Opinion ID: 1987767
Heading Depth: 2
Heading Rank: 1

Heading: The law generally. Iowa Code section 622.10 provides in relevant part:

Text: A ... counselor, physician, surgeon ... mental health professional, or the stenographer or confidential clerk of any such person, who obtains information by reason of the persons employment, ... shall not be allowed, in giving testimony, to disclose 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 according to the usual course of practice or discipline. The prohibition does not apply to cases where the person in whose favor the prohibition is made waives the rights conferred; nor does the prohibition apply to physicians or surgeons, physician's assistants, mental health professionals, or to the stenographer or confidential clerk of any physicians or surgeons, physician's assistants, or mental health professionals, in a civil action in which the condition of the person in whose favor the prohibition is made is an element or factor of the claim or defense of the person or of any party claiming through or under the person. The evidence is admissible upon trial of the action only as it relates to the condition alleged. Id. (emphasis added). The physician-patient privilege in section 622.10 has a unique and limited purpose. Chidester v. Needles, 353 N.W.2d 849, 852 (Iowa 1984). Because the section 622.10 privilege is in derogation of every person's duty to give evidence, it is subject to special restrictions. Id. Thus, the privilege, in the plain language of the statute, applies only to testimonial use of confidential information. Iowa Code § 622.10 (in giving testimony); Roosevelt Hotel Ltd. v. Sweeney, 394 N.W.2d 353, 355 (Iowa 1986). But see Chung v. Legacy Corp., 548 N.W.2d 147, 149 (Iowa 1996) (The statutory rule of testimonial exclusion [in section 622.10] has been extended by [Iowa Rule of Civil Procedure 122(a)] to the discovery of confidential communications.). Testimony includes declarations of a witness under oath. Sweeney, 394 N.W.2d at 355. For this reason, the section 622.10 privilege includes declarations by a witness in court or in a deposition. Id. On the other hand, the privilege does not prohibit a physician in a nontestimonial setting from disclosing any confidential communications. Id. Only the physician's ethical obligation prohibits the physician from making the disclosure without the patient's consent. Id. Referring again to the plain language of the statute, we note the privilege does not apply where the person in whose favor the privilege is made waives it. Iowa Code § 622.10 (The prohibition does not apply to cases where the person in whose favor the prohibition is made waives the right conferred....); Bradshaw v. Iowa Methodist Hosp., 253 Iowa 1360, 1362, 115 N.W.2d 816, 817 (1962) (holding that the section 622.10 privilege is personal to the patient and only the patient may claim or waive the confidentiality). B. The patient-litigant exception. That brings us to the patient-litigant exception in the statute which is the subject of this appeal: [N]or does the prohibition apply to ... mental health professionals ... in a civil action in which the condition of the person in whose favor the prohibition is made is an element or factor of the claim or defense of the person or of any party claiming through or under the person. Iowa Code § 622.10. This exception denies the privilege where the patient, or someone claiming through or under the patient, has brought the mental or physical condition of the patient into issue as the basis for the claim or as a basis for the defense. The object of the patient-litigant exception is to prevent the patient from using the privilege to suppress evidence after the patient has frustrated the purpose of the privilege by introducing evidence on his or her own medical condition. Steven P. Flood, The Physician-Patient Privilege Under the New Code, 33 J.B. Ass'n Kan. 10, 147 (1964) (discussing Kansas' patient-litigant exception which states: There is no privilege under [the physician-patient privilege provision] in an action in which the condition of the plaintiff is an element or factor of the claim or defense of the patient or of any party claiming through or under the patient....). Relying on the patient-litigant exception, we have held the physician-patient privilege is inapplicable in an involuntary hospitalization proceeding. In re T.C.F., 400 N.W.2d 544, 550 (Iowa 1987). We stated our rationale for doing so this way: We believe a hospitalization proceeding, which involves an application, notice, hearing, and a final adjudicative order by the court, must be considered to be an action under section 622.10. It is, in fact, difficult to conceive of any type of case in which the condition of the person asserting the privilege is any more at the heart of the controversy than in a proposed involuntary hospitalization. We hold the doctor-patient privilege of section 622.10, therefore, is inapplicable. Id. In contrast, in Chung we held that the mere denial of a physical condition does not call into play the patient-litigant exception. There, a motorist injured in an automobile accident sued, claiming the defendant was negligent in the operation of his motor vehicle while the defendant was under the influence of alcohol. The plaintiff attempted to take the deposition of the doctor who had treated the defendant following the accident. We granted an interlocutory appeal when the district court granted the plaintiff's application to take the deposition. On appeal, the plaintiff contended that the patient-litigant exception abrogates the physician-patient privilege when the condition of a party is in issue. See Chung, 548 N.W.2d at 147. Relying on the plain language of section 622.10, we rejected the plaintiff's contention: The statute requires the condition be an element or factor of the claim or defense of the person claiming the privilege. The denial of an element or factor of one's opponent's case does not make that element or factor part of the case of the person making the denial. In other words, even though [the defendant] denied he was intoxicated, his intoxication remains an element or factor in [the plaintiff's] claim. We can state with confidence that if [the defendant's] intoxication were not an element or factor in [the plaintiff's] claim, it would not be an issue in the case; [the defendant] would have no reason to make it a factor or element in his case. Therefore, the mere act of denying the existence of an element or factor of an adversary's claim does not fall within the statutory language. Chung, 548 N.W.2d at 150. In addition, we pointed to the underlying purpose of section 622.10 to support our interpretation of the patient-litigant exception: Any other interpretation of the patient-litigant exception would severely undermine the purpose of the statutory privilege.... The interpretation sought by [the plaintiff] would seriously thwart the legislature's goal of enhancing candid physician-patient communications.... There are few cases in which an imaginative lawyer could not make the opposing party's physical or mental condition at least a factor in the case. If such tactics were sufficient to trigger the exception, there would be little left of the privilege. Id. at 150-51 (footnote omitted).