelines and a forensic analysis
guide designed by the American Professional Society on the Abuse of Children.
9. The
court explained in Brown that the "'accuracy of the [p]olygraph
technique [cannot] be determined in a psychology laboratory setting or by the
use of fictitious crimes under other testing circumstances.  This limitation
prevails for the simple reason that it is practically impossible to simulate
conditions comparable to those involved in actual case situations.'"  297
Or at 428 (quoting John E. Reid & Fred Edward Inbau, Truth and
Deception:  The Polygraph (Lie-Detector Technique) 303-04 (2d ed 1977)). 
Even though the accuracy of polygraph results could not be verified, the court
held that those results still possessed sufficient indicia of scientific
validity to be admissible under OEC 401 and OEC 702.  Id. at 438.  The
problem, as the court explained, was that the potential for jurors to overvalue
the evidence outweighed its probative value, making the evidence inadmissible
under OEC 403.  Id. at 442.
10. Indeed,
the nature of the medical diagnosis in this case makes it difficult for
defendant to argue that the diagnosis does not meet a minimum level of
scientific validity; that is, it is difficult to understand why experienced
professionals, under controlled conditions, are incapable of accurately making
the same determination that we expect of a panel of lay jurors to make --
namely, whether sexual abuse has occurred.
11. This
court did not defer to the trial court in determining the admissibility of
scientific evidence under OEC 403.  See Brown, 297 Or at 442.
12. To
the extent that the doctor employed criteria that went beyond a juror's common
experience, defendant did not object to her explaining those criteria to the
jury.  Specifically, defendant did not object to the doctor's testimony
regarding how a child's age and stage of development affects his or her ability
to recount experiences, the kinds of words that a child the boy's age typically
would use to describe a sexual experience, or the fact that the boy's delayed
reporting did not necessarily mean that he had not been abused.  The jury was
thus free to employ those criteria in making its own assessment of the boy's
credibility.  The question that this case presents is whether the doctor's
ultimate conclusion of sexual abuse, standing alone, added anything helpful to
the jury's deliberations.