Court Opinion

ID: 9444620
Source: CourtListenerOpinion
Date Created: 2023-08-03 21:06:29.458582+00
Date Added: 2024-06-11T17:29:56.142579
License: Public Domain

PRETTYMAN, Circuit Judge
(dissenting) .
I disagree with my brethren in this case.
*405In the first place no objection to the testimony of Dr. Epstein was made at the time by defense counsel, no objection was made to the charge to the jury in which that testimony was discussed, and no point as to this testimony was made in the motion for a new trial. The Rules of Criminal Procedure provide that objections to evidence, and the grounds therefor, shall be made known to the trial judge1 2and that objections to instructions must be noted before the jury leaves the box.2 Substantial justice does not require a departure from the applicable rules; this man, Taylor, was clearly proven guilty and, indeed,^ did not even claim that ho did not commit the robbery. I would abide by the rules and not now entertain^ an attack upon the admission of the evidence or the instruction to the lury-
In the second place, under the statute 3 information otherwise inadmissible can be disclosed with the consent of the patient or of his legal representative. In the present case both the patient and his legal representative sat silent in the courtroom when it was proposed to disclose these communications and the other material. I would construe that willful silence as consent.
The court indicates that Taylor’s consent cannot be accepted, because he is now alleged to have been incompetent at the time and so could not either consent or authorize his legal representative to do so. But Taylor had been reported competent, and in the eyes of the law at the time he was competent; otherwise he would not then have been undergoing trial. My view is that if he was competent to stand trial he was competent to consent to this evidence. This ruling, that the privilege extends to an allegedly incompetent person but that neither he nor his legal representative can give consent for the use of the medical testimony, is a disturbing phase of this opinion. In the next place the statute does not require authorization from the patient to validate a consent given by a legal representative. It pointedly omits reference to any such authorization. Indeed, by validating a consent given by a “legal representative”, it seems to contemplate the possible absence on the part of the patient of capacity or willingness to consent. A guardian, custodian or committee, as well as a duly authorized attorney, may give consent under the statute.
jn ^he third place I think this testimony was not privileged. When pursuan^ ^o the dictates of criminal justice a person ¡s confined by order of a court in a state institution for the mentally the relationship between him and the doctor on the staff at that institution jg no^ the ordinary relationship between physician and patient contemplated and treated by the statute which confers the doctor-patient privilege.4 Under such circumstances the Government, as a matter of public concern, is entitled to the benefit of the testimony of those doctors, whether as to diagnosis, treatment or observation. It is contrary to the interests of justice to give such an accused person power to close the mouths of those doctors.
The practicalities of this decision by the court must be grasped. The facts in the case at bar are sufficient illustration, This man, Taylor, was examined for mental competency pursuant to Title 18, Section 4244, United States Code. One 0f the examining psychiatrists reported him incompetent; the other doctor did not report. An inquisition was thereupon had, and the man was found incompetent and committed to the hospital pursuant to the statute. All the while he was under indictment for robbery, housebreaking, and grand larceny. After Taylor had been in St. Elizabeths six months the Superintendent reported him competent. This court now holds that Taylor has the power, by refusing con*406sent to the doctor’s testimony, to close the mouth of any Government doctor who observed or treated him while he was at St. Elizabeths and who says he was and is sane and competent; but he can clear for admission into evidence the testimony of any doctor who says he is insane or incompetent. Dr. Gilbert can testify, but Dr. Epstein cannot. And this in spite of the fact that Dr. Gilbert made only spot examinations (on five separate days) whereas Dr. Epstein observed and treated the man regularly for six months. To me this result is simply not realistic or in the public interest.
It must be understood that the court is not merely excluding admissions against interest made by an accused. It is applying the physician-patient privilege statute, and that statute applies the privilege to “any information, confidential in its nature, which he [the doctor] shall have acquired in attending a patient in a professional capacity and which was necessary to enable him to act in that capacity”. This privilege covers all diagnosis and all treatment. So that this decision cuts off use of the testimony of all the Government doctors in these cases where an indicted man is in a Government hospital undergoing compulsory treatment as a result of which it is anticipated he will return to the authorities for trial. That is, it cuts off that testimony unless the accused consents, which in practical effect means unless it is favorable to him. It seems to me that this decision will badly handicap and confuse the handling of those cases in which persons accused of crime are committed to Government institutions because of incapacity to stand trial.
This court used the expression “ordinary patient-doctor relationship” in the Catoe case5 in describing this statutory privilege. The full sentence was: “It protects the personal nature of an ordinary patient-doctor relationship.” The cases clearly establish that, when an accused person is subjected to an examination by Government doctors, no doctor-patient relationship is established.6 Taylor’s commitment to St. Elizabeths was not for examination but was for treatment, and so those cases do not apply literally. But it seems to me the rationale applies. Certainly it is clear enough that the relationship between Taylor and Dr. Epstein was not the ordinary one of doctor and patient. Nothing was voluntary about it on either’s part. And certainly nothing was confidential about Taylor’s admissions; they were made before a conference of several physicians. He was a person in custody under authority of the criminal law. Dr. Epstein was acting in the capacity of a Government officer, not as a personal physician. It seems to me the rationale of the rule relating .to examinations by Government officers, rather than that of the rule relating to physician-patient relationships, applies to the present problem.
I agree with the view held by some New York courts,7 illustrated by the opinions in Liske v. Liske,8 Munzer v. Blaisdell,9 and Scolavino v. State.10 In *407the latter case the court quoted with approval from the Liske case, as follows:
“ ‘ * * * I do not think that the relation arising by operation of law between a patient committed by legal process to a state institution for the insane and the official physicians in charge thereof is within the professional relation contemplated by Section 834 of the Code of Civil Procedure, or that such section was designed to exclude the testimony of such official physicians, whose duty it is under the police power of the state to make physical examinations of irresponsible patients. * * *’”11
The New York court, in the Scolavino case, also cited and relied upon Professor Wigmore’s analysis of the physician-patient privilege.12
Finally, on this point, I doubt that Taylor’s admission to Doctor Epstein and his confreres, that the descriptions given other psychiatrists of delusions and hallucinations were just a gag, is covered by the privilege. The statute does not cover every communication; its protection is limited to confidential information which is necessary to the doctor to enable him to perform his professional duties. The statute actually was directed, of course, to revelations by patients, and others, of symptoms and defects which the doctor must know about but which would not be revealed to him except in confidence. That concept must be carried over into the field of mental illness, and so the mere fact of statements by the patient may be part of the diagnostic material. But it seems to me to stretch the principle of the rule beyond its elastic limits to hold that a candid, repeated statement that claims of delusions, etc., were false, is part of the data necessary to permit Dr. Epstein to perform his duties as an attending physician. Certainly an admission of guilt to a crime would not be privileged by this statute. Reasonably, then, an admission of the falsity of a defense ought not to be privileged.
I emphasize, as I have already noted, that Taylor’s admissions were not made to Dr. Epstein alone in the course of some sort of confidential inquiry. They were made and repeated to a group of doctors who heard him in a body. This is not the ordinary doctor-patient communication.
I do not agree with other parts of the opinion of the court, but those points are minor in comparison with the matter I have discussed. I will not extend this opinion to elaborate upon them.
I agree with the court that Taylor should have a hearing pursuant to Gunther.13 But I would not reverse the judgment for that purpose; I would follow the procedure as well as the principle of Gunther.

. Rule 51.

. Rule 30.

. 29 Stat. 138 (1896), as amended, D.O. Code § 14-308 (1951).

. Ibid.

. Catoe v. United States, 76 U.S.App.D.C. 292, 295, 131 F.2d 16, 19 (1942).

. State v. Fouquette, 67 Nev. 505, 221 P.2d 404 (1950), certiorari denied, 341 U.S. 932, 71 S.Ct. 799, 95 L.Ed. 1361 (1951); Commonwealth v. Gordon, 307 Mass. 155, 29 N.E.2d 719 (1940); Commonwealth v. Di Stasio, 294 Mass. 273, 1 N.E.2d 189 (1936); Commonwealth v. Sykes, 353 Pa. 392, 45 A.2d 43 (1946); People v. Dutton, 62 Cal.App.2d 862, 145 P.2d 676 (1944); Simecek v. State, 243 Wis. 439, 10 N.W.2d 161 (1943).

. Other New York courts hold the contrary.

. Sup., 135 N.Y.S. 176 (1912).

. 183 Misc. 773, 49 N.Y.S.2d 915 (1944), affirmed, 269 App.Div. 970, 58 N.Y.S.2d 359 (1945).

. 187 Misc. 253, 62 N.Y.S.2d 17 (1946), modified, 271 App.Div. 618, 67 N.Y.S.2d 202 (1946), affirmed as modified, 297 N.Y. 460, 74 N.E.2d 174 (1947).

. Id., 62 N.Y.S.2d at 20-21.

. 5 Wigmore, Evidence § 2285 (3d ed. 3940).

. Gunther v. United States, 94 U.S.App.D.C.-, 215 F.2d 493 (D.C.Cir.1954).