Opinion ID: 2258942
Heading Depth: 1
Heading Rank: 7

Heading: Says proposed hysterectomy wasn't needed

Text: The essence of the text of the article, as set forth in the opinion of the trial court, states: Dr. [Kanaga] ... recommend[ed] unnecessary and inappropriate surgery ... [Dr.] Kanaga did not respond to a reporter's telephone calls or a registered letter seeking comments. She has told the medical society she would withhold public comment on the case until the society issues its finding, expected in August. I [Kane] believe, ... Dr. Kanaga has committed a serious breach of the standard of care a patient has the right to expect and the duty of care required of a physician. Does this mean I don't need a hysterectomy?.... A what? he [Dr. Domingo] asked incredulously. My previous gynecologist said I needed a hysterectomy, . . . . . No you don't need one, [Dr. Domingo] said. I can only conclude ... that Dr. Kanaga... chose the treatment plan that was most profitable for her with no concern for me.... [22] Justice Brennan's dissent in Milkovich is an appropriate point of departure for the analysis of this case. He did not dispute the majority's articulation of the legal standard, but he disagreed on the application of that standard to the facts of that case. He concluded that there was no implied false assertion of fact. He reasoned that the reporter's: assumption that Milkovich must have lied at that court hearing is patently conjecture. ... [The reporter] not only reveals the facts upon which he is relying but he makes it clear at which point he runs out of facts and is simply guessing. Read in context, the statements cannot reasonably be interpreted as implying such an assertion as fact ... [497 U.S. at 28, 110 S.Ct. at 2710-11]. No reasonable reader could understand [the reporter] to be impliedly asserting  as fact  that Milkovich had perjured himself ... [497 U.S. at 30, 110 S.Ct. at 2711-12]. Readers ... are signaled repeatedly that the author does not actually know what Milkovich said at the court hearing and that the author is surmising, from factual premises made explicit in the column, that Milkovich must have lied in court ... [497 U.S. at 33, 110 S.Ct. at 2713] ... [A]s long as it is clear to the reader that he is being offered conjecture and not solid information, the danger to reputation is one we have chosen to tolerate in pursuit of `individual liberty [and] the common quest for truth and the vitality of society as a whole' [497 U.S. at 36, 110 S.Ct. at 2714-15]. [23] The majority and dissenting opinions of the United States Supreme Court in Milkovich and this Court's opinion in Riley all teach that there are limits to the perceived safe harbor of opinion in libel actions. Each case must rest on its own facts. Those facts revolve, in part, around the context of the entire writing. When that entire context is considered, it must be clear to the reader that he is being offered conjecture and not solid information. [24] In the words of Justice Brennan's dissent in Milkovich, it cannot be said that Ms. Kane's opinion as reported by Ms. Harriman is patently conjecture. The reader is not signaled repeatedly that the author ... is surmising. A reasonable jury can conclude that the author of the article (Ms. Harriman) and the supplier of information (Ms. Kane) have facts to support their opinion that Dr. Kanaga betrayed Ms. Kane by recommending a hysterectomy for Dr. Kanaga's financial gain without regard for the well-being of Ms. Kane. Thus, it is not correct, as the trial court concluded, that it is clear to the average reader that Kane added two and two and got nine. [25] Let us then parse the context of Ms. Harriman's July 5, 1992 article with Justice Brennan's words in mind: 1. The headline directs the reader to the fact that the patient feels betrayed. [26] 2. The sub-headline signals that the patient claims that the proposed hysterectomy wasn't needed. 3. The text of the article states that Ms. Kane believes Dr. Kanaga has committed a serious breach of the standard of care a patient has the right to expect. 4. The article editorializes that Dr. Domingo was allegedly incredulous at Dr. Kanaga's recommendation that Ms. Kane needed a hysterectomy. 5. The last sentence of the article asserts that Ms. Kane can only conclude ... that Dr. Kanaga chose the treatment plan that was most profitable for her with no concern for me. Applying the test of Riley, this is not an opinion based on nondefamatory facts [27] because we cannot say as a matter of law that an ordinary reader would not infer the existence of undisclosed facts. [28] The majority opinion in Milkovich makes it plain that (a) the Gertz dictum was not intended to create a wholesale defamation exemption for anything that might be labeled `opinion'; [29] and (b) [e]ven if the speaker states the facts upon which he bases his opinion, if those facts are either incorrect or incomplete, or if his assessment of them is erroneous, the statement may still imply a false assertion of fact. [30] As the Milkovich Court held, the connotation that petitioner committed perjury is sufficiently factual to be susceptible of being proved true or false. [31] Here, the ordinary reader could infer the existence of undisclosed facts which are capable of being proved true or false. Those facts include, for example, that (a) Dr. Kanaga knew or believed that the recommended hysterectomy was not necessary; (b) this conclusion is supported by the fact that Dr. Domingo was able to remove the tumor easily under emergency conditions; (c) Dr. Domingo was incredulous (which apparently is denied by him) at the suggestion that a hysterectomy had been recommended by Dr. Kanaga; and (d) Dr. Kanaga's motive was the personal gain she would receive, without concern for the patient, by recommending the more expensive hysterectomy rather than the myomectomy. As the majority said in Milkovich, Simply couching such statements in terms of opinion does not dispel these implications; and the statement, `In my opinion Jones is a liar,' can cause as much damage to reputation as the statement, `Jones is a liar.' [32] As the dissent stated in Milkovich, it should be clear to the reader that he is being offered conjecture and not solid information. [33] Here, it cannot be said that the ordinary reader would necessarily conclude from Ms. Kane's opinion as stated in the context of Ms. Harriman's article that he or she was being offered pure conjecture. Accordingly, these issues are for the jury. If a jury decides that there is more to the July 5, 1992 article than pure conjecture, the next issue is whether that which is not pure conjecture can be construed as defamatory. To accuse Dr. Kanaga of recommending unnecessary surgery for her own pecuniary gain is to malign her in her business or profession. Such an accusation, which harms her reputation and tends to disgrace her or bring her into contempt or ridicule, constitutes defamation. [34] Accordingly, if the jury finds that the ordinary reader could infer from the July 5, 1992 article the existence of undisclosed facts that are false and that tend to harm Dr. Kanaga's reputation, lowering her in the estimation of the community, then Dr. Kanaga has been libeled.