Jаmes D. ALLRED, Petitioner, v. STATE of Alaska, Respondent.
No. 2343.
Supreme Court of Alaska.
Aug. 12, 1976.
There is a substantial and reasonable probability that the instruction given, although open to other interpretations, could be construed by the jury as barring considerations of increased values based on prospective changes in uses to which the land may be devoted. The jury might well have concluded from the instruction given that the only use which could be considered in evaluating defendant‘s property was a present lawful use, and that the only present lawful use was for single family residences. This is not consistent with the rule adopted in Long Beach City High School Dist. v. Stewart, supra.
* * * * * *
In any event, there was not justification for an instruction, which upon a reasonable construction thereof, prevented the jury from considering defendant‘s theory, and the prejudice resulting to defendant as the result of the erroneous instruction is manifest. Upon a retrial of the cause it may be assumed that an instruction conforming to the statement in the Stewart case will be submitted.
In the case before us, as in Donovan, the erroneous instruction severely impaired appellants’ theory of valuation of their property, and since their substantial rights were affected, the trial court‘s error was reversible. Martinez v. Bullock, 535 P.2d 1200 (Alaska 1975).
Appellants also raise the issue of their entitlement to attorney‘s fees accrued during the period between the master‘s award and the jury‘s verdict. Because we are remanding this case for a new trial, there is no need for us to reach this issue.
The judgment is reversed and the case remanded for a new trial.
Phillip P. Weidner, Herbert D. Soll, Anchorage and Civil Rights-Civil Liberties Research Committee, Harvard Law School, for petitioner.
Stephen G. Dunning, Asst. Dist. Atty., and Joseph D. Balfe, Dist. Atty., Anchorage and Avrum M. Gross, Atty. Gen., Juneau, for respondent.
Before BOOCHEVER, C. J., RABINOWITZ, CONNOR and ERWIN, JJ., and DIMOND, J. Pro Tem.
OPINION
CONNOR, Justice.
On February 20, 1974, Paul D. O‘Keefe was found dead in a hotel room in Anchorage. The room was rented to James D. Allred. Subsequently he was located by the Anchorage police at the Langdon Psychiatric Clinic, and was taken to police facilities for further questioning.
It is claimed that following detailed questioning by Investigator Ronald J. Rice, Allred made incriminating statements concerning the death of O‘Keefe. There was no tape-recorded statement of this confession, however.
Once legal proceedings against petitioner commenced, he moved to suppress any testimony by Henderson concerning the conversation at the police station, on the theory that these communications were privileged. Judge Kalamarides heard and denied this suppression motion. At trial the state called Mrs. Henderson to testify. Following extensive argument Judge Edmond Burke ruled that she should testify to her conversation with Allred during their encounter at the police station. Henderson testified that:
“He [Allred] told me that he and Paul [O‘Keefe] went to the Kobuk, that they had some wine and had been drinking some wine prior to that time, and that they had some valiums between the two of them and that they split them up and that they had been together most of that day and were discussing a suicide pact and that that discussion continued there in the Kobuk. I don‘t recall whether or not a decision was made at that time—who would do what first. But Del [Allred] did recall and told me that he had blacked out or passed out and was awakened by Paul, who was crying and begging him and saying, if you are my friend you will kill me—please, and he—with tears in his eyes—ahh—and begging Del. Del told me that he had a gun and that he did shoot Paul, and that Paul laid on the floor and was jerking and moving and that he hit him with the gun but that he still didn‘t stop moving, and that this was his friend and he was doing this for his friend because they were such good friends, and that he picked Paul up and put him in the bath tub and turned the water on until Paul stopped moving. After that he went into the bedroom—the adjoining room there—and he laid down with a gun at his own head, with his hand (sic) on the trigger, and he tried several times and could not pull the trig—trigger. He told me that he did not have the guts to do it, and that he just laid there. He didn‘t—he didn‘t remember whether he slept or—but that he laid there until the phone rang, which was the motel people calling him at 7:00, as he had pre-arranged for them to wake him up. He ca—I don‘t remember whether Del called a cab or whether the motel people called a cab, but that he got a cab and he came out to our office after that.”
The defense apparently was able to introduce evidence tending to show that O‘Keefe had committed suicide. In any event, the jury was unable to reach a verdict, a mistrial resulted, and a new trial is contemplated. We have granted review to determine whether any psychotherapist-patient evidentiary privilege would prevent Mrs. Henderson at retrial from testifying to her conversation with the defendant at the police station.
I.
The word “privilege” is a corruption of the Latin phrase “privata lex“, meaning a private law applicable to a small group of persons as their special prerogative. Slovenko, Psychiatry аnd a Second Look at the Medical Privilege, 6 Wayne L.Rev. 175, 181 (1960). The English doctrine of privilege is nearly as old as common law compulsory testimony. Privilege was originally conceived of in England as a judicially recognized point of honor among lawyers1 and other gentlemen2 not to reveal confidential communications. This general rule of honor was conclusively repudiated in 1776,3 although lawyers were able to maintain a privilege for their profession.4
“A physician or surgeon shall not, against the objection of his patient, be examined in a civil action or proceeding as to any information acquired in attending the patient which was necessary to enable him to prescribe or act for the patient.”
II.
Allred relies on
It is only as an “anti-gossip” measure that
and possibly broadened the scope of common law duty11 in suits against indiscreet psychotherapists.
Allred argues that the federal and Alaska12 constitutions require an evidentiary psychotherapist privilege resulting from the right to privacy, citing Griswold v. Connecticut, 381 U.S. 479, 484 (1965), and In re Lifschutz, 2 Cal.3d 415, 85 Cal.Rptr. 829, 467 P.2d 557, 567-68 (1970). See Note, Psychotherapy and Griswold: Is Confidence a Privilege or a Right?, 3 Conn.L.Rev. 599, 604 (1971). Since it is apparent that Mrs. Henderson was not a police agent, we do not perceive any state action that would trigger the constitutional privacy guarantees, unlike the situation in Leyra v. Denno, 347 U.S. 556 (1954).13
III.
The question remains whether a common law psychotherapist privilege should be recognized and, if so, what its scope ought to be. As we have seen, the only professional relationship traditionally privileged at common law was that of lawyer and client.14 Because of the strong need for compulsory testimony, the creation of new privileges is generally looked upon with disfavor by the commentators. Branzburg v. Hayes, 408 U.S. 665, 690, n. 29 (1972); 8 J. Wigmore, Evidence § 2286 (McNaughton rev. ed.1961).
The courts have created privileges in modern times, however, when they have found sufficient policy justification for doing so. Mullen v. United States, 105 U. S.App.D.C. 25, 263 F.2d 275, 279 (1959) (Fahy, J., concurring) and Cook v. Carrol, [1945] Ir.R. 515 (High Ct., excerpted in 8 J. Wigmore, Evidence § 2394, at 871 [McNaughton rev.ed.1961]), are examples of judicial common law constructions of priest-penitent privileges. The English courts recognize the doctrine of “conversations without prejudice” whereby statements made to marriage counselors who are attempting to effectuate reconciliation cannot be used as evidence in divorce proceedings. See, e. g., McTaggart v. McTaggart, 2 [1948] All E.R. Reprint 754, 755 (Ct.App.). At least one Canadian court has followed suit. In re Kryschuk and Zulynik, 14 D.L.R.2d 676 (Sask.Magist.Ct.1958). One American trial court has
In the federal area, the United States Congress is apparently of the opinion that the creаtion of a psychotherapist-patient privilege is properly one of common law development through court decision. In reducing the privilege sections of the Proposed Federal Rules of Evidence to one general provision, Congress clarified its intent as follows:
“[I]t should be clearly understood that, in approving this general rule as to privileges, the action of Congress should not be understood as disapproving a recognition of a psychiatrist-patient, or husband-wife, or any other of the enumerated privileges contained in the Supreme Court rules. Rather, our action should be understood as reflecting the view that the recognition of a privilege based on a confidential relationship and other privileges should be determined on a case-by-case basis.” Senate Report, Fed.R. Evid. 501, J. Moore, Moore‘s Federal Practice: Federal Rules of Evidence 501 (1875) 511.
Professor Wigmore has proposed four canons to be used as a basis for determining whether, for any particular relationship, a common law privilege is desirable. These are:
“(1) The communications must originate in a confidence that they will not be disclosed.
(2) This element of confidentiality must be essential to the full and satisfactory maintenance of the relation between the parties.
(3) The relation must be one which in the opinion of the community ought to be sedulously fostered.
(4) The injury that would inure to the relation by the disclosure of the communications must be greater than the benefit thereby gained for the correct disposal of litigation.” 8 J. Wigmore, Evidence, § 2285. (Emphasis in original)16
In our view the psychotherapeutic relationship satisfies each of these canons. First, communications to a psychotherapist in the course of therapy are inherently confidential. Patients often make statements in psychotherapy which they would not make to even the closest members of their families. Psychotherapy tends to explore the innermost recesses of the personality, the very portions of the self which the individual seeks to keep secret from the world at large. Revelation of such matters could have an irrevocably harmful effect upon the reputation and well being of the patient. See Slovenko, supra note 15, at 185, 187.
Second, inviolability of the confidence is essential to achievement of the psychotherapeutic goal. Without foreknowledge that confidentiality will attach, the patient will be extremely reluctant to reveal to his therapist the details of his past life and his introspective thoughts and feelings. Without the patient‘s confidence a psychiatrist‘s efforts are worthless. In therapy the patient must often lay bare his entire inner life, including his fantasies, his past behavior, and his feelings of guilt or shame. See Taylor v. United States, 95 U.S.App.D.C. 373, 222 F.2d 398, 401 (1955) (Edgerton, J.). Third, the relationship between psychotherapist and patient is unquestionably one which should be fostered. Psy-
Finally, in balancing injury to the relation, by fear of disclosure, against the benefit to justice by compelling disclosure, the scales weigh heavily in favor of confidentiality. We believe that the goals of therapy may be frustrated if the privilege does not attach. Reason indicates that the absence of a privilege would make it doubtful whether either psychotherapists or their patients could communicate effectively if it were thought that what they said could be disclosed compulsorily in a court of law. We are also aware of the delicate position occupied by the psychotherapist himself. Because of the special nature of a patient‘s confidences,17 the psychotherapist is subject to an even more stringent honorable obligation not to disclose, under any circumstances, than are other professionals. We do not wish psychotherapists to be faced with the dilemma of either violating this extraordinary trust or being incarcerated. See In re Lifschutz, supra, at 559-60, 565-66.
In conclusion, we recognize a common law privilege, belonging to the patient, which protects communications made to psychotherapists in the course of treatment.18
IV.
We now turn to a consideration of the scope of the privilege.19 At the outset it appears to us that the psychotherapist privilege cannot be extended to all manner of counselors, social workers, and psychological associates. The number of persons engaged in such capacities is so great that it is hard to estimate the number of relationships and conversations which would fall within the privilege. Moreover, it appears to us that there is a substantive difference between the activities comprehended under the term “psychotherapy” and those covered by the fields of counseling and psychiatric social work.
Much psychological counseling has as its direct or indirect goal the improvement of the client or patient in his current adaptation to reality, his relationships with others, and his ability to handle his personality problems more adequately. But this does not mean that all forms of psychological counseling should be equated with “psychotherapy” in the serious sense of that term. Psychotherapy literally means “treatment of the mind.” It commonly refers to the use of psychological means to modify mental and emotional disorders of a serious, disabling nature. In its technical application the therapist, through interview sessions, verbally explores the patient‘s conflicts, feelings, memories and fantasies in order to provide insight into the causes of the disorder. Encyclopedia of Psychology, at 100 (N.Y.1972). “Psychotherapy” im-
By contrast “counseling” most often refers to psychological efforts of a non-medical nature, administered by non-medical personnel. Counseling is aimed not primarily at uncovering deep psychological processes but at enabling the client to make more effective use of his present resources. Counseling includes vocational, educational, employee, rehabilitation, marriage, and personal guidance within its spheres of operation.
An additional distinction between psychotherapy and counseling must be drawn according to the type of training which is a prerequisite for practicing each of those fields of endeavor. Counselors may have little or no training in formal psychology and methods of treatment.21 Psychotherapy should be practiced only by persons who have undergone rigorous intellectual and practical training. Only psychiatrists, who are medically qualified, and a limited number of professional psychologists should be permitted to practice psychotherapy. Professor J. Hadley, Clinical and Counseling Psychology (N.Y.1958) 560, states that to be adequately prepared to practice as a clinical or counseling psychologist one should have earned a Ph.D. in psychology, and should have received additional training in specific applications of psychology to clinical problems. The American Board of Examiners in Professional Psychology requires a doctorate plus five years of experience in order to achieve certification. Id., 561. It is only a few highly qualified psychologists who should practice psychotherapy at all, and even then it should be done in collaboration with licensed medical personnel in all but exceptional instances. Id. 611-617. See also W. Menninger, “The Relationship of Clinical Psychology and Psychiatry“, American Psychologist, 3, 4 (1950).
Moreover, counseling is considerably more superficial and less searching than what we understand to be included within the term “psychotherapy“. Counseling either does not, or should not, have as its aim a deep penetration into the psychic processes of the patient or client. The need for a privilege to foster the counsel-client relationship is, correspondingly, less readily apparent. It is true that clients of counselors may reveal incriminating or degrading facts about themselves, but this cannot be considered a necessary concomitant of the counseling relationship. Such revelations are more in the nature of an unintended byproduct of the counseling activity. Such utterances are neither essential nor necessary to the successful realization of the counseling goal. There may be instances in which counselors attempt to uncover the intimate, personal secrets of their clients, but we do not view such activity to be essential or proper to the counseling function. In any event, such occurrences would not provide sufficient justification for extending an evidentiary privilege to the field of counseling as a whole.
We note that the legislature has drawn a similar distinction in the statutes regulating the practice of professional psychology.
Statutorily only a psychologist may practice psychology.
We believe that the psychotherapist-patient privilege can be held within proper bounds—while still fulfilling the purposes of the privilege—by using a two-fold test of applicability. The first criterion focuses upon the professional status of the person to whom the communication is made. As we have shown above, the evidentiary privilege should extend only to communications made to a psychiatrist or a licensed psychologist.23 The second criterion focuses upon the type of communication in question. We believe that the evidentiary privilege should extend to communications made in the course of intensive, deep psychotherapy, of the type which requires confidentiality for its success. This necessarily includes communications made in the course of diagnostic interviews and examinations which might reasonably lead to psychotherapy, as we have delineated that term. Excluded from the privilege, for example, would be statements made by a pa-
In brief, the test can be stated as follows:
- Was the communication made to a psychiatrist or a licensed psychologist?
- Was the communication made in the course of psychotherapeutic treatment, or of examinations or diagnostic interviews which might reasonably lead to psychotherapeutic treatment?
If both these questions are answered affirmatively the privilege applies.24
Measured against this test, it is apparent that Allred‘s statements to Mrs. Henderson do not qualify as privileged, as she was neither a psychiatrist nor a licensed psychologist, and the statements were not given in the course of psychotherapeutic treatment.25
Allred asserts that a distinction between licensed and unlicensed practitioners is a violation of the “equal protection” clauses of the state and federal constitutions.26 He argues that the psychiatric social worker is “the poor man‘s psychiatrist,” and that limiting the evidentiary privilege to licensed practitioners results in impermissible practical discrimination based on wealth.
We stated in Ravin v. State, 537 P.2d 494, 498 (Alaska 1975), that where the right to privacy is involved, “we will require that the relationship between means and ends be not merely reasonable but close and substantial.” Since an evidentiary privilege affects some of the same concerns as does the right to privacy, we adopt the Ravin test in the instant case. We find, however, that the line we have drawn is a means closely and substantially related to our ends. The need for an evidentiary privilege decreases with the privacy of the communications invоlved, and hence with the “depth” of psychological probing and the seriousness of the case. This gradation can be equated, roughly, to the skill and training of the practitioner. The dividing line chosen provides a workable estimate of this skill and training. As with any drawing of lines, no absolute certainty is possible, but the line is not drawn arbitrarily or as a matter of caprice.
Allred argues that only a compelling state interest will suffice to uphold this distinction, on the authority of San Antonio Ind. School Dist. v. Rodriguez, 411 U.S. 1, 20-21 (1973). There the United States Supreme Court indicated that wealth discriminations would require strict scrutiny only if the facts involved an “absolute deprivation” of the benefit at issue, because the disadvantaged persons were “completely unable to pay.” Allred does not offer sufficient data to substantiate this constitutional claim.27
BURKE, J., not participating.
BOOCHEVER, C. J., concurring.
RABINOWITZ, J., concurs in separate opinion in which DIMOND, J. Pro Tem., joins.
DIMOND, J. Pro Tem., concurring.
BOOCHEVER, Chief Justice (concurring).
Because I believe that the statute establishing a privilege for communications made by a client to a psychologist or psychological associate is here controlling, it seems to me that the question of the existence of a common-law privilege need not be reached.
No psychologist or psychological associate may reveal to another person a communication made to him by a client of his about a matter concerning which the client has employed the psychologist or psychological associate in a professional capacity. This section does not apply to a case conference with other psychologists, psychological associates or with physicians and surgeons, or in the case in which the client in writing authorized the psychologist or psychological associate to reveal a communication.
A literal reading of this section indicates that a psychological associate is prohibited from revealing “to another person a communication made to him by a client of his about a matter concerning which the client has employed the psychologist or psycho-logical associate in a professional capacity“.
Mrs. Henderson was employed1 by Mr. Allred in a professional capacity. She characterized the session during which Allred made his confession as a “therapeutic sеssion“. Assuming that Mrs. Henderson was acting as a psychological associate, the communication clearly comes under the provisions of
This section does not apply to a case conference with other psychologists, psychological associates or with physicians and surgeons, or in the case in which the client in writing authorized the psychologist or psychological associate to reveal a communication.
Had the legislature also intended to exclude communications in court, it could easily have added such a provision. Under the well-recognized rule of construction, expressio unius est exclusio alterius,2 the exclusion of specified communications from the statute indicates an intent not to exclude additional communications such as those made in court. Therefore, unless there is some other reason for not applying the plain meaning of the statute,
The majority opinion relies in part upon the contention that if
We note, however, that
fect on those proceedings. The line between substance and procedure is difficult to draw, but in this case, it seems to me that the statute, while having some procedural effects, is basically substantive. The situation is similar to that addressed in Channel Flying, Inc. v. Bernhardt, 451 P.2d 570 (Alaska 1969), involving a statute providing for the peremptory disqualification of judges. We stated:
This statute does not merely regulate procedure. With or without it the particular action in court takes the same course. The statute rather creates and defines a right—the right to have a fair. trial before an unbiased and impartial judge. This is something more than merely prescribing a method of enforcing a right. The main subject matter of the statute is substantive in nature and was within the province of the legislature to deal with. AS 22.20.022 is not invalid as an attempt to usurp the rule-making powers of this court insofar as it provides for a peremptory disqualification of a judge.5
The majority relies in part on the fact that the same session of the legislature which enacted
The final reason advanced by the majority in its contention that
We have finally for consideration the question of whether Mrs. Henderson is to be regarded as a psychological associate so as to come under the provisions of the statute. If, as I contend,
“to practice psychology” means to apply established principles of learning, motivation, perception, thinking, and emotional relationships to problems of personnel evaluation, group relations and behavior adjustment, including (A) counseling and guidance; (B) using psychotherapeutic techniques with persons or groups of persons who have adjustment problems in the family, at school, or at work; (C) measuring and testing of personality, intelligence, aptitudes, emotions, and attitudes and skills; (D) conducting research on human behavior[.]
Mrs. Henderson worked directly under the supervision of Dr. Aaron Wolf, a psychiatrist, and was assigned by the Langdon Psychiatric Clinic staff as Mr. Allred‘s counsellor. He often sought her aid in resolving mental and emotional problems, and she worked with Dr. Wolf‘s staff in attempting to resolve Mr. Allred‘s mental and emotional problems. She had engaged in some 30-50 extended counselling sessions with him and had been his counsellor for at least a year prior to Allred‘s arrest. It would appear beyond dispute that she constituted a psychologist or psychological associate under the terms of this statute.
Since the legislature by
RABINOWITZ, Justice, with whom Dimond, Justice Pro Tem joins, concurring.
Prior to Allred‘s conversation with Mrs. Henderson at the jail, they had had numerous extended conferences concerning Allred‘s emotional problems.1 Allred was specifically informed that the Langdon Clinic staff had assigned Mrs. Henderson as his counselor and that she would be acting directly under the supervision of Dr. Aaron Wolf, a psychiatrist. Allred often sought her aid in resolving mental and emotional problems. In short, the record demonstrates that Mrs. Henderson was intimately familiar with Allred‘s problems and occupied a central role in Allred‘s therapy.2 Given Professor Wigmore‘s four canons for determining whether a common law privilege is desirable, and given the conclusion that a psychotherapist-patient privilege should be recognized, then the reason why the privilege ought not extend to the instant case should somehow relate to Wigmore‘s canons. I fail to see why the rationale which supports a common law privilege is less compelling here than in any case where the psychotherapist-patient privilege is recognized.3
The communication in question which took place between Allred and Mrs. Henderson was viewed by them as a therapeutic session in which Allred discussed his mental problems and looked to Mrs. Henderson for advice and counseling. Allred requested Mrs. Henderson‘s presence for the purpose of counseling. He talked to her because he needed counseling. His candor with Mrs. Henderson was based on the belief that he was in therapy with his counselor.4 Under the circumstances confidentiality was essential to the relationship between them.
In my opinion Allred‘s relationship with Mrs. Henderson, initiated to seek mental health, is one which sought to be sedulously fostered by the community. It is not necessarily relationships with psychiatrists or licensed psychologists that ought to be sedulously fostered; rather, what should be fostered is the therapeutic relationship which looks toward improvement of mental
I agree with the implicit assertion of Justice Dimond that Wigmore‘s four canons concerning common law privileges are descriptive and not prescriptive. As does Justice Dimond, I find them useful guides оn the path to determining whether a psychotherapist-patient privilege ought to be recognized.6 As I indicated at the outset, for the reasons in Justice Connor‘s opinion, I find it appropriate to recognize a psychotherapist-patient privilege in criminal proceedings. However, as opposed to the conclusion Justice Connor draws, I believe the privilege extends to the particular relationship between Allred and Mrs. Henderson. Nonetheless, because the statutes in question bear on the holding I reach, I consider it appropriate to comment on
The line between substance and procedure can hardly be termed a clear one, as United States Supreme Court cases emanating from Erie Railroad Co. v. Tompkins, 304 U.S. 64 (1938), indicate. An enlightening articulation of the problem of distinguishing between substance and procedure is found in Guaranty Trust Co. v. York, 326 U.S. 99, 108 (1945), where Justice Frankfurter, in reviewing a lower court‘s refusal to apply state law, asserted:
Matters of ‘substance’ and matters of ‘procedure’ are much talked about in the books as though they defined a great divide cutting across the whole domain of law. But, of course, ‘substance’ and ‘procedure’ are the same key-words to very different problems. Neither ‘substance’ nor ‘procedure’ represents the same invariants. Each implies different variables depending upon the particular problem for which it is used. See Home Ins. Co. v. Dick, 281 U.S. 397, 409 (1930). And the different problems are only distantly related at best, for the terms are in common use in connection with situations turning on . . . different considerations . . . .
The question which Justice Frankfurter faced in Guaranty Trust Co., namely, how
By virtue of its enactment of
This distinction between substance and procedure takes on importance here because our Alaska Constitution, Article IV, Section 15, vests the power to make and promulgate rules governing practice and procedure in this court.9 While the power to create substantive rights is a legislative power, thе power to fashion procedures to implement those rights is, by virtue of Article IV, Section 15, judicial.10 However,
this judicial power to fashion rules of procedure is not absolute. Leege v. Martin, 379 P.2d 447 (Alaska 1963). For instance, in Leege we noted that Alaska‘s Constitution provides that the legislature may change court rules of procedure by a two-thirds vote of the members of each house.
Consequently, I would hold, if I were to reach the question of the appropriate construction of
In ascertaining whether any legislative policy has been articulated concerning the nature of the psychotherapist-patient relationship,
In conclusion I wish to reiterate the view that since the basis for recognizing a common law psychotherapeutic privilege is a desire to protect the integrity of a commonly used process which looks to mental health, I would hold the psychotherapist-patient privilege applicable in the instant case.12
DIMOND, Justice Pro Tem (concurring).
I concur with Justice Connor in his recognition or creation of a psychotherapist-patient privilege as a matter of decisional common law. But I do not concur with his conclusion that this privilege does not cover the communication made by Allred to Mrs. Henderson. For the reasons stated by Justice Rabinowitz in his separate opinion, I would hold that the privilege extends to the relationship between Mrs. Henderson and Allred.
In determining that there is such a common law privilege, Justice Connor relies upon the four canons proposed by Professor Wigmore. I do not agree that the third canon must be satisfied, i.e., that “The relation must be one which in the opinion of the community ought to be sedulously fostered“. There may be a day when community opinion does not sedulously foster the relation between psychotherapist and patient. If that day should come to pass, my position is that the privilege should still be recognized.
Professor Wigmore apparently developed his canons to explain privileges then accepted. I feel that the inclusion of a criterion involving community approval is unfortunate if used for any purpose other than in an analysis of how some established privileges arose. I believe that if an antireligious sentiment should sweep the community, the court should still recognize the priest-penitent privilege; and if a substantial majority of the population, because of particular religious tenets, does not believe in medical science, the physician-patient privilege should still apply.
The need for a privilege should not depend upon community approval of the relationship. Rather, it is the purpose of the relationship and its legitimate value to the participants which should be weighed against the truth-finding function of the courts. Some persons feel that religion is of no value to society. If this belief became prevalent, then under the Wigmore canons, the priest-penitent privilege would
Another consideration is the effectiveness of the relationship in terms of the legitimate and valuable goals of that relationship. The purpose of the physcian-patient relationship is to promote the physical well-being of the patient. The effectiveness of modern medical science would not be affected at all by the belief of the community in the value of that relationship. Therefore, if community approval for the relationship vanishes, the legitimate interests of the parties to the relationship should still be recognized.
The psychotherapist-patient privilege is somewhat analogous to both the priest-penitent privilege and the physician-patient privilege. Like the priest-penitent privilege, the relationship between psychotherapist and patient often involves a central part of a person‘s life. The trust and confidence placed in the psychotherapist is often as deep, if not deeper, than that placed in a priest. Like a physician-patient relationship, the main purpose of the relationship between the psychotherapist and the patient is the well-being of the patient—emotional, mental and frequently physical.
Furthermore, often the purpose of the psychotherapist-patient relationship is the prevention and curing of antisocial behavior, such as the therapy in the instant case. If this type of activity is successful, then many potential crimes will not be committed. The prevention of a number of similar defendants being prosecuted in future cases is more than an adequate balance for the hampering of the truth-finding function in an individual case.
Psychotherapy is a relatively new endeavor, and as with all growing sciences, may not be adequately understood by the community. But it is its effectiveness, i.e., its central value to the participant and legitimate purposes which are to be considered, and not the community‘s conscious approval. Community approval, although perhaps some evidence of value, is only a secondary indication of what I feel to be the primary considerations.
I believe that regardless of community opinion, a psychiatrist‘s efforts to help an emotionally or mentally disturbed person would be fruitless if the patient did not place his entire trust in the psychiatrist and did not have complete confidence that their communications would never be revealed to others.
Psychotherapy could never be successful without such trust and confidence.
Justice Connor recognizes this by stating that without the patient‘s confidence, a psychiatrist‘s efforts are worthless, and that “in therapy a patient must often bare his entire inner life, including his fantasies, his past behavior, and his feelings of guilt or shame“. He cites the case of Taylor v. United States, 95 U.S.App.D.C. 373, 222 F.2d 398, 401 (1955), where Judge Edgerton, in quoting from Guttmacher and Weihofen, Psychiatry and the Law, stated:
The psychiatric patient confides more utterly than anyone else in the world. He exposes to the therapist not only what his words directly express; he lays bare his entire self, his dreams, his fantasies, his sins, and his shame. Most patients who undergo psychotherapy know that this is what will be expected of them, and that they cannot get help except on that condition. * * * It would be too much to expect them to do so if they knew that all they say—and all that the psychiatrist learns from what they say—may be revealed to the whole world from a witness stand.
Professor Wigmore was an eminent authority on the law of evidence. But his “authority” does not require this court to unalterably adhere to every rule that he
Finally, I respectfully suggest that Justice Connor‘s opinion should not have stated the additional rule of law that the psychotherapist-patient privilege is one “belonging to the patient“. This clearly implies that the psychiatrist cannot claim the privilege if the patient waives or abandons it.1
I realize that where the physician-patient privilege is concerned, for example, this is a rule that is generally, if not universally, applied by the courts. And in the few instances where the question has arisen involving the psychotherapist-patient privilege, the same rule has likewise been applied.2
But I question its validity in the latter instance. A seriously disturbed patient may very well not realize the consequences of his waiver of the privilege.
Where there has been intense psychotherapy over an extended period of time, it is more likely than not that to force the psychiatrist to breach the trust the patient has placed in him would destroy the psychiatrist-patient relationship, and could result in incalculable harm to the patient. I believe that circumstances may well exist where the psychiatrist should be permitted to assert the privilege—even in the face of an abandonment or waiver of the privilege by the patient—for the best welfare of the patient.
I do not propose to elaborate on this subject further for the reason that whether the psychotherapist-patient privilege is one belonging solely to the patient and may not be asserted by the psychiatrist is a question not involved in this case. Justice Connor‘s statement on this subject is dictum, i.e., a statement of a principle of law not essential to the determination of the ultimate issue in this case. I believe this question should not be decided here, but should await a case where it is directly involved, and where we have had the advantage of full adversary treatment of the issue, both in the trial court and in this court.
