Source: https://scocal.stanford.edu/opinion/re-lifschutz-22784
Timestamp: 2019-07-18 13:07:04
Document Index: 601094905

Matched Legal Cases: ['§ 2034', '§ 1014', '§ 1016', '§ 2396', '§ 404', '§ 2019', '§ 2904', '§ 2286', '§ 1013', '§ 996', '§ 2389', '§ 2380', '§ 998', '§ 1014', '§ 915', '§ 915', '§ 2020', '§ 2030', '§ 2033']

In re Lifschutz - 2 Cal.3d 415 - Wed, 04/15/1970 | California Supreme Court Resources
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Citation 2 Cal.3d 415
In re Lifschutz , 2 Cal.3d 415
Cesari & Werner and James B. Werner in support of Respondent. [2 Cal.3d 420]
In response to the psychiatrist's refusal to cooperate, defendant Arabian moved for an order of the superior court compelling the production of the subpenaed records and the answers to questions on deposition (Code Civ. Proc., § 2034, subd. (a)). Relying on the patient-litigant exception [2 Cal.3d 421] of section 1016 of the Evidence Code, the superior court determined that because the plaintiff, in instituting the pending litigation, had tendered as an issue his mental and emotional condition, the statutory psychotherapist-patient (Evid. Code, § 1014) privilege did not apply. On December 20, 1968, the court therefore ordered Dr. Lifschutz to comply with the subpena and to answer questions posed during deposition. fn. 1 On January 15, 1969, defendant attempted to continue with the deposition of Dr. Lifschutz as ordered by the superior court, but petitioner remained resolute in his refusal to respond or produce records. Thereafter, petitioner sought a writ of prohibition to restrain the superior court from enforcing its order; the writ was denied by the Court of Appeal, a petition for hearing was denied by this court, and finally a petition for certiorari to the United States Supreme Court was similarly denied.
We recognize the growing importance of the phychiatric profession in our modern, ultracomplex society. The swiftness of change--economic, cultural, and moral--produces accelerated tensions in our society, and the potential for relief of such emotional disturbances offered by psychotherapy [2 Cal.3d 422] undoubtedly establishes it as a profession essential to the preservation of societal health and well-being. Furthermore, a growing consensus throughout the country, reflected in a trend of legislative enactments, fn. 3 acknowledges that an environment of confidentiality of treatment is vitally important to the successful operation of psychotherapy. California has embraced this view through the enactment of a broad, protective psychotherapist-patient privilege.
Properly viewed, the broadest issue before our court is whether the Legislature, in attempting to accommodate the conceded need of confidentiality in the psychotherapeutic process with general societal needs of access to information for the ascertainment of truth in litigation, has unconstitutionally weighted its resolution in favor of disclosure by providing that a psychotherapist may be compelled to reveal relevant confidences of treatment when the patient tenders his mental or emotional [2 Cal.3d 423] condition in issue in litigation. For the reasons discussed below, we conclude that, under a properly limited interpretation, the litigant-patient exception to the psychotherapist-patient privilege, at issue in this case, does not unconstitutionally infringe the constitutional rights of privacy of either psychotherapists or psychotherapeutic patients. As we point out, however, because of the potential of invasion of patients' constitutional interests, trial courts should properly and carefully control compelled disclosures in this area in the light of accepted principles.
The primary contention of Dr. Lifschutz's attack on the judgment of contempt consists of the assertion of a constitutional right of a psychotherapist to absolute confidentiality in his communications with, and treatment of, patients. [2] Although, as we understand it, the alleged right draws its substance primarily from the psychological needs and expectations of patients, Dr. Lifschutz claims that the Constitution grants him an absolute right to refuse to disclose such confidential communications, regardless of the wishes of a patient in a particular case. fn. 4 In separating the interest of the psychotherapist from that of the patient for the purposes of analyzing this contention, we conclude that the compelled disclosure of relevant information obtained in a confidential communication does not violate any constitutional privacy rights of the psychotherapist. [2 Cal.3d 424]
In addition to his claim as to a "right of privacy," petitioner urges that the provisions of the Evidence Code requiring a psychotherapist to reveal confidential matters under some circumstances unconstitutionally impair [2 Cal.3d 425] the practice of his profession. This position rests on two distinct legal contentions: first, that the impairment is so severe as to constitute an unconstitutional "taking" of a valuable property right, the doctor's right to practice psychotherapy; and second, that compelled disclosure of any psychotherapeutic communication renders the continued practice of psychotherapy impossible and thus unconstitutionally constricts the realm of available medical treatment. [3] Although psychotherapists should, of course, be entitled to the constitutional protections requisite to the right to practice their profession (see Yakov v. Board of Medical Examiners (1968) 68 Cal.2d 67, 75 [64 Cal.Rptr. 785, 435 P.2d 553]), we doubt that the disclosure involved here goes so far as to constitute the claimed unconstitutional deprivation of that right.
Insofar as petitioner's argument rests on the economic loss that psychotherapists may suffer as a result of the disclosure requirement, his position runs contra to the current trend of constitutional adjudication involving the regulation of economic interests. Legal requirements prescribing mandatory disclosure of confidential business records are of course regular occurrences (see, e.g., Shapiro v. United States (1948) 335 U.S. 1, 32-33 [92 L.Ed. 1787, 1806-1807, 68 S.Ct. 1375]; Hickman v. Taylor (1947) 329 U.S. 495, 511-513 [91 L.Ed. 451, 462-463, 67 S.Ct. 385]; In re Sidebotham (1938) 12 Cal.2d 434, 436 [85 P.2d 453]), and although all compelled disclosures may interfere to some extent with an individual's performance of his work, such requirements have been universally upheld so long as the compelled disclosure is reasonable in light of a related and important governmental purpose. (E.g., Greyhound Corp. v. Superior Court (1961) 56 Cal.2d 355, 394 [15 Cal.Rptr. 90, 364 P.2d 266].) [4] In order to facilitate the ascertainment of truth and the just resolution of legal claims, the state clearly exerts a justifiable interest in requiring a businessman to disclose communications, confidential or otherwise, relevant to pending litigation. (Cf., e.g., Wilson v. United States (1911) 221 U.S. 361, 372-376 [55 L.Ed. 771, 776-777, 31 S.Ct. 538]; Blair v. United States (1919) 250 U.S. 273, 279-282 [63 L.Ed. 979, 981, 983, 39 S.Ct. 468].) [5, 6] Although we appreciate, as petitioner suggests, that because of the peculiar nature of psychotherapy, the debilitating effect of disclosure is particularly acute, the incidental infringement of the psychotherapist's economic interest in such practice does not succumb to constitutional challenge so long as the circumstances of disclosure are properly confined to serve a legitimate governmental interest. (Cf. Day-Brite Lighting, Inc. v. Missouri (1952) 342 U.S. 421, 423-424 [96 L.Ed. 469, 472-473, 72 S.Ct. 405]; Nebbia v. New York (1934) 291 U.S. 502, 537 [78 L.Ed. 940, 957, 54 S.Ct. 505].) Moreover, because, as we explain below, the patient-litigant exception at issue [2 Cal.3d 426] involves only that special instance in which a patient has chosen to forego the confidentiality of the privilege, we question whether the deterrence of patients and the impairment to the practice of psychotherapy will be as great as petitioner anticipates.
Petitioner's argument, resting as it does on assertions of medical necessity, exemplifies the type of question to which the judiciary brings little expertise. Although petitioner has submitted affidavits of psychotherapists who concur in his assertion that total confidentiality is essential to the practice of their profession, we cannot blind ourselves to the fact that the practice of psychotherapy has grown, indeed flourished, in an environment of a non-absolute privilege. No state in the country recognizes as broad a privilege as petitioner claims is constitutionally compelled. fn. 8 Whether psychotherapy's development has progressed only because patients are ignorant of the existing legal environment can only be a matter for speculation; psychotherapists certainly have been aware of the limitations of their recognized privilege for some time. (See, e.g., Hollender, [2 Cal.3d 427] Privileged Communication and Confidentiality (1965) 26 Diseases of the Nervous System 169 (paper and round table discussion); Sidel, Confidential Information and the Physician (1961) 264 New England J. of Med. 1133, 1136.)
The statutory provisions challenged here do not attempt to narrow the scope of psychotherapeutic treatment, by proscribing, for example, the discussion of certain subjects (cf. Poe v. Ullman (1961) 367 U.S. 497, 513-515 [6 L.Ed.2d 989, 1001-1003, 81 S.Ct. 1752] (Douglas, J., dissenting) (state statute barring advice on the use of contraceptives)). [8] Instead, the provisions are intended to serve the important state interest of facilitating the ascertainment of truth in legal proceedings. Although petitioner argues that, as a matter of social as well as medical policy, the benefits to be derived from a broadening of the existing privilege would outweigh the detriments resulting from a narrowing of evidence available in litigation, the balancing of those alternatives remains with the Legislature.
Section 1034 of the Evidence Code provides that: "a clergyman ... has a privilege to refuse to disclose a penitential communication if he claims the privilege"; the code provides no exceptions to the clergyman-penitent privilege comparable to the numerous exceptions to the psychotherapist-patient privilege. (See Evid. Code, §§ 1016-1026.) Petitioner contends that the Legislature, in so distinguishing between clergymen and [2 Cal.3d 428] psychotherapists, has denied psychotherapists the equal protection of the laws in violation of the Fourteenth Amendment.
Realistically, the statutory privilege must be recognized as basically an explicit accommodation by the secular state to strongly held religious tenets of a large segment of its citizenry. As the Law Revision Commission Comment accompanying the adoption of California's current privilege explains: "At least one underlying reason seems to be that the law will not compel a clergman to violate--nor punish him for refusing to violate--the tenets of his church which require him to maintain secrecy as to confidential statements made to him in the course of his religious duties." Wigmore, in his treatise, similarly relates the purpose of the privilege in a question and answer format: "Does the penitential relation deserve recognition and countenance? In a state where toleration of religion exists by law, and where a substantial part of the community professes a religion practising a confessional system, this question must be answered in the affirmative." (8 Wigmore, Evidence, supra, § 2396 at p. 878; see also Stoyles, The Dilemma of the Constitutionality of the Priest-Penitent Privilege--The Application of the Religion Clauses (1967) 29 U.Pitt.L.Rev. 27, 51.) [2 Cal.3d 429]
Although, as we have discussed above, Dr. Lifschutz on his own behalf can claim no constitutional privilege to avoid disclosure, he may in some circumstances assert the statutory privilege of his patient. fn. 11 Evidence Code section 1012 recognizes communications between patient and psychotherapist, diagnosis by the psychotherapist, and advice given during the [2 Cal.3d 430] therapy relationship as privileged communications. Section 1015 provides that: "[t]he psychotherapist who received or made a communication subject to the privilege under this article shall claim the privilege whenever he is present when the communication is sought to be disclosed and is authorized to claim the privilege under subdivision (c) of Section 1014." Section 1014, subdivision (c), indicates that the psychotherapist cannot claim the privilege of the patient "if there is no holder of the privilege in existence or if he is otherwise instructed by a person authorized to permit disclosure." The record in the present case shows no express instructions from plaintiff Housek directing Dr. Lifschutz to decline the privilege against disclosure. Thus, under Evidence Code section 1015 Dr. Lifschutz could generally assert the privilege of his patient to prevent disclosure of privileged communications.
Defendant contended in the superior court, however, that any communication [2 Cal.3d 431] between the plaintiff and Dr. Lifschutz has lost its privileged status because the plaintiff has filed a personal injury action in which he claims recovery for "mental and emotional distress." Defendant relies on section 1016 of the Evidence Code, the patient-litigant exception to the psychotherapist-patient privilege, which provides that: "[t]here is no privilege under this article as to a communication relevant to an issue concerning the mental or emotional condition of the patient if such issue has been tendered by: (a) the patient ...." To avoid the necessity for further contempt proceedings or delaying appellate review in the instant case, we have considered whether defendant has accurately identified the proper reach of the patient-litigant exception.
We believe that a patient's interest in keeping such confidential revelations from public purview, in retaining this substantial privacy, has deeper roots than the California statute and draws sustenance from our constitutional heritage. In Griswold v. Connecticut, supra, 381 U.S. 479, 484 [14 L.Ed.2d 510, 514], the United States Supreme Court declared that "Various guarantees [of the Bill of Rights] create zones of privacy," and we believe that the confidentiality of the psychotherapeutic session falls [2 Cal.3d 432] within one such zone. (Cf. People v. Belous (1969) 71 Cal.2d 954, 963 [80 Cal.Rptr. 354, 458 P.2d 194].) Although Griswold itself involved only the marital relationship, the open-ended quality of that decision's rationale evidences its far-reaching dimension. (See generally, Dixon, The Griswold Penumbra: Constitutional Charter for An Expanded Law of Privacy, supra, 64 Mich.L.Rev. 197.) fn. 12 Indeed, the decision's concern for valued aspects of individual privacy may ultimately aid in protecting man from the dehumanization of an ever-encroaching technological environment. The retention of a degree of intimacy in interpersonal relations and communications lies at the heart of the broad rationale of Griswold; the opinion itself significantly followed the teachings of NAACP v. Alabama (1958) 357 U.S. 449 [2 L.Ed.2d 1488, 78 S.Ct. 1163], which struck down a state statute requiring an association to disclose its membership list as an unconstitutional impingement upon the members' rights of privacy and anonymity. (Cf. Talley v. California (1960) 362 U.S. 60 [4 L.Ed.2d 559, 80 S.Ct. 536].)
[14] Even though a patient's interest in the confidentiality of the psychotherapist-patient relationship rests, in part, on constitutional underpinnings, all state "interference" with such confidentiality is not prohibited. [15] In section 1016 we do not deal with a provision which seeks to proscribe the association of psychotherapist and patient entirely, fn. 13 but instead we encounter a provision carefully tailored to serve the historically important state interest of facilitating the ascertainment of truth in connection with legal proceedings. (See, e.g., Blair v. United States (1919) 250 U.S. 273, 279-281 [63 L.Ed. 979, 981-983, 39 S.Ct. 468]; Wilson v. United States (1911) 221 U.S. 361, 372-373 [55 L.Ed. 771, 776, 31 S.Ct. 538]; Blackmer v. United States (1932) 284 U.S. 421 [76 L.Ed. 375, 52 S.Ct. 252].) fn. 14 In the past this state interest has been viewed as [2 Cal.3d 433] substantial enough to compel the disclosure of a great variety of confidential material. (See, e.g., Chronicle Publishing Co. v. Superior Court (1960) 54 Cal.2d 548, 574 [7 Cal.Rptr. 109, 354 P.2d 637]; Green v. Superior Court (1963) 220 Cal.App.2d 121 [33 Cal.Rptr. 604]; Tatkin v. Superior Court (1958) 160 Cal.App.2d 745, 753-754 [326 P.2d 201]; Garland v. Torre (2d Cir. 1958) 259 F.2d 545, 548-549, cert. den. 358 U.S. 910 [3 L.Ed.2d 231, 79 S.Ct. 237].) Moreover, since the exception compels disclosure only in cases in which the patient's own action initiates the exposure, "intrusion" into a patient's privacy remains essentially under the patient's control. As such, we find no constitutional infirmity in it.
Although no previous cases have arisen under the patient-litigant exception to the psychotherapist-patient privilege, decisions applying an analogous exception to the physician-patient privilege fn. 15 have identified two distinct grounds for the exception. First, the courts have noted that the patient, in raising the issue of a specific ailment or condition in litigation, in effect dispenses with the confidentiality of that ailment and may no longer justifiably seek protection from the humiliation of its exposure. fn. 16 Second, the exception represents a judgment that, in all fairness, a patient should not be permitted to establish a claim while simultaneously foreclosing inquiry into relevant matters. fn. 17 [16] As we explained in City & County of San Francisco v. Superior Court, supra, 37 Cal.2d 227, 232 [2 Cal.3d 434] (the Catton case), "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. The patient-litigant exception precludes one who has placed in issue his physical condition from invoking the privilege on the ground that disclosure of his condition would cause him humiliation. He cannot have his cake and eat it too."
Although defendant reads the above quoted language of the Catton case as implying that the patient-litigant exception contemplates an automatic, complete waiver of privilege whenever a patient institutes a claim for any physical or mental injury, we find nothing in either the rationale of the exception as explained in the Catton case, or in the cases applying the exception, fn. 18 to justify the breadth of this description. In previous physician-patient privilege cases the exception has been generally applied only to compel disclosure of medical treatment and communication concerning the very injury or impairment that was the subject matter of the litigation. fn. 19 There is certainly nothing to suggest that in the context of the more liberal psychotherapist-patient privilege this exception should be given a broader reading. fn. 20 [2 Cal.3d 435]
[17] In light of these considerations, the "automatic" waiver of privilege contemplated by section 1016 must be construed not as a complete waiver of the privilege but only as a limited waiver concomitant with the purposes of the exception. [18] Under section 1016 disclosure can be compelled only with respect to those mental conditions the patient-litigant has "disclose[d] ... by bringing an action in which they are in issue" (City & County of San Francisco v. Superior Court, supra, 37 Cal.2d 227, 232); communications which are not directly relevant to those specific conditions do not fall within the terms of section 1016's exception and therefore remain privileged. Disclosure cannot be compelled with respect to other aspects of the patient-litigant's personality even though they may, in some sense, be "relevant" to the substantive issues of litigation. fn. 21 The patient thus is not obligated to sacrifice all privacy to seek redress for a specific mental or emotional injury; the scope of the inquiry permitted depends upon the nature of the injuries which the patient-litigant himself has brought before the court.
In some situations, the patient's pleadings may clearly demonstrate that his entire mental condition is being placed in issue and that records of past psychotherapy will clearly be relevant. Thus in In re Cathey (1961) 55 Cal.2d 679 [12 Cal.Rptr. 762, 361 P.2d 426], for example, a mental [2 Cal.3d 436] patient confined in a prison hospital sought release contending, inter alia, that he was not a "dangerous" or "violent" individual as the state mental health officials asserted; when the officials offered Cathey's medical records to substantiate their position, he claimed such records were privileged. This court, analogizing the facts before it to those of the patient-litigant exception to the physician-patient privilege, fn. 22 found that "petitioner himself caused his mental condition to be put in issue by his application for habeas corpus and the averments of his brief ...." (55 Cal.2d at p. 691.) In such a case, section 1016 will of course be applicable.
[19] Because only the patient, and not the party seeking disclosure, knows both the nature of the ailments for which recovery is sought and the general content of the psychotherapeutic communications, the burden rests upon the patient initially to submit some showing that a given confidential communication is not directly related to the issue he has tendered to the court. (Cf. Evid. Code, § 404 (person claiming privilege against incrimination bears burden of showing proffered evidence might tend to incriminate him).) A patient may have to delimit his claimed [2 Cal.3d 437] "mental or emotional distress" or explain, in general terms, the object of the psychotherapy fn. 23 in order to illustrate that it is not reasonably probable that the psychotherapeutic communications sought are directly relevant to the mental condition that he has placed in issue. [20, 21] In determining whether communications sufficiently relate to the mental condition at issue to require disclosure, the court should heed the basic privacy interests involved in the privilege (cf. Wiesenberger v. W. E. Hutton & Co. (S.D.N.Y. 1964) 35 F.R.D. 556, 557-558); in general, the statutory psychotherapist-patient privilege "is to be liberally construed in favor of the patient." (Cf. Carlton v. Superior Court, supra, 261 Cal.App.2d 282, 288; Newell v. Newell (1956) 146 Cal.App.2d 166, 177 [303 P.2d 848].)
Even when the confidential communication is directly relevant to a mental condition tendered by the patient, and is therefore not privileged, the codes provide a variety of protections that remain available to aid in safeguarding the privacy of the patient. [22] When inquiry into the confidential relationship takes place before trial during discovery, as in the instant case, the patient or psychotherapist may apply to the trial court for a protective order to limit the scope of the inquiry or to regulate the procedure of the inquiry so as to best preserve the rights of the patient. Section 2019, subdivision (b), subsection (1), of the Code of Civil Procedure grants the court broad discretion to issue "any ... order which justice requires to protect the party or witness from annoyance, embarrassment or oppression." Section 2019, subdivision (b), subsection (1), specifically enumerates a number of protective orders that might be particularly helpful to a patient-litigant. For example, the section provides that, upon good cause shown, the court may direct that at the oral deposition fn. 24 "[1] certain matters shall not be inquired into or [2] that the scope of the examination shall be limited to certain matters, books, [or] documents ... or [3] that the examination shall be held with no one present except the parties to the action and their ... counsel or [4] that after being sealed the deposition shall be opened only by order of the [2 Cal.3d 438] court ...." (Bracketed numbers added.) (See Chronicle Publishing Co. v. Superior Court, supra, 54 Cal.2d 548, 575; cf. Reynolds Metals Co. v. Yturbide (9th Cir. 1958) 258 F.2d 321, 333, cert. den. 358 U.S. 840 [3 L.Ed.2d 76, 79 S.Ct. 66].) Such a protective order may be sought at any time during the deposition, and, in appropriate cases, the trial court may issue such an order on its own motion. (Code Civ. Proc., § 2019, subd. (d).)
In sum, we conclude that no constitutional right enables the psychotherapist to assert an absolute privilege concerning all psychotherapeutic communications. We do not believe the patient-psychotherapist privilege should be frozen into the rigidity of absolutism. So extreme a conclusion neither harmonizes with the expressed legislative intent nor finds a clear source in constitutional law. Such an application would lock the patient into a vice which would prevent him from waiving the privilege without the psychotherapist's consent. The question whether such a ruling would have the medical merit claimed by petitioner must be addressed to the Legislature; we can find no basis for such a ruling in legal precedent or principle. [2 Cal.3d 439]
Mosk, Acting C. J., McComb, J., Peters, J., Burke, J., Sullivan, J., and Molinari, J., concurred. [2 Cal.3d 440]
­FN 1. The order read in full: "The witness, Joseph E. Lifschutz, is hereby ordered to answer the questions involved in the taking of his deposition and to comply with the production requirements of the subpoena duces tecum issued in this proceeding (the declaration therefor being filed herein on October 11, 1968).
­FN 2. Section 1209, subdivision 5, provides: "The following acts or omissions in respect to a court of justice, or proceedings therein, are contempts of the authority of the court: ... 5. Disobedience of any lawful judgment, order, or process of the court; ...."
­FN 3. Until 20 years ago, no statutes dealt specifically with the question of the privilege for psychotherapeutic communications; protection was available only under the terms of existing physician-patient privileges. Such privilege only applied to medical practitioners who fell within the terms of various state statutes; often psychiatrists were covered, but clinical psychologists, though using many of the same techniques of psychotherapy, were not. In the nineteen-fifties and sixties several states, responding to the demands of organized spokesmen of psychology, enacted new privilege statutes, often granting psychologist-patient communications much broader protection than was provided by existing physician-patient privileges. (See Ferster, "Statutory Summary of Physician-Patient Privileged Communication Laws" in Allen, Ferster & Ruben, Readings in Law & Psychiatry (1968) pp. 161-165.) In 1960 California enacted such a statute, providing: "[T]he confidential relations and communications between psychologist and client shall be placed upon the same basis as those provided by law between attorney and client ...." (Bus. & Prof. Code, § 2904 (since repealed).)
­FN 4. Although at numerous points in his legal argument, petitioner asserts that his challenge is raised on behalf of his patient's rights as well as his own, the facts of this case demonstrate that the psychotherapist's interests and the patient's wishes do not always coincide on this issue. (See also Commonwealth ex rel. Romanowicz v. Romanowicz (1968) 213 Pa. Super. 382 [248 A.2d 238, 240] (psychiatrist compelled to testify if patient so desires).) Although under circumstances in which a patient cannot easily or effectively affirm his own rights, a physician may be granted standing to assert the constitutional rights of his patients (see, e.g., Griswold v. Connecticut (1965) 381 U.S. 479, 481 [14 L.Ed.2d 510, 512-513, 85 S.Ct. 1678]), in the instant case the patient, whose rights Dr. Lifschutz presumably seeks to protect, is a party to the action, and had full opportunity to challenge the disclosures which have so far been sought but declined to do so. Under these facts it would be inappropriate to find that Dr. Lifschutz could assert his patient's constitutional rights.
­FN 5. Since the Griswold defendants' "criminal" activities included the general dissemination of information concerning contraceptives and birth control, it has been persuasively argued that the convictions may have contravened the First Amendment rights of the individual physician-defendants. (See, e.g., Dixon, The Griswold Penumbra: Constitutional Charter For an Expanded Law of Privacy (1965) 64 Mich. L.Rev. 197, 213.) The Supreme Court, however, chose not to address that problem.
­FN 6. Indeed, in many instances a patient may desire to have a psychotherapist testify as to confidential communications. (See, e.g., Hampton v. Hampton (1965) 241 Ore. 277 [405 P.2d 549].) The granting of petitioner's broad contention could foreclose access to psychotherapeutic sessions even when the patient has no desire to preserve his "privacy."
­FN 7. Petitioner's contention that the recognition of a privilege is necessary to the preservation of a given occupation or profession is by no means unique to psychotherapy. In the past, organized occupational groups of journalists, accountants, and social workers, among others, have sought the establishment of a legal privilege and have proclaimed, on principle, that required revelation of information received in confidence would mean the destruction of their calling. (See generally, 8 Wigmore, Evidence (McNaughton rev. 1961) § 2286, pp. 532-537.) In many instances such organized groups have been able to convince state legislatures of the wisdom of their position and as a result statutory privileges have been created; the broad psychotherapist-patient privilege enacted in California is such an example.
­FN 8. Indeed, only six states have any laws specifically granting to the psychiatric relationship any special protection, over and above that given to medical communications generally. (See Slawson, Patient-Litigant Exception: Hazard to Psychotherapy (1969) 21 Arch. Gen. Psychiat. 347, 348.)
­FN 9. We note that this court has not been apprised of any present, established "tenet" of the medical profession that would be violated by petitioner's compliance with the order of the trial court. Section 9 of the "Principles of Medical Ethics" adopted by the American Medical Association, which petitioner submitted to the trial court, proclaims: "A physician may not reveal the confidences entrusted to him in the course of medical attendance, or the deficiencies he may observe in the character of patients, unless he is required to do so by law or unless it becomes necessary in order to protect the welfare of the individual or of the community." (Italics added.) Although there has been some criticism of this present principle (see, e.g., Sidel, Confidential Information and the Physician, supra, 264 New England J. of Med. 1133), we are not aware of any modification of the "official" principle of confidentiality.
­FN 10. See generally, Stoyles, The Dilemma of the Constitutionality of the Priest-Penitent Privilege--The Application of the Religion Clauses, supra, 29 U.Pitt.L. Rev. 27.
­FN 11. The statutory privilege established in section 1014 of the Evidence Code is a privilege of the patient, not of the psychotherapist. (Evid. Code, § 1013; cf. City & County of San Francisco v. Superior Court (1951) 37 Cal.2d 227, 233 [231 P.2d 26].)
­FN 12. The breadth of the principles of privacy and individual freedom recognized in Griswold is illustrated by the variety of the cases which have subsequently embraced that decision's conclusions. (See, e.g., Stanley v. Georgia (1969) 394 U.S. 557, 564 [22 L.Ed.2d 542, 549, 89 S.Ct. 1243] (right to view all books and films in the privacy of one's home); Roberts v. Clement (E.D.Tenn. 1966) 252 F.Supp. 835, 848 (Darr, J., concurring) (right to practice nudism in private); Finot v. Pasadena City Board of Education (1967) 250 Cal.App.2d 189, 197-198 [58 Cal.Rptr. 520] (right of adult teacher to wear beard); cf. Jessin v. County of Shasta (1969) 274 Cal.App.2d 737, 748 [79 Cal.Rptr. 359] (right to obtain voluntary sterilization).)
­FN 13. Cf. Roberts v. Clement, supra, 252 F.Supp. 835, 849 (Darr, J., concurring) (state statute prohibiting the practice of nudism unconstitutional under Griswold).
­FN 14. The justification for compelling disclosure of relevant psychotherapeutic communications when the patient himself has raised an issue of his mental condition has been recognized even by commentators who are strongly in favor of broadening the current psychotherapist-patient privilege. Two "model" psychotherapist-patient privilege acts, drafted by such proponents, have included a provision recognizing a patient-litigant exception. (See Model Psychotherapist-Patient Privilege (1968) 4 Harv.J. Legis. 307, 322; Fisher, The Psychotherapeutic Profession and the Law of Privileged Communication (1964) 10 Wayne L.Rev. 609, 644.)
­FN 15. The present patient-litigant exception to the physician-patient privilege (Evid. Code, § 996) which parallels the exception to the psychotherapist-patient privilege precisely, superseded section 1881, subdivision 4, of the Code of Civil Procedure, the initial patient-litigant exception enacted in 1917 and the section under which most of the relevant case law arose. Section 1881, subdivision 4, limited the physician-patient privilege by providing: "[W]here any person brings an action to recover damages for personal injuries, such action shall be deemed to constitute a consent by the person bringing said action that any physician who has prescribed for or treated said person and whose testimony is material in said action shall testify." (Italics added.)
­FN 16. See Moreno v. New Guadalupe Min. Co. (1917) 35 Cal.App. 744, 755 [170 P. 1088] ("clearly a patient should not be permitted to describe `at length to the jury in a crowded courtroom the details of his supposed ailment, and then neatly suppress the available proof of his falsities by wielding a weapon, nominally termed a privilege.' (4 Wigmore, § 2389, p. 3360.)").
­FN 17. Cf. Koump v. Smith (1969) 25 N.Y.2d 287, 294 [303 N.Y.S.2d 858, 864, 250 N.E.2d 857] ("A party should not be permitted to assert a mental or physical condition in seeking damages or in seeking to absolve himself from liability and at the same time assert the privilege in order to prevent the other party from ascertaining the truth of the claim and the nature and extent of the injury or condition."); Schlagenhauf v. Holder (1964) 379 U.S. 104, 126 [13 L.Ed.2d 152, 168, 85 S.Ct. 234] (Douglas, J., dissenting); 4 Harv.J. Legis. 307, 323, supra.
­FN 18. See, e.g., Phillips v. Powell (1930) 210 Cal. 39, 42 [290 P. 441] ("Pursuant to the provisions of section 1881, subdivision 4 of the Code of Civil Procedure, the bringing of the action to recover damages for personal injuries constitutes a waiver of the privilege, provided the testimony is material to the issues"); San Francisco Unified School Dist. v. Superior Court (1961) 55 Cal.2d 451, 454 [11 Cal.Rptr. 373, 359 P.2d 925, 82 A.L.R.2d 1156] ("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." (Italics added.))
­FN 19. For example, in Ballard v. Pacific Greyhound Lines (1946) 28 Cal.2d 357, 360 [170 P.2d 465], the plaintiff, injured in a bus accident, had consulted a physician concerning the injuries she sustained therein. When the patient later sued the bus company for damages, the court permitted the defendant to examine the physician concerning the injuries of which plaintiff complained, finding the patient-litigant exception directly applicable. (Accord, San Francisco Unified School Dist. v. Superior Court, supra, 55 Cal.2d 451, 454 (exception applicable to doctor who had been consulted "to diagnose and treat [the plaintiff] for the injuries for which recovery is now sought").)
­FN 20. Our reliance on precedents rendered in the context of the physician-patient privilege is not intended to suggest that authorities involving the physician-patient privilege will always be helpful in resolving issues concerning the psychotherapist-patient privilege. In the past the physician-patient privilege has been the subject of rather severe criticism (see, e.g., Chafee, Privileged Communications: Is Justice Served or Obstructed by Closing the Doctor's Mouth on the Witness Stand? (1943) 52 Yale L.J. 607; 8 Wigmore, Evidence, supra, § 2380a, at pp. 828-832), and in response the application of the privilege has been limited in a variety of circumstances (see, e.g., Evid. Code, §§ 998, 999, 1007). The psychotherapist-patient privilege, on the other hand, won legislative recognition in the face of legal antipathy toward privileges generally (see Louisell, The Psychologist in Today's Legal World: Part II, supra, 41 Minn.L.Rev. 731, 731-732); the Legislature acknowledged that the unique nature of psychotherapeutic treatment required and justified a greater degree of confidentiality than was legally afforded other medical treatment (see Legislative Committee Com. to Evid. Code, § 1014). Even commentators who concurred in the criticism of the general physician-patient privilege noted that the psychotherapeutic privilege rested on a much sounder basis and supported its adoption. (See, e.g., Louisell, supra, at pp. 740-746.) The differences that exist between these two medically oriented privileges caution against blind application of the precedents of the physician-patient privilege in future psychotherapist-patient privilege cases.
­FN 21. Thus in the instant case, for example, defendant would not be authorized to undertake an examination of psychotherapeutic communications to determine if the plaintiff has ever exhibited aggressive tendencies or had other personal attributes that might be related to the assault. The plaintiff has not disclosed such elements of his mental condition merely by instituting an action for damages resulting from an assault and thus the exception of section 1016 is not applicable. (Cf. Carlton v. Superior Court (1968) 261 Cal.App.2d 282, 289-290 [67 Cal.Rptr. 568]; Koump v. Smith, supra, 25 N.Y.2d 287, 294, 299 [303 N.Y.S.2d 858, 864, 868-869, 250 N.E.2d 857].)
­FN 22. The present psychotherapist-patient privilege was not yet enacted at the time Cathey was decided. Because the then existing statutory "patient-litigant" exception was, by its terms, limited to personal injury actions, the court reached its decision by analogy rather than by direct application of a statutory provision.
­FN 23. Although ordinarily a patient cannot bc required to disclose privileged information in order to claim the privilege (Evid. Code. § 915, subd. (a)), because the privileged status of psychotherapeutic communications under the patient-litigant exception depends upon the content of the communication, a patient may have to reveal some information about a communication to enable the trial judge to pass on his claim of irrelevancy. Upon such revelation, the trial judge should take necessary precautions to protect the confidentiality of these communications; for example, he might routinely permit such disclosure to be made ex parte in his chambers. (Compare the procedure suggested in Evid. Code, § 915, subd. (b).) (See also Developments in the Law-- Discovery (1964) 74 Harv.L.Rev. 940, 1017-1018.)
­FN 24. Although section 2019, subdivision (b), only applies to oral deposition, other discovery sections specifically provide that similar protective orders can be obtained to limit inquiries sought under their discovery devices. (See § 2020, subd. (d); § 2030, subd. (b); § 2033, subd. (a).)
­FN 25. Necessary information will often be accessible without delving deeply into specific intimate factual circumstances and such searching probes ought to be avoided whenever possible. The psychotherapist's general conclusions about specific emotional symptoms will often suffice to convey the needed information while preserving the patient's dignity and interest in privacy.
­FN 26. The draftsmen of two separate versions of "model" legislation in this field each suggested that only a "conditional" patient-litigant exception be adopted; under this suggestion, disclosure would be compelled only upon a finding of the court that it would be in "the best interests of justice." (See Fisher, The Psychotherapeutic Profession and the Law of Privileged Communications, supra, 10 Wayne L.Rev. 609, 644; Model Psychotherapist-Patient Privilege, supra, 4 Harv.J. Legis. 307, 322.) Similar protection can be afforded under the California statutory scheme through a sensitive exercise of the trial court's discretionary authority.
­FN 27. At oral argument petitioner raised the additional argument that the civil contempt provisions of section 1219 of the Code of Civil Procedure, providing that an individual who is in contempt because of his "omission to perform an act which is yet in [his] power ... to perform" may be confined until he performs the act, constitutes "cruel and unusual" punishment as applied to him. Petitioner contends that the application of the section will result in life imprisonment if the doctor refuses to betray his professional convictions. The short answer to petitioner's complaint is that civil contempt, as contrasted with criminal contempt, has traditionally been viewed as non-punitive, for its purpose is only to compel compliance with a lawful order of the court; petitioner, key to his jail cell in pocket (see Uphaus v. Wyman (1960) 364 U.S. 388, 404 [5 L.Ed.2d 148, 157-158, 81 S.Ct. 153] (Douglas, J., dissenting)), can secure his own release at any time by following the court order. Confinement until compliance, under civil contempt, has universally been upheld as consistent with constitutional strictures. (See, e.g., Shillitani v. United States (1966) 384 U.S. 364, 370 [16 L.Ed.2d 622, 627, 86 S.Ct. 1531]; Uphaus v. Wyman (1959) 360 U.S. 72, 81-82 [3 L.Ed.2d 1090, 1098-1099, 79 S.Ct. 1040].) Furthermore, petitioner misjudges the possible duration of his confinement; he can only be confined so long as the underlying litigation remains alive. (Cf. Shillitani v. United States, supra, 384 U.S. 364, 371-372 [16 L.Ed.2d 622, 627-628].) When the trial is concluded or the litigation is otherwise terminated, imprisonment for civil contempt must cease. (See Ex parte Rowe (1857) 7 Cal. 175, 177; cf. Morelli v. Superior Court (1969) 1 Cal.3d 328, 332 [82 Cal.Rptr. 375, 461 P.2d 655].)
Wed, 04/15/1970 2 Cal.3d 415 Review - Criminal Appeal Opinion issued
1 JOSEPH E. LIFSCHUTZ (Petitioner)
Apr 15 1970 Opinion: Reversed
SCOCAL, In re Lifschutz , 2 Cal.3d 415 available at: (https://scocal.stanford.edu/opinion/re-lifschutz-22784) (last visited Thursday July 18, 2019).