Court Opinion

ID: 9747387
Source: CourtListenerOpinion
Date Created: 2023-08-27 15:13:28.736436+00
Date Added: 2024-06-11T07:25:23.416425
License: Public Domain

CASTILLE, Justice,
dissenting.
The majority here holds that testimony by a nurse wherein she repeated statements made to her by an injured child *497identifying the child’s alleged abuser cannot be admitted under the medical treatment exception to the hearsay rule because the child’s identification of her abuser is not pertinent to the child’s medical treatment or diagnosis. Because I believe the statement of a child abuse victim to medical personnel that her abuser is a member of the victim’s immediate household presents a vastly different case from that envisioned by the general medical treatment hearsay exception and since I believe that such statements are reasonably pertinent to providing an effective comprehensive regimen of treatment for the totality of the child abuse victim’s injuries, I must respectfully dissent.
I agree with the general rule that statements attributing fault are not admissible under the medical treatment exception to the hearsay rule. The general rule banning statements of fault is premised on the assumption that the injury involved is purely somatic. United States v. Renville, 779 F.2d 430, 437 (8th Cir.1985). Moreover, as the majority notes, statements identifying the person at fault are seldom needed to promote effective treatment of the injury.
Child abuse, however, is one of the most devastating social ailments afflicting our society and the injuries suffered by an abused child differ dramatically from the types of injuries normally encompassed by the medical treatment exception to the hearsay rule. While most injuries are purely somatic, child abuse cases also often involve deep emotional and psychological injuries. State v. Nelson, 138 Wis.2d 418, 434, 406 N.W.2d 385, 391 (1987); Renville, supra; Goldade v. State, 674 P.2d 721, 725 (Wy.1983), cert. denied, 467 U.S. 1253, 104 S.Ct. 3539, 82 L.Ed.2d 844 (1984). In order to effectively treat child abuse victims, physicians must be attentive not only to the child’s emotional and psychological injuries which result from this crime, but they must also take care to ensure the safety of the child when he or she is released from the physician’s care, often back to the abusive situation that gave rise to the original injury. Renville, supra. Effective treatment can only be provided for the child’s physical and psychic injuries if the physician knows the identity of the abuser, *498especially when the abuser resides with the victim. Nelson, supra.
Because of the unique circumstances involved in child abuse cases, a number of other states have extended the medical treatment exception to the hearsay rule to situations where the abuse victim makes statements to a doctor or nurse as to the identity of the abuser since such statements are viewed as being pertinent to medical treatment. See Eakes v. State, 665 So.2d 852 (Miss.1995) (statement to physician as to identity of abuser of child sexual abuse victim admissible under medical treatment hearsay exception); Nelson, supra (child’s statement to psychologist that father assaulted her was admissible under medical treatment exception to the hearsay rule); State v. Vosika, 83 Or.App. 298, 731 P.2d 449 (1987) (physician who reasonably relied on child sexual abuse victim’s identification of her abuser as a family member in treating victim may testify under medical treatment exception as to victim’s statement); Goldade, supra, (statements by four year old victim to nurse and a physician identifying defendant as abuser were admissible under medical treatment exception). I agree with the rationale behind these decisions and thus, I would extend the medical treatment exception to the hearsay rule to situations like that presented in this case.1
*499Here, a jury found that appellant abused his five year old daughter by placing her in a tub of scalding water. The treating physician at the emergency room testified that the child’s burns led her to believe that the child had been subjected to abuse. The treating physician also testified that the identity of the abuser was an important fact to know in order to protect the child from that person. Moreover, the nurse who testified about the child’s statement that her father put her in the tub testified that the child was very frightened, upset and in pain when admitted to the emergency room and that she was concerned for the child’s emotional well-being. Based on this testimony, I believe that the nurse’s testimony regarding the child’s statement as to the identity of her abuser was properly admitted by the trial court under the medical treatment exception to the hearsay rule since it was pertinent to the total treatment of the child’s physical and emotional injuries resulting from the father’s abusive conduct.2
For the reasons stated above, I believe that the testimony of the nurse in this case about the statement made to her at the hospital by a child abuse victim undergoing medical treatment that the abuser was a member of the victim’s immediate household was admissible under the medical treatment exception to the hearsay rule because it presents a vastly different *500case from that envisioned by the general medical treatment hearsay exception and such a statement was reasonably pertinent to effectively treating the child abuse victim. Accordingly, I must respectfully dissent.
NIX, C.J., joins in this dissenting opinion.

. The majority here supports its decision by looking to the medical treatment hearsay exception contained in Rule 803(4) of the Federal Rules of Evidence and the accompanying Notes of Advisory Committee. Federal Advisory Committee Note to Rule 803(4) explains that hearsay statements as to fault "would not ordinarily qualify” for admission under this rule. While this note speaks in terms of generality, it does not speak in terms of absolute exclusion. Thus, some federal courts have used reasoning similar to the above and allowed a medical professional to testify about statements made by a child as to the identity of her abuser. See United States v. Tome, 61 F.3d 1446 (10th Cir.1995) (hearsay statement to physician identifying the identity of a sexual abuser who is a family member admissible under Rule 803(4)); United States v. Longie, 984 F.2d 955 (8th Cir.1993) (identity of abuser admissible under Rule 803(4) since such information is particularly important as it affects the physician’s treatment and recommendation for counseling); Renville, supra (statements by victim to her treating physician identifying her stepfather as her abuser were admissible under the medical treatment exception).

. The majority, in reversing the Commonwealth Court, only addressed whether the child’s statement to the nurse was pertinent to the child's medical treatment. The majority never examined the other requirement of the medical treatment hearsay exception, that is, that the child’s motive for making the statement was consistent with obtaining medical treatment. While the child’s motive here may not be readily apparent, a young child is generally aware of the emotional and physical pain that she is suffering and is able to comprehend that she is receiving medical treatment to alleviate that suffering. See Nelson, supra at 432-33, 406 N.W.2d at 391 (four year old child understood purpose of sessions with psychologist and thus passed motive prong of medical treatment hearsay exception); United States v. Nick, 604 F.2d 1199, 1201-02 (9th Cir.1979) (statement by three year old to physician as to cause of injuty admissible under Rule 803(4) of the Federal Rules of Evidence). Moreover, there is nothing in the record to suggest an ulterior motive for the child to make the statement to the nurse other than to receive medical treatment. Therefore, I believe that record here supports the conclusion that the child’s motive in making the statement to the nurse that her father placed her in the hot tub was to obtain medical treatment.