Opinion ID: 1527587
Heading Depth: 1
Heading Rank: 3

Heading: the psychiatric testimony as to dangerousness

Text: When the District proffered Dr. Byrd as an expert witness in the field of psychiatry, Melton's counsel objected on the grounds that the doctor's involvement in the case was minimal and that he had only just finished his training. The judge overruled the objection and found Dr. Byrd to be qualified to testify as an expert. Counsel for Melton interposed no objection to Dr. Cornet's qualifications, and does not contend on appeal that the trial judge abused his discretion (or, in Dr. Cornet's case, committed plain error) in holding that each of the witnesses was properly qualified as an expert. After testifying that Melton was mentally ill, however, Dr. Byrd was asked to state his opinion whether, in light of the mental illness, Melton would be likely to injure himself or others if he were not under the care of the hospital. Melton's counsel objected. Noting that we've been through this before, the judge overruled the objection, but allowed Melton's counsel to make a record at the bench. Going directly to the heart of the issue, the judge asked whether counsel was maintaining that the doctor who made the examination [of] the records [and] the staff cannot say that if he will be released today that he will not take his medication or, in his opinion ..., would be likely to injure himself or others? Is that what you're saying? Relying on a trial court opinion in another case, Melton's counsel responded that a physician had no particular ability to predict dangerousness. Insisting that we have heard nothing about this doctor being able to predict the future, and that predicting the future, I would submit, is a very difficult thing, counsel insisted that the government was obliged to qualify the witness further. The judge adhered to his original ruling, held that no further qualification was required, and permitted Dr. Byrd to answer the question. Although no comparable objection was made with respect to Dr. Cornet's testimony, [5] Melton argues on appeal that the trial judge committed reversible error in permitting the two doctors to testify regarding Melton's alleged dangerousness to himself or others without a separate demonstration of their expertise on that subject. A majority of the panel which heard the original appeal upheld this contention. Melton I, supra, 565 A.2d at 647-49. Specifically, the panel was of the opinion that the trial judge abused his discretion by refus[ing] to consider Melton's counsel's objection to the psychiatrists' qualifications to predict his clients' dangerousness. Id. at 648. The criteria for admitting expert testimony in this jurisdiction are set forth in the three-part test in Dyas v. United States, 376 A.2d 827 (D.C.1977), cert. denied, 434 U.S. 973, 98 S.Ct. 529, 54 L.Ed.2d 464 (1977), as follows: (1) the subject matter `must be so distinctively related to some science, profession, business or occupation as to be beyond the ken of the average [lay person]'; (2) `the witness must have sufficient skill, knowledge, or experience in that field or calling as to make it appear that his [or her] opinion or inference will probably aid the trier in his [or her] search for truth'; and (3) expert testimony is inadmissible if `the state of the pertinent art or scientific knowledge does not permit a reasonable opinion to be asserted even by an expert.' 376 A.2d at 832 (quoting EDWARD W. CLEARY, MCCORMICK ON EVIDENCE § 13, at 29-31 (2d ed. 1972)) (emphasis deleted). The trial judge has wide latitude in the admission or exclusion of expert testimony, and his[ [6] ] decision with respect thereto should be sustained unless it is manifestly erroneous. Coates v. United States, 558 A.2d 1148, 1152 (D.C.1989). The question whether an expert has been sufficiently qualified is likewise recognized as a matter for the trial judge's discretion reviewable only for abuse. Reversals for abuse are rare. E. CLEARY, MCCORMICK ON EVIDENCE § 13, at 34 (3d ed. 1984) (emphasis added and footnote deleted). As Judge (later Chief Justice) Burger wrote for the court in Baerman v. Reisinger, 124 U.S.App.D.C. 180, 181, 363 F.2d 309, 310 (1966), [i]t is settled law that [a] physician is not incompetent to testify as an expert merely because he is not a specialist in the particular field of which he speaks. The training and specialization of the witness goes to the weight rather than admissibility of the evidence, generally speaking. (Citations and internal quotation marks deleted). Ordinarily, a specialist in a particular branch within a profession is not required. See McCORMICK, supra, § 13, at 34 & n. 11. Even an ordinary medical practitioner is, and should be, permitted to testify as to a patient's sanity. See 2 JOHN HENRY WIGMORE, EVIDENCE IN TRIALS AT COMMON LAW § 569, at 785-86 & n. 2 (James H. Chadbourn rev. ed. 1979); see Jenkins v. United States, 113 U.S.App.D.C. 300, 306-07, 307 F.2d 637, 643-44 (1962) (en banc). [7] Both Dr. Byrd and Dr. Cornet are practicing psychiatrists. Each stated that he was eligible for board certification. Each had previously testified as an expert before the Mental Health Commission, and Dr. Byrd had done so in court as well. As we show below, the prediction of dangerousness is reasonably related to the practice of psychiatry. Both witnesses were obviously more qualified with respect to this subject than an ordinary physician, and neither expressed any reservation about his ability to form an opinion regarding the question whether Melton was likely to injure himself or others. In the present case, as we have noted, Melton's dangerousness to himself and others was alleged to stem from his failure, when not under the hospital's supervision, to take psychotropic medicine with the requisite regularity. The consequences of such failure are, in our view, so `distinctively related [lay person] to some science... as to be beyond the ken of the average layman,' Dyas, supra, 376 A.2d at 832 (citation and emphasis omitted). It defies common sense to suggest that a lay juror knows as much as a qualified psychiatrist does about what is likely to happen if a schizophrenic patient does not receive Prolixin shots. The doctors' testimony would therefore probably assist the trier of fact to understand the evidence or to determine a fact in issue. FED.R.EVID. 702. Accordingly, the psychiatric testimony in this case satisfied the first prong of Dyas. The judge could likewise reasonably conclude that Dr. Byrd and Dr. Cornet had sufficient knowledge of the characteristics of Prolixin and of the potential consequences of Melton's not taking it, as well as sufficient familiarity with other matters related to Melton's condition, that their testimony could `probably aid the [lay jurors] in [their] search for truth,' as required by the second prong of the Dyas test. 376 A.2d at 832 (emphasis and citation omitted). If the testimony of the ordinary medical practitioner should be received on all matters as to which a regular medical training necessarily involves some general knowledge, 2 WIGMORE, supra, § 569, at 785, then a fortiori, the judge did not abuse his discretion in permitting Dr. Byrd and Dr. Cornet to express expert opinions as to the probable consequences for Melton of not requiring him to report for medication. When an oncologist testifies that a malignancy, unless properly treated, is likely to metastasize and cause danger to the patient, he too is predicting the future. Nevertheless, such a cancer specialist need not demonstrate expertise with a crystal ball as well as in medicine in order to render his prognosis receivable in evidence. The same holds true for a psychiatrist. In the final analysis, Melton's argument must therefore stand or fall on the notion that the present state of psychiatric knowledge does not permit the District's witnesses to express opinions on the question of Melton's dangerousness to himself or others, within the meaning of the third prong of Dyas, 376 A.2d at 832. We do not believe that this question can seriously be said to be in doubt. `[T]here is nothing inherently unattainable [even] about a [lay judicial officer's] prediction of future criminal conduct' for purposes of preventive detention. United States v. Salerno, 481 U.S. 739, 751, 107 S.Ct. 2095, 2103, 95 L.Ed.2d 697 (1987) (quoting Schall v. Martin, 467 U.S. 253, 278, 104 S.Ct. 2403, 2417, 81 L.Ed.2d 207 (1984)). A trained psychiatrist must surely be qualified, a fortiori, to assess Melton's dangerousness to himself or others, especially where, as here, that assessment is based on the patient's need for medication and his failure in the past to take it with the requisite regularity. As the Supreme Court stated in Addington v. Texas, 441 U.S. 418, 429, 99 S.Ct. 1804, 1811, 60 L.Ed.2d 323 (1979), [t]here may be factual issues to resolve in a commitment proceeding, but the factual aspects represent only the beginning of the inquiry. Whether the individual is mentally ill and dangerous to either himself or others and is in need of confined therapy turns on the meaning of the facts which must be interpreted by expert psychiatrists and psychologists. (Emphasis added to last nine words). In Barefoot v. Estelle, 463 U.S. 880, 103 S.Ct. 3383, 77 L.Ed.2d 1090 (1983), a capital sentencing case, the defendant argued, in conformity with the views of the American Psychiatric Association (APA), [8] that psychiatric testimony as to dangerousness is inherently unreliable and ought not to be admitted where a defendant's life is on the line. The issue was cast in constitutional terms, but the Supreme Court's response was sufficiently broad and emphatic to dispel any appreciable doubt as to how that Court would rule in this case: The suggestion that no psychiatrist's testimony may be presented with respect to a defendant's future dangerousness is somewhat like asking us to disinvent the wheel. In the first place, it is contrary to our cases.... In the second place, the rules of evidence generally extant at the federal and state levels anticipate that relevant, unprivileged evidence should be admitted and its weight left to the factfinder, who would have the benefit of cross-examination and contrary evidence by the opposing party. Psychiatric testimony predicting dangerousness may be countered not only as erroneous in a particular case but also as generally so unreliable that it should be ignored. If the jury may make up its mind about future dangerousness unaided by psychiatric testimony, jurors should not be barred from hearing the views of the State's psychiatrists along with opposing views of the defendant's doctors. Id. at 896, 898-99, 103 S.Ct. at 3396, 3397 (emphasis added). Melton seeks to distinguish Barefoot on the ground that it involved a constitutional contention, and that psychiatric testimony as to dangerousness should be excluded as a matter of the substantive District of Columbia law of evidence. Aside from the breadth of the Court's language in Barefoot and its allusion to applicable rules of evidence, however, the statutory law of this jurisdiction explicitly contemplates that such determinations will be made by psychiatrists. The administrator of a public hospital may detain a person for emergency observation if the psychiatrist on duty certifies that the person has symptoms of a mental illness and, as a result thereof, is likely to injure himself or others unless he is immediately hospitalized. D.C.Code § 21-522 (1989). The Mental Health Commission, which is made up of psychiatrists and psychologists, is required to determine, inter alia, whether a patient is likely to injure himself or other persons if allowed to remain at liberty. § 21-544. Two physicians, one of whom must be a specialist on nervous or mental disorders, are required to determine whether an allegedly mentally ill person found on certain federal reservations shall be hospitalized for his own safety and welfare and for the preservation of the peace and good order. § 21-902(b)(2). In proceedings to determine whether a person acquitted of an offense by reason of insanity should be released, psychiatric testimony may be submitted on the issue whether such person has recovered his sanity and will not in the reasonable future be dangerous to himself or others. § 24-301(e)(1)-(2). [9] We therefore agree with the District that to accept appellant's theory that psychiatrists cannot predict dangerousness, and therefore should not be permitted to testify on this issue, would nullify the entire legislative scheme for treatment of mentally ill persons in the District of Columbia. The legislature has effectively decided that `the state of the pertinent art or scientific knowledge [permits] a reasonable opinion to be asserted ... by an expert,' Dyas, supra, 376 A.2d at 832 (citation omitted), and we would be impermissibly intruding upon a legislative prerogative if we were to challenge that judgment.