Opinion ID: 1124716
Heading Depth: 2
Heading Rank: 1

Heading: Privileged Communication Between Physician and Patient.

Text: January 20, 1961  the day after Mr. Sullivan's body was exhumed  the court commissioner of Snohomish County entered an order ... that Northern State Hospital at Sedro Woolley, Washington, be and is hereby designated as the detention ward for the detention, observation and treatment of the above named [Irene Sullivan] (Snohomish County not having any observation ward or county hospital), and the said Irene Sullivan is committed thereto for a period not exceeding sixty (60) days for such observation, examination and treatment, and it is requested that a report be made by said hospital on the alleged mental illness of the said Irene Sullivan.  (Italics ours.) The order was entered at the request of Mr. Conroy on the recommendation of two physicians, pursuant to RCW 71.02. After her confinement in Northern State Hospital, Irene Sullivan was returned to Snohomish County. The hospital reported that she has never been psychotic any time during her life. Thus, the purpose of the order was accomplished. While at the hospital, defendant was under the care, observation, and treatment of Paulus Vanderwielen, M.D., a psychiatrist, employed by the state. He was one of her attending physicians. The transcript on appeal contains a 36-page, single-spaced typewritten report, most of which was purportedly made by Dr. Vanderwielen on defendant's physical and mental condition while she was in the hospital. Dr. Vanderwielen was called as a witness for the state. Over strenuous objections, the court permitted him to repeat statements made by defendant to him during her psychiatric examinations and treatments. It is not necessary that we detail the doctor's testimony. It is sufficient to state that his testimony, if believed by the jury, supported the state's case. We emphasize that insanity is not a defense in the instant case, nor is the mental competency of Irene Sullivan to stand trial an issue. Defendant's remaining assignments of error present one question: At the trial of defendant on the charge against her, was it error to permit Dr. Vanderwielen, a state-employed psychiatrist, to testify to statements defendant made to him in the course of psychiatric examination and treatment in a state mental hospital? Three statutes must be considered: (1) RCW 5.60.060(4): A regular physician or surgeon shall not, without the consent of his patient, be examined in a civil action as to any information acquired in attending such patient, which was necessary to enable him to prescribe or act for the patient. (Italics ours.) (2) RCW 10.58.010: The rules of evidence in civil actions, so far as practicable shall be applied to criminal prosecutions. (3) RCW 10.52.020: Witnesses competent to testify in civil cases shall be competent in criminal prosecutions, but regular physicians or surgeons, clergymen or priests, shall be protected from testifying as to confessions, or information received from any defendant, by virtue of their profession and character; ... [5] State v. Miller, 105 Wash. 475, 178 Pac. 459 (1919), firmly establishes, in this jurisdiction, the rule that the doctor-patient privilege applies in criminal proceedings under the statutes quoted supra. The privilege is for the benefit of the patient, to the end that he will be encouraged to disclose his ailments to a physician so that he may receive proper treatment. State v. Fackrell, 44 Wn. (2d) 874, 877, 271 P. (2d) 679 (1954), and cases cited. On the other hand, a forensic examination by a physician is not within the statutory testimonial prohibitions of the doctor-patient privilege. State v. Winnett, 48 Wash. 93, 92 Pac. 904 (1907); State v. Thomas, 1 Wn. (2d) 298, 95 P. (2d) 1036 (1939); State v. Fackrell, supra . The reasons are: the relationship of doctor and patient does not exist; the examination is not for the purpose of treatment, but for the publication of results. In Strafford v. Northern Pac. R. Co., 95 Wash. 450, 453, 164 Pac. 71 (1917), this court said: ... In order to render a physician incompetent, the information which he is called upon to disclose must have been acquired while he was attending the patient in a professional capacity for the purpose of treating her ailments; there is no privilege when the examination is made by the physician for the express purpose of publishing the results  such, for example, as testifying in an action for personal injuries.... See also: Randa v. Bear, 50 Wn. (2d) 415, 312 P. (2d) 640 (1957). In Ballard v. Yellow Cab Co., 20 Wn. (2d) 67, 72, 145 P. (2d) 1019 (1944), the court quoted with approval from Smart v. Kansas City, 208 Mo. 162, 105 S.W. 709, 123 Am. St. 415, 13 Ann. Cas. 932, 14 L.R.A. (N.S.) 565, as follows: `It is not necessary in order to create the relation of physician and patient that he should actually treat the patient. If he makes an examination of the patient, with her knowledge and consent, she believing that the examination is being made for the purpose of treating her, then the relation is created by implication, and it is wholly immaterial what the secret object or purpose of the physician was in making it; and in the absence of evidence to the contrary, the plaintiff had the perfect right to assume and rely upon the assumption that the physicians who were apparently in charge of the hospital were rightfully there, and, as such, had the authority to examine and prescribe for her, and he will not afterwards be heard to say he was not connected with the institution and had no authority to examine or treat her. If such a thing as that could be done, then the privilege accorded the patient could be taken from her by trick or fraud.' (Italics ours.) See annotation, 22 A.L.R. 1217: Competency of hospital physician or attendant to testify as to condition of patient. The statutes under consideration do not state or imply that the created privilege may be withheld from a patient confined in a public mental hospital. [6] The opinion in Taylor v. United States, 222 F. (2d) 398 (CADC; 1955), fortifies our conclusion that the court erred in admitting Dr. Vanderwielen's testimony of statements defendant made to him during the extended period of the psychiatric examination and treatment. Defendant Taylor was indicted for robbery; found to be mentally incompetent; and committed to a hospital. Later, it was certified that he was mentally competent to stand trial. At the time of trial, the Code of the District of Columbia contained a privilege statute similar to ours. [1] The hospital-staff psychiatrist, who had had five recorded psychiatric interviews with the defendant during his confinement, was called to the stand by the prosecution. The Court of Appeals held this to be error, saying: In regard to mental patients, the policy behind such a statute is particularly clear and strong. Many physical ailments might be treated with some degree of effectiveness by a doctor whom the patient did not trust, but a psychiatrist must have his patient's confidence or he cannot help him. `The psychiatric patient confides more utterly than anyone else in the world. He exposes to the therapist not only what his words directly express; he lays bare his entire self, his dreams, his fantasies, his sins, and his shame. Most patients who undergo psychotherapy know that this is what will be expected of them, and that they cannot get help except on that condition.... It would be too much to expect them to do so if they knew that all they say  and all that the psychiatrist learns from what they say  may be revealed to the whole world from a witness stand.'[2] `Presumably all of the patients in any good mental hospital are receiving psychiatric treatment. That is true of persons whether they are sent to St. Elizabeths Hospital as civil insane, as criminal insane, or as sexual psychopaths.'[3] ... [2] Guttmacher and Weihofen, Psychiatry and The Law (1952), p. 272. [3] Winfred Overholser, Superintendent of St. Elizabeths, `Some Problems of the Criminal Insane at Saint Elizabeths Hospital', Med. Ann. of D.C., Vol. XXII, p. 349, July 1953. (p. 401) Finally, we have heretofore noted that defendant was sent to Northern State Hospital upon petition of her counsel, Mr. Conroy. On cross-examination, defendant testified: Q. Then you don't remember seeing Mr. Conroy from that day until you saw him  when was that? A. He [Mr. Conroy] was up one day at Northern State, and told me to tell the doctor everything so that they could help me.  (Italics ours.) In circumstances somewhat similar to the instant case, the Supreme Court of New Jersey, in State v. Hunt, 25 N.J. 514, 533, 138 A. (2d) 1 (1958), said: ... Within the holding of Kociolek [23 N.J. 400, 129 A. (2d) 417 (1957)], the admissions made by the defendant to the doctors obtained by application of his counsel were as privileged as if they had been made directly to his counsel. (Italics ours.) In view of our conclusion that Dr. Vanderwielen's testimony is within the ambit of the doctor-patient privilege [2] , we do not deem it necessary to discuss the thesis of the Hunt case, supra. The judgment and sentence, from which this appeal is prosecuted, is reversed, and the case is remanded to the superior court for a new trial. FINLEY, C.J., HILL, ROSELLINI, and FOSTER, JJ., concur.