Opinion ID: 2510618
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Heading Rank: 3

Heading: The Child's Statements to the Doctor

Text: We start our analysis by determining whether the child's statements to the doctor [2] are testimonial in nature, and specifically, whether the statements fit into any of the clearly proscribed areas of testimonial evidence, as delineated by Crawford. 541 U.S. at 68, 124 S.Ct. 1354. Clearly, the child did not make his statements in the course of a preliminary hearing, in front of a grand jury, or at a prior trial; therefore, these formulations of testimonial evidence are not at issue. However, the defendant contends that the child made his statement in the course of a police interrogation, the fourth clearly defined area of testimonial evidence in Crawford, and therefore the statements are testimonial in nature.
Ordinarily, if a law enforcement official is involved during the course of questioning, such questioning would be considered a police interrogation. [3] Because the questioning in this case was done by a doctor as a part of a sexual assault examination, we must decide whether this questioning constituted police interrogation. Unfortunately, we are not helped in our determination of this issue by Crawford, as the Court explained that it used the term interrogation in a colloquial sense and noted that one can imagine various definitions of interrogation. Crawford, 541 U.S. at 53 n. 4, 124 S.Ct. 1354 ([W]e need not select among [the various definitions of interrogation] in this case.). This dicta does suggest, however, that police interrogation may extend beyond the type of structured police questioning at issue in Crawford, particularly in light of Crawford 's stated concern that the [i]nvolvement of government officers in the production of testimony with an eye toward trial presents a unique potential for prosecutorial abuse. 541 U.S. at 56 n. 7, 124 S.Ct. 1354. [4] We must determine, therefore, whether the doctor's questioning, as part of a sexual assault examination, constituted the functional equivalent of police interrogation. In light of the concerns stated in Crawford, we examine first, whether and to what extent government officials were involved in producing the statements and second, whether their purpose was to develop testimony for trial. Courts from other jurisdictions which have considered this issue are divided in their conclusions. The supreme courts in Oregon and Maryland have analyzed this issue and determined that questioning by social workers, at the behest of the police, constitutes police interrogation and that, therefore, the Confrontation Clause bars the testimony. Specifically, in State v. Mack, 337 Or. 586, 101 P.3d 349 (2004), a social worker acted at the direction of the police when she interviewed a three-year-old witness and the police videotaped the interview. 101 P.3d at 349-50. The social worker explained that she primarily intended the interview to aid law enforcement in completing their investigation. Id. at 350. The trial court found that the social worker acted as an agent of the police and that the social worker interviewed the child in a manner structured to obtain information for the state's use in prosecuting the defendant. Id. The Oregon Supreme Court recognized this as the functional equivalent of police interrogation and thus found that the statements were testimonial. Id. at 354. We agree with this outcome. An application of Crawford's concerns regarding the extent of government involvement and the purpose of the questioning yields only one resultthe social worker functioned as an agent of the police. Similarly, in State v. Snowden, 385 Md. 64, 867 A.2d 314 (2005), the police asked a social worker who specialized in sexual abuse to interview three child victims. Id. at 316. The social worker began the interview with a police report in hand; a detective was present during the interview, and the children were aware of the detective's presence. Id. at 326, 327. The trial court found, the children were interviewed for the express purpose of developing testimony ... in a sexual abuse trial. Id. at 326. The Maryland Supreme Court held that these circumstances rendered the interview functionally equivalent to formal police questioning. [5] Id. at 325. Again, we agree with this result. In addition, courts which have analyzed the police interrogation issue in terms of questioning by doctors have reached the opposite conclusion, reasoning that a doctor is questioning the child for the purpose of providing a diagnosis and treatment, rather than eliciting the child's testimony for trial. See State v. Krasky, 696 N.W.2d 816 (Minn.Ct. App.2005) (holding that statements made by a child victim to a medical professional are not testimonial if the circumstances under which the statements were made would not lead the child, or a reasonable child of her age, to believe that the statements would be available for use at a later trial) cert. granted, (Minn. Aug. 16, 2005); State v. T.T., 351 Ill.App.3d 976, 287 Ill.Dec. 145, 815 N.E.2d 789 (2004) (holding that statements a child victim made to a physician describing the cause of symptoms or pain or the general character of the assault were not testimonial in nature); State v. Vaught, 268 Neb. 316, 682 N.W.2d 284 (2004) (holding that a statement a child victim made to a physician, which was properly admitted under the medical diagnosis or treatment exception, was not testimonial); People v. Geno, 261 Mich.App. 624, 683 N.W.2d 687 (2004), cert. denied, 471 Mich. 921, 688 N.W.2d 829 (2004) (holding a child's response to an interviewer who was not a government employee was not testimonial). Although each factual situation must be judged on its own merits, the facts of this case are more like those in the cases where courts found a child's statements to a doctor to be non-testimonial. As the doctor testified at trial, his purpose in questioning the child was to determine whether the child would say something that could help [the medical personnel] understand what the potential injuries were. The child's responses helped the doctor develop his opinion regarding whether a sexual assault had occurred and how best to treat the child. Thus, rather than being an agent of the police, the doctor's job involved identifying and treating sexual abuse. The fact that the doctor was a member of a child protection team does not, in and of itself, make him a government official absent a more direct and controlling police presence, such as the presence demonstrated in Mack, 337 Or. 586, 101 P.3d 349 (2004), and Snowden, 385 Md. 64, 867 A.2d 314 (2005). In fact, the police officer in the instant case testified that she was not involved in the medical examination or in the room when the doctor performed the examination. Moreover, even though the trial court analyzed the issue under the Rules of Evidence and not under Crawford, the same factors that led the trial court to rule that the child's statements to the doctor were admissible as statements made for the purpose of medical diagnosis and treatment under CRE 803(4) are helpful to our determination that the doctor did not purport to develop testimony for trial but rather intended to gather information in order to reach a medical diagnosis. Specifically, the trial court found that a doctor making a diagnosis of sexual penetration would need a history to rule out other causes for the perianal bruising and redness. Once the doctor learned that JW had been hurt by a penis, he could reasonably form the opinion that the bruising was caused by sexual penetration. In addition, even though the trial court analyzed the issue under the Rules of Evidence, the trial court carefully distinguished between those aspects of the examination which were diagnostic in nature and those aspects which could arguably be labeled investigatory. Thus, the trial court noted that the child's statements specifically referring to Vigil by name were not admissible under CRE 803(4) because the identity of the male who penetrated the child was immaterial to the doctor's opinion. In sum, we hold that the doctor's questioning of the child during the course of the medical examination did not constitute the functional equivalent of police interrogation. The doctor was not a government official who produced the child's statements with a purpose of developing testimony for trial, nor was the police officer involved in producing the statements with a purpose of developing testimony for trial. Accordingly, we conclude that, under Crawford 's explicit guidance, the child's statements to the doctor are not testimonial evidence.
Even though the child's statements were not the product of police interrogation and therefore are not clearly testimonial according to Crawford, we must also determine whether the child's statements fall into one of the three formulations of the core class of testimonial statements at which the Confrontation Clause was directed and are therefore testimonial. Crawford, 541 U.S. 36, 51-52, 124 S.Ct. 1354, 158 L.Ed.2d 177 (2004). In this regard, Vigil argues that these statements are testimonial because the child made the statements to the doctor under circumstances which would have led an objective witness reasonably to believe that the statements would be available for use at a later trial. Id. at 52, 124 S.Ct. 1354. In addition, Vigil argues that the phrase objective witness must be defined as an objectively reasonable adult observer educated in the law. The People disagree with this construction and argue that the phrase objective witness should be defined as an objectively reasonable person in the position of the declarant. Based on our reading of Crawford and our review of other courts deciding this issue, we hold that the objective witness language in Crawford refers to an objectively reasonable person in the declarant's position. Applying this test to the instant case, we determine that an objectively reasonable person in the declarant's position would not have believed that his statements to the doctor would be available for use at a later trial. We first discuss our holding that the term reasonable, objective witness refers to an objectively reasonable person in the declarant's position. This holding is consistent with the Crawford majority's reference identifying a hearsay statement from Dutton v. Evans, 400 U.S. 74, 91 S.Ct. 210, 27 L.Ed.2d 213 (1970), as non-testimonial. Crawford, 541 U.S. at 58, 124 S.Ct. 1354. In Dutton, the declarant was the defendant's co-conspirator, and he made a statement to his cell mate blaming the defendant for his predicament. 400 U.S. at 87-89, 91 S.Ct. 210. The Supreme Court characterized this statement as spontaneous and against penal interest. Id. at 89, 91 S.Ct. 210. If the Crawford Court had intended the objective witness test to be applied from the perspective of an objectively reasonable observer educated in the law, [6] the Crawford Court would have labeled the co-conspirator's statement testimonial. However, by labeling the statement non-testimonial, Crawford directs us to apply the objective witness test from the perspective of an objectively reasonable person in the declarant's position. [7] In addition, we are mindful of the concern expressed in Crawford to safeguard an accused's confrontation right. Like the United States Tenth Circuit Court of Appeals in United States v. Summers, 414 F.3d 1287 (10th Cir.2005), however, we believe that an objective test focusing on the reasonable expectations of a person in the declarant's position under the circumstances of the case most adequately safeguards the accused's confrontation right and most closely reflects the concerns underpinning the Sixth Amendment. Summers, 414 F.3d at 1302; See Richard D. Friedman, Confrontation: The Search for Basic Principles, 86 Geo. L.J. 1011, 1040-43 (1998). This is because the common nucleus shared by the Supreme Court's three formulations of testimonial evidence, Crawford, 541 U.S. at 52, 124 S.Ct. 1354, centers upon the declarant's reasonable expectations. Summers, 414 F.3d at 1302. Thus, as noted by the Tenth Circuit, it is the reasonable expectation that a statement may be later used at trial that distinguishes the flippant remark, proffered to a casual acquaintance, from the true testimonial statement. Id. (citing Crawford 541 U.S. at 51, 124 S.Ct. 1354). Accordingly, we find the holding in Summers namely that a statement is testimonial if a reasonable person in the position of the declarant would objectively foresee that his statement might be used in the investigation or prosecution of a crimepersuasive. Id. We also find persuasive the numerous other courts which have held likewise. See United States v. Saget, 377 F.3d 223, 228 (2d Cir.2004) ( Crawford at least suggests that the determinative factor in determining whether a declarant bears testimony is the declarant's awareness or expectation that his or her statements may later be used at trial.); United States v. Cromer, 389 F.3d 662, 675 (6th Cir.2004) (The proper inquiry, then, is whether the declarant intends to bear testimony against the accused. That intent, in turn, may be determined by querying whether a reasonable person in the declarant's position would anticipate his statement being used against the accused in investigating and prosecuting the crime.); State v. Hembertt, 269 Neb. 840, 696 N.W.2d 473, 482 (2005) ([T]he determinative factor in determining whether a declarant bears testimony is the declarant's awareness or expectation that his or her statements may later be used at a trial.); State v. Davis, 364 S.C. 364, 613 S.E.2d 760, 779 (Ct.App.2005) (inquiring whether a reasonable speaker in the declarant's position would believe the statements would be available for use at a later trial). Further, we note with approval the formulation of the objective witness test that our court of appeals stated in People v. Sharp, ___ P.3d ___, 2005 WL 2877807, at  (Colo. App. Nov.3, 2005) ([T]he test in determining whether the child's statement is testimonial depends on whether an objective person in the child's position would believe her statements would lead to punishment of defendant.). Based upon our review of these cases, an assessment of whether or not a reasonable person in the position of the declarant would believe a statement would be available for use at a later trial involves an analysis of the expectations of a reasonable person in the position of the declarant. Expectations derive from circumstances, and, among other circumstances, a person's age is a pertinent characteristic for analysis. See Lagunas v. State, ___ S.W.3d ___, 2005 WL 2043678 (Tex.App. Aug.26, 2005) (considering child declarant's age as a circumstance relevant to the inquiry of whether the child's statement constituted testimonial evidence); State v. Scacchetti, 690 N.W.2d 393 (Minn.Ct.App. 2005) (holding that admission of a three-year-old victim's out-of-court statements made to an examining physician did not violate the defendant's right of confrontation where the circumstances surrounding the statements would not lead a reasonable child of her age to have that expectation) cert. granted (Minn. March 29, 2005). Other factors for consideration may include whether an objectively reasonable child would be aware of government involvement and whether an objectively reasonable child would be aware that the defendant faces the possibility of criminal punishment. Turning now to the application of the objective witness test to the statements the child made to the doctor, we analyze the circumstances surrounding the statements to determine whether an objective witness in the position of the child would believe that his statements would be used at trial. We hold that no objective witness in the position of the child would believe that his statements to the doctor would be used at trial. Rather, an objective seven-year-old child would reasonably be interested in feeling better and would intend his statements to describe the source of his pain and his symptoms. In addition, an objectively reasonable seven-year-old child would expect that a doctor would use his statements to make him feel better and to formulate a medical diagnosis. He would not foresee the statements being used in a later trial. Thus, from the perspective of an objective witness in the child's position, it would be reasonable to assume that this examination was only for the purpose of medical diagnosis, and not related to the criminal prosecution. No police officer was present at the time of the examination, nor was the examination conducted at the police department. The child, the doctor, and the child's mother were present in the examination room. [8] Accordingly, we reverse the court of appeals and conclude that the child's statements to the doctor were not testimonial.
In Compan v. People , we held that the constitutionality of non-testimonial statements is controlled by the federal confrontation clause as set forth in Roberts.  121 P.3d 876, 882 (Colo.2005) (discussing Ohio v. Roberts, 448 U.S. 56, 66, 100 S.Ct. 2531, 65 L.Ed.2d 597 (1980)). Since we find that the child's statements to the doctor are non-testimonial, we must next apply Roberts. To satisfy the Roberts test, the child's statements must bear sufficient indicia of reliability by falling within a firmly rooted hearsay exception or bearing particularized guarantees of trustworthiness. Roberts, 448 U.S. at 66, 100 S.Ct. 2531. A statement made for the purpose of medical diagnosis or treatment qualifies as a firmly rooted exception to the hearsay rule. White v. Illinois, 502 U.S. 346, 356 n. 8, 112 S.Ct. 736, 116 L.Ed.2d 848 (1992). Where a firmly rooted hearsay exception is at issue, reliability is implied and it is not necessary for the declarant to be unavailable. Id. at 354-57, 112 S.Ct. 736 (citing, inter alia, United States v. Inadi, 475 U.S. 387, 394-99, 106 S.Ct. 1121, 89 L.Ed.2d 390 (1986)). Vigil argues that the prosecution failed to meet its burden of proving that the child's statements to the doctor satisfied the hearsay exception for statements made for purposes of medical diagnosis or treatment. Specifically, Vigil implies that the prosecution had a burden to support the child's statements to the doctor through some independent demonstration of trustworthiness. We conclude otherwise. Colorado Rule of Evidence 803(4) excepts from the hearsay rule statements made for purposes of medical diagnosis or treatment and describing medical history, or past or present symptoms, pain, or sensations, or the inception or general character of the cause or external source thereof insofar as reasonably pertinent to diagnosis or treatment. CRE 803(4) (2005). The exception includes a party's statement to a non-treating physician for purposes of diagnosis in connection with pending criminal litigation. King v. People, 785 P.2d 596, 602 (Colo.1990). It is not necessary for the proponent of hearsay to offer an independent demonstration of trustworthiness. Id. Under the rule, once the proponent establishes that the statements were made to a physician for purposes of diagnosis or treatment, that the statements were reasonably pertinent to diagnosis or treatment, and that the physician relied on the statements in reaching an expert opinion, then the statements qualify for admission without regard to an independent demonstration of trustworthiness. Id. at 603. In its written order, the trial court found all the facts necessary to admit the child's statements to the doctor as statements made for purposes of medical diagnosis or treatment. Those facts include the following: the child's mother and the police officer took the child to the doctor so that he could offer a diagnosis regarding whether the child was sexually assaulted; the statements regarding the history as to where the child was hurt were reasonably pertinent to diagnosing the cause of the child's bruising and redness; the doctor relied on the statements in reaching the opinion that the child had been hurt by a penis. Therefore, the trial court properly found that the history the doctor elicited from the child was admissible under CRE 803(4) and that the People provided an adequate foundation. Accordingly, we conclude that the child's statements for purposes of medical diagnosis and treatment bore sufficient indicia of reliability. Admission of these statements did not violate Vigil's federal constitutional right to confront the witnesses against him.
Next, we must determine whether the admission of the child's non-testimonial statements to the doctor offended the Colorado Confrontation Clause. The test announced in People v. Dement, 661 P.2d 675 (Colo.1983), controls this inquiry. Compan v. People, 121 P.3d 876, 885 (Colo.2005). To admit non-testimonial evidence when the defendant has not had a prior opportunity for cross-examination, the prosecution must show that the declarant is unavailable and the statement bears sufficient indicia of reliability. Dement, 661 P.2d at 679-81 (citing Roberts, 448 U.S. at 65, 100 S.Ct. 2531); see Compan, 121 P.3d at 885 (applying the unavailability prong, but declining to consider whether unavailability is still required under the state constitution). The child's statements to the doctor satisfy the Dement test. Neither party disputes the trial court's ruling that the child was incompetent to testify and consequently unavailable at trial. In the preceding section we determined that the child's statements to the doctor fell within a firmly rooted exception to the hearsay rule, statements for purposes of medical diagnosis or treatment, CRE 803(4). Accordingly, admission of the child's statements to the doctor did not violate Vigil's state constitutional right to confront the witnesses against him.