Court Opinion

ID: 9670832
Source: CourtListenerOpinion
Date Created: 2023-08-24 03:26:54.271376+00
Date Added: 2024-06-11T18:16:06.759021
License: Public Domain

SNELL, Justice
(dissenting).
I respectfully dissent.
The majority opinion convincingly presents the case for protecting the confidentiality of communications between a patient and the psychologist from whom professional advice is sought. Authorities are cited that speak *762eloquently of the need to guard a patient’s right of privacy, lest the harsh glare of exposure buries the hope for treatment in the dark recesses of fear. Recognition of this need to provide a measure of protection under law is accorded by the majority in requiring an in camera inspection. However, I believe that the confidentiality thus sought to be protected is compromised by the majority’s analysis of the statutes and is inadequately safeguarded by any in camera inspection.
The statute controlling the majority’s result is section 258A.6 (1991) captioned “Hearings — Power of Subpoena — Decisions.” (currently codified at Iowa Code § 272C.6 (1993)). That section provides subpoena powers to licensing boards authorized to perform various functions set out by the legislature under a general regulation chapter called “Continuing Education and Regulations — Professional and Occupational.” (Iowa Code ch. 258A (1991)). Chapter 258A covers general provisions for twenty-seven regulating boards or commissions including shorthand reporters, barber examiners, landscape architect examiners, and hearing aid dealers. Id. § 258A.l(l)(b), (f-g), (v). Section 258A.6 is a general statute applying wholesale to all of the twenty-seven boards or commissions grouped under Chapter 258A. Nothing in Section 258A.6 makes any reference to the Board of Psychology Examiners or gives any indication of a legislative intent to dilute or abridge the right of privacy inherently needed in the patient-psychologist relationship. Actually, a contrary legislative intent is indicated by specifically stating that information privileged against disclosure under section 622.10 shall not be obtained by a licensing board by means of section 258A.6. Id. § 258A.6(3). That would include information sought in the instant case from Marsha Hines’s psychologist. It is also made clear in the statute on subpoena power that information gathered by the board will lose all privacy protection. Id. § 258A.6(4). Professional records, papers, and correspondence — whether or not privileged or confidential under law — become evidence in the disciplinary proceeding. Id. Subsection (4) of section 258A.6 further provides that a final written decision and finding of fact of the licensing board is a public record. Id. Thus, the confidential thoughts, fears, hopes, and secret dreams of the patient confided to her psychologist may well appear as supporting facts in the board’s decision, for all the world to see. Small solace and unlikely anonymity is provided by the statute’s authorizing the court to withhold the identity of the patient whose confidences are publicly proclaimed. See id.
We considered the statutory protection given to communications received in professional confidence in Newman v. Blorn, 249 Iowa 836, 89 N.W.2d 349 (1958). We held that medical records that contained information gathered from a patient were to be considered “confidential communications” under section 622.10 because the records contained information which would be inadmissible at trial as oral testimony from the physician. Id. at 843-45, 89 N.W.2d at 354-56.
We said:
Prohibited direct revelations by a doctor cannot be revealed by indirect methods.
We have in the past had several occasions to discuss our privilege statute (section 622.10) and, as to the extent of the matters covered, we announced the rule that we will draw no fine lines as to whether a communication, professionally secured, is necessary or unnecessary. The policy of the statute is to provide for great freedom of disclosure by a patient to his physician, for the patient is often in no position to know what disclosures may or may not be necessary for his proper treatment.
Id. at 843, 89 N.W.2d at 354-55 (citations omitted). In Howard v. Porter, 240 Iowa 153, 155, 35 N.W.2d 837, 838 (1949), we stated that section 622.10
should receive a liberal construction designed to carry out its manifest purpose to make consultation by a patient with his physician entirely confidential and free from anticipation or fear that this confidence will be broken by the examination of the physician as a witness in some legal proceedings.
Id. 249 Iowa at 844, 89 N.W.2d at 355.
In Chidester v. Needles, we cited with approval our construction of section 622.10 in *763Newman, but distinguished it from the issue involved in Chidester. Chidester v. Needles, 358 N.W.2d 849, 852 (Iowa 1984). In Chides-ter the issue concerned a nontestimonial setting in which a subpoena duces tecum was issued under Iowa Rule of Criminal Procedure 5(6) as part of a county attorney’s general investigatory power in lieu of a grand jury proceeding. Id. We noted that information obtained under rule 5(6) may not be used to perpetuate testimony for trial. Id. at 852. Moreover, documents produced in response to a county attorney’s subpoena remain confidential unless and until criminal charges are filed and the court may thereafter order such documents to remain confidential. Iowa R.Crim.P. 5(6). Under these circumstances, we held that the statutory patient-physician privilege under section 622.10 must yield to the subpoena requirements of Iowa Rule of Criminal Procedure 5(6). Id. at 853.
We also held in Chidester that the patient’s constitutional privacy interest must yield to the state’s interest in well-founded criminal charges and the fair administration of criminal justice. Id. at 853-54.
The same considerations are not present in the case at bar as in Chidester. There are no criminal charges involved or suggested against psychologist Hines, psychologist Guenther, Marsha McMaster Hines or anyone else. Criminal administration is not involved. Further, there are no protections in the instant case against disclosure of confidential information, unlike those in Chidester found to be of special significance. The fact that the information sought by the Board of Psychology Examiners will be evidence and may well be a public record places this ease clearly within the scope of the protection outlined by our court in Newman rather than under the narrow sphere of Chidester.
The constitutional right of privacy should extend to the patient records of mental health professionals, as held by the majority. However, the majority fractures this principle, by holding that a sufficient showing of need by the Board of Psychology Examiners will prevail over the right to privacy protection. I do not concede that the privacy privilege can be overcome by any showing of some compelling need for the information sought by the Board of Psychology Examiners.
This case is a poor vehicle for deciding a legal point of such sweeping dimension. We have no idea what information is sought; the Board either does not know or has kept it a secret.
Yet, faced with a vacuum of facts from which to consider whether a compelling interest of the Psychology Board should subjugate the patient’s constitutional right of privacy, the majority held it was possible and remanded for the Board to make a showing. In so doing, the court has assumed legitimacy where the United States Supreme Court has cautioned against it.
‘Where certain fundamental rights are involved, the Court has held that regulations limiting these rights may be justified only by a compelling state interest, and that legislative enactments must be narrowly drawn to express only the legitimate interests at stake.” Roe v. Wade, 410 U.S. 113, 155, 93 S.Ct. 705, 728, 35 L.Ed.2d 147, 178 (1973) (citations omitted). If there are less drastic means to achieve a compelling state interest with a lesser burden on constitutionally protected rights, the state must utilize those means. Attorney General of New York v. Soto-Lopez, 476 U.S. 898, 909-10, 106 S.Ct. 2317, 2324, 90 L.Ed.2d 899, 910 (1986). The state cannot employ means that broadly stifle fundamental liberties when the end can be more narrowly achieved. Carroll v. President and Comm’rs of Princess Anne, 393 U.S. 175, 183-84, 89 S.Ct. 347, 353, 21 L.Ed.2d 325, 333 (1968).
Moreover, statutes affecting constitutional rights must be “drawn with precision,” and must be “tailored to serve” their objectives. Dunn v. Blumstein, 405 U.S. 330, 343, 92 S.Ct. 995, 1003, 31 L.Ed.2d 274, 285 (1972).
This statute, section 258A.6, under the majority’s construction of it today, is far from “narrowly tailored.” To the contrary, in its protection of a citizen’s constitutional privacy rights it leaves the scissors in the hands of licensing boards free to shear off whatever fabric they wish from an individual’s raiment of liberties. Chapter 258 is much too broad *764in scope to allow such an infringement on personal liberty. If an intrusion of this sort is constitutional at all, it should be provided for under a much more precise enactment.
The fact that the majority provides for in camera review does not alleviate the constitutional concerns in this case. Nor does the majority’s requirement that the Board show that the patient’s confidential records are relevant to its investigation provide any real privacy protection. Disagreements about what is relevant have fueled lawyers and judges for hundreds of years. And, whatever decision is made by the district court is appealable through the state or federal appellate process, automatically expanding the in camera inspection to scores or more reviewers. The constitutional right of privacy should not be diminished, as it is, under the facts and law of this case. No citizen should be forced, without compelling reason and adequate constitutional safeguards, to turn over their dreams, fantasies, sins, and shame, even to the most sensitive stranger.
The Board has already obtained the records of Dr. Hines, who is the subject of its investigation. Other information can be considered through voluntary sources. There is no compelling state interest to justify the Board’s invasion of privacy.
I believe section 622.10 bars the compulsory production of Marsha Hines’s patient records from her psychologist, Susan Guenther and section 258A.6 as applied by the majority is of doubtful constitutionality. On this basis I would hold that section 258A.6 does not permit the Board to subpoena records of a person not under investigation in connection with a licensee disciplinary hearing.