Opinion ID: 2244731
Heading Depth: 3
Heading Rank: 2

Heading: Right to Privacy and The Petrillo Doctrine

Text: We next consider plaintiffs' argument that section 2-1003(a) violates the privacy rights of Illinois citizens. In support of this argument, plaintiffs cite to the two clauses in the Illinois Constitution which expressly refer to privacy. See Ill. Const.1970, art. I, §§ 6, 12. They further ground their privacy argument in the Petrillo doctrine, which recognized a strong public policy in preserving the confidential and fiduciary physician-patient relationship and held that such public policy is violated by ex parte communications between defendants or their counsel and plaintiffs' treating physicians. Defendants counter that there is no constitutional right to privacy in medical information under federal or state decisions. Furthermore, the defendants argue, the branch of government charged with declaring the public policy of this state is the legislature. According to defendants, the legislature acted well within its authority in providing for ex parte conferences between the plaintiff's health care practitioners and representatives of the defendants. Finally, defendants posit that the Petrillo doctrine was never expressly adopted by this court and that the legislature is free to overturn it. In 1970, the Illinois Constitution was amended to include two separate provisions which expressly refer to a citizen's expectations of privacy. Section 12 of the Illinois Constitution's Bill of Rights provides that [e]very person shall find a certain remedy in the laws for all injuries and wrongs which he receives to his person, privacy, property or reputation. He shall obtain justice by law, freely, completely, and promptly. (Emphasis added.) Ill. Const.1970, art. I, § 12. Section 6 of the Illinois Bill of Rights states, The people shall have the right to be secure in their persons, houses, papers and other possessions against unreasonable    invasions of privacy   . Ill. Const.1970, art. I, § 6. [11] The Constitutional Commentary to section 6 of the Bill of Rights explains that [t]he protection against `invasion of privacy' is new and is stated broadly and expands upon the individual rights which were contained in Section 6 of Article II of the 1870 Constitution and the guarantees of the Fourth and Fourteenth Amendments to the United States Constitution. Ill.Ann.Stat., 1970 Const., art. I, § 6, Constitutional Commentary, at 522 (Smith-Hurd 1997). With reference to section 6, this court has observed that [b]ecause the Illinois Constitution recognizes a zone of privacy, the protections afforded by the Illinois Constitution go beyond the guarantees of the Federal Constitution. In re May 1991 Will County Grand Jury (1992), 152 Ill.2d 381, 178 Ill.Dec. 406, 604 N.E.2d 929. King v. Ryan, 153 Ill.2d 449, 464, 180 Ill.Dec. 260, 607 N.E.2d 154 (1992); see also Fink v. Ryan, 174 Ill.2d 302, 220 Ill.Dec. 369, 673 N.E.2d 281 (1996); cf. People v. DiGuida, 152 Ill.2d 104, 119, 178 Ill.Dec. 80, 604 N.E.2d 336 (1992) (referring to a 1984 decision in which this court indicated it would interpret section 6 of the Illinois Bill of Rights as consistent with its counterpart, the fourth amendment to the federal constitution). This court has stated that governmental conduct or state action must be present before a citizen claiming a violation of the privacy right referenced in section 6 of the Illinois Bill of Rights may obtain relief. See Barr v. Kelso-Burnett Co., 106 Ill.2d 520, 526, 88 Ill.Dec. 628, 478 N.E.2d 1354 (1985) (rejecting plaintiff's argument that employer's alleged violation of free speech, equal protection, due process, and privacy rights provided a proper foundation on which to premise plaintiff's action for retaliatory discharge); see also People v. DiGuida, 152 Ill.2d at 121-24, 178 Ill.Dec. 80, 604 N.E.2d 336 (rejecting defendant's free speech and free elections challenge as a means to challenge his conviction for criminal trespass to private store owner's land). In considering section 6 of the Illinois Bill of Rights in conjunction with section 12, this court has stated that the constitutional right to be free from governmental invasions of privacy [in section 6] is supplemented by the constitutional right to a certain remedy for invasions or injuries to one's privacy provided for in article I, section 12, of the Illinois Constitution of 1970. In re A Minor, 149 Ill.2d 247, 256, 172 Ill.Dec. 382, 595 N.E.2d 1052 (1992). In Minor, a news organization attending a juvenile court hearing sought permission to disclose the names of the minor victims of abuse. Pursuant to a provision of the Juvenile Court Act, the circuit court prohibited the newspaper from disclosing the identities of the minor victims. The newspaper appealed. This court affirmed, holding that the statutory provision which permitted the news media to attend hearings closed to the general public did not grant the media a right to disclose the minor victims' names. This court held that the circuit court's order barring disclosure of the victims' identities was not an unconstitutional prior restraint on the freedom of the press. Minor, 149 Ill.2d at 253-57, 172 Ill.Dec. 382, 595 N.E.2d 1052. After citing the two privacy clauses of the Illinois Constitution, the court determined that the minor victims had a compelling privacy interest at stake. Minor, 149 Ill.2d at 255, 172 Ill.Dec. 382, 595 N.E.2d 1052. In reviewing the history of section 12 of the Illinois Bill of Rights, the Minor court held it does not require the presence of state action. The court concluded, It is clear from the debates in the Sixth Illinois Constitutional Convention that article I, section 12, was intended to protect an individual's privacy from invasions or injuries caused by another nongovernmental individual or company. 3 Record of Proceedings, Sixth Illinois Constitutional Convention 1531-32. (Emphasis in original.) Minor, 149 Ill.2d at 256, 172 Ill.Dec. 382, 595 N.E.2d 1052. Consistent with this court's holding in the Minor case, we recognize that section 12 of the Illinois Constitution, unlike section 6, does not require state action before its protections are activated. However, the precise nature and scope of the privacy interest set forth in section 12 has not been the subject of much case law in this state. Plaintiffs cite cases in which a constitutional right to privacy was found in bank records ( People v. Jackson, 116 Ill.App.3d 430, 434-35, 72 Ill. Dec. 153, 452 N.E.2d 85 (1983)) and telephone records ( People v. DeLaire, 240 Ill. App.3d 1012, 1020, 183 Ill.Dec. 33, 610 N.E.2d 1277 (1993); cf. People v. Smith, 72 Ill.App.3d 956, 964, 28 Ill.Dec. 766, 390 N.E.2d 1356 (1979)). In addition, plaintiffs rely on Petrillo for the proposition that the privacy rights of individual patients and the confidential and fiduciary relationship existing between patients and their physicians are compelling interests deserving of protection for reasons of public policy. Petrillo, 148 Ill.App.3d at 607, 102 Ill.Dec. 172, 499 N.E.2d 952. In Petrillo, a product liability action, defense counsel informed the trial court that he had previously met in private with a treating physician for one of the 26 plaintiffs in the case. Upon learning of the meeting, plaintiffs' counsel moved to bar any future ex parte communications between defense counsel and any other physician. The trial court granted the motion and entered an order to that effect. Defense counsel, however, informed the court that he did not intend to comply with the order. The trial court, therefore, held the attorney in direct contempt, and the attorney appealed. In affirming the trial court's order, the appellate court initially noted that ex parte conferences were not necessary to obtain information for defending a lawsuit because the discovery methods outlined by Supreme Court Rule 201 were sufficient. The court determined that a review of case law from other jurisdictions revealed that there was not a single instance in which a court found that an ex parte conference was necessary to assist defense counsel in obtaining information that they were unable to acquire through regular channels of discovery. Petrillo, 148 Ill.App.3d at 587, 102 Ill.Dec. 172, 499 N.E.2d 952. The Petrillo court emphasized that society places a high value on the professional duties under which a physician operates, including the dual duties of confidentiality and loyalty. Petrillo, 148 Ill.App.3d at 589-92,102 Ill.Dec. 172, 499 N.E.2d 952. The court noted that certain conduct could be against public policy even in the absence of an express constitutional or statutory prohibition because public policy could be inferred from such sources as statutes or constitutions. Reasoning that there exists a strong public policy in preserving the sanctity of the patient-physician relationship and acknowledging the plaintiff's privacy interests, the court determined that ex parte conferences unduly threatened society's interest in maintaining the fiduciary and confidential nature of the relationship. Petrillo, 148 Ill.App.3d at 589-96,102 Ill.Dec. 172, 499 N.E.2d 952. Accordingly, the court held that ex parte conferences between a plaintiff's physician and defendant or his counsel should not be permitted. Petrillo, 148 Ill.App.3d at 596, 102 Ill.Dec. 172, 499 N.E.2d 952. In the years following the decision in Petrillo, all five districts of our appellate court have followed the decision and, although the specific application of Petrillo to various facts has differed in some respects, the fundamental holding that ex parte discussions between defense counsel and plaintiff's treating physician shall be conducted only through authorized methods of discovery has been overwhelmingly approved in subsequent Illinois Appellate Court cases. L. Bonaguro & M. Jochner, The Petrillo Doctrine: A Review and Update, 83 Ill. B.J. 16,16 (1995). Other articles, which have analyzed the policy grounds on which the Petrillo court based its decision, have either endorsed the prohibition of ex parte communications (see P. Corboy, Ex Parte Contacts Between Plaintiff's Physician and Defense Attorneys: Protecting the Patient-Litigant's Right to a Fair Trial, 21 Loy. U. Chi. L.J 1001 (1990)) or questioned the new type of witness privilege created in Petrillo and the perceived expansion of the original decision beyond its natural boundaries (see W. McVisk, A More Balanced Approach to Ex Parte Interviews by Treating Physicians, 20 Loy. U. Chi. L.J. 819 (1989); see also C. Redden & W. Bower, Qualifications to the Bar of Ex Parte Contacts With Physicians, 79 Ill. B.J. 442 (1991)). We do not believe it is necessary, practical, or appropriate for this court to review every case in which the Petrillo rule has been applied, distinguished, or otherwise discussed. However, because the legislative decision to eviscerate the Petrillo rule has been questioned by plaintiffs as part of their challenge to section 2-1003(a), we find it appropriate to examine the rationale of the Petrillo decision and to ascertain whether there exists a constitutional source for the recognition of a strong public policy interest in preserving the sanctity of the physician-patient relationship. We acknowledge that the Petrillo decision did not directly recognize a constitutional basis for its holding, and we further acknowledge that there was no issue raised in Petrillo that the plaintiff's privacy interest in confidential medical information was protected by the Illinois Constitution. However, the Petrillo court expressly acknowledged that the public policy of this state is reflected in constitutional provisions as well as statutes. We believe that it is proper for this court to consider the Illinois Constitution's privacy provisions as reflective of an important policy. With that in mind, we consider the important public policy considerations that the Petrillo court found compelling enough to bar ex parte conferences. In his appeal from the order holding him in contempt of court, the attorney in Petrillo raised several arguments. A group of arguments, collectively referred to as the waiver challenges, stated that a plaintiff, by filing suit, places his mental and physical condition at issue, thereby waiving the physician-patient privilege. The waiver issue was further broken down into 10 related arguments in which the attorney sought to justify ex parte conferences between defense counsel and the treating physicians of the plaintiff. In addition, the attorney posited that prohibiting defense counsel from engaging in ex parte conferences with a plaintiff's treating physician violated defense counsel's first amendment rights. Petrillo, 148 Ill.App.3d at 584, 102 Ill.Dec. 172, 499 N.E.2d 952. After initially concluding that ex parte conferences were not necessary for the preparation of a defense, the Petrillo court announced its disagreement with the defense attorney's contention that no public policy in Illinois prohibited ex parte conferences. According to the court, Public policy is found in a State's constitution and statutes, and where those are silent, in the decisions of the judiciary. Petrillo, 148 Ill.App.3d at 587, 102 Ill.Dec. 172, 499 N.E.2d 952. Noting that public policy forbids that conduct which tends to harm an established and beneficial interest of society the existence of which is necessary for the good of the public, the court held that modern public policy strongly favors the confidential and fiduciary relationship existing between a patient and his physician. Petrillo, 148 Ill.App.3d at 587, 102 Ill.Dec. 172, 499 N.E.2d 952. The court stated its belief that this public policy was reflected in at least two separate indicia: (1) the code of ethics adopted by the medical profession, upon which the public necessarily relies as a protection of the confidential relationship existing between a patient and his physician; and (2) the fiduciary relationship which exists between a physician and his patient, which is widely recognized in court opinions. The first indicia of the public policy invaded by ex parte conferences, the medical profession's code of ethics, was further broken down by the Petrillo court into three prongs: (1) the Hippocratic Oath; (2) The American Medical Association's Principles of Medical Ethics; and (3) the Current Opinions of the Judicial Council of the AMA (1984 ed.) [12] Observing that the relationship between doctor and patient remains confidential only for so long as a patient can trust that his consent is a prerequisite to the disclosure of the information he conveyed to his doctor, the Petrillo court concluded that when a physician and defense counsel engage in ex parte conferences without the consent of the patient, the confidentiality which once existed between the doctor and patient is irreparably breached and the sanctity of the relationship existing between a patient and his physician is thereby destroyed. Petrillo, 148 Ill. App.3d at 591, 102 Ill.Dec. 172, 499 N.E.2d 952. Significantly, the Petrillo court distinguished between medical information which is considered waived by the filing of a lawsuit and information which is not waived. The court noted that disclosure of information could be accomplished by either an express consent or one implied at law by the patient's conduct, such as the filing of a lawsuit. With respect to the latter situation, the patient filing suit implicitly agrees to his or her doctor's release of any medical information related to the specific physical or mental condition which the patient has placed in issue. However, the plaintiff's implied consent (or waiver of information) is obviously and necessarily limited; he consents only to the release of his medical information (relative to the lawsuit) pursuant to the methods of discovery authorized by Supreme Court Rule 201(a) (87 Ill.2d R. 201(a)). (Emphasis in original.) Petrillo, 148 Ill.App.3d at 591, 102 Ill.Dec. 172, 499 N.E.2d 952. The plaintiff-patient does not, by the simple act of filing suit, consent to ex parte discussions between his treating doctor and defense counsel, nor does he consent to disclosure of confidential information unrelated to the subject matter of the lawsuit. The Petrillo court concluded, consistent with the courts of other jurisdictions, that patients have the right to rely on their physicians' compliance with the ethical obligations of confidentiality, and barring ex parte conferences is a necessary adjunct to preserve that right. The Petrillo court also discussed what it considered to be the second indicia of the public policy against ex parte conferences between defense counsel and plaintiff's treating physicians. Similar to the confidentiality/privacy discussion addressed above, this portion of the appellate court's opinion found that society has an established interest in the fiduciary quality of the physician-patient relationship. Citing cases from Illinois and other jurisdictions, the Petrillo court stated that the fiduciary relationship between doctor and patient is founded upon trust and confidence. Implied in this fiduciary relationship is a good faith requirement that the physician will not engage in conduct adverse to his or her patient, including ex parte conferences with the patient's opposing counsel. Emphasizing that at the heart of a fiduciary relationship is trust, loyalty, and faith in the discretion of the fiduciary, the court in Petrillo concluded that ex parte conferences with defense counsel constituted a serious breach of trust. Petrillo, 148 Ill. App.3d at 596, 102 Ill.Dec. 172, 499 N.E.2d 952. We believe that the rationale of the Petrillo court is sound and that there is a strong public policy against ex parte conferences between the plaintiffs' health care practitioners and defendants or their representatives. We further believe that the privacy interest referred to in the certain remedy clause of section 12 provides a constitutional source for the protection of the patient's privacy interest in medical information and records that are not related to the subject matter of the plaintiff's lawsuit. We acknowledge that the certain remedy provision has been referred to in general as a statement of philosophy rather than a guarantee of a specific remedy. See Sullivan v. Midlothian Park District, 51 Ill.2d 274, 277, 281 N.E.2d 659 (1972). Nonetheless, we believe that a statement of constitutional philosophy is reflective of the strong public policy that was recognized in Petrillo. Therefore, we conclude that patients in Illinois have a privacy interest in confidential medical information, and that the Petrillo court properly recognized a strong public policy in preserving patients' fiduciary and confidential relationship with his or her physicians. [13]