Opinion ID: 2045731
Heading Depth: 1
Heading Rank: 4

Heading: Rieflin's Physician-Patient Privilege.

Text: Rieflin's second argument is that the district court violated his physician-patient privilege by relying on the testimony of Dolley and Pospisil. In response, the State argues that Rieflin waived any such privilege by placing his competency in issue. We agree. Iowa Code section 622.10 provides that no physician or physician's assistant may testify with respect to ... any confidential communication properly entrusted to the person in the person's professional capacity, and necessary and proper to enable the person to discharge the functions of the person's office.... The physician-patient privilege is strictly statutory; there is no common law privilege. State v. Cole, 295 N.W.2d 29, 32 (Iowa 1980). The purpose of the privilege is to promote uninhibited and full communication between patient and physician, in order for the physician to obtain the information necessary to competently diagnose and treat a patient. Chung, 548 N.W.2d at 149. For the privilege to exist, three conditions must be satisfied: (1) the relationship of physician-patient; (2) the acquisition of information during the relationship; and (3) the necessity and propriety of the information to enable the physician to treat the patient skillfully. State v. Eldrenkamp, 541 N.W.2d 877, 881 (Iowa 1995). The statutory physician-patient privilege does not attach when a defendant gives notice of the defense of insanity or diminished responsibility. State v. Rhomberg, 516 N.W.2d 803, 808 (Iowa 1994); State v. Craney, 347 N.W.2d 668, 672 (Iowa 1984); Cole, 295 N.W.2d at 35. The reasoning for waiver of the privilege under such circumstances is simple. In Cole, we stated: We believe the defense of diminished capacity waived the privilege here, even if it had existed, for the simple reason it would be incongruous to allow a party to put a matter in issue and then deny access of an opposing party to relevant information concerning it. Our modern concept of criminal trials favors full disclosure of facts, within constitutional limitations, on both sides of the table.... Even the most restrictive authorities would say [defendant] would have waived the privilege by introducing evidence on it.... Cole, 295 N.W.2d at 35 (citations omitted) (emphasis added). Other authorities support waiver of the privilege under such circumstances. See 1 Kenneth S. Broun et al., McCormick on Evidence § 103, at 384 (John W. Strong ed., 4th ed.1992) [hereinafter  McCormick on Evidence ] (policy considerations support a finding of waiver when the patient has voluntarily placed his condition in issue in a judicial proceeding); 8 J. Wigmore, Evidence § 2388, at 855 (McNaughton rev. ed.1961) (waiver may occur when the conduct places the claimant in such position, with reference to the evidence, that it would be unfair and inconsistent to permit retention of the privilege); 81 Am.Jur.2d Witnesses § 468, at 413-14 (1992); McCormick on Evidence § 134, at ___ ([I]t is arguable that by asserting incompetency to stand trial or nonliability by reason of insanity the accused has, to a limited extent at least, waived his right to rely on his privilege in regard to those matters.). Further, Iowa Code section 622.10 has a patient-litigant exception. See Chung, 548 N.W.2d at 150-51 (where we discussed the exception, even though it did not apply in that case). This exception abrogates the physician-patient privilege when the condition of a person is an element or factor of the claim or defense of the person claiming the privilege. Iowa Code § 622.10; see Chung, 548 N.W.2d at 150. As we noted in Chung: The exception will not inhibit communication between a patient and his doctor because the patient knows his statements will remain confidential unless he affirmatively and voluntarily chooses to reveal them by raising his condition as an element or factor of any claim or defense the patient makes. Chung, 548 N.W.2d at 151. Based on our prior cases and the patient-litigant exception, we conclude Rieflin waived any physician-patient privilege. Rieflin gave notice that he intends to rely on the defense of insanity and diminished responsibility, yet he wishes to exclude the testimony of Dolley and Pospisil. Iowa Code section 662.10 clearly was not intended to allow such a result. Rieflin's mental condition is not just an element or factor of his defense; it is the entire basis for his defense. The privilege is not designed as a shield behind which a patient can conceal information. Eldrenkamp, 541 N.W.2d at 881. AFFIRMED.