OPINION
delivered the opinion for a unanimous Court.
This case addresses whether a trial court’s omission of a “medical care” defensive jury instruction was harmless error.
1
In the first ground in his petition for discretionary review, Walter Cornet, appellant, contends that the court of appeals erred in its harm analysis by failing to consider that the erroneous omission of a medical-care-defense instruction “preclude[d] the jury from giving the defensive argument any effect.”
See Cornet v. State,
No. 08-09-00054-CR,
I. Background
A. The Facts
The complainant was appellant’s stepdaughter. In June 2006, when she was eight years old, she told a forensic interviewer that appellant had, on one occasion, told her to sit on his face, at which point he made oral contact with her anus. The complainant also said that appellant had, on one occasion, showed her various “sex toys” and placed one between her legs so that she could “feel the vibration.”
Appellant responded to these accusations by providing a written statement to police that was admitted at his trial. His statement indicated that, based on prior comments by the complainant, he suspected that she had been sexually active with her brothers. He said that on one occasion in March 2006, the complainant entered his bedroom, lifted her dress, and exposed herself, causing him to notice that she was not wearing underwear. Because she covered her genital area with her hand, appellant stated that he decided to examine her to see if she had any physical evidence of sexual contact or injury. To examine the complainant, appellant laid her down on the bed and spread her legs while she was on her stomach. After that, he opened her buttocks to visually check her anus and labia. He claimed that his fingers made contact with her labia, which he “spread to see if her hymen was intact,” and he noticed that “she did not have a hymen,” but he did not “know if it had been developed or had been broken.” He believed that his fingers may have gotten wet at that time and made contact with her anus while he was examining her. He determined that the “examination was inconclusive and her anus did not appear to be streached/ripped [sic].” He maintained that there was no intent for any sexual gratification.
Appellant was subsequently charged with three counts of aggravated sexual assault of a child. Tex. Penal Code § 22.021(a)(1)(B), (a)(2)(B). At his trial for the three charges that were tried concurrently, appellant testified about the same March 2006 incident that had given rise to the investigation. In his testimony, appellant added that he initially saw the complainant masturbating in her room and told her to stop. He went into his own room, and within a short period of time she knocked on his door. She then entered his room wearing a dress, lifted it, and exposed her naked bottom to him, telling him that he could lick it. He then testified similarly to his written statement describing how he examined her. Appellant maintained that he did not invade “her private parts.” He specifically denied placing his tongue into the complainant’s anus and placing his finger into her vagina. He also stated that he would never molest a child and that “any type of sexual activity with a child is wrong.” After that *449 incident, appellant claimed that, in an attempt to obtain the complainant’s confidence to talk to him about whether she had been sexually touched by others, he made a bargain with her: She would tell him if anyone had touched her in exchange for him showing her his sex toys. After he showed her the toys, the complainant confided to him that someone had “licked her pee-pee.”
Appellant was convicted of two out of three charged counts of aggravated sexual assault of a child by digitally penetrating the complainant’s genitals, as charged in count one, and making oral contact with her anus, as charged in count three. See Tex. Penal Code § 22.021(a)(l)(B)(I), (iii), (a)(2)(B). The trial court granted appellant’s motion for directed verdict as to the second count, in which appellant had been charged with digital penetration of the complainant’s anus. Id. at § 22.021(a)(l)(B)(I). Although appellant requested a jury instruction on the medical-care defense on the count pertaining to the digital penetration, the trial court denied his request for that instruction. Id. at § 22.021(d). For each count on which he was convicted, he was sentenced to 10 years in prison to run concurrently and a $7,500 fine.
On direct appeal, the court of appeals determined that the trial court properly excluded the medical-care-defense instruction. Cor
net v. State,
No. 08-09-00054-CR,
II. Omission of Appellant’s Medical-Care Jury Instruction was Harmless Error
The parties agree that the court of appeals applied the proper procedural framework described in
Almanza v. State,
A. The Entire Jury Charge
The first category of
Almanza
requires a reviewing court to consider the entire jury charge.
Almanza,
1. The Medical-Care Legal Justification is Different from Criminal Intent
The parties dispute whether, in finding appellant guilty of aggravated sexual assault of a child, the jury has determined that he acted with the “intent to arouse or gratify sexual desire.” See Tex. Penal Code § 22.021(a)(l)(B)(I), (a)(2)(B). Appellant accurately observes that the statute’s plain language does not require this.
See id.
Pointing to this Court’s earlier decision in this case, appellant suggests that, without the medical-care defensive instruction, appellant has admitted to all the elements of the offense and is left without the instruction that would legally justify the conduct and permit the jury to acquit him.
See Cornet,
The State, however, responds that the jury implicitly found this sexual intent in finding appellant guilty.
See Evans v. State,
2. Generalities Are No Substitute for Record-Specific Analysis for Harm
As explained more fully below, the wrongful omission of a medical-care-defense jury instruction is generally considered harmful, however, in view of the totality of the record before us, we conclude that its omission was harmless in this case. The medical-care defense is one of confession and avoidance.
See Cornet,
The absence of this type of instruction is generally harmful because its omission leaves the jury without a vehicle by which to acquit a defendant who has admitted to all the elements of the offense.
See, e.g., Vasquez v. State,
Although generalities may be instructive, they cannot substitute for the record-specific analysis for harm that must be conducted in each case.
See, e.g., Almanza,
This situation contrasts with
Villa v. State,
a case in which we similarly considered the implications that reasonably could be drawn from a jury’s verdicts on two different offenses tried simultaneously.
Villa,
No. PD-0792-12,
The jury’s not guilty verdict for the indecency with a child charge indicates that the jury found no intent by Appellant to arouse or gratify his sexual desires. This verdict is supported by the record as there was no evidence presented by the State relating to intent to arouse or gratify, and both [complainant] and Appellant stated that someone else was in the room when the touching took place. Thus, it appears that the jury’s guilty verdict on the aggravated sexual assault charge was based solely on the very specific act of penetration of the sexual organ. The statements by [complainant] and Appellant related to this specific act are not inconsistent.... Given the fact that the jury specifically found no sexual intent to Appellant’s actions, it is likely that the verdict on the aggravated sexual assault charge would have been different had the jury been provided with a vehicle to give effect to Appellant’s medical-care defense.
Id.
at
*453
This case also contrasts with another case in which the erroneous omission of the medical-care-defense instruction was determined to be harmful. Appellant cites to
Watrous v. State
to support his argument that the omission of the medical-care instruction was harmful in his case.
See Watrous v. State,
Our record-specific analysis of the totality of the instructions to the jury indicate that the error in the omission of the medical-care-defense charge was harmless in this case.
B. The State of the Evidence
Under the second category in
Almanza,
an appellate court must consider the state of the evidence, including the contested issues and weight of probative evidence.
Almanza,
In his second ground, appellant specifically challenges the court of appeals’s analysis by claiming that it inappropriately conducted a review for sufficiency of the evidence rather than assessing the record for the harmful impact from the charge error. Appellant refers to the portion of the court of appeals’s opinion in which the court stated that the jury “had sufficient evidence before it to disbelieve Appellant’s version of the events and his defensive testimony regarding his medical-care examination.” Corn
et,
C. The Arguments of Counsel
Under the third category in
Almanza,
an appellate court must consider the arguments of counsel in deciding whether a defendant was harmed by an erroneous jury instruction.
Almanza,
D. Other Relevant Information
Other relevant information in the record suggests that appellant’s defensive theory at trial was focused on his argument that the State failed to prove that he penetrated the sexual organ of the complainant rather than on the medical-care defense. Neither defense counsel nor the prosecutor asked questions on voir dire about the medical-care defense. In his opening statement, appellant’s trial counsel presented his defensive theory that the jury would “find that the State has not proved these specific allegations.” He did not mention the medical-care defense and appeared to disavow the suggestion that this was appropriate medical care. Rather than suggesting that the jury consider appellant’s conduct with the complainant as a proper examination for her medical benefit, trial counsel described appellant as
*455 making the “mistake” of examining the complainant “to see if he could see any injuries, or whatever.” Because he did not question the jury about the defense during voir dire or invoke the defense in his opening statement, and because he made comments suggesting to the jury that appellant’s conduct was a mistake and inappropriate, trial counsel’s request for the medical-care defense appears to be an afterthought and does not appear to be the primary focus of his defensive theory at trial. This further suggests that the error in omitting the defensive instruction was harmless.
Our review of the totality of the record shows that the error in the omission of the medical-care-defense instruction was harmless. Had appellant been tried solely for the digital penetration count or only for offenses to which the medical-care-defense instruction applied, we likely would have no information from which to determine whether the jury would have found appellant’s medical-care-defense evidence credible.
See Watrous,
III. Conclusion
We affirm the judgment of the court of appeals.
Notes
. The Texas Penal Code provides for a medical-care defense to charges of sexual assault and aggravated sexual assault. See Tex. Penal Code §§ 22.011(d), 22.021(d) (adopting Section 22.011 (d)'s language verbatim). Section 22.011(d) states, "It is a defense to prosecution ... that the conduct consisted of medical care for the child and did not include any contact between the anus or sexual organ of the child and the mouth, anus, or sexual organ of the actor or a third party.” Tex. Penal Code § 22.011(d).
. The record of the prosecutor’s closing argument includes the following relevant portions:
He’s telling you that he is examining the child and his fingers get wet, that must be why she mistook it for licking her butt, I— I'm not getting that. I’m sorry. You’ve got a child lying on a bed and she's on her stomach and you’re like this (indicating) and you’re touching her with your fingers, where do you get a mistake of licking on [sic] butt? ... When you have a statement by this defendant who says, "I was just examining her to see if she was okay after masturbating.” He’s an educated person. He has a freaking Ph. D. Come on. And he doesn’t think that you should go to an M.D. to have a child examined? He should examine a little girl outside the presence of her mother? Even if you accepted that that was okay, do it when the mom is gone? How does that make any sense? How does it? When you take it in context and you take all the facts and circumstances surrounding everything that he admitted to doing and you take it with what [complainant] said, I think the answer is clear.
