Opinion ID: 1478763
Heading Depth: 1
Heading Rank: 2

Heading: admissibility of the history given by petitioner to doctor weiner as a treating physician.

Text: The Appellate Division seems to have rested its reversal upon a determination that it was improper for Doctor Weiner to base his opinion in part upon some of the history given to him by Bober. Although no proper objection was made at the trial, and although in any event we would find no prejudicial error because the facts which were given as part of the history were already in the record through the petitioner's testimony, we put these facts aside in order to deal with the meritorious issue. We have long held the view in this State that declarations of a patient as to his condition, symptoms and feelings, made to his physician for the purpose of diagnosis and treatment, are admissible in evidence. Departure in this respect from the hearsay rule has been sanctioned because the law recognizes that such statements spring from natural reflexes and are made at a time when the desire for relief furnishes an impelling incentive to truth telling. State v. Gruich, 96 N.J.L. 202 ( E. & A. 1921). But it has been said in general terms also that statements as to the cause of the symptoms or condition are not relieved of the hearsay ban because the same compelling motivation may not be present; they may be the product of ulterior considerations. Helminsky v. Ford Motor Co., 111 N.J.L. 369 ( E. & A. 1933). And respondent urges here that Bober's statements in the history given to the doctor as to the chrome dust environment in which he worked and his physical reactions to it do not constitute revelation of factors necessary for diagnosis and treatment, but rather declarations relating to the cause of those factors. It is true that in a sense the statements relate to cause, but in this type of situation they cannot be denied either admissibility or probative force for that reason. As can be seen readily upon analysis, they stand arrayed in the same cloak of reliability as those expressions which are thought of ordinarily as symptoms. According to Doctor Weiner, in allergy cases the patient may be sensitive to many antigens. And, as Doctor Tucker said, an allergic state which has been activated may be aggravated by a host of secondary factors. Moreover, if a latent allergic condition is activated by specific allergens or irritants, it is undisputed that part of the treatment consists of removal of the sufferer from the offending environment. Consequently, on being consulted, the doctor must seek out the particular allergen or allergens or irritants which are responsible for the condition, and the place of exposure, if a particular location can be isolated. The record indicates that in some instances when an allergen to which the patient is hypersensitive is in season in an area the treatment consists in part of a vacation in or removal to another part of the state or country. And so, much more consideration must be given to history than in the diagnosis and care of other kinds of ailments or injuries. As Doctor Weiner put it: The history is the most important method of diagnosing an allergic condition, and among the allergic conditions, of course, allergic rhinitis and bronchial asthma. Roughly 80, to 90% of the diagnosis depends on a history well taken. A history at the first sitting takes at least one hour and there usually are three or four subsequent sittings at which at least 15 minutes is spent in history. The history is asked in detail, hashed and rehashed in such a manner that it becomes clear to the doctor that the history is accurate in its general detail. Q. Did you take such histories, Doctor, in this case? A. In this case the initial history took at least one hour, and I saw this man subsequently for the following months about five or six times and I talked to him for at least 15 or 20 minutes on the history. I was convinced that the history that I had was quite accurate, and from this history, of course, I was able to infer that this was probably an allergic condition, probably allergic rhinitis and asthma. And further: In taking a history, it's important to study the environmental factors in the patient's life. We have to go through everything he does practically from morning to night, where he lives, and so on. It is evident that the answers and information given by the patient during the doctor's probing for possible causes of the condition have the same driving and spontaneous motivation for truthfulness as in the usual case to be found in the reports where the hearsay exception has been recognized. In our judgment, therefore, the history thus gleaned which described the inception, the general character of the cause or external source of the condition to be treated, so far as it is pertinent to the purpose of diagnosis and treatment, is within the rule and admissible as substantive evidence. Cf. McCormick on Evidence, 564 (1954); Stewart v. Baltimore & O.R. Co., 137 F. 2 d 527, 530 (2 Cir. 1943); Baker v. Industrial Commission, 44 Ohio App. 539, 186 N.E. 10 ( Ct. App. 1933); Dabbert v. Travelers' Ins. Co., 13 Ohio Dec. ( Reprint ) 792 (1870); Ferne v. Chadderton, 375 Pa. 302, 100 A. 2 d 854 (1953); Hammond v. Industrial Commission, 84 Utah 67, 34 P. 2 d 687 (1934). Accordingly, there was no error in receiving in evidence the portions of the history of which complaint is now made.