Opinion ID: 1953459
Heading Depth: 1
Heading Rank: 3

Heading: Patient-Litigant Exception.

Text: Chung argues the exception abrogates the physician-patient privilege when the condition of a party is in issue. The statute's plain language, as well as its underlying purpose, oppose Chung's interpretation. 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 Karns denied he was intoxicated, his intoxication remains an element or factor in Chung's claim. We can state with confidence that if Karns' intoxication were not an element or factor in Chung's claim, it would not be an issue in the case; Karns 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. Peisach v. Antuna, 539 So.2d 544, 546 (Fla.Dist.Ct.App.1989) (statute waives privilege when patient introduces his mental condition as an element of his claim or defense; holding a party's denial of allegations of mental instability does not operate as a waiver of the patient-psychotherapist privilege); Pritchard, 547 N.E.2d at 1287-88 (statute allowing disclosure when patient introduces his mental condition . . . as an element of his claim or defense interpreted as requiring patient to affirmatively place communication at issue); State v. George, 223 Kan. 507, 575 P.2d 511, 517 (1978) (same statutory language as Iowa; holding not guilty plea does not place condition of patient at issue); Merhige v. Gubbles, 657 So.2d 1098, 1101 (La.App.1995) (statute allowing disclosure when patient relies upon condition as an element of his claim or defense; held answer not sufficient to place health at issue); Shamburger v. Behrens, 380 N.W.2d 659, 662 (S.D.1986) (statute waives privilege when patient relies upon the condition as an element of his claim or defense; held simple denial did not waive privilege); In re KS., 137 Wis.2d 570, 405 N.W.2d 78, 82 (1987) (statute waives privilege when patient relies upon the condition as an element of his claim or defense; held not waived by objecting to guardianship proceedings); see Carlton v. Superior Ct., 261 Cal.App.2d 282, 67 Cal. Rptr. 568, 573 (1968) (defendant's denial of plaintiff's allegation that defendant was intoxicated at time of accident is not a tender of that issue so as to abrogate the physician-patient privilege under California statute); Muller v. Rogers, 534 N.W.2d 724, 726 (Minn.App.1995) (A straightforward denial of liability by a defendant does not constitute a waiver of medical privilege.); McCormick on Evidence § 103, at 385 (With respect to defenses, a distinction is clearly to be seen between the allegation of a physical or mental condition, which will effect the waiver, and the mere denial of such a condition asserted by the adversary, which will not.). Any other interpretation of the patient-litigant exception would severely undermine the purpose of the statutory privilege. By choosing to adopt the privilege, the legislature made the policy judgment that complete and honest communications between a physician and patient would be enhanced by making these communications confidential. The interpretation sought by Chung would seriously thwart the legislature's goal of enhancing candid physician-patient communications. If a patient knows an adversary in a civil suit would have the power to make the patient's medical condition an issue in the case, the patient is more likely to be guarded in the information he shares with his physician. [2] 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. See Peisach, 539 So.2d at 546 (noting if a party could obtain privileged information simply by alleging mental infirmity, no psychiatrist could ever assure his patient of confidentiality); Muller, 534 N.W.2d at 726-27 (it would defeat the purposes underlying the recognition of the physician-patient privilege to afford wholesale access to confidential medical records of defendants on the basis of nothing more substantial than the plaintiff's election to sue). In contrast, our interpretation of the patient-litigant exception does not undermine the purpose of the statutory privilege; the existence of 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. See McCormick on Evidence § 103, at 384 (policy considerations support a finding of waiver only when the patient has voluntarily placed his condition in issue in a judicial proceeding). [3] We recognize our holding will preclude the discovery and admission of relevant evidence. That fact, however, is no reason not to apply the privilege, for it is in precisely this situation that the privilege is intended to operate. Dillenbeck, 539 N.Y.S.2d at 714, 536 N.E.2d at 1133; see Merhige, 657 So.2d at 1101 (The waiver does not depend solely on the relevance of the privileged material, or on the adversary's need, no matter how strong, for the communication.); Muller, 534 N.W.2d at 727 (the rules of privilege codify policy determinations that certain relationships and situations are deserving of protection, even if crucial information is thereby withheld). As the highest court of New York has observed, Were we to carve out an exception to the privilege whenever it inhibited the fact-finding process, [the privilege] would quickly become eviscerated. Dillenbeck, 539 N.Y.S.2d at 714, 536 N.E.2d at 1133. The Iowa legislature presumably balanced the competing interests when it made the policy decision to adopt the physician-patient privilege. It is not for this court to question the wisdom of the legislature's decision. See Krull v. Thermogas Co., 522 N.W.2d 607, 612 (Iowa 1994) (In searching for legislative intent, we are bound by what the legislature said, not by what it should or might have said.) (emphasis added); Spurbeck v. Statton, 252 Iowa 279, 284, 106 N.W.2d 660, 663 (1960) (in considering the constitutionality of a statute, the courts have no concern with the wisdom, justice, policy or expediency of a statute).