E.M., age 13, complained to a social worker that her father had sexually abused her. The social worker called Dr. Ornelas, a pediatrician who examined E.M.. She concluded that E.M. had indeed been sexually abused. Dr. Montoya, a clinical psychologist and neuropsychologist also examined E.M.. Dr. Montoya stated that E.M. told her that she had been sexually abused by her father. Evaluations by both doctors, identifying the father as the perpetrator, were presented at trial. Although the evaluations contained hearsay, they were admitted pursuant to the medical diagnosis or treatment exception to the hearsay rule, which admits reasonably pertinent statements made for purposes of medical diagnosis. Accordingly, a children's court found that E.M. had been abused by her father.
E.M.'s parents appealed, contending that the lower court was in error in admitting the testimony of both the pediatrician and the psychologist. They argued that the statements given to the pediatrician were for purposes of investigation, not diagnosis. They further argued that the state had failed to lay a proper foundation for the testimony of the psychologist and that therefore it should have been deemed inadmissible evidence.
Holding: Reversed. The pediatrician's statements were correctly admitted because the identity of the perpetrator of the abuse was reasonably pertinent to diagnosis. However, since the psychologist had testified that she did not need to know the perpetrator of the sexual abuse to counsel E.M., the court found that the lower court had abused its discretion in admitting her testimony.
| Russell M. Coombs Professor of Law Rutgers University School of Law |
Professor Coombs comments: The court based its holding on the differences between the foundational testimony of the two doctors.
Given Dr. Ornelas' testimony that the identification was reasonably pertinent to her diagnosis, the court held that the statement therefore came within the purview of the medical treatment or diagnosis exception to the hearsay rule. Dr. Montoya, however, initially testified that she did not need to know the identity of the abuser in order to counsel E.M. Only after "suggestive prodding" did she concede the fact that the identity of a child abuse victim's close relative as the perpetrator is important for family dynamics (and therefore pertinent to psychological diagnosis and treatment). The court concluded that Dr. Montoya' testimony "did not establish that [she] considered the identity of the abuser to be pertinent or necessary to E.M.'s treatment."
Esperanza clearly implies that application of this hearsay exception depends not just on whether the statement objectively is reasonably pertinent to diagnosis or treatment, but also on whether the doctor who heard the statement subjectively considered it pertinent. This implication is unsound.
The statutory language requires only that the statement be reasonably pertinent. It would have been easy to draft the rule to require also that the doctor who heard the statement consider it pertinent, but that was not done.
The statutory language requires only that the statement be reasonably pertinent. It would have been easy to draft the rule to require also that the doctor who heard the statement consider it pertinent, but that was not done.
Esperanza's implication is inconsistent with other well-established features of this hearsay exception. Almost all authorities hold that a reasonably pertinent statement is admissible whether or not the doctor to whom it was made testifies to his or her expert opinion. Indeed, the committee that drafted this exception wrote that the exception even covers a statement made not to a doctor but to an ambulance driver or a family member, for example. (See Advisory Committee's Note to Fed.R.Evid. 803(4)).
Courts in other states should not follow this unsound aspect of Esperanza. There are other ways to exclude unreliable statements. In an appropriate case, a court could find that the extrajudicial declarant made the statement for a purpose other than diagnosis or treatment, or for mixed purposes in which another purpose predominated. In another suitable case, a court could properly find that, objectively, the statement was not reasonably pertinent to diagnosis or treatment.
Occasionally a statement that fits within this exception will have been made under circumstances undercutting its reliability and its probative value so much that it can be, and sometimes, must be, excluded under Rule 403 (the rule that lets a judge exclude otherwise admissible evidence if its probative value is substantially outweighed by factors such as jury confusion, waste of time, and unfair prejudice). Applying the rule rather than the approach of the Esperanza court would not affect the scope of appellate review, since in both contexts an abuse of discretion standard is applied. There was no need to twist the meaning of the statute as the court did in this case.