Court Opinion

ID: 9595934
Source: CourtListenerOpinion
Date Created: 2023-08-22 00:44:31.027197+00
Date Added: 2024-06-11T09:07:09.037073
License: Public Domain

ELDER, Judge,
concurring in part and dissenting in part.
I respectfully concur in part and dissent in part from the majority’s opinion. I believe that portions of the psychologist’s testimony were properly admitted because they fell under an exception to the hearsay rule and did not violate Cartera.1
*229As the majority recognizes, Cartera provides an exception to the hearsay rule permitting “a physician to testify to a patient’s statements concerning his ‘past pain, suffering, and subjective symptoms’ to show ‘the basis of the physician’s opinion as to the nature of the injuries or illness.’ ” Cartera, 219 Va. at 518, 248 S.E.2d at 785-86. A physician may also testify as to his or her observations of a patient’s physical and emotional conditions and may “state what examinations and tests he performed upon the victims and what medical conclusions he reached as a result.” Id. at 519, 248 S.E.2d at 786. A physician may not, however, “recite the details of the offenses and the description of the assailant, as reported to him [or her] by the victimf ].” Id.
In this case, the following exchange occurred between the Commonwealth’s Attorney and the psychologist:
Q: ... After these sessions, Sir, or some time during these sessions, were you able to form an opinion to a reasonable degree of certainty in your expertise as to whether [the child] was suffering from any psychological disorder?
A: Yes, Ma’am.
Q: And what opinion is that, Sir?
A: That [the child] suffers from an adjustment disorder with mixed emotional—mixed—features of emotion and conduct.
*230Q: Do you have an opinion to a reasonable degree of certainty, in your expertise, what adjustment disorder-why he had suffered from this adjustment disorder, Sir?
A: An adjustment disorder is a persistent or unusual reaction to some identifiable stress.2
Q: And in this case, what—what opinion do you have as to that identifiable stress?
A: That he had been sexually abused.
Preceding this exchange, the psychologist described the tests he had used to form his opinion, including interviews with and observations of the child. The psychologist testified that on one occasion, the child indicated to him that the child “had been sexed” and made corresponding body movements to describe what being “sexed” meant.
In this case, I believe the trial court followed Cartera’s guidelines in allowing the psychologist’s testimony regarding the child’s report that he had been “sexed.” The child’s statement conveyed information that clearly formed the basis for the psychologist’s diagnosis of the child’s adjustment disorder and was therefore not introduced in violation of the hearsay rule.
However, I agree with the majority that the doctor’s statement that, in his opinion, the child had been sexually abused was inadmissible under Cartera. The psychologist opined not as to what could have been the causative stressor, but rather what was the causative stressor, which, in this case, was the ultimate issue. As the majority correctly asserts, Cartera stands for the proposition that opinion testimony is not admissible on an ultimate fact in issue. Cartera, 219 Va. at 519, 248 S.E.2d at 786 (stating that “[wjhether rape had occurred was the precise and ultimate issue in the case”). I also agree with *231the majority’s analysis of Price v. Commonwealth, 18 Va.App. 760, 446 S.E.2d 642 (1994). In this case, the psychologist testified specifically as to whether the child was sexually abused, a precise element of the charge, which amounted to ultimate issue testimony and invaded the jury’s province as the fact finder.
For these reasons, I concur and dissent in the majority’s opinion.

. Although Cartera labels such testimony as an exception to the hearsay rule, it appears that a doctor’s testimony about a patient's statement might be categorized as non-hearsay, necessitating no exception for the statement’s introduction into evidence.
For example, if a doctor diagnoses a patient as suffering from a herniated disc and testifies that the patient described having back pain, this testimony might be offered not for the truth of the matter (i.e., whether back pain actually existed), but rather for the fact that back pain was reported to the doctor and formed the basis of the doctor’s diagnosis.
As Charles E. Friend wrote:
This "not-for-truth” exception is a difficult rule to apply in the context of real cases. It has always caused controversy, and presumably will always do so, because it is often arguable whether the declaration is being offered to prove the truth of the content of the *229declaration or not, and lawyers and judges may quite reasonably reach different conclusions on this question in any given case....
Part of the difficulty in "not-for-truth” situations is due to the fact that often such evidence will have a dual nature; the declaration may indeed be relevant on some matter unrelated to the truth of the content of the statement, and yet the content of the statement may go to the issues of the case as well. See, e.g., Donahue v. Commonwealth, [225 Va. 145, 300 S.E.2d 768 (1983)]. This is perhaps the situation which creates the greatest dilemma for the courts. In that regard, however, it should be remembered that it is a time-honored principle of evidence law that, in general, if evidence is admissible for any purpose, it is admissible.
Charles E. Friend, The Law of Evidence in Virginia § 18-3 at 95-96 (4th ed.l993)(footnote omitted); see Hanson v. Commonwealth, 14 Va.App. 173, 416 S.E.2d 14 (1992).

. According to DSM-III-R (Diagnostic & Statistical Manual of Mental Disorders 329-30 (3d. ed. rev. 1987), one of the diagnostic criteria for "adjustment disorder” is a "reaction to an identifiable psychological stressor (or multiple stressors).”