Opinion ID: 2053900
Heading Depth: 2
Heading Rank: 1

Heading: The first question asks:

Text: 1. Does the Privileged Communications Act, § 9-17-24, violate Article 5 of the Rhode Island Constitution as an unconstitutional intrusion upon the function of the Judiciary? Article 5 of the Rhode Island Constitution states: OF THE DISTRIBUTION OF POWERS The powers of the government shall be distributed into three departments: the legislative, executive and judicial. Question 1 essentially asks this court whether the Legislature's creation of a privilege that restricts testimony and documentary health-care information impermissibly intrudes on the function of the Judiciary. This court has consistently interpreted article 5 as granting to the Legislature significant authority. In particular, all powers not specifically granted to the executive and judicial branches of government have been deemed as granted to the legislative department unless prohibited by the constitution. City of Providence v. Moulton, 52 R.I. 236, 241, 160 A. 75, 77 (1932). Consequently, the General Assembly is vested with all legislative power except where expressly limited by the constitution. Gorham v. Robinson, 57 R.I. 1, 17-18, 186 A. 832, 842 (1936). Gorham interpreted article 3 (now article 5) as devoid of any requirement that the judicial branch be independent of the exercise of legislative power. Id. at 19, 186 A. at 842. That the Legislature is vested with the constitutional authority to enact laws, including those that affect the judicial branch, is elemental: The general assembly shall pass all laws necessary to carry this Constitution into effect. R.I. Const. art. 6, sec. 1. Indeed, article 10, of the Rhode Island Constitution grants judicial power to the Supreme Court and to such inferior courts as the general assembly may, from time to time, ordain and establish, R.I. Const. art. 10, sec. 1, but grants to the Legislature the authority to prescribe by law other jurisdiction to the Supreme Court beyond that delineated in the Constitution and grants to the Legislature the authority to establish and prescribe the jurisdiction of any inferior courts, R.I. Const. art. 10, sec. 2. In addition to establishing such tribunals and delineating their jurisdiction, the General Assembly clearly affects rights and remedies in the state's tribunals through statutes that define crimes and establish sentences, set filing fees, and establish periods of limitations on bringing suit and in statutes that determine the overall budget and the number of judges in the various courts. It is equally clear that the Legislature may permissibly create the privilege defined in § 9-17-24. In fact, this court, by adopting the Rhode Island Rules of Evidence, has explicitly recognized the Legislature's authority to create such privileges. Rule 501 of the Rhode Island Rules of Evidence provides: Existing privileges retained.  Nothing in these rules shall be deemed to modify or supersede existing law relating to privilege. Recognizing that `the public    has the right to every man's evidence' except for persons protected by privilege, United States v. Bryan, 339 U.S. 323, 331, 70 S.Ct. 724, 730, 94 L.Ed. 884, 891 (1950), the Advisory Committee on the Rules of Evidence (committee) explained its formulation of Rule 501 as follows: This rule retains the present Rhode Island law with respect to privileges. All constitutional, statutory, and court-created privileges continue in force by operation of the rule[.] (Emphases added.) R.I.R.Evid. 501 advisory committee's note. Following the approach of many states, including Minnesota, Iowa, Michigan, and Ohio, this court left the matter of privileges essentially undisturbed from what it was prior to codification. Id. It follows, therefore, that the authoritative response to question 1 has already been given in the committee's explanation of the merit of its own approach to issues of privilege: Since privileges have the effect of excluding relevant evidence, they exist only where a compelling public policy interest in protecting confidential relationships or privacy is recognized. Thus, in this area of the rules it is difficult to draw a bright line between a rule of procedure or evidence that is clearly within the competence and authority of the court to announce, and a rule of substantive law that may be more appropriate for legislative treatment. By adopting by reference existing privilege statutes and common law constructions, this conceptual problem and any direct confrontation between branches of government is avoided. Further, the Committee believes that this approach will promote both desirable consistency and flexibility in the treatment of privileges. Consistency is promoted by retaining intact the current law with respect to privileges. (Emphasis added.) Id. Thus, the court, by adopting the Rules of Evidence by order dated July 23, 1987, subsequent to the 1986 enactment of § 9-17-24, see P.L. 1986, ch. 341, § 1, had, in effect, affirmed the privilege enacted by the statute. The committee's note to Rule 501 cites forty-two privileges under the United States Constitution, Rhode Island Constitution, the laws of the state, and common law. The constitutional privilege against compulsory self-incrimination provided by the Fifth Amendment to the United States Constitution and article 1, section 13, of the Rhode Island Constitution and the other privileges that restrict, limit, or prevent the disclosure of information continue in effect, except for one that has been statutorily repealed and one that has been held invalid. This court, in Bartlett v. Danti, 503 A.2d 515, 517 (R.I. 1986), held that the protection of health-care information from compulsory legal process under G.L. 1956 (1987 Reenactment) § 5-37.3-6(a)(1) impermissibly intruded on the judicial function. 503 A.2d at 517. All other privileges  attorney-client privilege (common law), newsman's privilege (G.L. 1956 (1985 Reenactment) § 9-19.1-2), records of alcoholics and intoxicated persons (G.L. 1956 (1990 Reenactment) § 40.1-4-13), public-assistance records (G.L. 1956 (1990 Reenactment) § 40-6-12), confidential information of department of employment security employees (G.L. 1956 (1986 Reenactment) § 28-39-19, as amended by P.L. 1989, ch. 421, § 1), vital statistics records confidentiality (G.L. 1956 (1989 Reenactment) § 23-3-23), department of children, youth, and families (G.L. 1956 (1993 Reenactment) § 42-72-8), confidentiality of bank tax returns (G.L. 1956 (1988 Reenactment) § 44-14-23), confidentiality of communications to clergyman (G.L. 1956 (1985 Reenactment) § 9-17-23)  virtually identical to § 9-17-24  continue intact. Why this law [the confidentiality of medical records], was singled out in contrast to the lawyer/client and clergy/parishioner privileges was not, and still is not clear, commented a Providence Journal editorial, Keeping sacred the privileged relationship, Providence Journal Bulletin, April 14, 1986, in support of the enactment of § 9-17-24 after this court's Bartlett decision. The majority's holding in Bartlett is apparently unique among all the courts in the United States. Although forty-three states and the District of Columbia have enacted physician-patient privileges and all but three states provide psychiatrist/therapist-patient privileges, Harvey F. Wachman, Hear All, See All, But Silence May be Golden: Confidentiality, Privacy, and Privileged Communication, 13 Legis. Aspects of Med. Prac. 5 (1985), as of 1989 no state has withdrawn the privilege after adopting it. In fact, the number of states recognizing the privilege has gradually grown. Robert A. Wade, The Ohio Physician-Patient Privilege: Modified, Revised, and Defined, 49 Ohio St. L.J. 1147, 1151 n. 34 (1989). The courts in these jurisdictions have routinely applied such privileges without questioning the constitutionality of the statutes. See, e.g., People v. Marquez, 692 P.2d 1089 (Colo. 1984); Collins v. Bair, 256 Ind. 230, 268 N.E.2d 95 (1971); State v. George, 223 Kan. 507, 575 P.2d 511 (1978); Popp v. Crittenton Hospital, 181 Mich. App. 662, 449 N.W.2d 678 (1989); State v. Smorgala, 50 Ohio St.3d 222, 553 N.E.2d 672 (1990). Accord Samuelson v. Susen, 576 F.2d 546, 553 (3d Cir.1978) (Ohio statute providing that deliberations of medical-review committee should be privileged did not deprive party of access to courts). The majority's response to questions 1 and 2 rests significantly on its Bartlett decision that rejected the same public-policy considerations at stake in § 9-17-24. In contrast, the decisions of the supreme courts in other states whose health-care-privilege statutes encompass the sweep of the Rhode Island statutes have interpreted and applied their privilege statutes pragmatically (as did this court in adopting the Rules of Evidence), cooperatively, and flexibly in response to their Legislatures' effectuation of the public policy expressed in the statutes. Apparently, no court, except this court, has concluded that such privilege statutes represent an unconstitutional coercion or intrusion into the operation of the judicial branch. Under many of the statutes, disclosures, by a physician, against the will of the patient, of communications from the patient or information concerning the patient acquired by the physician in his professional capacity, are incompetent as privileged. 97 C.J.S. Witnesses § 293 at 824-25 & n. 93 (1957) (citing approximately thirty-nine cases). The Indiana Civil Code, for example, provides: XX-X-XX-X. Who are incompetent.  Except as otherwise provided by statute, the following persons shall not be competent witnesses:       (3) Physicians, as to matter [matters] communicated to them, as such, by patients, in the course of their professional business, or advice given in such cases. Ind. Code Ann. § 34-1-14-5 (Burns 1986). Such statutes enable patients to secure appropriate medical treatment by encouraging complete disclosure to a treating health-care provider. Lewin v. Jackson, 108 Ariz. 27, 31, 492 P.2d 406, 410 (1972). The beneficial public purpose of such statutes is `not the suppression of truth needed for reaching correct results in litigation, though this may sometimes incidentally occur (as it may also in other instances of exclusion on the ground of wise policy), but the purpose is the promotion and protection of confidence of a certain kind, the inviolability of which is deemed of more importance than the results sought through compulsory disclosure in a court of justice. ' (Emphasis added.) Collins v. Bair, 256 Ind. at 236, 268 N.E.2d at 98. These historic privileges of confidential communication protect significant human values in the interest of the holders of the privileges[.] David W. Louisell, Confidentiality, Conformity And Confusion: Privileges In Federal Court Today, 31 Tul.L.Rev. 101, 101 (1956-1957). Illustrative of numerous supportive judicial decisions on such statutes, the Minnesota Supreme Court noted that [d]espite persistent academic and judicial criticism of this evidentiary privilege    it is nevertheless our duty to enforce it to the full extent reasonably necessary for the attainment of the longstanding legislative policy for which it was created[.] State v. Staat, 291 Minn. 394, 397, 192 N.W.2d 192, 196 (1971). After pointing out that a majority of jurisdictions apply the privilege to criminal proceedings, the Staat court, in view of the broad language of [Minnesota's] statute, ruled by judicial assumption that the privilege in Minnesota would be applied to criminal proceedings as well as to civil proceedings. Id. at 398 n. 2, 192 N.W.2d at 196 n. 2. In Michigan, the Court of Appeals reconciled a broad physician-patient privilege with a requirement that any wound inflicted by a deadly weapon be reported to police. People v. Traylor, 145 Mich. App. 148, 151, 377 N.W.2d 371, 372-73 (1985) (per curiam). That court reasoned that if a general statute, such as the one creating the privilege, conflicts with a specific statute, such as the reporting statute, the specific statute is considered to be an exception to the general statute. Id. at 151, 377 N.W.2d at 372. Rhode Island's confidentiality-of-medical-records statute, through a specific exemption, allows release of confidential health-care records to law enforcement personnel in the case of a gunshot wound reportable under § 11-47-48. Section 5-37.3-4(b)(4). The Ohio Supreme Court in Smorgala confronted Ohio's broad privilege statute that provided in pertinent part, A physician    [shall not testify] concerning a communication made to him by his patient in that relation or his advice to his patient. Ohio Rev. Code Ann. § 2317.02(B)(1) (Page 1991). That court held that under the statute, it was impermissible for the court to create a public-policy limitation on the physician-patient privilege in order to allow otherwise clearly inadmissible evidence in drunk-driving cases. 50 Ohio St.3d at 225, 553 N.E.2d at 676. Where the words of a statute are free of ambiguity and express plainly and distinctly the sense of the lawmaking body  clearly the case with Rhode Island's § 9-17-24  the courts should look no further in their efforts to interpret the intent of the General Assembly. 50 Ohio St.3d at 223, 553 N.E.2d at 674. After determining that the law of privilege was substantive in nature, thereby precluding the court from amending its Rules of Evidence so as to deny the privilege in drunk-driving cases, the Ohio court concluded that since the legislature has enacted a specific statutory provision in [§] 2317.02(B) to establish and control the physician-patient privilege, there is no vacuum within which we can proceed by common-law pronouncement. 50 Ohio St.3d at 225, 553 N.E.2d at 676. The Ohio court warned that `courts should not forget that the legislature's valid laws control policy preferences,' id. at 224, 553 N.E.2d at 675, a caveat not heeded today by this court. In an important and relevant example of the Judiciary's recognition of legislative authority to enact laws that determine the discovery of evidence, the Supreme Court of Illinois rejected the argument that the legislative grant of confidentiality    violates the separation of powers. Niven v. Siqueira, 109 Ill.2d 357, 368, 94 Ill.Dec. 60, 66, 187 N.E.2d 937, 943 (1985). It pointed out that the Illinois court has upheld legislative grants of confidentiality and legislative creation of privileges.    [A]nd we see no reason why the promulgation of rules regarding discovery should be solely a function of the judicial branch. Id. Apparently, no other Supreme Court, aside from the Rhode Island Supreme Court in its anomalous Bartlett decision, has found that a privilege or confidentiality statute has interfered with the operation of the Judiciary. Consequently, this court's response to question 1 should not rest on such an inauspicious precedent. Instead, this court should acknowledge that in enacting § 9-17-24, the Legislature has not assumed a power that is `central or essential to the operation of' the Judiciary, In re Advisory from the Governor, 633 A.2d 664, 675 (R.I. 1993), but rather has exercised its constitutional prerogative to enact laws that establish public policy. In recognizing that the doctrine of separation of powers must be viewed as a general principle, not as the creation of isolated compartments, the Supreme Court of Wisconsin in State v. Washington, 83 Wis.2d 808, 266 N.W.2d 597 (1978), noted that `As a principle of statesmanship the practical demands of government preclude its doctrinaire application.    Nor has it been treated by the [United States] Supreme Court as a technical legal doctrine. From the beginning that Court has refused to draw abstract, analytical lines of separation and has recognized necessary areas of interaction.' Id. at 826-27 n. 13, 266 N.W.2d at 606 n. 13 (quoting Frankfurter and Landis, Power of Congress Over Procedure in Criminal Contempts in Inferior Federal Courts  A Study in Separation of Powers, 37 Harv.L.Rev. 1010, 1012-14 (1923-1924)). Citing its own precedents, the Wisconsin court commented, `[B]etween these several powers, which seem so distinct in their general character, there are great borderlands of power which may be said to approach nearer and nearer until they merge gradually into each other.' 83 Wis.2d at 826 n. 13, 266 N.W.2d at 606 n. 13. The United States Supreme Court has formulated a similarly expansive response in separation-of-powers cases, using a balancing approach in Nixon v. Administrator of General Services, 433 U.S. 425, 443, 97 S.Ct. 2777, 2790, 53 L.Ed.2d 867, 891 (1977) and in Public Citizen v. United States Department of Justice, 491 U.S. 440, 484-85, 109 S.Ct. 2558, 2582, 105 L.Ed.2d 377, 410-11 (1989) (Kennedy, J., concurring). After applying the analysis formulated in those cases, it is clear that § 9-17-24 is not violative of judicial authority but rather represents the Rhode Island Legislature's performance of its core constitutional governmental function, that of establishing public policy. The Legislature has, by providing for the confidentiality of medical records and by establishing a privilege between a patient and health-care provider  each with exceptions that recognize important public-policy concerns  balanced the need for personal privacy in certain communications with the need for probative evidence at trials. See Daniel W. Shuman, The Origins of the Physician-Patient Privilege and Professional Secret, 39 Sw.L.J. 661, 667 (1985). In its opinion, the majority has disregarded the substantial precedents that direct this court's review of statutes. First, a duly enacted statute is presumed to be constitutional in form and in application. State v. Capone, 115 R.I. 426, 432, 347 A.2d 615, 619 (1975). A challenger to a statute's constitutionality bears the heavy duty of proving the statute's unconstitutionality beyond a reasonable doubt, id., and the state, here the challenger, has not met such a burden. Moreover, this court must presume `every reasonable intendment in favor of    constitutionality' in order to preserve the statute. Lynch v. King, 120 R.I. 868, 875, 391 A.2d 117, 121 (1978). At the same time, a statute may not be construed in such a way that the interpretation of the Legislature's intent would result in absurdities or would defeat the underlying purpose of [the] legislation. Landrigan v. McElroy, 457 A.2d 1056, 1060-61 (R.I. 1983). This court has consistently applied rules of statutory construction to avoid constitutional issues and to render the provisions of laws consistent and valid, even when a literal reading of [a] statute[]    would defeat or frustrate the evident intendment of the legislature. Town of Scituate v. O'Rourke, 103 R.I. 499, 507, 239 A.2d 176, 181 (1968). For example, this court has interpreted the statute permitting application by a victim to obtain the name of a juvenile (G.L. 1956 (1981 Reenactment) § 14-1-66, as enacted by P.L. 1981, ch. 317, § 1) as also permitting the release of a juvenile's police record notwithstanding the separate statute that provides for confidentiality of such a record (§ 14-1-64, as amended by P.L. 1990, ch. 325, § 1). Matter of Falstaff Brewing Corporation Re Narragansett Brewery Fire, 637 A.2d 1047 (R.I. 1994). These cogent considerations clearly support the constitutionality of § 9-17-24, considerations that are essential in the wake of Bartlett. But in fact the constitutional issue in question 1 need not be reached at all. The privilege under § 9-17-24 applies to information obtained about a patient in the course of the customary professional health care relationship. (Emphasis added.) In the case at bar, defendant has invoked the privilege for the purpose of excluding the testimony of a treating physician and others at a hospital, testimony that allegedly included incriminating statements connecting defendant to a fire. Because a putative confession of criminal acts cannot reasonably be construed as information necessary for rendering customary professional health care, such information is not privileged under § 9-17-24. Therefore, testimony from the treating physician and other hospital workers and the hospital's medical records are not privileged under the statute. Such a conclusion in respect to the admissibility of a defendant's statements is one that has generally been reached under the physician-patient-privilege statutes in other states. For example, a patient's statements to a doctor that he was driving a car at the time of an accident and a patient's statement that he drew a gun have been held to be outside the privilege. See Kimberly A. Kmentt, Private Medical Records: Are they Public Property? 1987 Med. Trial Tech. Q. 274, 280. Thus, if the information sought was not related to a patient's diagnosis, treatment, or medical care, the privilege generally does not attach. Id. at 278; McCormick on Evidence § 101 at 378 n. 7 (John W. Strong ed., 4th ed. 1992). The state seeks information that is not privileged under § 9-17-24 and thus such information is discoverable irrespective of the confidentiality statute. Hence, the constitutionality of § 9-17-24 need not be reached. See State ex rel. Widergren v. Charette, 110 R.I. 124, 128, 290 A.2d 858, 860 (1972). That the court today chose to address the constitutional issue creates a troubling precedent for future certified questions and constitutional challenges to statutes. Question 1 should be answered in the negative. Section 9-17-24 does not violate article 5 of the Rhode Island Constitution and does not represent an unconstitutional intrusion upon the function of the Judiciary. This issue need not be reached, however, because the information sought is not privileged under the Act.