Opinion ID: 2053900
Heading Depth: 2
Heading Rank: 4

Heading: The fourth question asks:

Text: 4. May the Superior Court order a health-care provider to disclose medical records when such disclosure does not meet the requirements of subsections 1 through 5 of section 9-17-24 of the General Laws? Because this court should uphold the constitutionality of § 9-17-24, the response to question 4 must be in the negative. Medical records, however, are not only discoverable under §§ 9-17-24(1)-(5), but also are admissible under Rule 803(4) of the Rhode Island Rules of Evidence (Hearsay Exceptions, Statements for Purposes of Medical Diagnosis or Treatment), or under other evidentiary rules. Whether such disclosures violate a First Amendment privacy right or constitute an invasion of the right to privacy protected by the Fourth Amendment would need to be considered, however. The United States Supreme Court has articulated the persuasive public purposes behind even the most sweeping privilege statutes: The privileges between priest and penitent [for example in Rhode Island under § 9-17-23], attorney and client [by common law in Rhode Island], and physician and patient [under § 9-17-24 in Rhode Island]    are rooted in the imperative need for confidence and trust. The priest-penitent privilege recognizes the human need to disclose to a spiritual counselor[.]    The lawyer-client privilege rests on the need for the advocate and counselor to know all that relates to the client's reasons for seeking representation   . Similarly, the physician must know all that a patient can articulate in order to identify and to treat disease; barriers to full disclosure would impair diagnosis and treatment. Trammel v. United States, 445 U.S. 40, 51, 100 S.Ct. 906, 913, 63 L.Ed.2d 186, 195 (1980). The Rhode Island General Assembly, through its enactment of § 9-17-24, has affirmed the importance of a patient's right to privacy and of the significant human values ensconced in the privilege. `For many people, judges, lawyers and laymen, the protection of confidential communications from enforced disclosure has been thought to represent rights of privacy    too important to relinquish to the convenience of litiganta. Growing concern    with the increase in official prying and snooping into the lives of private individuals has reinforced support for the traditional privileges.' Robert S. Catz & Jill J. Lange, Judicial Privilege, 22 Ga. L.Rev. 89, 114 (1987). Along with federal statutes that are creating rights similar to the physician-patient privilege, ( see, e.g., 42 U.S.C.A. § 242a(b) (West Supp. 1994) on mental health and 42 U.S.C.A. § 260(d) (West 1991) on treatment of drug addicts), the physician-patient privilege may be emerging as an aspect of federal constitutional guarantees of the right to privacy. See Doe v. Bolton, 410 U.S. 179, 197, 93 S.Ct. 739, 750, 35 L.Ed.2d 201, 216 (1973). Although such privacy issues have focused on reproductive decisions, similar concerns for privacy arise in mental disorders and controversial medical conditions such as Acquired Immune Deficiency Syndrome. Privacy issues requiring constitutional protection will expand as discoveries from the Human Genome Project reveal the complete menu of each individual's genetic components, including the flaws in one's genetic makeup and the likely time and nature of one's death. Information on whether an individual carries a gene for Alzheimer's disease or early heart disease would be of interest to employers as well as insurance companies. See Robert C. Deegan, The Gene Wars: Science, Politics, & the Human Genome (1993). The Legislature had spoken by enacting § 9-17-24, but now must speak again. Courts should not substitute their own pleasure to the constitutional intentions of the legislature.    [A]nd if they should be disposed to exercise will instead of judgment, the consequence would equally be the substitution of their pleasure to that of the legislative body. The Federalist No. 78, at 526 (Alexander Hamilton) (Jacob E. Cooke ed., 1961). `Were the power of judging joined with the legislative    the judge would then be the legislator, ' The Federalist No. 47, at 326 (James Madison) (Jacob E. Cooke ed., 1961), and that clearly is violative of article 5. And although Judges have, of course, the power, though not the right, to ignore the mandate of a statute, and render judgment in despite of it, Benjamin N. Cardozo, The Nature of the Judicial Process, 129 (1921), reprinted in Selected Writings of Benjamin Nathan Cardozo 107, 160 (Margaret E. Hall ed., 1947), our Constitution is not well served by such an undertaking. Section 9-17-24 embodies a sound principle. Once the individual's control of his or her physical and mental health records becomes generally subservient to the adversary legal process, a precious right will be lost. Keeping sacred the privileged relationship, Providence Journal Bulletin, April 14, 1986.