Opinion ID: 149086
Heading Depth: 2
Heading Rank: 2

Heading: Applicability of Section 117 to this Case

Text: The Plaintiffs' arguments on appeal raise two challenges to the district court's ruling. First, they contend that Section 117 does not govern Dr. Jonsson's duty to them. Second, they contend that even if the statute applies, Dr. Jonsson had a duty to warn them about Wellington because he had communicated to her a serious threat of imminent physical violence against them.
The Plaintiffs' arguments are not entirely clear. But as best we can tell, they contend that Section 117 is inapplicable to their claim because (1) Dr. Jonsson did not treat Wellington but performed only what they term a forensic evaluation and (2) Wellington waived any rights he may have had to confidentiality from Dr. Jonsson. They argue that the language of the statute restricts its application to a relationship between a therapist and a patient receiving treatment. And they assert that [w]hat the legislative history of [Section 117] indicates is that the purpose of the statute was to balance confidentiality in a treatment situation (in-patient and out-patient) with social need for protection of individuals who would be targeted by persons suffering mental illness. Aplt. Br. at 33. On this latter point, however, the Plaintiffs' brief neither cites, nor even mentions, what would ordinarily be considered legislative history, such as committee reports or floor debates. But the brief does discuss common-law precedents at some length, so we assume that by legislative history, the Plaintiffs mean the common-law context of the statute. They also claim support for their position in the Colorado victim-rights statute. We first address the language and common-law context of Section 117, and conclude that the statute applies in this case. We then consider the Colorado victim-rights statute and conclude that it is irrelevant to the issue before us.
The Plaintiffs' best argument is based on the use of the word patient in Section 117. The first sentence of the statute states: A ... mental health professional ... shall not be liable for damages in any civil action for failure to warn or protect any person against a mental health patient's violent behavior, and any such person shall not be held civilly liable for failure to predict such violent behavior, except where the patient has communicated to the mental health care provider a serious threat of imminent physical violence against a specific person or persons. Colo.Rev.Stat. § 13-21-117 (emphases added). The statute does not define patient, nor does it state explicitly that it applies only when the violent person has been treated by the mental-health professional. But the Plaintiffs contend that the ordinary meaning of the word patient is a person receiving treatment. The Plaintiffs' best example of this usage is the Colorado Supreme Court opinion in Martinez v. Lewis, 969 P.2d 213 (Colo.1998). In that case Dr. Lewis conducted an independent medical examination (IME) of Martinez for her insurer to evaluate the existence and extent of Martinez's claimed neurological injuries. Id. at 215. After repeated evaluations he concluded that she was faking her injuries. See id. at 216. She sued Dr. Lewis for negligence, alleging that he had erred in his diagnosis, resulting in her not receiving necessary treatment. See id. The court held that he owed her no duty to diagnose her correctly. See id. at 220. In explaining that a physician's duties depend on the purpose of the medical examination, the court used the word patient to refer to one who is being treated, as opposed to one who is being examined only for an IME. It wrote: Martinez sought psychological and psychiatric treatment from her own health care providers. Martinez does not contend that she sought medical advice or treatment from Dr. Lewis, [or] that he advised her in any way. . . . The agreement between [the insurer] and Dr. Lewis was solely for the insurance company's benefit. Under that agreement, Dr. Lewis's obligations were to report to [the insurer] his opinions regarding the diagnosis, prognosis, and other pertinent information regarding any treatment Martinez might need. Thus, . . . no physician- patient relationship existed between Dr. Lewis and Martinez. See id. at 218-19 (emphasis added). Martinez is certainly helpful to the Plaintiffs. But it is hardly dispositive on the meaning of the term patient in a Colorado statute. At least as compelling as the authority of Martinez, but in the opposite direction, is the Colorado legislature's use of the word patient to describe the same relationship at issue in Martinez. The Colorado statute setting forth the duties of independent medical examiners, who do not provide treatment but conduct examinations only for insurance purposes, refers to the persons being examined as patients. Indeed, the statutory title is, Accountability of Independent Medical Examiners to Their Patients. Colo.Rev. Stat. § 10-16-601; see also id. § 10-16-602(3) (defining patient as an individual covered by, or denoted as an insured, subscriber, enrollee, or purchaser under any health coverage or health benefit or health care services certificate, agreement, contract, policy, or plan.). In addition, in the section of the psychologist licensing statute entitled Practice of psychology defined, the Colorado legislature appears to use the word patient in a broader sense than the state supreme court did in Martinez. See id. § 12-43-303. The section includes within the practice of psychology several types of work that do not involve treatment. For example, the first type of work listed is (a) Psychological testing and the evaluation or assessment of personal characteristics such as intelligence, personality, abilities, interests, and aptitudes. Id. And, most pertinent to this case, the list includes (g) forensic psychology, which is the science of psychology that deals with the relation and application of psychological research and knowledge to legal issues, including, but not limited to, assessments of competency in civil or criminal matters, legal questions of sanity, or civil commitment proceedings. Id. Yet even though these types of work do not involve treatment, the only term used in the section to refer to a person seen by a psychologist is the word patient, which appears in the general definition of the practice of psychology: For the purposes of [the part of the Professions and Occupations Code relating to Psychologists], the practice of psychology is defined as the observation, description, evaluation, interpretation, treatment, or modification of behavior, cognitions, or emotions by the application of psychological, behavioral, and physical principles, methods, or procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior, cognitions, or emotions and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. Psychologists use any and all psychological principles, methods, and devices to consider the full range of possible causes of patients ' illnesses and select and apply the appropriate treatment methods. Id. § 12-43-303(1) (emphasis added). [2] If nothing more, the use of the term patient in the IME and licensing statutes reflects the unavailability of a better term to describe all persons who are seen professionally by health-care providers. Moreover, the common-law background to Section 117 does not support the Plaintiffs' arguments. Although the Plaintiffs suggest that the common-law cases show that it is the confidential, treatment relationship between a patient and a therapist that has created limits on the liability of psychologists, a review of the cases indicates the contrary. Not only has the confidential nature of the relationship not been a ground for limiting liability, but the treatment of the patient has been a ground for imposing liability. The general rule under the common law is that one has no duty to control the conduct of another. But an exception can arise because of a special relation. The Restatement (Second) of Torts § 315 (1965) states the exception as follows: There is no duty so to control the conduct of a third person as to prevent him from causing physical harm to another unless, (a) a special relation exists between the actor and the third person which imposes a duty upon the actor to control the third person's conduct, or (b) a special relation exists between the actor and the other which gives to the other a right to protection. The California Supreme Court invoked this exception in Tarasoff v. Regents of the University of California, 17 Cal.3d 425, 131 Cal.Rptr. 14, 551 P.2d 334, 343 (1976), the leading opinion on the liability of a mental-health professional for failure to warn or protect a third person. Tarasoff, cited in the Plaintiffs' opening brief on appeal, considered a suit against a psychologist by the estate of a person murdered by his patient. Of most significance to the case before us, Tarasoff did not treat confidentiality as a factor in its analysis of the scope of the psychologist's common-law duty. It considered confidentiality only after balancing various considerations, such as foreseeability and the risk of unnecessary warnings, in arriving at what it believed to be the proper duty. See id. at 342-46. Then, in response to an argument that the duty it was recognizing would require psychologists to violate their duty of confidentiality, the court acknowledged the value of safeguarding confidentiality but concluded that this interest must yield to the extent to which disclosure is essential to avert danger to others. Id. at 347. It did not indicate that the duty to warn would be broader in the absence of a confidential relationship. McIntosh v. Milano, 168 N.J.Super. 466, 403 A.2d 500 (1979), also cited by the Plaintiffs, adopted a similar analysis. And the Colorado Supreme Court, in its only decision regarding this common-law duty, did not include confidentiality in its analysis regarding the scope of the duty to disclose. See Perreira v. State, 768 P.2d 1198, 1215-20 (Colo. 1989); see also id. at 1209-10 n. 7 (quoting Tarasoff regarding confidentiality). (The Perreira decision postdated Section 117; but the court did not apply the statute because the underlying facts arose before Section 117's effective date. See id. at 1210 n. 8.). Nor does the common-law background to Section 117 suggest that the duties of a nontreating psychologist are greater than those who have treated the dangerous person. Tarasoff's discussion of the special-relation doctrine never makes such a distinction. See 131 Cal.Rptr. 14, 551 P.2d at 342-46; see also Brady v. Hopper, 570 F.Supp. 1333, 1337-38 (D.Colo.1983) (applying Colorado law; discussing special relationship between therapist and patient), aff'd, 751 F.2d 329 (10th Cir.1984). If anything, the absence of a therapy relationship would suggest the absence of the special relation necessary to impose any duty whatsoever on the psychologist. [3] In sum, we have been pointed to nothing in the common-law background to Section 117 suggesting that its limits on liability are confined to the context of a confidential, therapeutic relationship. Further, the relevant analysis conducted by the mental-health providerdetermining whether the person being evaluated is a danger to otherswould seem to be the same whether or not the person is being treated by the provider. It would therefore be reasonable to assume that the legislature intended the statute to address the entire subjectthat is, all such assessments by mentalhealth providers. This is not to say that public policy would never support imposing on mental-health professionals in certain contexts some common-law duties beyond those duties recognized in Section 117 to protect third persons from the conduct of persons they evaluate. Indeed, Section 117 itself provides two exceptions to its general rule. The final sentence of Section 117 states: The provisions of this section shall not apply [1] to the negligent release of a mental health patient from any mental health hospital or ward or [2] to the negligent failure to initiate involuntary seventy-two-hour treatment and evaluation after a personal patient evaluation determining that the person appears to have a mental illness and, as a result of the mental illness, appears to be an imminent danger to others. Colo.Rev.Stat. § 13-21-117. The Plaintiffs, however, do not suggest that either exception applies here. We would be arrogating to this court the authority of the Colorado legislature were we to declare an additional exception.
The Plaintiffs contend that the Colorado victim-rights statute supports their claim that Section 117 is inapplicable here. They argue as follows: As crime victims, [they] were entitled to protection pursuant to the provisions of C.R.S. § 24-4.1-301, et seq., relating to assurances of rights of victims and witnesses to crimes. The declaration of the act specifically sets forth that [sic] the intent to ensure that all victims of and witnesses to crimes are guaranteed certain protections under the law. Rights to justice and due process are ensured under C.R.S. § 24-4.1-302.5. Specifically § 24-4.1-303 mandates that law enforcement agencies, prosecutorial agencies, judicial agencies and correction agencies shall ensure that victims of crimes are afforded rights. C.R.S. § 24-4.1-303(5) specifies that all reasonable attempts shall be made to protect any victim or the victim's immediate family from harm, harassment, intimidation or retaliation arising from cooperating in the reporting, investigation, and prosecution of a crime. From these and other stated rights there is no question that probation and state actors were obligated to afford protections and rights guaranteed under the statute. The Plaintiffs were intended beneficiaries of protection with a right to be warned, if the criminal Wellington contemplated harm to them, or threatened harm to them. Aplt. Br. at 44. We are not persuaded. The victim-rights statute does not support any expansion of liability of mental-health providers. In the first place, the statute imposes no duties on them. Its purpose is to assure that all victims of and witnesses to crimes are honored and protected by law enforcement agencies, prosecutors, and judges.  Colo.Rev.Stat. § 24-4.1-301 (emphasis added). Dr. Jonsson is not a law-enforcement agent, prosecutor, or judge. Likewise, § 24-4.1-303(1) states: Law enforcement agencies, prosecutorial agencies, judicial agencies, and correctional agencies shall ensure that victims of crimes are afforded the rights described in section 24-4.1-302.5. Again, no duty is imposed on mental-health providers. In addition, the statute does not impose liability for damages on anyone: The statute provides no damages remedy; and those on whom a duty is imposed cannot be sued for damages. Judges, for example, are immune from suits for damages. See State v. Mason, 724 P.2d 1289, 1290 (Colo.1986). And the Colorado Governmental Immunity Act protects the other officials who have duties under the statute. See Colo.Rev.Stat. § 24-10-118(2)(a). Accordingly, we see no reason to modify our interpretation of Section 117 based on the victim-rights statute.