Opinion ID: 70614
Heading Depth: 1
Heading Rank: 3

Heading: Cross-examination of the psychiatrist

Text: 16 At his first trial Strickland relied on an insanity defense. By court order he had been examined by Dr. Boaz Harris, a psychiatrist, who had interviewed him on January 23, 1986, some three months after the shooting, for about two hours. Dr. Harris testified at the first trial that, in his opinion, when Strickland shot his wife he was unable to distinguish right from wrong and unable to form an intent to kill his wife. He based his opinion on the hospital records showing the drugs that Strickland had been given and on the description Strickland had given in his interview of the events when he shot his wife and of his intent and state of mind at that time. 17 Before the retrial Dr. Harris interviewed Strickland twice more for a total of about four hours. Strickland was not given Miranda warnings for any of his interviews. 18 During the retrial, before Dr. Harris testified, Strickland withdrew his insanity defense and stood on a contention that he was incapable of forming an intent to kill. Dr. Harris was asked his opinion whether, around 8:30 a.m. on October 16, Strickland could have formed the intent to kill his wife. He responded with the opinion that, because of the side effects of the valium and demerol administered as indicated on Strickland's hospital records, his ability to think in a logical, rational manner was so impaired that he could not in a rational manner have formed the intent to kill his wife. He discussed automatism--i.e., a person's functioning automatically without knowing what he is doing--and, considering the drugs administered as shown by the hospital records, stated that it was quite possible that Strickland's act of shooting his wife was such an automatic reaction. Dr. Harris based his opinions given at the retrial upon the hospital records, his knowledge and experience relating to the particular drugs, and an authoritative publication, the Physician's Desk Reference. 19 When direct examination was concluded the prosecution sought to inquire into statements made by Strickland to Dr. Harris during the interviews. The defense objected on Fifth Amendment grounds. On examination by the court Dr. Harris restated his position that his opinion was not based on anything learned from his interviews with Strickland. 20 A host of questions remained when direct examination of Dr. Harris was concluded. Was Dr. Harris's opinion reliable? Did he in fact rely upon only the hospital records, his experience, and the Physician's Desk Reference? Were these bases alone an acceptable basis for a psychiatrist's opinion of the defendant's state of mind when he had heard from the defendant himself statements describing his state of mind at the relevant time and place, i.e., was it an acceptable methodology for forming an opinion to limit the basis for an opinion as Dr. Harris did? Was other information available that should have been considered before an opinion was rendered based on only the truncated predicate that Dr. Harris described? Did Dr. Harris know whether before the drugs were administered Strickland entertained an intent to kill his wife, and did he seek that information? Was it necessary to consider the shooting of the boyfriend as evidence of a willingness or propensity by Strickland to engage in violence when faced with knowledge of his wife's misconduct and, if it was, could the expert properly accept as correct Strickland's version of what occurred and reject the boyfriend's very different version? 21 The Fifth Amendment problem presented by this case was foreshadowed in Estelle v. Smith, 451 U.S. 454, 101 S.Ct. 1866, 68 L.Ed.2d 359 (1981). Smith did not plead insanity nor did he introduce psychiatric evidence, but the state offered evidence obtained from a court-ordered competency examination as affirmative evidence to support the sentence of death at the sentencing phase of a capital murder case. The Court held that this violated his Fifth Amendment rights. It distinguished its decision from other situations: 22 Nor was the interview analogous to a sanity examination occasioned by a defendant's plea of not guilty by reason of insanity at the time of his offense. When a defendant asserts the insanity defense and introduces supporting psychiatric testimony, his silence may deprive the State of the only effective means it has of controverting his proof on an issue that he interjected into the case. Accordingly, several Courts of Appeals have held that, under such circumstances, a defendant can be required to submit to a sanity examination conducted by the prosecution's psychiatrist. See, e.g., United States v. Cohen, 530 F.2d 43, 47-48 (CA5), cert. denied, 429 U.S. 855 [97 S.Ct. 149, 50 L.Ed.2d 130] (1976); Karstetter v. Cardwell, 526 F.2d 1144, 1145 (CA9 1975); United States v. Bohle, 445 F.2d 54, 66-67 (CA7 1971); United States v. Weiser, 428 F.2d 932, 936 (CA2 1969), cert. denied, 402 U.S. 949 [91 S.Ct. 1606, 29 L.Ed.2d 119] (1971); United States v. Albright, 388 F.2d 719, 724-25 (CA4 1968); Pope v. United States, 372 F.2d 710, 720-21 (CA8 1967) (en banc), vacated and remanded on other grounds, 392 U.S. 651 [88 S.Ct. 2145, 20 L.Ed.2d 1317] (1968). 10 23 Id. at 465-66, 101 S.Ct. at 1874. 24 In Buchanan v. Kentucky, 483 U.S. 402, 107 S.Ct. 2906, 97 L.Ed.2d 336 (1987), the Court found there was no Fifth Amendment violation by use of a psychiatrist's report because petitioner's entire defense strategy was to establish the 'mental status' defense of extreme emotional disturbance and his counsel had joined in a motion for his examination. Id. at 423, 107 S.Ct. at 2918. The Court found the case to be one of the situations distinguished from the facts of Smith. [W]ith petitioner not taking the stand, the Commonwealth could not respond to this defense [extreme emotional disturbance, based on psychiatric reports] unless it presented other psychological evidence. Id. The psychologist's testimony consisted of his general observations and did not concern the crime itself. This particular application of the distinction pointed out in Smith does not limit the principle itself. Indeed Buchanan restates the Smith principle: 25 [I]f a defendant requests such [a psychiatric] evaluation or presents psychiatric evidence, then, at the very least, the prosecution may rebut this presentation with evidence from the reports of the examination that the defendant requested. The defendant would have no Fifth Amendment privilege against the introduction of this psychiatric testimony by the prosecution. 26 Id. at 422-23, 107 S.Ct. at 2917-18. 27 Subsequent cases read the Smith/ Buchanan principle in terms of waiver. 28 Language contained in Smith and in our later decision in Buchanan v. Kentucky, 483 U.S. 402 [107 S.Ct. 2906, 97 L.Ed.2d 336] (1987), provides some support for the Fifth Circuit's discussion of waiver [in Battie v. Estelle, 655 F.2d 692 (1981) ]. In Smith we observed that [w]hen a defendant asserts the insanity defense and introduces supporting psychiatric testimony, his silence may deprive the State of the only effective means it has of controverting his proof on an issue that he has interjected into the case. 451 U.S., at 465, 101 S.Ct., at 1874. And in Buchanan the Court held that if a defendant requests a psychiatric examination in order to prove a mental-status defense, he waives the right to raise a Fifth Amendment challenge to the prosecution's use of evidence obtained through that examination to rebut the defense. 483 U.S., at 422-423, 107 S.Ct., at 2917-18. 29 Powell v. Texas, 492 U.S. 680, 684, 109 S.Ct. 3146, 3149-50, 106 L.Ed.2d 551 (1989). See also, Hughes v. Mathews, 576 F.2d 1250 (7th Cir.1978) (no Fifth Amendment violation by admitting psychiatric testimony when the defendant admitted that he did the act and argued only that he lacked the specific intent required by the act), cert. dismissed, 439 U.S. 801, 99 S.Ct. 43, 58 L.Ed.2d 94 (1978). 30 Dr. Harris' opinion presented by Strickland was said to be based upon the hospital records, his experience, and the Physician's Desk Reference manual, and not to any extent on factual data that came from Strickland himself. But the doctor's opinion rested in part upon factual predicates the only source of which was Strickland. Time of death was relevant because it bore on whether the effect of the drugs that had been administered at a known time continued to the time the wife was shot. Dr. Harris' opinion assumed that Strickland killed his wife about 8:30 a.m. But Strickland, the only eye witness, was the sole source of that information; his activities from around 5:30 a.m. to around 10:00 a.m. are not known except from Strickland's own testimony. 3 The doctor's opinion also embraced the effects of fatigue, exhaustion, and loss of sleep, additional information that could have come only from Strickland. Also, Dr. Harris discussed the effect that having a personality that concealed one's feelings would have on capacity to form intent. This was an issue Strickland drew into the case, and the details of his personality came from interviews. 31 We hold that Strickland had waived any Fifth Amendment objections to Dr. Harris' testimony. Dr. Harris' subsequent testimony on cross-examination bore directly on intent. He testified that Strickland related to him going to the house and specifically spelled out what had occurred there between him and his wife. He testified that Strickland had been able to relate his conversations at the scene with his wife and to describe his own physical sensations. Strickland recalled specific names of lovers mentioned by the wife. Strickland recalled that he had a firearm in his jacket, that he pulled it out, and that he pointed it at his wife's head. He recalled firing the first shot. Despite Dr. Harris' opinion that Strickland could not think in a rational way, he accepted that Strickland knew where he was, knew that a gun would fire a shot, and knew that if a gun were placed against someone's head it was likely to cause immediate death. 32 As the cross-examination developed it revealed that reliance upon only the hospital records was not as firm or as reliable a basis as the direct examination had indicated. It revealed that Dr. Harris had not pursued other available sources of information and that had he had knowledge of preexisting intent his opinion would have changed. Though Dr. Harris stood on his testimony that he had relied on only the hospital records and had not relied on what Strickland had related to him, elsewhere he indicated that records alone, without an interview, would not be a sufficient basis for an opinion. 33 Q [Is your opinion] based on your clinical experience of the drugs and your reviews of the drugs that he received, and not on your conversation with him? 34 A It is based on that. I would not have ever had to examine Mr. Strickland to give you an opinion that that much medication in an individual who's not accustomed to using large amounts of drugs or Valium would greatly interfere with his cortical functioning. 35 Q Okay. Could you have--and could you have come into this court without ever having seen Robert Strickland and simply reviewed the medical records and testify to what you're testifying to today on Direct Examination? 36 A I could testify on that basis, but I would not, in that he was available to me. 37 Q But it would be theoretically possible? 38 A It would be theoretically possible, yes, sir. 39 Q And you would in fact be comfortable doing that? 40 A Oh, yes, sir. 41 Tr. 1106-07. Second, as we discuss in Part IV, there was substantial evidence that Strickland's intent to kill predated the administration of the drugs. Dr. Harris acknowledged that if he had known of a preexisting intent to kill his opinion would have changed. 42 Q What if he had pre-existing intent before taking the drug, sir? What if he, before he went to DeKalb General Hospital that morning, intended to kill his wife that day? Would that change your opinion? 43 A If I knew him to have pre-existing intent? 44 Q Yes, sir. If you knew that he intended to kill his wife when he got up that morning before he ever went to DeKalb General, before he ever took any Demerol, before he ever took any Valium, would that change your opinion? 45 A It would change my opinion. 46 Tr. 1113-14. In his testimony, after Dr. Harris testified, Strickland acknowledged that after the incident with the boyfriend he had thought about killing himself and his wife. 47 With respect to the shooting of the boyfriend and its possible relevance, Dr. Harris accepted Strickland's representations (except for his contention that the first shot was accidental) and rejected the boyfriend's version of the incident, which was sharply different from Strickland's. He did so without talking with the boyfriend. Though Strickland shot the boyfriend five times Dr. Harris gave as his opinion that he did not intend to kill. 48 The first person with whom Strickland talked after the shooting was a police officer at the station. Dr. Harris did not talk to him. The last persons known to talk with Strickland before the shooting were the doctor who prescribed the medication he received and the nurse who administered it. Dr. Harris talked with neither of them. 49 Moreover, the breadth to which Dr. Harris' opinions swept was relevant in assaying the reliability of his specific opinion concerning Strickland's capacity to form an intent to kill. There was no evidence of when and where Strickland emptied the spent shells from the gun, or when and where he disposed of the gun, or that he told Dr. Harris about either of those events. But Dr. Harris gave as his opinion that when Strickland emptied the gun he was not in good contact with reality but rather was performing an automatic act, and that disposing of the gun was neither automatic nor intentional and that Strickland merely lost it or mislaid it. And, as we have already pointed out, he expressed an opinion that Strickland did not intend to kill the boyfriend in the affray that took place three days before he was administered the drugs. 50 The trial court did not err in permitting the testimony of Dr. Harris to be tested by cross-examination.