Title: Charles Johnson v. Rogers Memorial Hospital, Inc.

State: wisconsin

Issuer: Wisconsin Supreme Court

Document:

2005 WI 114 
 
 
SUPREME COURT OF WISCONSIN 
 
 
 
 
 
CASE NO.: 
2003AP784 & 2003AP1413 
COMPLETE TITLE: 
 
 
Charles Johnson and Karen Johnson,  
          Plaintiffs-Appellants, 
     v. 
Rogers Memorial Hospital, Inc.,  
          Defendant-Respondent, 
Heartland Counseling Services and South  
Street Clinic,  
          Defendants, 
Kay Phillips, Ph.D., Jeff Hollowell, Tim  
Reisenauer, and Wisconsin Patients  
Compensation Fund,  
          Defendants-Respondents. 
 
 
 
 
ON CERTIFICATION FROM THE COURT OF APPEALS 
 
 
OPINION FILED: 
July 8, 2005   
SUBMITTED ON BRIEFS: 
        
ORAL ARGUMENT: 
November 3, 2004   
 
 
SOURCE OF APPEAL: 
 
 
COURT: 
Circuit   
 
COUNTY: 
Dane   
 
JUDGE: 
Daniel R. Moeser   
 
 
 
JUSTICES: 
 
 
CONCURRED: 
PROSSER, J., concurs (opinion filed). 
WILCOX and CROOKS, J.J., join concurrence.   
 
CONCURED/DISSENTED: WILCOX, J., concurs in part, dissents in part 
(opinion filed). 
 
DISSENTED: 
BRADLEY, J., dissents (opinion filed). 
ABRAHAMSON, C.J., joins dissent.   
 
NOT PARTICIPATING: 
ROGGENSACK, J., did not participate.   
 
 
 
ATTORNEYS: 
 
For the plaintiffs-appellants there were briefs by William 
Smoler and Smoler Law Office, LLC, Monona, and oral argument by 
William Smoler. 
 
For the defendant-respondent, Rogers Memorial Hospital, 
Inc., there was a brief by Laurie J. McLeroy and Otjen, Van Ert, 
Lieb & Weir, S.C., Milwaukee, and oral argument by Laurie J. 
McLeroy. 
 
 
 
2
For the defendant-respondent, Kay Phillips, Ph.D., there 
was a brief by David McFarlane, Francis X. Sullivan and Bell, 
Gierhart & Moore, S.C., Madison, and oral argument by David 
McFarlane. 
 
For the defendants-respondents, Drs. Jeff Hollowell and Tim 
Reisenauer, there was a brief by Bradway A. Liddle, Jr., Sarah 
A. Zylstra and Boardman, Suhr, Curry & Field, LLP, Madison, and 
oral argument by Sarah A. Zylstra. 
 
2005 WI 114 
NOTICE 
This opinion is subject to further 
editing and modification.  The final 
version will appear in the bound 
volume of the official reports.   
No.  2003AP784 & 2003AP1413  
(L.C. No. 
96 CV 001228) 
STATE OF WISCONSIN  
 
 
   : 
IN SUPREME COURT 
 
 
Charles Johnson and Karen Johnson,  
 
          Plaintiffs-Appellants, 
 
     v. 
 
Rogers Memorial Hospital, Inc.,  
 
          Defendant-Respondent, 
 
Heartland Counseling Services and South  
Street Clinic,  
 
          Defendants, 
 
Kay Phillips, Ph.D., Jeff Hollowell, Tim  
Reisenauer, and Wisconsin Patients  
Compensation Fund,  
 
          Defendants-Respondents. 
 
FILED 
 
JUL 8, 2005 
 
Cornelia G. Clark 
Clerk of Supreme Court 
 
 
 
 
 
APPEAL from a judgment of the Circuit Court for Dane 
County, Daniel R. Moeser, Judge.  Reversed and cause remanded. 
 
¶1 
LOUIS B. BUTLER, JR., J.   This case stems from 
allegations that therapists implanted and reinforced in a 
patient false memories of childhood physical and sexual abuse 
committed by the patient's parents.  The patient, Charlotte, has 
No. 
2003AP784 & 2003AP1413   
 
2 
 
since accused her parents, Charles and Karen Johnson (Johnsons) 
of being child abusers and disassociated herself from them.  The 
Johnsons commenced an action against, among other parties, her 
therapists for negligent treatment, but the action has been 
impeded by Charlotte's refusal to waive her therapist-patient 
privilege. 
¶2 
We accepted the court of appeals' certification to 
determine whether there should be an exception to the therapist-
patient privilege when an adult child accuses her parents of 
physical and sexual abuse based on memories recovered during 
therapy, and the parents sue the child's therapists for 
infliction of emotional harm.  The Johnsons submit that this 
court need not reach that issue, because they argue Charlotte 
waived her privilege or, in the very least, did not have a 
privilege with respect to communications made to an unlicensed 
therapist.   
¶3 
We 
conclude 
that 
Charlotte 
did 
not 
waive 
her 
therapist-patient privilege, as she did not disclose any 
significant part of a confidential matter or communication.1  We 
further conclude that 
Charlotte's 
communications 
with the 
unlicensed therapist were privileged because of Charlotte's 
                                                 
1 Chief Justice Shirley S. Abrahamson, Justices Ann Walsh 
Bradley and Louis B. Butler, Jr. agree with this conclusion.  
Justices Jon P. Wilcox, N. Patrick Crooks, and David T. Prosser 
conclude that Charlotte waived her privilege.  Justice Patience 
Drake Roggensack did not participate.       
No. 
2003AP784 & 2003AP1413   
 
3 
 
reasonable expectation that they would be and because the 
unlicensed therapist worked under the direction of a physician.2  
¶4 
In response to the court of appeals' certified 
question, we conclude that there is a public policy exception to 
the therapist-patient privilege and to the confidentiality in 
patient health care records where negligent therapy causes false 
accusations against the parents for sexually or physically 
abusing their child.  The exception is not unlimited and is 
implicated only where the plaintiff can establish a reasonable 
likelihood that negligent therapy occurred and the trial court 
agrees that the records contain relevant information regarding 
negligent treatment after conducting an in camera review.  In 
those limited instances, the trial court must disclose those 
records to the plaintiff, and the privilege and confidentiality 
associated with those particular records is removed.3  Therefore, 
                                                 
2 All participating justices agree with this conclusion. 
3 Justices N. Patrick Crooks, David T. Prosser and Louis B. 
Butler, Jr. agree with this conclusion.  Chief Justice Shirley 
S. Abrahamson and Justices Jon P. Wilcox and Ann Walsh Bradley 
conclude that there is no public policy exception. 
No. 
2003AP784 & 2003AP1413   
 
4 
 
we reverse the circuit court's order and remand this case for 
further proceedings.4 
I 
¶5 
This is the second time this case is before this 
court.  See Johnson v. Rogers Memorial Hosp., Inc., 2001 WI 68, 
244 Wis. 2d 364, 627 N.W.2d 890 (Johnson II).  The factual 
record is still relatively sparse, as this case was first before 
this court after a motion to dismiss, and is again before us 
after limited discovery was conducted following this court's 
reversal of the order granting the motion to dismiss and remand 
to the circuit court.  For completeness, the following factual 
background 
discussion 
is 
taken 
from 
Johnson 
II, 
with 
supplementations from the discovery that has since occurred.   
¶6 
In late summer or fall of 1991, the Johnsons' 
daughter, Charlotte, began psychotherapy treatment with Kay 
Phillips and Heartland Consulting Services.  Id., ¶2.  Shortly 
after that, Phillips referred Charlotte to Rogers Memorial 
Hospital for treatment for eating and addictive disorders and 
for sexual and physical abuse issues.  Id.  Charlotte was 
                                                 
4  Three Justices, N. Patrick Crooks, David T.  Prosser, and 
Louis B. Butler, Jr., agree with the in camera procedure under a 
public 
policy 
exception, 
irrespective 
of 
their 
positions 
regarding waiver.  One Justice, Jon P. Wilcox, concludes that 
there is no need for an in camera review because of Charlotte's 
waiver.  Because there are four votes that would allow the 
Johnsons to proceed on their claim, and because the votes for in 
camera review represent the least restrictive means of enforcing 
this decision, the trial court should proceed, for purposes of 
this proceeding only, with the in camera review procedures 
described infra. 
No. 
2003AP784 & 2003AP1413   
 
5 
 
admitted as an inpatient to Rogers Memorial in early November 
1991 and remained there until nearly the end of the month.  Id., 
¶¶2-3. 
¶7 
At Rogers Memorial, Charlotte received therapy from 
Jeff Hollowell and Tim Reisenauer, both licensed psychologists 
under Wis. Stat. ch. 455 at all relevant times, during which she 
developed the belief that Charles raped her and Karen physically 
abused her as a young child.5  Id., ¶3.  Charlotte confronted 
Charles about this abuse on November 22, 1991, and confronted 
Karen on October 28, 1993.  Id., ¶3.   
¶8 
Although the Johnsons denied the abuse occurred, 
Charlotte terminated her relationship with her parents.  Id., 
¶4.  The Johnsons have been unsuccessful in reestablishing any 
relationship with her, and Charlotte continues to believe that 
her parents abused her.  Id. 
¶9 
On May 29, 1996, the Johnsons filed a complaint 
against the defendants alleging, among other claims, that 
Phillips, Hollowell, and Reisenauer provided negligent treatment 
that resulted in Charlotte falsely believing that she had been 
sexually and physically abused by her parents as a young child.  
Id., ¶5.  Without counseling Charlotte to determine the validity 
of these memories, even after the Johnsons indicated the 
memories 
were 
unfounded, 
the 
Johnsons 
asserted 
that 
the 
                                                 
5 At her deposition, Charlotte also stated she now believes 
that 
her 
paternal 
grandfather 
raped 
her. 
 
Additionally, 
regarding the physical abuse, Charlotte indicated she believed 
her mother beat her using fists and tried to kill her with a 
knife and by drowning.  
No. 
2003AP784 & 2003AP1413   
 
6 
 
therapists' continuous negligent therapy reinforced these false 
memories.  Id.   
¶10 After a series of motions to dismiss, the Dane County 
Circuit Court, the Honorable Daniel R. Moeser, eventually 
dismissed the Johnsons' complaint for, as relevant here, failing 
to state a claim upon which relief could be granted.  Id., ¶¶9-
10.  The Johnsons appealed, and in the meantime this court 
decided Sawyer v. Midelfort, 227 Wis. 2d 124, 129, 136, 595 
N.W.2d 423 (1999), which recognized a parent of an adult child's 
third-party professional negligence claim against a therapist 
for therapy that resulted in implanting and reinforcing false 
memories of sexual abuse in their child.   
¶11 Notwithstanding Sawyer, the court of appeals affirmed 
the circuit court.  Johnson v. Rogers Memorial Hosp., Inc., 2000 
WI App 166, 238 Wis. 2d 227, 616 N.W.2d 903 (Johnson I).  The 
court of 
appeals 
noted 
that the 
Johnsons 
did 
not 
have 
Charlotte's medical records.  Id., ¶11. The court of appeals 
also believed that Charlotte neither waived her right to 
maintain their confidentiality, nor relinquished her privilege 
to retain the privacy of her communications with the therapists.  
Id.  Thus, the court of appeals determined that the Johnsons 
could not prove their claim, nor could the therapists defend 
against it, without imposing significant collateral burdens on 
the therapist-patient confidential relationship.  Id., ¶12.  Due 
to the public policy underlying the patient-therapist privilege, 
the court of appeals concluded that a patient's records cannot 
No. 
2003AP784 & 2003AP1413   
 
7 
 
be fair game whenever a suit of this kind was commenced.  Id., 
¶17. 
¶12 This court reversed, determining that resort to public 
policy was premature because the record did not clearly indicate 
whether 
a 
burden 
would 
be 
placed 
on 
therapist-patient 
confidentiality. 
Johnson 
II, 
244 
Wis. 
2d 
364, 
¶18.  
Specifically, this court found the record unclear as to whether 
Charlotte waived her privilege or whether a privilege applied at 
all under the circumstances.  Id., ¶¶18-19.  The matter was 
remanded to the circuit court to further develop the record. 
¶13 On remand, the following factual record was developed 
regarding whether a privilege applied to Charlotte's therapy 
with Phillips.  During Charlotte's therapy with Phillips, 
Phillips was not certified as a professional counselor pursuant 
to Wis. Stat. § 457.12.  In fact, Phillips did not receive her 
certification until March 21, 1995.  
¶14 While 
treating 
Charlotte, 
however, 
Phillips 
was 
supervised by Dr. David Israelstam, a licensed psychiatrist who 
supervised all the therapists at Heartland Counseling.  Once a 
month, for one hour, Israelstam met with the four or five 
therapists so that they could present their cases and diagnoses.  
Israelstam would then sign-off on the diagnoses if he agreed 
with it.  Israelstam also indicated he had continued supervision 
over cases depending on the frequency with which the patient met 
with the therapist.  He reviewed the case in the same manner 
described above every 90 days if the patient was seen once a 
week or less and every 30 days if the patient was seen twice a 
No. 
2003AP784 & 2003AP1413   
 
8 
 
week or more.  He also stated he was screening the cases to 
determine if medications were or hospitalization was necessary. 
¶15 Sometime in April 1992, Charles went to Phillips' 
office and attempted to interrupt one of Charlotte's therapy 
sessions.  As a result, the police were called.   
¶16 The factual record was also developed on remand 
regarding whether Charlotte waived her privilege.  The Johnsons 
submitted 
affidavits 
that 
averred 
that 
Charlotte's 
confrontations regarding the alleged abuse occurred during 
Charlotte's therapy sessions at Rogers Memorial Hospital.  They 
further asserted that in addition to Charlotte, Reisenauer, and 
Hollowell being in the room during the confrontation, another 
patient, Charlotte's "silent advocate," was present.   
¶17 Charles' affidavit stated that in late 1991 and early 
1992, he agreed to help Charlotte pay for her therapy and began 
receiving billing statements from the defendants.  The bills 
detailed the dates and times Charlotte underwent therapy as well 
as who provided therapy. 
¶18 Charles also produced an authorization for records 
release that Charlotte signed in February 1992 while an 
inpatient at St. Mary's Hospital for psychiatric problems.  The 
release form contained check boxes that allowed the patient to 
decide what type of information to be released.  Charlotte did 
not mark the box for "Records relating to treatment for 
psychiatric condition," but rather marked the box for "The 
specific information listed here."  Next to this marked box, 
No. 
2003AP784 & 2003AP1413   
 
9 
 
Charlotte wrote "medical (physical) test results; medications 
prescribed; general progress."   
¶19 Based on the release, Charles received Charlotte's 
psychiatric 
admission 
note, 
consultation 
notes, 
and 
the 
discharge summary.  The psychiatric admission note indicated 
that Charlotte was recently treated at Rogers Memorial for an 
eating disorder.  The note goes on to explain: 
She has been flooded with memories of what she recalls 
as a sexual rape by her father when she was 3 years 
old, along with physical and emotional abuse by her 
mother when she was a child.  She found the Rogers 
program quite helpful during the 3-4 weeks she was 
there.  She was then in an outpatient program on the 
grounds, attending groups and living in home with 
other patients without staff present.  She then had an 
episode where she started screaming for 4 hours, with 
recall of abuse by her mother.  She was seen as 
impulsive by the medical staff at Rogers and was not 
allowed reentry.  
The medical note similarly stated: 
She has been experiencing flashbacks related to abuse 
as a child.  She was a victim of sexual abuse by her 
father at age 3.  She was the victim of repeated 
physical abuse by her mother throughout her childhood.  
She also was a victim of emotional abuse from both 
parents throughout her childhood and adolescent years.  
. . .  She also has an eating disorder in which she 
overeats.  . . .  She was hospitalized at Rogers 
Memorial Hospital from November through December 1991 
for this eating disorder.   . . .  Since her discharge 
from Rogers Institute in December, she continues to 
have increasing flashbacks.  During these flashbacks, 
she becomes very emotionally distraught and suicidal. 
The discharge summary, written by Dr. Israelstam, identified 
Phillips as the person who referred Charlotte for admission to 
St. Mary's Hospital.    
No. 
2003AP784 & 2003AP1413   
 
10 
 
¶20 The Johnsons also presented Charlotte's June 1992 
restraining order petition.  Charlotte's grounds for the 
petition read: 
Because of past physical, emotional, and sexual abuse 
as a child perpetrated by my parents (Charles and 
Karen) and subsequent confrontation with my father in 
Nov. of 1991, I have experienced severe stress and 
anxiety. 
The restraining order was extended in July 1993, after Charlotte 
wrote to the court that "[t]he respondents, my parents (Charles 
J. and Karen K. Johnson) are perpetrators of incest and physical 
abuse which has created a condition diagnosed by my physicians 
as post-traumatic stress disorder." 
 
¶21 The Johnsons additionally established that Charlotte 
considered other legal action.  In the beginning of January 
1994, Charlotte retained an attorney to explore her options for 
seeking a civil remedy against the Johnsons for the childhood 
abuse she believed she suffered.  Her attorney communicated with 
the Johnsons and their attorney regarding settling this possible 
claim.  In one response letter, Charlotte's attorney wrote: 
I have handled cases such as this for many years.  I 
have conversed with and/or corresponded with some of 
the finest, unbiased minds in both the legal and 
medical/psychological communities.  I have no doubts 
as to the validity of repressed memories.  Therefore, 
if your letter was intended to impress me, it has 
failed. 
After various offers of settlement letters were exchanged, it 
seems that no further action was taken on the possible lawsuit. 
¶22 In addition to discovering the above facts, the 
Johnsons deposed Phillips, Hollowell, and Reisenauer.  All three 
No. 
2003AP784 & 2003AP1413   
 
11 
 
therapists asserted privilege and refused to answer questions 
regarding treatment they provided Charlotte.  The Johnsons also 
deposed Charlotte, but she too asserted her privilege. 
¶23 The Johnsons did, however, obtain an affidavit from a 
high school friend of Charlotte's, Nidhi Jain.  Jain stated that 
after Charlotte began therapy, she visited Charlotte in June 
1992.  Although Jain could not remember many specifics of the 
conversations with Charlotte, Jain remembered Charlotte saying 
that she was seeing a therapist and was being hypnotized as part 
of her therapy. 
 
¶24 Following this discovery, Hollowell and Reisenauer 
moved for summary judgment.  They asserted that they were bound 
to abide by Charlotte's invocation of privilege; the Johnsons 
could not prove their claim with Charlotte claiming privilege; 
and public policy otherwise required protecting the therapist-
patient privilege.  Rogers Memorial and Phillips advanced 
similar reasons in their motions for summary judgment, while 
Phillips also argued her records from Charlotte's therapy were 
confidential because prior to the time she became a licensed 
counselor on March 21, 1995, she practiced under the direction 
and supervision of a licensed psychiatrist, Israelstam.   
¶25 The Johnsons moved to compel access to Charlotte's 
records, asserting that a public policy exception should be 
created to the therapist-patient relationship in cases like 
this.  Alternatively, the Johnsons claimed that confidentiality 
did not apply to Phillips' records, and Charlotte otherwise 
waived her privilege and confidentiality rights by:  (1) signing 
No. 
2003AP784 & 2003AP1413   
 
12 
 
the limited release for her records; (2) providing medical bills 
to her parents that related to her treatment; (3) confronting 
her parents about the abuse during her therapy sessions; (4) 
telling her high school friend, Jain, that she was in therapy 
and being hypnotized; (5) filing a restraining order against her 
parents; (6) communicating with an attorney about commencing a 
suit against her parents for the abuse she believed she 
suffered.  
¶26 The circuit court, the Honorable Daniel R. Moeser, 
denied 
the 
Johnsons' 
motion 
and 
eventually 
granted 
the 
defendant's summary judgment motions.  The court declined the 
Johnsons' invitation to create a new exception to the therapist-
patient privilege for cases such as these for four reasons.   
¶27 First, the court began by acknowledging there is an 
exception 
to 
confidentiality 
of 
records 
in 
Wis. Stat. § 146.82(2)(a)11 
(2001-02)6 
when 
child 
abuse 
is 
suspected, but noted that this exception related narrowly to the 
disclosure of health records to the sheriff, police department, 
or 
district 
attorney 
for 
purposes 
of 
investigation 
or 
prosecution.  Second, the court agreed with the Johnsons that 
privileges in general are to be narrowly construed, but 
concluded that the trend has been to expand the categories of 
health care providers covered by the privilege.  Third, the 
court acknowledged the Johnsons' claim that there is little 
                                                 
6 All references to the Wisconsin Statutes are to the 2001-
02 version, unless otherwise noted.   
No. 
2003AP784 & 2003AP1413   
 
13 
 
evidence that the "dangerous patient"7 exception to privilege and 
confidentiality caused psychotherapy to be less effective.  
Nevertheless, 
the 
court 
was 
persuaded 
that 
the 
general 
importance of maintaining the confidentiality of medical records 
surpassed the need for disclosure.  Fourth, the court recognized 
that Sawyer gave third parties a cause of action against 
therapists for negligent therapy.  However, the court was not 
persuaded that the therapist-patient privilege will generally 
impair the cause of action, because in many other cases the 
patient may have already waived the privilege or otherwise made 
the medical records available.   
¶28 Turning to waiver, the circuit court disagreed that 
Charlotte waived her privilege.  Regarding Phillips' lack of 
licensure, the court noted that the court of appeals in Locke 
held that the key consideration for privilege is the "patient's 
objectively reasonable perceptions and expectations of the 
medical provider."   State v. Locke, 177 Wis. 2d 590, 604, 502 
N.W.2d 891 (Ct. App. 1993).   The court found that the Johnsons 
had not presented any evidence to establish Charlotte did not 
expect her communications with Phillips to be privileged.  
Concerning the release of the various medical records and 
therapy bills and Charlotte's disclosure that she was being 
hypnotized to Jain, the circuit court concluded that none of 
these disclosures constituted a "significant part of the matter 
                                                 
7 See Schuster v. Altenberg, 144 Wis. 2d 223, 424 N.W.2d 159 
(1988), and Tarasoff v. Regents of University of California, 551 
P.2d 334 (Cal. Rptr. 1976).   
No. 
2003AP784 & 2003AP1413   
 
14 
 
or communication" under Wis. Stat. § 905.11.  With regard to 
Charlotte's confronting the Johnsons about the abuse during 
therapy, the court held that the Johnsons' presence, as family 
members, 
did 
not 
abrogate 
the 
privilege. 
 
See 
Wis. Stat. § 905.04(2).  The court also held that the presence 
of the "silent advocate" did not invade the privilege because 
that person was "present to further the interest of the patient" 
or was "participating in the diagnosis and treatment."  See 
Wis. Stat. § 905.04(1)(b).  Lastly, the court stated it was not 
convinced 
that 
the 
restraining 
order 
waived 
Charlotte's 
privilege.   
¶29 The Johnsons appealed, and the court of appeals 
certified the case to us for a public policy determination of 
whether there ought to be an exception to the therapist-patient 
privilege when an adult child accuses her parents of physical 
and sexual abuse based on memories recovered during therapy, and 
the parents sue the child's therapists under a Sawyer third-
party claim. 
II 
¶30 This court reviews a circuit court's grant of summary 
judgment de novo, applying the same methodology as the circuit 
court.  Green Spring Farms v. Kersten, 136 Wis. 2d 304, 315, 401 
N.W.2d 816 (1987).  Summary judgment must be entered "if the 
pleadings, 
depositions, 
answers 
to 
interrogatories, 
and 
admissions on file, together with the affidavits, if any, show 
that there is no genuine issue as to any material fact and that 
the moving party is entitled to a judgment as a matter of law."  
No. 
2003AP784 & 2003AP1413   
 
15 
 
Wis. Stat. § 802.08(2).  The papers filed by the moving party 
must be carefully scrutinized.  Grams v. Boss, 97 Wis. 2d 332, 
339, 294 N.W.2d 473 (1980).  All reasonable inferences drawn 
from the underlying facts contained in these documents that are 
in the record must be viewed in the light most favorable to the 
non-moving party.  See id.  However, this court does not resolve 
issues of fact on summary judgment, but rather decides whether 
genuine issues of material fact exist.  Id. at 338. 
¶31 Whether Charlotte waived her privilege requires the 
application of undisputed facts to a legal standard.  This is a 
question of law we review de novo.  See Towne Realty v. Zurich 
Ins. Co., 201 Wis. 2d 260, 267, 548 N.W.2d 64 (1996).  As a key 
factual dispute is whether Charlotte underwent recovered memory 
therapy, we cannot assume for purposes of our waiver discussion 
that recovered memory therapy occurred.  
¶32 Additionally, whether public policy requires creating 
an exception to the therapist-patient privilege in order to 
sustain a third-party professional negligence cause of action 
against a therapist is a question of law we review de novo.  See 
Stephenson v. Universal Metrics, Inc., 2002 WI 30, ¶42, 251 
Wis. 2d 171, 641 N.W.2d 158; Sawyer, 227 Wis. 2d at 137; State 
v. Hydrite Chem. Co., 220 Wis. 2d 51, 59, 582 N.W.2d 411 (Ct. 
App. 1998). 
III 
 
¶33 We begin with an overview of the confidentiality and 
privilege statutes at issue as well as the principle of waiver.  
No. 
2003AP784 & 2003AP1413   
 
16 
 
A patient's health care records are confidential pursuant to 
Wis. Stat. § 146.82(1), which states: 
All patient health care records shall remain 
confidential.  Patient health care records may be 
released only to the persons designated in this 
section or to other persons with the informed consent 
of the patient or of a person authorized by the 
patient.  
In general, "patient health care records" are defined as "all 
records related to the health of a patient prepared by or under 
the 
supervision 
of 
a 
health 
care 
provider 
. . . ."  
Wis. Stat. § 146.81(4).  There are exceptions to this rule.  
Wis. Stat. § 146.82(2)(a)1.-21.  One exception provides that 
records can be released without the patient's informed consent, 
however, when required "[u]nder a lawful order of a court of 
record."  Wis. Stat. § 146.82(2)(a)4.  See Crawford v. Care 
Concepts, 2001 WI 45, ¶2, 243 Wis. 2d 119, 625 N.W.2d 876 
(nonprivileged information can be released by order of a court 
of record). 
 
¶34 In 
addition 
to 
the 
record's 
confidentiality, 
Wis. Stat. § 905.04(2) confers on a patient an evidentiary 
privilege: 
to refuse to disclose and to prevent any other person 
from disclosing confidential communications made or 
information obtained or disseminated for purposes of 
diagnosis or treatment of the patient's physical, 
mental or emotional condition, among the patient, 
 . . . or persons, including members of the patient's 
family, who are participating in the diagnosis or 
treatment 
under 
the 
direction 
of 
the 
 . . . psychologist . . . . 
No. 
2003AP784 & 2003AP1413   
 
17 
 
The privilege applies "at all stages of all actions, cases and 
proceedings."  Wis. Stat. § 911.01(3).  The purpose of the 
privilege is to prevent unnecessary disclosure of "confidential" 
communications.  Steinberg v. Jensen, 194 Wis. 2d 439, 459, 534 
N.W.2d 361 (1995).  Section 905.04(1)(b) defines confidential as 
follows: 
A communication or information is "confidential" if 
not intended to be disclosed to 3rd persons other than 
those present to further the interest of the patient 
in the consultation, examination, or interview, or 
persons reasonably necessary for the transmission of 
the communication or information or persons who are 
participating in the diagnosis and treatment under the 
direction 
of 
the . . . psychologist . . . including 
the members of the patient's family.  
¶35 While confidentiality under Wis. Stat. § 142.82 is 
relinquished either by informed consent or by application of an 
exception, a testimonial privilege is waived where the person 
"while holder of the privilege, voluntarily discloses or 
consents to disclosure of any significant part of the matter or 
communication."  Wis. Stat. § 905.11. 
¶36 As the court of appeals observed in State v. Allen, 
200 Wis. 2d 301, 309, 546 N.W.2d 517 (Ct. App. 1996), the 
information 
covered 
by 
Wis. Stat. § 905.04 
and 
Wis. Stat. § 146.82 will overlap in many instances "because a 
patient's health care record under § 146.82 may often include a 
record of a confidential communication between the patient and a 
health care provider under  § 905.04."  As the court of appeals 
in Allen stated:  "Reading the two statutes in pari materia, 
they represent a collective statement as to the reach and limits 
No. 
2003AP784 & 2003AP1413   
 
18 
 
of the confidentiality and privilege which attach to such 
records or communications."  Id. at 311.  Because a cannon of 
statutory construction provides that where the more specific 
statute ordinarily controls over the more general statute, a 
patient does not waive the confidentiality in his or her 
confidential communications absent the more specific and more 
demanding requirement of furnishing informed consent.   
¶37 The Johnsons contend Charlotte waived her privilege 
by:  (a) signing the authorization for medical documents 
release; (b) providing her medical and treatment billing 
statements; (c) inviting the Johnsons into her therapy sessions 
for confronting them about the alleged abuse; (d) discussing her 
therapy with her high school friend, Jain; (e) filing a 
restraining order against the Johnsons; and (f) relaying certain 
information to her attorney when she contemplated civil action 
against the Johnsons for the abuse.  We do not agree that any of 
these actions or disclosures caused Charlotte to waive her 
privilege. 
A 
¶38 We first consider the limited authorization Charlotte 
signed for disclosure of certain medical records and the 
accompanying records the Johnsons received as a result.  As 
previously noted, health care records are confidential and shall 
not be disclosed absent informed consent or application of one 
of the exceptions.  Wis. Stat. § 146.82.   
¶39 Charlotte 
consented 
to 
release 
the 
"specific 
information 
listed 
here," 
which 
was 
limited 
to 
"medical 
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2003AP784 & 2003AP1413   
 
19 
 
(physical) tests; medications prescribed; general progress."  
Because Charlotte consented to disclose these records, any 
accompanying privilege associated with these records is waived.   
¶40 However, 
Charlotte's 
hospitalization 
was 
for 
psychiatric treatment, 
not 
physical 
or 
medical 
treatment.  
Although Charlotte could have provided the Johnsons her records 
that related to her psychiatric treatment by marking the box on 
the authorization form that authorized disclosure of "records 
relating to treatment for psychiatric condition," Charlotte did 
not do so.  Instead, she explicitly limited the authorization's 
scope.   The Johnsons, nonetheless, inadvertently received 
records relating to Charlotte's psychiatric treatment. 
¶41 The psychiatric admission note, consultation notes, 
and the discharge summary all included information regarding 
Charlotte's prior psychiatric care.  Even the psychiatric 
admission note indicates that Charlotte "is very guarded about 
her information and does not want it shared with her parents or 
sisters at this time."  As Charlotte clearly did not give her 
informed consent to release the "records relating to treatment 
for psychiatric condition," the hospital either should not have 
disclosed any records containing this type of information or 
redacted it.  The hospital's inadvertence in disclosing these 
records cannot obviate the need for Charlotte's informed consent 
to disclose them.  Because she did not give such consent, she 
could not have waived her privilege as to any confidential 
matter or communication with respect to those records.  See 
Allen, 200 Wis. 2d at 310. 
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2003AP784 & 2003AP1413   
 
20 
 
¶42 Even after viewing the information that was released 
by the hospital, however, we still are not persuaded that the 
records constitute a waiver of Charlotte's privilege.  At most, 
the medical documents reveal Charlotte believes she has been a 
victim of abuse and that she previously underwent therapy at 
Rogers Memorial in November 1992.  There is no discussion of  
anything she said to her therapist, that her therapist said to 
her, or the type of therapy she underwent.  Under these 
circumstances, we conclude that none of the records constitute a 
voluntary disclosure of "any significant part of the matter or 
communication." 
B 
¶43 Similar reasoning 
applies 
to the 
medical 
bills.  
Although there is an exception for disclosing medical bills 
without informed consent for billing, collection or payment of 
claims, Wis. Stat. § 146.82(2)(a)3., it does not follow that 
releasing these bills constitutes a waiver of the confidential 
communications made during the rendition of the services that 
lead to issuing the bill.  And the bills themselves that 
Charlotte gave to the Johnsons simply identify who performed 
therapy, on which date, and for how long.  No substance of any 
communications is listed on the statements.  This does not 
constitute a disclosure of a significant part of the matter or 
communication.  See Lane v. Sharp Packaging Systems, Inc., 2002 
WI 28, ¶40, 251 Wis. 2d 68, 640 N.W.2d 788 ("Billing records are 
communications from the attorney to the client, and producing 
these communications violates the lawyer-client privilege if 
No. 
2003AP784 & 2003AP1413   
 
21 
 
production of the documents reveals the substance of lawyer-
client communications.").   
C 
¶44 Regarding Charlotte inviting the Johnsons to the 
therapy 
session 
to 
confront 
them 
about 
the 
abuse, 
Wis. Stat. § 905.04(1)(b) 
protects 
communications 
made 
to 
"persons who are participating in the diagnosis and treatment 
under 
the 
direction 
of 
the . . . psychologist 
. . . or 
professional counselor, including the members of the patient's 
family."  Notably, the Johnsons submit that Charlotte was 
subjected to negligent therapy given that confrontations are 
indicia of "recovered memory therapy."  As such, the Johnsons 
have conceded that the confrontations were part of Charlotte's 
treatment, even though they allege the treatment itself was 
negligent.   
¶45 The fact that another person was in the room, the so-
called "silent advocate," does not result in a waiver either.  
Charlotte's deposition reveals that this person was there to 
support Charlotte.  According to Wis. Stat. § 905.04(1)(b), 
communications made in front of third persons are still 
confidential provided that the third person is "present to 
further the interest of the patient."  Id.  The silent 
advocate's 
presence, therefore, did 
not waive 
Charlotte's 
privilege. 
D 
¶46 Jain's affidavit also does not result in a waiver.  
The general assertions that Charlotte said she was "seeing a 
No. 
2003AP784 & 2003AP1413   
 
22 
 
therapist" and "being hypnotized," without anything more, cannot 
reasonably 
be 
considered 
a 
voluntary 
disclosure 
of 
any 
significant part of a matter or communication.  The privilege 
protects 
against 
disclosure 
of 
confidential 
matters 
or 
communications, and no such disclosure of "confidential" matters 
or communications can be inferred by the affidavit. 
E 
¶47 Neither does the 
restraining 
order 
constitute a 
waiver.  The Johnsons observe that the allegations made to 
obtain a restraining order include "[t]hat the respondent 
engaged in, or based on prior conduct of the petitioner and the 
respondent may engage in, domestic abuse of the petitioner."  
See Wis. Stat. § 813.12(5)(a)3.  As part of her petition for a 
restraining order, Charlotte attested that her parents were the 
perpetrators of incest and physical and emotional abuse.  A year 
later, Charlotte asked that the order be extended for another 
year, writing "my parents . . . are perpetrators of incest and 
physical abuse which has created a condition diagnosed by my 
physicians as post-traumatic stress disorder."  By making her 
emotional condition as being a survivor of incest and abuse an 
element of her restraining order claim, the Johnsons argue 
Charlotte waived her privilege.  We disagree. 
 ¶48 The 
waiver 
of 
privilege 
provision 
is 
found 
in 
Wis. Stat. § 905.11, and states: 
A person upon whom this chapter confers a 
privilege 
against 
disclosure 
of 
the 
confidential 
matter or communication waives the privilege if the 
person or his or her predecessor, while holder of the 
No. 
2003AP784 & 2003AP1413   
 
23 
 
privilege, 
voluntarily 
discloses 
or 
consents 
to 
disclosure of any significant part of the matter or 
communication.  This section does not apply if the 
disclosure 
is 
itself 
a 
privileged 
communication.  
(Emphasis added). 
However, Wis. Stat. § 905.04(4)(c) establishes: 
There is no privilege under this section as to 
communications relevant to or within the scope of 
discovery examination of an issue of the physical, 
mental or emotional condition of a patient in any 
proceedings in which the patient relies upon the 
condition as an element of the patient's claim or 
defense.  (Emphasis added). 
Thus, although Charlotte previously relied on her emotional 
condition to obtain an injunction, she did not waive her 
privilege, since she did not have one.  As such, there is 
nothing improper with Charlotte raising her privilege now.  
 
¶49 Even if the allegations made in the petition for 
restraining 
order 
could 
somehow 
be 
construed 
as 
waiving 
something, just what was waived?  The allegations were that "the 
respondent engaged in, or based on prior conduct of the 
petitioner and the respondent may engage in, domestic abuse of 
the petitioner."  She stated that her parents were the 
perpetrators of incest and physical and emotional abuse.  But 
there was no discussion or disclosure of medical records or 
treatment 
obtained, 
and 
certainly 
no 
disclosure 
of 
any 
"significant part of the matter or communication" between 
Charlotte and her therapist. 
 
¶50 The only item that related to Charlotte's medical 
condition came a year later, when she sought to extend the 
restraining order for one year because "my parents . . . are 
No. 
2003AP784 & 2003AP1413   
 
24 
 
perpetrators of incest and physical abuse which has created a 
condition diagnosed by my physicians as post-traumatic stress 
disorder."  While Charlotte disclosed the diagnosis, she did not 
disclose any confidential communications made or information 
obtained or disseminated for purposes of diagnosis or treatment 
of the patient's physical, mental, or emotional condition.  In 
short, she did not waive her privilege against disclosure of 
confidential matters or communications. 
F 
 
¶51 Lastly, 
the 
Johnsons 
argue 
that 
Charlotte's 
communications with her attorney regarding commencing an action 
against 
them 
for 
civil 
damages 
constitutes 
a 
waiver 
of 
Charlotte's privilege.  During settlement correspondence before 
any lawsuit was filed,8 Charlotte's attorney wrote the Johnsons' 
attorney and stated, "I have no doubts as to the validity of 
repressed memories."   This, the Johnsons contend, constitutes a 
waiver.  We do not agree. 
 
¶52 Charlotte's attorney's statement suggests Charlotte 
discussed 
the 
type 
of 
therapy 
she 
underwent. 
 
That 
communication, 
however, 
was 
also 
privileged. 
 
See 
Wis. Stat. § 905.03(2) 
(attorney-client 
privilege); 
Wis. Stat. § 905.11 (no waiver where subsequent communication is 
itself privileged).  And because Charlotte was the holder of the 
attorney-client privilege, her attorney could not waive her 
privilege without her consent.  See Wis. Stat. § 905.03(3); see 
                                                 
8 The lawsuit was never filed. 
No. 
2003AP784 & 2003AP1413   
 
25 
 
also Harold Sampson Children's Trust v. Linda Gale Sampson 1979 
Trust, 2004 WI 57, ¶46, 271 Wis. 2d 610, 679 N.W.2d 794 ("[O]nly 
the client can waive the attorney-client privilege under Wis. 
Stat. § (Rule) 905.11 regarding attorney-client privileged 
documents.").  With there being no indication of Charlotte's 
consent, 
Charlotte's 
attorney 
could 
not 
have 
waived 
her 
therapist-patient privilege in the context of their attorney-
client relationship. 
IV 
¶53 The Johnsons next contend that even if Charlotte did 
not waive her privilege, she has no privilege with regard to 
communications made to Phillips, as Phillips was not a licensed 
professional therapist until March 21, 1995, nearly four years 
after she began treating Charlotte.  We disagree for two 
reasons. 
¶54 As 
noted 
above, 
Wis. Stat. § 905.04(2) 
creates 
a 
privilege for communications made between the patient and the 
patient's 
physician, 
registered 
nurse, 
chiropractor, 
psychologist, social worker, marriage and family therapist, 
professional counselor, or other persons participating in the 
diagnosis or treatment of the patient under the direction of the 
above-mentioned personnel.  In Locke, 177 Wis. 2d 590, the court 
of appeals concluded that a defendant's statements to a social 
worker, a profession not explicitly listed under § 905.04(2), 
were privileged because the defendant reasonably believed that 
the social worker was working under the supervision of a 
psychiatrist.  The court of appeals noted that "[t]he patient's 
No. 
2003AP784 & 2003AP1413   
 
26 
 
objectively reasonable perceptions and expectations of the 
medical provider are the proper gauge of the scope of the sec. 
905.04 privilege."    Id. at 604 (citation omitted). 
¶55 We conclude that Charlotte reasonably believed her 
communications 
with 
Phillips 
would 
be 
confidential 
with 
Phillips.  Another individual, whose name Charlotte was advised 
by her attorney not to disclose on privilege grounds, referred 
Charlotte to Phillips for psychotherapy.  Phillips presented 
herself as a psychotherapist and provided therapy through 
"Heartland Counseling Services and the Wisconsin Psychotherapy 
and Healing Center."  Additionally, Charles attempted to 
interrupt one of Phillips' counseling sessions with Charlotte, 
only to be escorted off the premises by the police.  Given these 
circumstances, sufficient evidence supports the conclusion that 
Charlotte reasonably believed her communications with Phillips 
would remain confidential. 
¶56 Aside from Charlotte's reasonable expectations, her 
communications 
with 
Phillips 
are 
still 
privileged because 
Phillips was working "under the direction" of a "physician," 
specifically Israelstam.  Wisconsin Stat. § 905.04(1)(d) defines 
physician as "a person as defined in s. 990.01(28), or 
reasonably 
believed 
by 
the 
patient 
so 
to 
be."  
Wisconsin Stat. § 990.01(28), in turn, defines physician as "a 
person holding a license or certificate of registration from the 
medical examining board."   
¶57 It is undisputed that Israelstam was a licensed 
psychiatrist.  Further, at his deposition, Israelstam stated 
No. 
2003AP784 & 2003AP1413   
 
27 
 
that 
he 
reviewed 
Phillips' 
diagnoses 
once 
a 
month 
and 
periodically reevaluated each patient's treatment plan.  We 
agree with Phillips that this constitutes working under the 
direction of a physician.   
V 
¶58 Finally, the Johnsons argue that this court should 
create a public policy exception to the therapist-patient 
privilege and confidentiality for Sawyer claims.  In Sawyer this 
court determined that there is a third-party negligence claim 
against a therapist whose treatment allegedly resulted in 
implanting false memories of child abuse.  See Sawyer, 227 
Wis. 2d at 129, 136.  This court left open the question of 
whether confidentiality could defeat the cause of action in 
cases where the patient persists in invoking privilege.  We 
agree that public policy requires that the therapist-patient 
confidentiality and privilege give way to Sawyer third-party 
negligence claims, but only in limited circumstances. 
A 
¶59 We begin with a discussion of the therapist-patient 
privilege.  It is an evidentiary privilege, which "interfere[s] 
with the trial's search for the truth[] and must be strictly 
construed, consistent with the fundamental tenet that the law 
has the right to every person's evidence."  State v. Echols, 152 
Wis. 2d 725, 736-37, 449 N.W.2d 320 (Ct. App. 1989).  We have to 
be mindful that "this privilege must coexist in a judicial 
system seeking to find the truth, serve the interests of 
justice, and have all relevant information available for 
No. 
2003AP784 & 2003AP1413   
 
28 
 
consideration by the fact-finder."  Crawford v. Care Concepts, 
2001 WI 45, ¶15, 243 Wis. 2d 119, 625 N.W.2d 876.  Within this 
framework, we now turn to consider the therapist-patient 
privilege. 
¶60 The public policy purpose of the privilege "is to 
facilitate communication between a patient and his or her health 
care providers."  Id., ¶25.  The privilege "encourage[s] 
patients to candidly discuss health concerns with those treating 
them."  State v. Agacki, 226 Wis. 2d 349, 357, 595 N.W.2d 31 
(Ct. App. 1999).   
¶61 But the privilege is concerned with more than simply 
facilitating and encouraging discussion.  The United States 
Supreme Court commented on the psychotherapist-patient privilege 
in Jaffee v. Redmond, 518 U.S. 1, 10 (1996).  After noting that 
the privilege is "rooted in the imperative need for confidence 
and trust," id. (citation omitted), the Court declared: 
Effective 
psychotherapy . . . depends 
upon 
an 
atmosphere of confidence and trust in which the 
patient is willing to make a frank and complete 
disclosure of facts, emotions, memories, and fears.  
Because of the sensitive nature of the problems for 
which individuals consult psychotherapists, disclosure 
of confidential communications made during counseling 
sessions may cause embarrassment or disgrace.  For 
this reason, the mere possibility of disclosure may 
impede development of the confidential relationship 
necessary for successful treatment. 
Id.   
¶62 As the Court recognized, the privilege serves as a 
means to facilitate frank discussion in order to provide 
"effective psychotherapy," with the ultimate end aimed at 
No. 
2003AP784 & 2003AP1413   
 
29 
 
"successful treatment."  See id.  When the end is divorced from 
the means, however, such that "negligent therapy" is left to 
flourish 
within 
the 
confines 
of 
the 
therapist-patient 
relationship, the privilege no longer serves its purpose.  What 
was meant to be a device to help care for problems becomes a 
shelter to protect careless and negligent practices.  The 
privilege cannot be distorted in this manner. 
¶63 While 
we 
recognize 
the 
benefit 
from 
allowing 
therapists to diagnose and treat victims of sexual and physical 
abuse as children, no utility can be derived from protecting 
careless or inappropriate therapists and their practices.  The 
costs are simply too severe:  the therapist is allowed to 
continue negligently "treating" others, the patient remains 
disillusioned by the falsehoods, and the accused suffers the 
torment of being branded a child-abuser.  We do not hesitate to 
conclude that mechanical application of the therapist-patient 
privilege to allow such results to continue unimpeded ill serves 
the public.9  
                                                 
9We also note that at oral argument, Reisenauer and 
Hollowell contended that it is "extremely paternalistic" for 
this court to be telling people what treatment is beneficial for 
their problems.  Their contention misses the mark, however, 
because the allegation in this case is that Charlotte is an 
unsuspecting victim 
of 
falsely implanted, 
and 
reinforced, 
memories of particularly horrifying acts.  That is to say, the 
allegation here presumes that the therapy precluded Charlotte 
from rationally determining whether the therapy was beneficial. 
No. 
2003AP784 & 2003AP1413   
 
30 
 
B 
¶64 We next turn to Sawyer, the case that recognized 
third-party professional negligence claims for implanting false 
memories of child abuse.  After recognizing the cause of action, 
Sawyer described the serious and grievous harm associated with 
being branded a "child abuser."  The Sawyer court called 
attention to Doe v. Archdiocese of Milwaukee, 211 Wis. 2d 312, 
355 n.31, 565 N.W.2d 94 (1997), where this court acknowledged, 
"Society's justifiable repugnance toward sexual abuse of a child 
. . . is the reason why a falsely accused defendant can be 
gravely harmed."  Sawyer, 227 Wis. 2d at 143 (citation and 
alterations omitted).  The same holds true for false accusations 
of physical abuse of a child.  The Sawyer court also pointed out 
that "[o]thers have observed that it is indisputable that being 
labeled a child abuser is one of the most loathsome labels in 
society and most often results in grave physical, emotional, 
professional, and personal ramifications."  Id. at 143-44 
(citation and alterations omitted).   
¶65 Considering the seriousness of being falsely accused a 
child 
abuser, 
we 
remain 
"quite 
confident 
that 
negligent 
treatment which encourages false accusations of sexual abuse is 
highly culpable for the resulting injury."  Id. at 144.  That 
                                                                                                                                                             
Finally, we do not intend to suggest that piercing the 
therapist-patient privilege in these circumstances will remedy 
all the wrongs that may have occurred.  If Charlotte was indeed 
subjected 
to 
negligent 
therapy, 
that 
damage 
may 
now 
be 
irreparable.   
No. 
2003AP784 & 2003AP1413   
 
31 
 
culpability also weighs in favor of recognizing a public policy 
exception to the therapist-patient privilege in this case.   
C 
 
¶66  We are also persuaded by this court's previous 
determination that public policy can overcome the therapist-
patient privilege.  In Schuster v. Altenberg, 144 Wis. 2d 223, 
424 N.W.2d 159 (1988), this court upheld a third-party cause of 
action for a therapist's unreasonable failure to warn third 
parties of a patient's dangerous condition.  Id. at 239-40.  
Schuster involved a therapist who did not inform a patient's 
family, specifically the patient's daughter and husband, of the 
patient's psychotic condition or its dangerousness.  Id. at 226.  
As a result, the patient later was involved in a car accident 
that caused her death and significant injuries to her daughter.  
Id. at 227.  The family sued the therapist for, among other 
third-party claims, failing to warn them of the patient's 
condition and its dangerous implications.  Id. at 229.  This 
court determined the family had a third-party negligence claim.  
Id. at 239-40.   
¶67 Focusing on whether public policy limited liability, 
the therapist strenuously argued that the public policy of 
protecting 
the 
confidentiality 
of 
therapist-patient 
communications required precluding liability.  Id. at 249.  In 
rejecting the therapist's argument, this court acknowledged the 
valid concern for protecting therapist-patient confidentiality 
but ultimately focused on the nature of the injury to be 
remedied.  The court stated that the confidentiality of 
No. 
2003AP784 & 2003AP1413   
 
32 
 
therapist-patient communications "must yield in those limited 
circumstances where the public interest in safety from violent 
assault is threatened."  Id. at 249.  
¶68 The court also appealed to the various exceptions to 
the therapist-patient privilege in the evidence code.  Id. at 
250.  After observing that there was a particular exception for 
mental illness hospitalization proceedings if the psychologist 
determines that the patient is in need of hospitalization, the 
court said, "[a]t the very least, the statutory exception to the 
evidentiary 
privilege 
suggests 
a 
balance 
struck 
by 
the 
legislature between patient confidentiality and public safety."  
Id.  "More generally," the court continued, "the exception to 
the general rule of privilege demonstrates that the privilege is 
not sacrosanct and can properly be waived in the interest of 
public policy under appropriate circumstances."  Id. (citation 
and quotations omitted). 
¶69 Similar reasoning applies for creating an exception to 
the therapist-patient relationship in this case.  Turning to the 
injury to be remedied, although Schuster involved physical 
injury, this court has since acknowledged the grievous harm 
associated with being falsely labeled a child abuser.  See 
Sawyer, 227 Wis. 2d at 143-44.    
¶70 And, as did the Schuster court, we observe that both 
the evidence code and the informed consent statute contain 
specific exceptions to confidentiality where child abuse is 
suspected. 
 
See 
Wis. Stat. § 146.82(2)(a)11 
and 
Wis. Stat. § 905.04(4)(e).  Although the Johnsons concede that 
No. 
2003AP784 & 2003AP1413   
 
33 
 
neither exception is applicable here (as Charlotte was an adult 
when she underwent therapy), the exceptions nonetheless suggest 
a balance struck between confidentiality and investigating and 
determining whether child abuse has actually occurred.  See 
Schuster, 144 Wis. 2d at 251.  As the Schuster court stated, the 
exception at a minimum "demonstrates that the privilege is not 
sacrosanct and can properly be waived in the interest of public 
policy under appropriate circumstances."  Id. (citation and 
quotations omitted).   
VI 
 
¶71 For these reasons, we conclude that public policy 
requires 
creating 
an 
exception 
to 
therapist-patient 
confidentiality and privilege where negligent therapy is alleged 
to have caused accusations against parents for sexually or 
physically abusing their child.  Consistent with the significant 
purposes underlying the privilege, however, we are still 
concerned with maintaining and protecting the therapist-patient 
relationship to the greatest extent possible.  Along similar 
lines, we also are sensitive to the implications of requiring a 
patient's 
records 
automatically be 
surrendered 
whenever a 
lawsuit such as this is commenced.  Fishing expeditions cannot 
be allowed.  Therefore, we further conclude that an in camera 
inspection of the patient's records is necessary.  For guidance 
on how to fashion the prerequisites and parameters of this in 
camera inspection to limit the disclosure of privileged and 
confidential material, we turn to criminal law. 
 
No. 
2003AP784 & 2003AP1413   
 
34 
 
A 
¶72 In State v. Green, 2002 WI 68, 253 Wis. 2d 356, 646 
N.W.2d 298, this court refined and heightened the standard to be 
applied when criminal defendants seek an in camera review of the 
victim's therapy records.  After agreeing that in informant 
cases a defendant need only establish that the informant's 
testimony "may be necessary to a determination of guilt or 
innocence," this court held that "in light of the strong public 
policy favoring protection of the counseling records . . . a 
slightly higher standard is required before the court must 
conduct an in camera review of privileged counseling records."  
Id., ¶32.  That higher standard required the defendant to "set 
forth, in good faith, a specific factual basis demonstrating a 
reasonable 
likelihood 
that 
the 
records 
contain 
relevant 
information necessary to a determination of guilt or innocence 
and is not merely cumulative to other evidence available to the 
defendant."  Id., ¶34.  The evidentiary showing the defendant 
must set forth must describe as precisely as possible the 
information sought.  Id., ¶33.   Information is "necessary to a 
determination of guilt or innocence" if it "tends to create a 
reasonable doubt that might not otherwise exist."  Id., ¶34.  
Prior to making that showing, the court reaffirmed "a defendant 
must undertake a reasonable investigation into the victim's 
background and counseling through other means first before the 
records will be made available."  Id., ¶33. 
¶73 If the defendant satisfies this standard, the trial 
court reviews the records only if the victim consents to the 
No. 
2003AP784 & 2003AP1413   
 
35 
 
review.  State v. Solberg, 211 Wis. 2d 372, 386-87, 564 N.W.2d 
775 (1997).  If the victim does not consent, there is no in 
camera review and the victim is barred from testifying.  State 
v. Shiffra, 175 Wis. 2d 600, 612, 499 N.W.2d 719 (Ct. App. 
1993).  If after the in camera review, the circuit court 
determines that the records contain relevant evidence, it should 
be disclosed to the defendant if the patient again consents.  
Solberg, 211 Wis. 2d at 386-87. 
B 
¶74 We employ a similar standard here, but modify it for 
application in a civil proceeding.  We conclude the plaintiff 
must first commence a reasonable investigation into the type of 
therapy the plaintiff's child underwent before moving for an in 
camera review.  This includes exploring whether the child has 
already waived the privilege or is otherwise willing to disclose 
the records.  After the investigation, the plaintiff must set 
forth 
a 
good 
faith 
fact-specific 
basis 
demonstrating 
a 
reasonable likelihood that the records contain information 
regarding negligent treatment.  This showing cannot be based on 
mere speculation or conjecture as to what information is in the 
records, and the information sought cannot be merely cumulative 
to that already available to the plaintiff.  As part of the 
showing, the plaintiff should present evidence to provide the 
trial court with features of the negligent therapy believed at 
issue to help guide its in camera review. 
¶75 Here is where we depart from the criminal law 
standard.  If the plaintiff establishes a reasonable likelihood 
No. 
2003AP784 & 2003AP1413   
 
36 
 
that 
the 
records 
contain 
information 
regarding 
negligent 
treatment, the circuit court must proceed to conduct an in 
camera review regardless of the victim's lack of consent.  We 
deviate from the criminal law standard in this respect given the 
peculiarity of the cause of action at issue here.  Again, this 
case presents a claim that essentially contends that Charlotte 
is the unsuspecting victim of falsely implanted and reinforced 
memories.  To require Charlotte to give consent to open her 
medical records makes little sense considering that as a result 
of the negligent therapy Charlotte understandably wants nothing 
to do with her parents.  We note that our procedure not only 
allows those who have been wrongfully accused a way to proceed 
with a Sawyer cause of action, but also ultimately enables the 
court to identify negligent therapists, which can only work to 
protect future potential victims from such negligent therapy. 
Bearing this in mind, we conclude that the victim cannot impede 
the claim. 
¶76 The same holds true after the trial court concludes 
its in camera review:  If the court finds information relevant 
to the plaintiff's claim, the court shall turn that information, 
and only that information, over to the plaintiffs.  The 
therapist-patient privilege is also overcome, but only with 
respect to those disclosures.  All other records not disclosed 
retain confidentiality and privileged status.   
¶77 With this standard at hand, we remand the case to 
furnish the Johnsons with an opportunity to present a good faith 
fact-specific basis demonstrating a reasonable likelihood that 
No. 
2003AP784 & 2003AP1413   
 
37 
 
the records contain information regarding negligent therapy.  If 
the Johnsons satisfy the standard we articulate, the court must 
conduct an in camera review of Charlotte's records.  And if that 
review uncovers relevant evidence, the trial court must turn 
that evidence over to the parties and the accompanying privilege 
is concurrently overcome as to that evidence.   
VII 
 
¶78 In sum, we conclude that Charlotte did not waive her 
therapist-patient 
privilege. 
 
We 
further 
conclude 
that 
Charlotte's communications with Phillips were privileged because 
of Charlotte's reasonable expectation that they would be and 
because Phillips worked under the direction of a physician.  
However, we conclude that there is a public policy exception to 
the therapist-patient privilege and to the confidentiality in 
patient health care records where negligent therapy causes false 
accusations against the parents for sexually or physically 
abusing their child.  The exception is not unlimited and is 
implicated only where the plaintiff can establish a reasonable 
likelihood that negligent therapy occurred and the trial court 
after conducting an in camera review agrees that the records 
contain relevant information regarding negligent treatment.   
By the Court.—Reversed and cause remanded for further 
proceedings consistent with this opinion. 
¶79 PATIENCE DRAKE ROGGENSACK, J., did not participate.   
 
 
2003AP784 & 2003AP1413.dtp 
 
 
1 
 
¶80 DAVID T. PROSSER, J.   (concurring).  In our society, 
sexual abuse of a child ranks among the most heinous crimes a 
person can commit.  Accord Doe v. Archdiocese of Milwaukee, 211 
Wis. 2d 312, 
355, 
565 
N.W.2d 94 
(1997). 
 
Charlotte 
Dawn 
(Charlotte) openly and repeatedly leveled allegations of child 
sexual abuse against her father, Dr. Charles Johnson, gravely 
damaging his personal and professional reputations.  She made 
additional allegations against her mother and her grandfather.  
Charlotte now asks the court to acquiesce in her efforts to 
shield the psychotherapists who, Dr. Johnson alleges, implanted 
Charlotte's memories of abuse.  As the lead opinion recognizes, 
that result would be contrary to public policy. 
¶81 I join sections I, II, IV, V, and VI of Justice 
Butler's lead opinion because I agree that there is an exception 
to 
therapist-patient 
confidentiality 
and 
privilege 
where 
negligent therapy is alleged to have caused accusations against 
parents for sexually or physically abusing their children.  
However, I do not agree with Section III or with other 
statements in the lead opinion that conclude that Charlotte did 
not waive confidentiality and privilege in this case.  I write 
separately to emphasize that in this case, numerous undisputed 
facts 
show 
that 
Charlotte 
waived 
her 
privilege 
of 
confidentiality by voluntarily disclosing a significant part of 
the privileged matter. 
I. STANDARD OF REVIEW 
¶82 Determinations 
of 
waiver 
generally 
present 
mixed 
questions of fact and law.  See Reckner v. Reckner, 105 
2003AP784 & 2003AP1413.dtp 
 
 
2 
 
Wis. 2d 425, 435, 314 N.W.2d 159 (Ct. App. 1981); accord State 
v. Arredondo, 2004 WI App 7, ¶12, 269 Wis. 2d 369, 674 
N.W.2d 647 (waiver of right to testify); Meyer v. Classified 
Ins. Corp. of Wis., 179 Wis. 2d 386, 396, 507 N.W.2d 149 (Ct. 
App. 1993) (waiver of right to arbitrate).  Normally, we uphold 
a circuit court's findings of fact unless they are clearly 
erroneous. 
¶83 In this case, however, the defendants moved for 
summary judgment, and their motion was granted even though the 
court acknowledged that there were "material issues of fact."  
The court entered judgment against the plaintiffs on grounds 
that "defendants [were] unable to defend against plaintiff's 
allegations because of the [therapist-patient] privilege." 
¶84 After reviewing the facts, the circuit court concluded 
that Charlotte had not waived her privilege against the 
disclosure 
of 
confidential 
matters 
or 
communication 
under 
Wis. Stat. § 905.11.  This was a legal determination.  Thus, the 
question 
whether 
Charlotte 
waived 
the 
therapist-patient 
privilege comes to us as a question of law, which we review de 
novo, applying the facts to the legal standard for waiver of 
privilege.  Most of the facts are undisputed, but the circuit 
court, obeying well-established rules governing motions for 
2003AP784 & 2003AP1413.dtp 
 
 
3 
 
summary judgment,10 construed disputed facts in favor of the 
nonmoving party——the Johnsons.  After performing this analysis, 
the court "dismissed" the action. 
II. QUESTIONS PRESENTED 
¶85 This case presents two separate questions of "waiver."  
The first is whether Charlotte waived the confidentiality 
applicable to her medical records under § 146.8211 by causing 
certain records to be sent to her father for billing purposes 
and to keep him aware of her "general progress."  The second is 
whether the released medical records, and any other voluntary 
disclosures Charlotte made, constitute a "significant part" of 
the privileged matter, thus 
waiving 
the therapist-patient 
confidentiality privilege embodied in Wis. Stat. § 905.04(2). 
¶86 These two questions are interrelated.  As the court of 
appeals observed in State v. Allen, "[i]n many instances, the 
                                                 
10 Before the circuit court, all the defendants filed 
motions to dismiss and Rogers Memorial Hospital filed an 
alternative motion for summary judgment.  The circuit court, 
while continuing to refer to the defendants' "motion to 
dismiss," effectively converted the motions to dismiss into 
summary judgment motions by considering facts outside the 
pleadings.  See Wis. Stat. § 802.06(2)(b) ("If on a motion 
asserting . . . failure of the pleading to state a claim upon 
which relief can be granted . . . matters outside of the 
pleadings are presented to and not excluded by the court, the 
motion shall be treated as one for summary judgment . . . .") 
(emphasis added).  The lead opinion follows this approach, lead 
op., ¶¶10, 31-51, and so does this concurrence. 
11 "All 
patient 
health 
care 
records 
shall 
remain 
confidential.  Patient health care records may be released only 
to the persons designated in this section or to other persons 
with the informed consent of the patient or of a person 
authorized by the patient."  Wis. Stat. § 146.82 (2001-02). 
2003AP784 & 2003AP1413.dtp 
 
 
4 
 
data covered by these two statutes will overlap because a 
patient's health care record under § 146.82 may often include a 
record of a confidential communication between the patient and a 
health care provider under § 905.04."  State v. Allen, 200 
Wis. 2d 301, 309, 546 N.W.2d 517 (Ct. App. 1996).  Section 
905.04(2) contains the therapist-patient privilege, protecting 
"confidential communications made or information obtained or 
disseminated for purposes of diagnosis or treatment of the 
patient's 
physical, 
mental 
or 
emotional 
condition . . . ."  
However, the privilege-holder waives that privilege if she 
"voluntarily 
discloses 
or 
consents 
to 
disclosure 
of 
any 
significant 
part 
of 
the 
matter 
or 
communication."  
Wis. Stat. § 905.11. 
¶87 Here, 
Charlotte's 
voluntary 
disclosure 
of 
a 
significant part of the privileged matter justifies a limited 
release of her medical records to her parents.  The plaintiffs 
need not have unlimited access to Charlotte's therapy records 
because parts of the records would not be relevant to this 
litigation.  The lead opinion's condition of in camera review is 
an appropriate method to determine exactly which records must be 
released.  
¶88 In contrast to this concurrence, the lead opinion 
identifies 
individual 
voluntary 
disclosures 
that 
could 
constitute waiver, but rejects each one in piecemeal fashion.  
Lead op., ¶¶25, 33.  These individual disclosures are like 
pieces in a puzzle.  When the puzzle is assembled, the resulting 
picture leaves little doubt that Charlotte voluntarily waived 
2003AP784 & 2003AP1413.dtp 
 
 
5 
 
her privilege of confidentiality.  In my view, at least two 
disclosures relating to litigation would have been sufficient in 
themselves 
to 
effect 
a 
waiver 
of 
the 
therapist-patient 
privilege.  But any vestige of uncertainty is removed when the 
total picture of revelations is compared to commonly recognized 
features of treatment by recovered memory therapy. 
¶89 To show the significance of Charlotte's voluntary 
disclosures, this concurrence will discuss features of recovered 
memory therapy,12 and then will discuss the grounds for waiver.   
III. RECOVERED MEMORY THERAPY 
¶90 This concurrence is not intended to pass judgment on 
the legitimacy of recovered memory therapy.  However, an 
understanding of commonly practiced methods of recovered memory 
therapy is essential to any evaluation of whether Charlotte 
waived her privilege by voluntarily disclosing "any significant 
part" of the privileged matter.  Without understanding the 
salient features of the privileged matter, it would be nearly 
impossible 
to 
determine 
whether 
Charlotte 
disclosed 
any 
significant part of the matter or the communications relating to 
the matter. 
                                                 
12 The terms "recovered memory therapy" and "repressed 
memory 
therapy" 
are 
often 
used 
interchangeably 
in 
the 
professional literature.  See Alan W. Scheflin & David Spiegel, 
From Courtroom to Couch: Working With Repressed Memory and 
Avoiding Lawsuits, 21:4 Psych. Clinics of N. Am. at 847, 857 
(Dec. 1998).  This concurrence refers to "recovered memory 
therapy."  No significance should be ascribed to this word 
choice. 
2003AP784 & 2003AP1413.dtp 
 
 
6 
 
¶91 Studies reveal that therapists practicing recovered 
memory therapy use a wide variety of techniques,13 including 
hypnosis, age regression, free narrative recall, flashbacks, 
body memories, and survivors' groups.  See Daniel Brown, et al., 
Memory, Trauma Treatment, and the Law 482-83 (W.W. Norton & Co. 
1998)14 (hereinafter Brown, Memory, Trauma Treatment, and the 
Law); Ellen Bass & Laura Davis, The Courage To Heal 73-75 
(Harper & Row, 1st ed. 1988) (hereinafter Bass, The Courage to 
Heal); Hollida Wakefield & Ralph Underwager, Return of the 
Furies: An Investigation Into Recovered Memory Therapy 128 (Open 
Court Publishing 1994) (hereinafter Wakefield, Return of the 
Furies); Joanne M. Hall & Lori Kondora, Beyond "True" and 
"False" Memories: Remembering and Recovery in the Survival of 
Childhood Sexual Abuse, 19:4 Advances in Nursing Science (June 
1997) (hereinafter Hall, Beyond "True" and "False" Memories).  
Clinicians disagree about which techniques are preferable, or 
even acceptable.  Brown, Memory, Trauma Treatment, and the Law 
at 482-83.  However, some observers believe there are certain 
common patterns running through treatment methods.  Wakefield, 
Return of the Furies at 149.  This concurrence relates some of 
these commonalities in an effort to understand Charlotte's 
disclosures.   
                                                 
13 Because there is no single method of practicing recovered 
memory therapy, this concurrence summarizes only some of the 
more commonly practiced features of the technique. 
14 This 
extensive 
volume 
comprehensively 
reports 
and 
summarizes the professional literature in this area.  Dr. 
Israelstam referred to this book in preparation for his 
deposition in this case. 
2003AP784 & 2003AP1413.dtp 
 
 
7 
 
¶92 For many patients the first step on the road to 
recovered memories is entering treatment for problems other than 
abuse, 
such 
as 
depression, 
eating 
disorders, 
or 
marital 
distress.  Cathy Spatz Widom & Suzanne Morris, Accuracy of Adult 
Recollections of Childhood Victimization: Part 2 Childhood 
Sexual 
Abuse, 
9 
Psych. 
Assessment 
34, 
42 
(Mar. 
1997) 
(hereinafter Widom, Accuracy of Adult Recollections of Childhood 
Victimization); Bass, The Courage to Heal at 50, 217-19; 
Wakefield, Return of the Furies at 149; see generally Harrison 
G. Pope Jr. & James I. Hudson, "Recovered Memory" Therapy for 
Eating Disorders: Implications of the Ramona Verdict, 19:2 Int. 
J. of Eating Disorders (Mar. 1996) (hereinafter Pope, "Recovered 
Memory" Therapy for Eating Disorders).  Some therapists question 
women exhibiting these symptoms about the possibility that they 
were abused as children.  Id.   
¶93 A common thread running through most recovered memory 
treatment methods is the use of hypnosis.  Donald A. Eisner, The 
Death of Psychotherapy 72 (Praeger Publishers 2000); Wakefield, 
Return of the Furies at 128-130.  In one recent survey about 
recovery of repressed memories of sexual abuse, 97 percent of 
therapists agreed that "[h]ypnosis is a worthwhile psychotherapy 
tool."  Wakefield, Return of the Furies at 133.  Almost 90 
percent of the respondents had either a master's degree or a 
Ph.D.  "[T]he issue is not whether hypnosis is used, but how it 
is used."  Brown, Memory, Trauma Treatment, and the Law at 519.  
A critical feature of the hypnotic procedure is a "flashback," 
or "the reliving of a traumatic experience, or an aspect of 
2003AP784 & 2003AP1413.dtp 
 
 
8 
 
trauma, as if it were happening now."  Wakefield, Return of the 
Furies at 137-42.   
¶94 Recovered memory practitioners concede that hypnotized 
patients are "especially vulnerable to suggestive influence from 
their doctors," and therefore therapists should not "'push' 
their clients to recall [child abuse.]"  John G. Watkins, 
Dealing With the Problem of "False Memory" in Clinic and Court, 
Fall 1993 J. Psych. & Law 297, 301 (hereinafter Watkins, Dealing 
With the Problem of "False Memory").  However, memories of abuse 
"usually emerge only after much resistance . . . ."  Id. at 303.  
A patient recalling abuse may exhibit physical manifestations of 
terror, including "sweating through" and physically reliving the 
abuse.  Id. at 308.   
¶95 During these physical manifestations, patients may 
experience 
"body 
memories" 
to 
"gain 
information 
about 
hypothesized abuse that is not remembered."  Wakefield, Return 
of the Furies at 145; see also Hall, Beyond "True" and "False" 
Memories. 
 
In 
essence, 
the 
patient's 
physical 
symptoms 
correspond to the childhood abuse even without conscious 
memories.  Id. 
¶96 Some therapists believe that once patients recover 
memories of abuse, they "can get well only if they 'confront the 
abuser.'"  Watkins, Dealing With the Problem of "False Memory" 
at 301.  However, there is dispute over whether this technique 
is effective.  Id.; see also Brown, Memory, Trauma Treatment, 
and the Law at 36, 167.   
2003AP784 & 2003AP1413.dtp 
 
 
9 
 
¶97 As therapy continues, patients are often asked to make 
journal entries, keep a diary, or create artwork in an effort to 
recover more memories.  Brown, Memory, Trauma Treatment, and the 
Law at 414-16; Christine Courtois, Recollections of Sexual 
Abuse: Treatment Principles and Guidelines 36-37 (W.W. Norton & 
Co. 1999); Wakefield, Return of the Furies at 145-46; Bass, The 
Courage to Heal at 83.  In a related tactic, patients are asked 
to read books relating to remembered childhood abuse such as The 
Courage to Heal.15   
¶98 Another common technique is to advise the patient to 
cut off all ties with her family and join a "survivors' group" 
which becomes the patient's "new family."  Wakefield, Return of 
the Furies at 143-44.  As The Courage to Heal puts it, "It is 
painful to make a break with your family, but it is even more 
painful to keep waiting for a miracle."  Bass, The Courage to 
Heal at 305.  The book also notes that some women "have changed 
                                                 
15 The Courage to Heal, by Ellen Bass and Laura Davis, is 
one of the seminal texts on recovered memory therapy and is seen 
as the "Bible" of its practices.  Hollida Wakefield & Ralph 
Underwager, 
Return 
of 
the 
Furies: 
An 
Investigation 
Into 
Recovered Memory Therapy 133 (1994).  It has sold more than 
750,000 copies and is used by many practitioners.  Id. at 133-
34.  The authors published a companion workbook in 1990 and a 
revised edition of the main volume in 1996.  
The meteoric rise of the recovered memory therapy movement 
began in 1988 with publication of The Courage to Heal.  Donald 
A. Eisner, The Death of Psychotherapy 68 (2000).  Later, some 
professionals questioned the legitimacy of The Courage to Heal 
because at the time of its first publication, neither of its 
authors had any degrees or formal training.  Id. at 134.  But in 
the late 1980s and early 1990s, the book was at the height of 
its popularity. 
2003AP784 & 2003AP1413.dtp 
 
 
10 
 
their names, casting off any identification with the abuser."  
Id. at 306. 
¶99 As one of the final steps in the cleansing process, 
recovered 
memory 
therapists 
and 
survivors' 
groups 
often 
recommend filing civil lawsuits against the accused abuser.16  
One recent study reported that 1 of every 16 accused parents has 
a lawsuit filed against him or her, and "[m]any others have been 
threatened." 
 
Wakefield, 
Return 
of 
the 
Furies 
at 
146.  
Practitioners believe that civil litigation fulfills a double 
purpose by ensuring that the abuser is held liable for the abuse 
and providing therapeutic closure for the victim.  Id. at 147. 
¶100 Having outlined some of the broad characteristics of 
the admittedly diverse therapy at issue, I turn to the 
discussion of waiver. 
IV. WAIVER 
A. 
Records Release 
¶101 As the lead opinion correctly notes, patient health 
care 
records 
prepared 
by 
"health 
care 
providers" 
are 
confidential.  Wis. Stat. § 146.82(1).  The lead opinion appears 
to assume, without expressly deciding, that Charlotte waived the 
confidentiality of some of her records because it analyzes 
whether the information contained in those records constituted a 
waiver under Chapter 905.   
                                                 
16 "In my experience, nearly every client who has undertaken 
this 
kind 
of 
suit 
has 
experienced 
growth, 
therapeutic 
strengthening, and an increased sense of personal power and 
self-esteem as a result of the litigation."  Bass, The Courage 
to Heal at 310. 
2003AP784 & 2003AP1413.dtp 
 
 
11 
 
¶102 Two categories of records are at issue.  The first 
category encompasses Charlotte's billing records from various 
medical 
providers. 
 
Section 
146.82(2)(a)3. 
specifically 
authorizes release of records "[t]o the extent that the records 
are needed for billing, collection or payment of claims."  
Charlotte repeatedly wrote her father to ask for money and she 
appears to have sent him some of her bills directly.  She wrote 
her father on February 12, 1992, "you should receive a bill 
[from Kay Phillips]," and on April 22, 1992, "I will transfer 
the bills for prior hospitalizations to you . . . I will mail 
the bills later this week."  
¶103 While Charlotte may have sent some billing records 
directly, she undoubtedly caused other billing records to be 
sent to her father for payment.  In his sworn affidavit, Dr. 
Johnson described the billing records he received from Rogers 
Memorial Hospital, South Street Clinic, Kay Phillips and her 
employer, Heartland Counseling Services, Grand Teton Mental 
Health Consultants (for Dr. Israelstam), St. Marys Hospital, and 
Waukesha Memorial Hospital.  It is unlikely that six different 
providers would have sent medical bills to Dr. Johnson in St. 
Louis without Charlotte's explicit authorization.  By this 
authorization, Charlotte waived any applicable privilege under 
§ 146.82 with respect to these records.   
¶104 A second set of records relates to an intake report 
filled out upon Charlotte's admittance to St. Marys Hospital.  
At intake, Charlotte voluntarily filled out a form empowering 
St. Marys to disclose some of her medical records.  The form 
2003AP784 & 2003AP1413.dtp 
 
 
12 
 
allows the patient to determine the purpose of the disclosure 
and to decide exactly what information will be disclosed by 
checking boxes on the form.   
¶105 Charlotte indicated that the purpose of disclosure was 
to show her "progress."  She signed a form stating "I hereby 
request and authorize St. Marys Hospital Medical Center to 
provide access to my hospital records" to "Dr. Charles Johnson 
(father)" to show her "progress."  This authorization was signed 
several months after she had accused Dr. Johnson to his face of 
sexually abusing her. 
¶106 Charlotte also checked the box marked "The specific 
information listed here," to indicate what information should be 
disclosed.  By hand, she then made the following notations: 
"medical 
(physical) 
test 
results; 
medications 
prescribed; 
general progress." 
¶107 Under the umbrella of "general progress," St. Marys 
released Charlotte's admission report, some consultation notes, 
and a discharge report to Dr. Johnson. 
¶108 In her deposition, Charlotte conceded the possibility 
that her father required her to provide some medical records if 
she wanted him to continue paying for her treatment.  This can 
be seen in the following exchange between counsel for Rogers 
Memorial Hospital and Charlotte: 
Q: 
. . .  Do you know if it's possible that your dad 
required some sort of update on your treatment in 
exchange for making any types of payments for 
your medical bills? 
2003AP784 & 2003AP1413.dtp 
 
 
13 
 
A: 
It's possible.  I'm not aware of it, but it is 
possible.   
 
¶109 This concession mirrors Dr. Johnson's sworn statement 
that "I asked Charlotte to provide me with information regarding 
her care." 
 
¶110 Charlotte waived the confidentiality of the admission 
report, consultation notes, and discharge report by signing the 
release form as she did and by her statements at the deposition. 
 
¶111 In any event, Charlotte's voluntary admissions at her 
deposition duplicate much of the information in these reports. 
B. 
Chapter 905 Waiver 
¶112 It is undisputed that patients can prevent disclosure 
of communications made "for purposes of diagnosis or treatment 
of the patient's physical, mental or emotion condition . . . ."  
Wis. Stat. § 905.04(2).  However, the 
patient 
waives 
this 
privilege if she voluntarily discloses "any significant part of 
the matter or communication."  Wis. Stat. § 905.11.  In this 
case, the "matter" at issue is whether Charlotte underwent 
recovered memory therapy.  Charlotte and the defendants deny 
that such therapy occurred.  However, Charlotte's voluntary 
disclosures lead to a different conclusion.  Charlotte waived 
her 
§ 905.04(2) 
privilege 
by 
voluntarily 
disclosing 
a 
"significant part of the matter"——namely, persuasive information 
that she underwent recovered memory therapy. 
¶113 The lead opinion summarizes the grounds for waiver: 
[T]he Johnsons claimed that confidentiality did not 
apply to Phillips' records, and Charlotte otherwise 
waived her privilege and confidentiality rights by: 
(1) signing the limited release for her records; (2) 
2003AP784 & 2003AP1413.dtp 
 
 
14 
 
providing medical bills to her parents that related to 
her treatment; (3) confronting her parents about the 
abuse during her therapy sessions; (4) telling her 
high school friend, [Nidhi] Jain, that she was in 
therapy and being hypnotized; (5) filing a restraining 
order against her parents; (6) communicating with an 
attorney about commencing a suit against her parents 
for the abuse she believed she suffered. 
Lead op., ¶25. 
¶114 After evaluating each of these grounds in isolation, 
the lead opinion concludes that Charlotte did not waive her 
confidentiality privilege.  Lead op., ¶78.  But the grounds 
cannot be fairly evaluated by considering one, rejecting it, and 
then considering another afresh, as if no other ground existed.  
Rather, the grounds should be considered together, as a totality 
of information.17   
¶115 In furtherance of this purpose, the following is an 
application of the facts construed in favor of the nonmoving 
party (the Johnsons), to the legal standard of voluntary 
disclosure.  It reflects two changes from the lead opinion's 
waiver analysis: First, it considers some additional grounds 
culled from Charlotte's voluntary admissions at her deposition.  
Second, it revises the order of presentation.  As noted above, 
some of these grounds individually justify a finding of waiver, 
                                                 
17 The court briefly mentioned a similar "totality of the 
circumstances" approach in Harold Sampson Children's Trust v. 
The Linda Gale Sampson 1979 Trust, 2004 WI 57, ¶30 n.16, 271 
Wis. 2d 610, 679 N.W.2d 794.  The court did not seriously 
consider the test, commenting that it would be "difficult to 
apply."  Id.  On the facts of this case, the totality analysis 
is not difficult to apply and presents a workable analytic 
framework. 
2003AP784 & 2003AP1413.dtp 
 
 
15 
 
and when the grounds are viewed collectively the finding is 
inescapable. 
¶116 Charlotte 
testified 
at 
her 
deposition 
that 
she 
originally entered therapy, in the form of 12-step programs in 
Alcoholics Anonymous (AA) and Overeaters Anonymous (OA), due to 
alcohol abuse and an eating disorder, bulimia. 
¶117 In 1991 she entered the care of Kay Phillips, but she 
has refused to disclose who referred her to Phillips.  Most 
patients entering treatment for eating disorders or alcohol 
abuse do not undergo recovered memory therapy to treat their 
problems.  We know, however, that many recovered memory therapy 
patients enter treatment for a disorder other than their 
memories of abuse.  Widom, Accuracy of Adult Recollections of 
Childhood Victimization at 42; Bass, The Courage to Heal at 50, 
217-19; Wakefield, Return of the Furies at 149; see generally 
Pope, "Recovered Memory" Therapy for Eating Disorders. 
¶118 Charlotte's billing 
records 
show 
that 
after her 
referral 
to 
Kay 
Phillips, 
Charlotte 
received 
extensive 
psychotherapy treatment during 1991, 1992, and 1993.  While this 
fact is not determinative of the type of treatment Charlotte 
received, it provides another data point to consider.  The AA 
12-step recovery program makes no mention of psychotherapy.18  
The OA 12-step program was adapted directly from the AA program 
                                                 
18 Alcoholics Anonymous 
Recovery 
Program, 
available at 
http://www.alcoholics-anonymous.org/default/en_about_aa_sub.cfm? 
subpageid=17&pageid=24 (last visited July 1, 2005). 
2003AP784 & 2003AP1413.dtp 
 
 
16 
 
and similarly does not reference psychotherapy.19  This suggests 
that Charlotte's therapy progressed beyond limited treatment for 
an eating disorder or alcohol abuse.20  At her deposition, 
Charlotte testified that she believed her eating disorder and 
alcohol abuse were symptoms of the fact that she was abused as a 
child. 
¶119 Next, as Charlotte testified at several points during 
her deposition, she began to experience——and experiences to this 
day——flashbacks to her childhood, and specifically, to memories 
of childhood abuse.  Charlotte also experiences "body memories" 
of abuse.  As discussed above, "body memories" are commonly 
reported among abuse survivors undergoing recovered memory 
therapy.  Charlotte has somehow preserved these memories despite 
the fact that she can remember almost nothing else from her life 
before age 14, and little of her life thereafter.  At her 
deposition, Charlotte had trouble remembering the names of 
lifelong friends, and testified that she could not remember the 
names of old roommates, boyfriends, or other acquaintances.  It 
is of course possible to maintain the belief that a patient 
                                                 
19 Overeaters Anonymous (OA) Recovery Program, available at 
http://www.oa.org/twelve_steps.html (last visited July 1, 2005). 
20 This is not to say that a person could not enter 
psychotherapy as part of treatment for an eating disorder or 
alcohol abuse.  In fact, OA recommends that its patients 
independently seek psychotherapy.  See  http://www.oa.org/ 
courier02/courier02.htm (last visited July 1, 2005).  However, 
neither OA nor AA provides psychotherapy services as part of a 
recovery 
program, 
meaning 
that 
Charlotte's 
therapy 
had 
progressed beyond the "12-step program" level. 
2003AP784 & 2003AP1413.dtp 
 
 
17 
 
might experience such flashbacks and body memories absent the 
use of recovered memory therapy.  
¶120 At her deposition, Charlotte admitted that she owned 
The Courage To Heal, but claimed that she "never read it."  She 
stated that she bought it because it was "common knowledge" 
among participants in the types of programs she took part in 
that she should purchase it.  She also admitted that "maybe" she 
had told her mother to read the book.  As already noted, The 
Courage to Heal has been called the "'Bible' of the recovered 
memory movement."  Wakefield, Return of the Furies at 133.  It 
has also been termed the "greatest impetus to the search for 
memories of forgotten childhood sexual abuse."  Eisner, The 
Death of Psychotherapy at 68.   
¶121 In her affidavit, Nidhi Jain, now a physician, 
testified that she spoke to Charlotte in 1992 and that Charlotte 
revealed that "she was being hypnotized by her therapist."  
Charlotte denied admitting as much to Jain, but acknowledged 
that Jain was her "best friend" during high school.  Charlotte's 
admission that she underwent hypnosis is a disputed fact.  
Nevertheless, the circuit court correctly considered this fact 
to be true on defendants' motion to dismiss.   
¶122 The lead opinion concludes that even if this court 
could find the fact that Charlotte was hypnotized, that would 
prove nothing.  Hypnosis has many uses apart from recovered 
memory therapy.  Nonetheless, evidence of Charlotte's hypnosis 
is very significant. 
2003AP784 & 2003AP1413.dtp 
 
 
18 
 
¶123 The undisputed portion of the puzzle assembled to this 
point reveals a patient suffering from depression and eating 
disorders, taking part in psychotherapy, experiencing flashbacks 
and body memories, and in possession of The Courage to Heal.  
The disputed piece is the admission of hypnosis. 
¶124 In November 1991, Charlotte asked her father to come 
to Rogers Memorial Hospital for a meeting.  At that meeting, 
Charlotte openly accused Dr. Johnson and her grandfather of 
sexual abuse.  In October 1993, Charlotte similarly "confronted" 
her 
mother, 
accusing 
her 
of 
physical 
abuse. 
 
These 
confrontations 
conform 
to 
another 
belief 
held 
by 
some 
practitioners of recovered memory therapy——that the patients 
"can get well only if they 'confront the abuser.'"   Watkins, 
Dealing With the Problem of "False Memory" at 301. 
¶125 As her therapy continued, Charlotte testified that she 
kept a journal to express her feelings "[o]ff and on since I 
started recovery probably."  Once again, keeping a journal does 
not link a person to recovered memory therapy, but keeping a 
journal is often recommended to recovering patients by their 
therapists.  See Bass, The Courage to Heal at 145-46; Wakefield, 
Return of the Furies at 145-46.  This admission is another piece 
of circumstantial evidence. 
¶126 On June 18, 1992, Charlotte filed a petition for a 
temporary restraining order against her parents and cut off all 
contact with them.  In her accompanying statement of the facts, 
Charlotte accused her parents of "physical, emotional and sexual 
abuse" and discussed the confrontation with her father "after 
2003AP784 & 2003AP1413.dtp 
 
 
19 
 
recalling the sexual abuse."  (Emphasis added.)  A year later, 
she wrote to the court requesting renewal of the restraining 
order alleging that her parents "are perpetrators of incest and 
physical abuse which has created a condition diagnosed by my 
physicians 
as 
post-traumatic 
stress 
disorder." 
 
(Emphasis 
added.) 
¶127 It is unclear from the record whether the Johnsons 
contested the restraining order.  However, had they done so, 
they could have made a strong argument to obtain Charlotte's 
medical records under Wis. Stat. § 905.04(4)(c): 
(c) Condition an element of claim or defense.  
There is no privilege under this section as to 
communications relevant to or within the scope of 
discovery examination of an issue of the physical, 
mental or emotional condition of a patient in any 
proceedings in which the patient relies upon the 
condition as an element of the patient's claim or 
defense . . . . 
¶128 With her own words, Charlotte claimed that she had a 
"condition," namely, "post-traumatic stress disorder," caused by 
"physical, emotional and sexual abuse" from her parents, and she 
made this claim in litigation.  In Steinberg v. Jensen, 194 
Wis. 2d 439, 534 N.W.2d 361 (1995), Justice Janine Geske wrote: 
"Clearly, once a patient-litigant puts his or her physical, 
mental, or emotional condition into issue in a lawsuit, any 
confidential physician-patient communications relating to that 
issue, including those relevant to discovery under ch. 804, 
2003AP784 & 2003AP1413.dtp 
 
 
20 
 
Stats., are not privileged."  Steinberg, 194 Wis. 2d at 481 
(Geske, J., concurring).21 
¶129 The lead opinion concludes, somewhat cryptically, that 
"[a]lthough 
Charlotte 
previously 
relied 
on 
her 
emotional 
condition to obtain an injunction, she did not waive her 
privilege, since she did not have one.  As such, there is 
nothing improper with Charlotte raising her privilege now."  
Lead op., ¶48.  This appears to mean that Charlotte waived her 
privilege for the sole purpose of obtaining the restraining 
order, and now reasserts it in the present context.   
¶130 Yet "[o]nce a privilege has been waived, it cannot be 
invoked at a later time unless the particular privilege so 
permits."22  7 Blinka Wisconsin Practice: Wisconsin Evidence 
§ 511.1 at 318 (2d ed. 2001).  As another court succinctly wrote 
long ago, "when a secret is out, it is out for all time, and 
                                                 
21  Other courts, construing similar privileges, have 
reached similar conclusions.  "'The whole purpose of the 
(physician-patient) privilege is to preclude the humiliation of 
the patient that might follow disclosure of his ailments.  When 
the patient himself discloses those ailments by bringing an 
action in which they are in issue, there is no longer any reason 
for the privilege.'"  In re Lifschutz, 467 P.2d 557, 569 (Cal. 
1970) (quoting City and County of San Francisco v. Superior 
Court, 231 P.2d 26, 28 (Cal. 1951)).  "The physician-patient 
privilege . . . [is] 
to be 
used for 
preserving 
legitimate 
confidential communications, not for suppressing the truth after 
the privileged one lets the bars down."  State v. Carter, 641 
S.W.2d 54, 59 (Mo. 1982).   
22 Professor Blinka cites the Fifth Amendment right against 
self-incrimination, which a person may waive at one hearing and 
assert at a later one.  7 Blinka Wisconsin Practice: Wisconsin 
Evidence § 511.1 at 318 n.1 (2d ed. 2001).  The therapist-
patient privilege does not fall within that category. 
2003AP784 & 2003AP1413.dtp 
 
 
21 
 
cannot be caught again like a bird, and put back in its cage."  
People v. Al-Kanani, 307 N.E.2d 43, 44 (N.Y. 1973) (quoting 
People v. Bloom, 85 N.E. 824, 826 (N.Y. 1908)).  For that 
reason, in State v. Johnson, this court did not allow a litigant 
who had waived the physician-patient privilege in a prior 
proceeding to reassert the privilege in a subsequent proceeding.  
133 Wis. 2d 207, 225-26, 395 N.W.2d 176 (1986). 
¶131 The lead opinion also asks the question, "just what 
was waived [by Charlotte's allegations in her petition for 
restraining order]?"  Lead op., ¶49.  The lead opinion 
concludes, in essence, that nothing was waived because Charlotte 
made no mention of her medical records or her communications to 
her therapists.  Id.  The lead opinion's interpretation 
stretches the coverage of the privilege unnecessarily and passes 
over the well-accepted maxim that the law has a right to every 
person's evidence and that therefore, privileges are narrowly 
construed.  See Burnett v. Alt, 224 Wis. 2d 72, 88, 589 
N.W.2d 21 (1999).  It is unreasonable to expect a privilege-
holder to detail her medical records when disclosing facts about 
her medical condition.  When a patient makes allegations in 
litigation of abuse based on her medical condition, there is a 
due process requirement that the accused have some access to the 
accuser's records.  Failure to allow reasonable access would 
2003AP784 & 2003AP1413.dtp 
 
 
22 
 
deny the accused the right to present a complete defense.23  The 
Johnsons would have had the right to examine Charlotte's medical 
records as a result of Charlotte's petition, and once waived, 
this privilege may not be reclaimed.  This ground alone would 
justify a finding of waiver.   
¶132 Continuing our collective analysis, many recovered 
memory therapists recommend that the patient cut off all contact 
with her biological family and instead establish a new family 
within the patient's treatment groups.  See Bass, The Courage to 
Heal at 305-06; Wakefield, Return of the Furies at 143-44.  
Charlotte's action is consistent with that recommendation.  She 
even changed her name from Charlotte Johnson to Charlotte Dawn. 
¶133 Finally, the record contains a series of letters sent 
during 1994 by Charlotte's attorney, Lee Atterbury, to Bruce 
Gillman, the attorney then representing the Johnsons.  In 
Attorney Atterbury's first letter, dated January 6, 1994, he 
                                                 
23 In criminal cases, the defendant has the right to examine 
the alleged victim's medical records if (1) the defendant makes 
a prima facie showing that "the records contain relevant 
information 
necessary 
to 
a 
determination 
of 
guilt 
or 
innocence . . . not 
merely 
cumulative 
to 
other 
evidence 
available to the defendant;" and (2) after an in camera 
inspection of the records, the court concludes that "the records 
will likely contain evidence that is independently probative to 
the defense."  State v. Green, 2002 WI 68, ¶34, 253 Wis. 2d 356, 
646 N.W.2d 298. 
In civil cases, a party's medical records must be produced 
if the party places his or her medical condition "in issue."  
Ranft v. Lyons, 163 Wis. 2d 282, 291-92, 471 N.W.2d 254 (Ct. 
App. 1991).  If the records are "in issue," the circuit court 
may conduct an in camera inspection and redact information not 
"in issue."   
2003AP784 & 2003AP1413.dtp 
 
 
23 
 
threatened a lawsuit against the Johnsons as a "civil remedy 
against her parents for childhood sexual abuse," and offered the 
possibility of "negotiating a settlement of this matter prior to 
the commencement of a lawsuit."  On February 25, Attorney 
Atterbury sent Attorney Gillman a detailed settlement proposal 
consisting of an annuity with lump sum and monthly payments 
totaling more than one million dollars.24  This proposal 
apparently was rejected, because on April 6, Attorney Atterbury 
made very revealing statements in a third letter: 
I have handled cases such as this for many years.  I 
have conversed with and/or corresponded with some of 
the finest, unbiased minds in both the legal and 
medical/psychological communities.  I have no doubts 
as to the validity of repressed memories. 
. . . .  
[T]he majority of the reputable therapists in this 
country 
subscribe 
to 
the 
reality 
of 
repressed 
memories.  In my experience, those who have testified 
to the contrary are either "experts for hire" or 
members of a bizarre fringe that all but advocate 
pedophilia as a valid lifestyle.  (Emphasis added.) 
¶134 Even a cursory reading of these letters reveals 
Attorney's Atterbury's unveiled references to the "validity" and 
"reality" of repressed memories.  The lead opinion admits that 
the passage "suggests Charlotte discussed the type of therapy 
she underwent."  Lead op., ¶52.  However, the opinion refuses to 
conclude that Charlotte waived the privilege on those grounds 
                                                 
24 Attorney Gillman demanded monthly payments of $1200 for 
ten years to cover Charlotte's therapy expenses, monthly 
payments of $2500 for ten years to cover Charlotte's living 
expenses, a lump sum payment of $100,000 after five years, and a 
lump sum payment of $500,000 after ten years. 
2003AP784 & 2003AP1413.dtp 
 
 
24 
 
because any communication between Charlotte and her attorney is 
privileged.  Id.   
¶135 The same cannot be said of the communications between 
Charlotte's attorney and the Johnsons' attorney.  The lead 
opinion glosses over this distinction, and attempts to excuse 
the disclosure based on Harold Sampson Children's Trust v. The 
Linda Gale Sampson 1979 Trust, 2004 WI 57, ¶46, 271 Wis. 2d 610, 
679 N.W.2d 794.   
¶136 Sampson simply does not control this case.  In 
Sampson, an attorney inadvertently, but voluntarily, produced 
privileged documents during discovery because the attorney did 
not realize that the documents were privileged.  Id., ¶4.  The 
court held that under those circumstances, no waiver had 
occurred because "only the client can waive the attorney-client 
privilege."  Id. 
¶137 This 
case 
is 
much 
different, 
because 
it 
is 
inconceivable 
that 
Attorney 
Atterbury's 
disclosure 
was 
inadvertent.  It also is impossible to conclude that Charlotte 
did not have full knowledge of her attorney's activities, as the 
letters make clear: 
I will forward your letter to my client.  That is my 
duty. 
I 
will 
also 
advise 
my 
client 
that 
threats 
of 
retribution, promises of tough defense, etc., are not 
new to me. 
. . . .  
I have previously advised my client that litigation of 
this type can be as nasty and vindictive as the 
perpetrators' budget allows. 
2003AP784 & 2003AP1413.dtp 
 
 
25 
 
¶138 In fact, it is hard to escape the conclusion that 
Charlotte not only knew of these letters, but also caused the 
letters to be sent.  If that is not the case, Charlotte may have 
a claim of malpractice against her attorney.25   
¶139 Therefore, the Sampson rule does not protect this 
disclosure because (1) this disclosure was not inadvertent; and 
(2) 
the 
privilege 
holder 
(Charlotte) 
acquiesced 
in 
the 
disclosure. 
¶140 This ground, too, is enough to justify waiver.  It is 
worth noting once again that the filing of such a lawsuit is 
recommended in the recovered memory literature as one of the 
final steps in the recovery process, as it may help lead to 
closure for the victim.  See Bass, The Courage to Heal at 310. 
¶141 Despite 
Charlotte's 
professed 
ignorance26 
of 
the 
procedures and practices of recovered memory therapy, she had a 
violent reaction to one question from the plaintiffs' attorney: 
                                                 
25 SCR 20:1.2(a) ("Scope of representation") provides that 
"A lawyer shall abide by a client's decisions concerning the 
objectives of representation . . . and shall consult with the 
client as to the means by which they are to be pursued."  
Similarly, SCR 20:1.6(a) ("Confidentiality of information") 
provides that "A lawyer shall not reveal information relating to 
representation of a client unless the client consents after 
consultation . . . ."  
26 The following exchange occurred at Charlotte's deposition 
as the plaintiff's attorney questioned her about books she might 
have read: 
Q: 
Repressed Memories? 
A: 
I don't know what you're talking about. 
2003AP784 & 2003AP1413.dtp 
 
 
26 
 
Q: 
Are you presently aware of the controversy about 
whether or not false memories can be produced by 
suggestive influences? 
A: 
I believe that's a load of shit, if that's what 
you're asking me. 
¶142 It is hard to believe that Charlotte would feel so 
passionately about a subject she claimed to know very little 
about. 
¶143 Given all this information, the grounds for waiver may 
be summarized as follows: (1) Charlotte disclosed that she 
entered therapy due to an eating disorder and alcohol abuse 
before ever having a flashback; (2) she underwent psychotherapy; 
(3) she was the subject of hypnosis as part of her therapy; (4) 
she experienced flashbacks and body memories of childhood abuse; 
(5) she purchased The Courage to Heal, the "Bible" of repressed 
memory therapy; (6) she "confronted" her parents during therapy 
sessions; (7) she kept a journal and did artwork detailing her 
experiences; (8) she filed a restraining order against her 
parents and cut off all contact with them; (9) she changed her 
name; and (10) she threatened to file a civil lawsuit against 
her parents, and as part of that threat, her attorney referenced 
repressed memories.  Reference to the literature discussed above 
reveals that all these events are hallmarks of recovered memory 
therapy. 
¶144 When the grounds for waiver are considered singly, it 
is perhaps possible to conclude that Charlotte did not disclose 
any significant part of the privileged matter.  Considered 
together, however, it is difficult, if not impossible, to escape 
the 
conclusion 
that 
she 
voluntarily 
admitted 
undergoing 
2003AP784 & 2003AP1413.dtp 
 
 
27 
 
recovered memory therapy.  Accordingly, I would hold that 
Charlotte waived her privilege under Chapter 905 and allow the 
Johnsons to access her medical records pertaining to recovered 
memory therapy.   
¶145 Having reached that conclusion, it becomes necessary 
to determine the records Charlotte must disclose.  Like the lead 
opinion, I am wary of "fishing expeditions."  Accordingly, I 
join the lead opinion's suggested procedure encompassing in 
camera review to determine which records should be produced to 
the plaintiffs.  In my view, the court should require production 
of 
any 
of 
Charlotte's 
records 
specifically 
dealing 
with 
recovered or repressed memory therapy.  The court could redact 
any information not waived, pursuant to Ranft v. Lyons, 163 
Wis. 2d 282, 292, 471 N.W.2d 254 (Ct. App. 1991). 
¶146 With these comments and observations, I respectfully 
concur. 
¶147 I am authorized to state that Justice JON P. WILCOX 
joins this opinion's discussion of waiver and Justice N. PATRICK 
CROOKS joins this opinion in its entirety. 
 
 
No.  2003AP784.jpw 
 
1 
 
 
¶148 JON P. WILCOX, J.   (concurring in part, dissenting in 
part).  I agree with Justice Bradley's well-written dissent that 
"[t]he rationale proffered by the lead opinion in carving out an 
exception to the patient-therapist privilege and right of 
confidentiality, 
and 
in 
engrafting 
criminal 
procedure 
to 
implement the exception, is supported neither by public policy 
nor precedent."  Justice Bradley's dissent, ¶152.  Therefore, I 
do not agree with the lead opinion's decision to set up an in 
camera review procedure of Charlotte's records.  See lead op., 
¶71.   
¶149 However, 
I 
wholeheartedly 
join 
Justice 
Prosser's 
concurrence insomuch as it recognizes that "in this case, 
numerous undisputed facts show that Charlotte waived her 
privilege 
of 
confidentiality 
by 
voluntarily 
disclosing 
a 
significant part of the privileged matter."  Justice Prosser's 
concurrence, ¶81.  As such, I would allow the Johnsons access to 
Charlotte's medical records.   
 
 
 
No.  2003AP784 & 2003AP1413.awb 
 
1 
 
¶150 ANN WALSH BRADLEY, J.   (dissenting).  This case rests 
upon the holding in Sawyer v. Midelfort, 227 Wis. 2d 124, 595 
N.W.2d 423 (1999).  There, this court determined that plaintiffs 
could 
maintain 
a 
third-party 
negligence 
claim 
against 
a 
therapist whose treatment allegedly resulted in implanting and 
reinforcing false memories of child sexual abuse.  Id. at 129.  
However, the holding of Sawyer was limited. 
¶151 The concurring opinion in Sawyer wrote separately to  
"reiterate the narrow scope of the majority's decision based on 
the unique facts of [the] case."  Id. at 162 (Wilcox, J. 
concurring).  It sounded a caution that the majority opinion, if 
expanded, would "place an unreasonable burden on therapists' 
treatment choices" and undermine the confidentiality that is 
essential to the patient-therapist relationship.  Id.  The 
concurrence forewarned of a future day when "[other suits] will 
soon follow" and of the risks attendant to any future expansion 
of the majority's limited holding.  Id.  Regrettably, with this 
case, that day has now arrived. 
¶152 While I am in concert with the lead opinion in many 
respects, 
I 
cannot 
agree 
with 
its 
attempted 
significant 
expansion of the Sawyer court's limited holding.  Rather, I 
embrace the sentiments expressed in the Sawyer concurring 
opinion.  The rationale proffered by the lead opinion in carving 
out an exception to the patient-therapist privilege and right of 
confidentiality, 
and 
in 
engrafting 
criminal 
procedure 
to 
implement the exception, is supported neither by public policy 
nor precedent. 
No.  2003AP784 & 2003AP1413.awb 
 
2 
 
I 
¶153 The lead opinion, after heralding the substantive 
right to confidentiality of health care records set forth in 
Wis. Stat. § 146.82 and the importance of the Wis. Stat. 
§ 905.04 patient-therapist evidentiary privilege, ultimately 
diminishes both.  It concludes that in certain circumstances 
"public 
policy 
requires 
that 
the 
therapist-patient 
confidentiality and privilege give way to Sawyer third-party 
negligence claims . . . ."  Lead op., ¶58.  It therefore carves 
out an exception to the privilege and right and establishes a 
procedure to advance that exception. 
¶154 If the lead opinion's holding was truly limited to the 
third-party negligence claim set forth in Sawyer, I would 
probably swallow hard, and obligingly yield to the doctrine of 
stare decisis.  The lead opinion's holding, however, attempts to 
extend well beyond Sawyer in four significant ways. 
¶155 First, the lead opinion extends the Sawyer holding to 
cases where the substantive right to confidential therapy 
records is being asserted.  
¶156 In Sawyer, the substantive right to confidentiality of 
health care records was not in issue.  The patient-daughter was 
deceased, and the Sawyers brought a claim on behalf of the 
estate.  As administrators of their daughter's estate, they 
already had custody of her therapy records.  Here, relying on 
her substantive right to confidentiality in her therapy records 
pursuant to Wis. Stat. § 146.82, Charlotte vigorously fought for 
nondisclosure of the record to her parents.   
No.  2003AP784 & 2003AP1413.awb 
 
3 
 
¶157 Second, the lead opinion extends the Sawyer holding to 
cases where the patient-therapist privilege is being asserted. 
¶158 In Sawyer, because the parents brought a claim on 
behalf of the deceased daughter's estate, they put their 
daughter's medical condition at issue under Wis. Stat. §§ 804.10 
and 905.04(4)(c).  As holders of their deceased daughter's 
patient-therapist privilege, they waived the privilege.  Here, 
Charlotte has fought hard, as holder of the privilege, to assert 
that privilege. 
¶159 Third, the lead opinion extends Sawyer to general 
modalities of therapeutic treatment, not just recovered memory 
therapy. 
¶160 The holding of the Sawyer case was explicitly limited 
to situations involving recovered memory therapy.  Here, the 
lead opinion acknowledges that it is unclear that the therapy 
involved was recovered memory therapy.  It notes that "a key 
factual dispute is whether Charlotte underwent recovered memory 
therapy."  Lead op., ¶31.  Thus, the lead opinion's holding and 
analysis is extended to allegations of all forms of negligent 
therapy. 
¶161 Fourth, the lead opinion enlarges the Sawyer holding 
to other kinds of abuse. 
¶162 The 
Sawyer 
court 
limited 
its 
holding 
to 
cases 
involving sexual abuse.  The lead opinion expands the scope of 
cases to also include cases of physical abuse.  See lead op., 
¶¶2, 4. 
No.  2003AP784 & 2003AP1413.awb 
 
4 
 
¶163 I agree with Judge (now Justice) Roggensack, who 
authored the court of appeals decision in this case.  The court 
of appeals rejected this expansion of Sawyer advanced by the 
plaintiffs (and now embraced by the lead opinion).  Instead it 
supported the public policy underlying the privilege, that of 
protecting the free exchange of information between the patient 
and the therapist.  The court of appeals determined that keeping 
the communication privileged enhances the therapist's ability to 
provide the needed treatment to the patient.  It explained: 
[T]he public policy underlying the privilege, that of 
encouraging patients to freely and candidly discuss 
their health care concerns with their health care 
providers so they may be adequately treated, would be 
thwarted if patients' health care records were fair 
game whenever any third-party initiated a lawsuit to 
which those records might be relevant.  Additionally, 
the legislature has clearly mandated the protection of 
confidential psychologist-patient communications and 
of patient health care records in Wis. Stat. §§ 905.04 
and 146.82(1). 
Johnson v. Rogers Memorial Hosp., Inc., 2000 WI App 166, ¶17, 
238 Wis. 2d 227, 616 N.W.2d 903 (Johnson I). 
 
¶164 Like the court of appeals, I conclude that a patient's 
records cannot be "fair game" whenever a suit of this kind is 
commenced.  Such a result would thwart the public policy 
underlying 
the 
patient-therapist 
evidentiary 
privilege 
and 
undermine 
the 
legislative 
mandate 
protecting 
confidential 
therapy records set forth in Wis. Stat. § 146.82(1).   
II 
 
¶165 The lead opinion maintains that the Johnsons' claim 
for 
financial 
compensation 
may 
prevail 
over 
privileged 
communications and the right to confidential records.  In 
No.  2003AP784 & 2003AP1413.awb 
 
5 
 
carving out an exception to the privilege and right, the opinion 
articulates the rationale that impels it to this conclusion. 
 
¶166 It cautions that if negligent therapy "is left to 
flourish 
within 
the 
confines 
of 
the 
therapist-patient 
relationship, the privilege no longer serves its purpose."  Lead 
op., ¶62.  The lead opinion observes, "we remain quite confident 
that negligent treatment which encourages false accusations of 
sexual abuse is highly culpable for the resulting injury.  That 
culpability also weighs in favor of recognizing a public policy 
exception to the therapist-patient privilege in this case."  
Id., ¶65 (citations and internal quotation omitted). 
¶167 Having decided that an exception is desirable, the 
lead opinion offers as support Schuster v. Altenberg, 144 Wis. 
2d 223, 424 N.W.2d 159 (1988), which concluded that exceptions 
to a general rule of privilege can be waived in the interest of 
public policy.  Lead op., ¶70.  It then proceeds to craft a 
public policy exception and a procedure, modeled after a similar 
criminal law exception refined in State v. Green, 2002 WI 68, 
253 Wis. 2d 356, 646 N.W.2d 298.  Lead op., ¶72.   
¶168 Under the lead opinion's attempted new standard, a 
plaintiff must "first commence a reasonable investigation into 
the type of therapy the plaintiff's child underwent."  Id., ¶74.  
Afterward, "the plaintiff must set forth a good faith fact-
specific basis demonstrating a reasonable likelihood that the 
records contain information regarding negligent treatment."  Id.  
If the plaintiff meets this burden, the court "must proceed to 
No.  2003AP784 & 2003AP1413.awb 
 
6 
 
conduct an in camera review regardless of the victim's lack of 
consent."  Id., ¶75. 
¶169 Although well-intentioned, the lead opinion's analysis 
ultimately proves unconvincing.  Its reliance on Schuster, as 
authority for the exception, is misplaced.  Schuster was a 
different sort of case altogether. 
¶170 Edith 
Schuster, 
a 
patient 
of 
psychiatrist 
Dr. 
Altenberg, was in an automobile accident.  She was injured and 
her passenger, daughter Gwendolyn, was paralyzed.  Edith's 
husband Robert filed suit against Dr. Altenberg, alleging that 
Edith's psychological condition was responsible for the accident 
and that Dr. Altenberg was negligent for failing to warn the 
family of Edith's condition.  The court ultimately imposed 
liability on Dr. Altenberg, holding that "even under the broader 
ethical duty of confidentiality, this duty finds exception where 
disclosure is necessary to protect the patient or the community 
from imminent danger."  Schuster, 144 Wis. 2d. at 252 (citation 
and internal quotation omitted). 
¶171 The reasoning of Schuster stemmed from the seminal 
duty-to-warn 
case, 
Tarasoff 
v. 
Regents 
of 
University 
of 
California, 551 P.2d 334 (Cal. 1976).  In that case, Prosenjit 
Poddar, a patient of psychologist Dr. Moore, killed Tatiana 
Tarasoff.  Tatiana's parents filed suit, alleging that Poddar 
stated to Dr. Moore his intentions to kill Tatiana and that Dr. 
Moore was negligent for failing to warn them of their daughter's 
peril.  The court imposed liability on Dr. Moore, holding that 
"[w]hen a therapist determines . . . that his patient presents a 
No.  2003AP784 & 2003AP1413.awb 
 
7 
 
serious danger of violence to another, he incurs an obligation 
to use reasonable care to protect the intended victim against 
such danger."  Tarasoff, 551 P.2d at 340. 
¶172 The public safety concerns in Schuster and Tarasoff 
are simply not present here.  There is no allegation that 
Charlotte poses a danger to her parents or to the public at 
large.  The only "danger" alleged is damage to the Johnsons' 
reputation.  The Johnsons' claim cannot be seen as on equal 
footing with the claims put forward by the Schusters or the 
Tarasoffs. 
¶173 The standard articulated by the lead opinion today 
marks a grave departure from traditional privilege standards, as 
well as from criminal law.  The lead opinion models its standard 
after Green, which "refined and heightened the standard to be 
applied when criminal defendants seek an in camera review of the 
victim's therapy records."  Lead op., ¶72.  Under Green, a 
defendant must investigate the victim's treatment and make a 
good faith showing that the records sought are likely to contain 
relevant information.  253 Wis. 2d 356, ¶¶32-33.  Once these 
burdens are met, the court will conduct an in camera review of 
the records and disclose them to the defendant only if the 
victim consents.  State v. Solberg, 211 Wis. 2d 372, 386-87, 564 
N.W.2d 775 (1997). 
¶174 The standard set forth in the lead opinion mirrors 
Green, with the exception of the requirement of consent.  "[T]he 
circuit court must proceed to conduct an in camera review 
regardless of the victim's lack of consent."  Lead op. ¶75.  The 
No.  2003AP784 & 2003AP1413.awb 
 
8 
 
lead opinion reasons that the special circumstances of this case 
mandate this result, asserting that "requir[ing] Charlotte to 
give consent to open her medical records makes little sense 
considering that as a result of the negligent therapy Charlotte 
understandably wants nothing to do with her parents."  Id. 
¶175 This argument fails.  No matter how "peculiar" this 
case may be, Charlotte alone possesses waiver rights.  The court 
recognized this in Solberg, requiring a victim's consent before 
a criminal defendant could access records.  Thus, this court 
found that the interests in preserving privilege outweighed the 
interests a criminal defendant had in accessing the records.  
This is significant considering that a criminal defendant faces 
the ultimate sanction:  loss of liberty.  Blanton v. North Las 
Vegas, 489 U.S. 538, 542 (1989) (loss of liberty is a more 
severe form of punishment than any monetary sanction); In re 
Winship, 397 U.S. 358, 366 (1970) (requiring due process 
safeguards where loss of liberty is at stake).  And yet the 
court today affords the privilege less protection, though the 
risk to the Johnsons is far less severe than the risk faced by 
any criminal defendant. 
III 
¶176 The lead opinion may have an admirable goal, but its 
resolution is not a satisfactory means to that end.  As Justice 
Wilcox 
cautioned 
in 
his 
Sawyer 
concurrence, 
this 
result 
jeapordizes patient-therapist relationships: 
This result would, we believe, place therapists in a 
difficult 
position, requiring 
them 
to 
answer to 
competing demands and to divide their loyalty between 
sharply 
different 
interests . . . . 
 
[T]herapists 
No.  2003AP784 & 2003AP1413.awb 
 
9 
 
would feel compelled to consider the possible effects 
of treatment choices on third parties and would have 
an incentive to compromise their treatment because of 
the threatened liability.   
227 Wis. 2d 124, 162 (quoting Doe v. McKay, 700 N.E.2d 1018, 
1023-24 (Ill. 1998)).   
¶177 In the end, this is a difficult case and the position 
the Johnsons find themselves in is not a comfortable one.  But 
this court's sympathy for the plaintiffs should not force our 
hand.   
¶178 Ultimately, I agree with the court of appeals' 
determination that "we have been presented with no argument that 
causes us to conclude that the Johnsons' interest in financial 
compensation for the injury they claim to have suffered should 
trump Charlotte's right to maintain the confidentiality of her 
privileged communications and health care records."  Johnson I, 
238 Wis. 2d 227, ¶18.  Accordingly, I respectfully dissent.27 
¶179 I am authorized to state that Chief Justice SHIRLEY S. 
ABRAHAMSON joins this dissent. 
 
                                                 
27 It is evident that the court is splintered in this case.  
See lead op. ¶3 n. 1; ¶4 n. 3 & 4.  As such, the lead opinion 
has no precedential value.  Its holding is binding only on the 
parties here.     
No.  2003AP784 & 2003AP1413.awb 
 
 
 
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