In Re OL
In re O.L.
Appeal of B.L.
District of Columbia Court of Appeals.
Nicholas J. Hluchyj, Washington, D.C., appointed by this court, for appellant B.L.
Ann Sungmie Suh, Washington, D.C., appointed by this court, for appellee O.L.
Donna M. Murasky, Asst. Corp. Counsel, with whom Herbert O. Reid, Sr., Corp. Counsel, and Charles L. Reischel, Deputy Corp. Counsel, Washington, D.C., were on the brief, for appellee District of Columbia.
Before TERRY, SCHWELB and FARRELL, Associate Judges.
SCHWELB, Associate Judge:
The principal issue presented in this appeal is whether, in a child neglect proceeding based on the mother's alleged mental illness and drug abuse, the trial judge may, over the mother's objection, "waive" her physician-patient privilege with respect to past professional evaluations of her mental condition. Substantially for the reasons stated by Judge A. Franklin Burgess, Jr. in his excellent opinion in In re D.H., 117 Daily Wash.L.Rptr. 2109 (Super.Ct.D.C. 1989),[1] we answer that question in the affirmative.[2]
*1231 I
O.L., (the child), was born to B.L., (the mother), on October 21, 1986. On December 21, 1987, the Corporation Counsel filed a petition alleging that O.L. was a neglected child within the meaning of
[s]aid child's mother is unable to provide appropriate care and supervision for said child due to her mental illness and drug usage. On or about April 22, 1987, said child's mother admitted using illegal drugs in said child's presence. Said child's mother was treated for mental illness in 1982. Ms. [L.] was then diagnosed as suffering from "brief reactive psychosis." On several occasions in March, April, and November 1987, Ms. [L.] was observed to exhibit inappropriate, violent behavior and rapid mood swings, including private and public property destruction, displaying signs of mental illness.
After the petition was filed, the government sought a pretrial order waiving the mother's physician-patient privilege with respect to her prior treatment at St. Elizabeths Hospital. The government relied on
The case subsequently came before Judge Curtis von Kann, who ruled at trial, and subsequently reiterated in a written opinion, In re O.L., 117 Daily Wash.L.Rptr. 1329 (Super Ct.D.C.1989) (O.L. II), that the psychiatrist and psychologist who examined the mother pursuant to
The mother now appeals from the adjudication of neglect. Her primary contention in this court[5] is that the trial judge committed reversible error by overruling her claim of physician-patient privilege.
II
Although Judge von Kann, treating Judge Alprin's construction of
Counsel for the mother contends that Judge Burgess' construction of
The problem with this purportedly literal construction is that it puts the cart before the horse; under the mother's scenario, the judge must make the most important decision implicating the child's safety and welfare before receiving what may be the most important information on the subject. As we observed in In re N.H.,
[t]he statutory definition of neglected child includes a child whose parents are unable to discharge their responsibilities because of mental incapacity.D.C.Code § 16-2301(9)(B) . Obviously, to exclude information about the mother's mental condition would deprive the judge of important information required for a disposition in the best interests of the child.
It is in determining whether the child has been neglectedwhether the mother is unable to discharge her responsibilities because of mental incapacitythat the court needs the information about the parent's mental health.
Moreover, as we have previously noted, the Mental Health Act requires mental health professionals to report suspected cases of neglect or abuse to the appropriate District of Columbia agencies.[7] "It taxes logic to suggest that the Mental Health Act authorizes disclosure but would prohibit the same physician, despite
The statutory definition of "neglected child" does not specify that there must have been a prior adjudication of neglect.
Our conclusion that Judge Burgess' analysis of
In In re S.K.,
Our approach in N.H. and S.K. is altogether incompatible with the notion that remedial child neglect legislation should be construed to deprive the judge of information which he or she needs in order to protect the safety and welfare of a minor child who has allegedly been neglected or abused. We do not minimize the importance of the physician-patient privilege, especially in the area of mental health. As the court stated in In re S.W.,
[w]hen a parent is afflicted with an illness or disability which may affect the welfare of the child, the confidentiality of communication with a therapist may encourage the parent to seek treatment, and may permit a kind of treatment otherwise impossible.
It is therefore of some importance that
As this court explained in N.H., supra,
III
For the foregoing reasons, the judgment appealed from is hereby
Affirmed.
APPENDIX
SUPERIOR COURT OF THE DISTRICT OF COLUMBIA FAMILY DIVISION
IN THE MATTERS of D.H., D.H. RESPONDENTS, Sup.Ct., Fam.Div., Neglect Branch, Nos. N098-89, & N098-89, August 1, 1989. Opinion per Burgess, J. Robert A. Garske for Mother. Teresa R. Donohoe for D.H. Laurie McManus for D.C.
BURGESS, J.: The issue in this case is whether
I.
The facts available at the time of the motion may be summarized briefly. The government alleged that the child was neglected by reason of the mental illness and hospitalization of the mother.[3] The government proffered, based on information from family members, that the mother had been hospitalized at St. Elizabeths for some time. The government sought information regarding the length of the hospitalization, and the nature, severity and chronicity of the illness. The mother did not argue that the information sought was irrelevant to the issues to be determined. Rather, she contended that the physician-patent *1235 privilege protected the information and that the Court had no authority to waive it.
II.
There is no doubt that section 14-307(a) would protect the information at issue unless the privilege granted there has been waived or unless the Court could waive it. No one argued that the information was otherwise available through the record of an involuntary commitment proceeding in the District of Columbia or through a prior waiver. Thus, the issue of the authority granted by
Relying on the opinion in In the Matter of O.L., supra, the mother argues that the context of
Actually, there are two legislatures whose intent is at issue.
When the waiver provision was first enacted, it was, as the Court in In the Matter of O.L. observed, part of legislation aimed at identifying child neglect cases by requiring doctors to report abuse of children and by protecting them from liability when they did so. The stated purpose of section one of the 1966 Act was "to provide for the protection of children who have had physical injury inflicted upon them or who have suffered physical harm due to neglect." It stated that physicians who observed such abuse should report it so that governmental agencies could "intervene to protect the children and preserve family life." Section two required physicians to report or cause *1236 reports to be made of abuse "notwithstanding section 14-307 of the District of Columbia Code." Section three prescribed the content of the report and the procedures for making it. Section four granted immunity to doctors and hospitals making a good faith report of abuse and provided that any person making the report "shall have the same immunity with respect to participation in any judicial proceeding involving such report." Section five is the section at issue here. Section six provided that children being treated by spiritual means in accord with the tenets of recognized religious denominations were not considered to be "neglected."
In In the Matter of O.L., supra, the Court concluded, "It is clear from its title and content that the 1966 law was intended to be a reporting statute and nothing more." 116 WLR 2738. Although the evidence for this conclusion is ambiguous, this Court is inclined to agree that Congress in 1966 intended the waiver provision to apply only to neglect cases in which a report was required to be made. It is necessary, however, to give a somewhat detailed history of the legislation to understand both the ambiguity of the evidence and the conclusion this Court has reached regarding Congress' intent.
A child abuse reporting bill was first introduced in Congress by Rep. Multer of New York in January 1964, as H.R. 9652. 88th Cong., 2nd Sess. (1964). That bill, apparently substantially similar to a model bill developed by the Children's Bureau of the Department of Health Education and Welfare,[4] contained reporting measures similar to those in the statute under consideration, except that what the doctor was required to report was limited to "serious physical injury or injuries". Id. § 2. Other differences appear in section five of the bill. It provided as follows (the parts of the section materially different from
Neither the physician-patient privilege nor the husband-wife privilege shall be a ground for excluding evidence regarding a child's injuries or the cause thereof, in any judicial proceeding resulting from a report pursuant to this Act.
Id. § 5. That bill, of course, was not enacted into law.
Around January 19, 1965, the Commissioners of the District of Columbia submitted to the Speaker of the House of Representatives their own draft bill covering the same subject. Unfortunately, the Court has been unable to locate that bill, but a letter accompanying it appears in the legislative history of the 1966 Act. In that letter, Walter Tobriner, President of the Board of Commissioners, summarized the provisions of the bill. H.R.Rep. No. 744, Letter by W. Tobriner, supra note 4. He stated that the mandatory reporting provision covered children who had been "seriously injured other than by accidental means" and who had been "seriously harmed due to neglect." Id. at 4. He summarized section five, as follows:
Section 5 declares that, notwithstanding existing provisions of law establishing the husband-wife privilege (D.C. code, sec. 14-306) and the physician-patient privilege (D.C.Code, sec. 14-307), neither of such privileges shall be a ground of excluding evidence in any judicial proceeding resulting from a report made pursuant to the bill.
Id. at 5. Although the issue is not absolutely free from doubt, the Court infers that the waiver provision in the Commissioner's bill, like the same provision in Rep. Multer's prior bill, was limited to a proceeding *1237 "resulting from a report made pursuant to [the] Act." The evidence for this inference is that the comment in Mr. Tobriner's letter virtually tracks the language of the prior bill, in the manner of section-by-section analyses often found in legislative committee comments on statutes. The Commissioners' bill was different from the first bill, however, in that it required reports not only about physical injuries, but also about "physical harm due to neglect." Id. Correspondingly, it appears that the limitation on "evidence", namely, that it be "regarding a child's injuries or the cause thereof", was dropped because the reporting requirement was extended to "physical harm due to neglect" as well as to "injuries".
When the bill was introduced, again by Rep. Multer, in August 1965, as H.R. 10304, the extension of the reporting requirement to "serious physical harm due to neglect" was retained, but significant changes occurred in the waiver section. This time, section five read as follows (the materially new parts are [italicized]):
Notwithstanding the provisions of the District of Columbia Code, sections 14-306, 14-307 and 14-308, neither the physician-patient privilege nor the husband-wife privilege shall be a ground for excluding evidence in any proceeding in the Juvenile Court of the District of Columbia concerning the welfare of such child, provided that the Juvenile Court determines such privilege should be waived in the interest of public justice.
89th Cong., 1st Sess., at 3 (1965). Thus, the bill actually introduced dropped from Rep. Multer's prior bill and the Commissioners' draft the limitation of the waiver to only those judicial proceedings "resulting from a report pursuant to this Act", and substituted for it: "provided that the Juvenile Court determines such privilege should be waived in the interest of public justice." As the Commissioners' draft did, the revised bill also eliminated the limitation on what was to constitute potentially nonprivileged "evidence" under this section, no longer limiting it to evidence "regarding a child's injuries and the cause thereof". Instead, evidence could be admitted over the assertion of the privilege in any proceeding "concerning the welfare of such child." Section five of the House bill was enacted into law exactly as written, except for technical corrections.
It is clear that, in dropping the phrase "resulting from a report pursuant to this Act", the drafters of the legislation intended the waiver authorization to extend to cases beyond those that actually arose from a report made by a doctor. How far beyond that category of cases is not obvious. A reasonable inference is that the legislators wanted no limitation on the neglect cases to which the waiver authorization applied, except that the judge determine that the waiver be "in the interests of public justice." In calling up the bill for a vote, Rep. Multer explained:
Whereas present District of Columbia lawDistrict of Columbia Code, section 14-308provides for the waiver of the physician-patient privilege in the instance of judicial proceedings in criminal cases, no such waiver is presently provided in regard to proceedings in the juvenile court. Since such proceedings are often necessary as a step in protecting a child who is apparently the subject of abuse, the vital importance of section 5 of this bill, which provides for the waiver of both physician-patient and husband-wife privilege in a juvenile court proceeding when the judge of such court determines this to be in the interest of public justice, is amply clear.
111 Cong.Rec. 19,685 (1965). The same remark appears in the report of the District of Columbia Committee recommending passage of the bill without amendment. H.R. Rep. 744, 89th Cong., 1st Sess., at 3 (1965). Evidently, the drafters took as their model, not the waiver provision in the model bill first introduced in 1964, but
evidence in criminal cases where the accused is charged with causing the death of, or inflicting injuries upon, a human being, and the disclosure is required in the interests of public justice.
It is apparent that the legislators concerned with this bill believed that the public interest in an accurate determination of child neglect proceedings was on a par with its interest in the outcome of criminal cases where injury was inflicted. If this is so, it would appear inconsistent to want the waiver authorization applied to some neglect cases, those in which a doctor was required to report evidence of abuse, and not to others.
Nevertheless, the drafters chose to define the cases in which the waiver could be invoked as "any proceeding ... concerning the welfare of such child". P.L. 89-775, Sec. 5, 80 Stat. 1354, 1355 (1966). (Emphasis added.) Although there is no referent for "such child" in section five, there is in other sections. Section two of the 1966 Act, which imposed the reporting requirement applied to a physician who observed injury or physical harm to "a child under the age of eighteen brought to [the physician] or coming before [the physician] for examination". P.L. 89-775, Sec. 2, 80 Stat. 1354 (1966). And section three required the physician to report, among other things, "the child's age, nature and extent of the child's injuries...." P.L. 89-775, Sec. 3, 80 Stat. 1354 (1966). Unless the use of "such child" in section five were considered inadvertentan assumption a court should hesitate to make, the phrase must be interpreted to refer to the child described in sections two and three, that is, a child about whom the report was required to be made. Accordingly, it appears that Congress in 1966 did intend the waiver authorization to apply only in cases in which doctors had been required to make a report.
The elimination of the phrase "resulting from a report" is not inconsistent with this interpretation. Congress may have thought that phrase unduly restrictive because, read literally, it did not include proceedings which did not in fact result from a report, as where the doctor did not make one, but in which the doctor ought to have made a report. Moreover, given that the kind of neglect that concerned Congress was non-accidental physical injury and "physical harm due to neglect," P.L. 89-775, Sec. 2, supra, it was not illogical to confine the waiver authorization to cases in which the doctor was required to make a report. Doctors were likely to see such cases, and the information from a doctor needed for an accurate determination of the facts as to whether abuse occurred was likely to be held by doctors required to make a report, not by doctors who had not seen the child.[6]
In the 1977 Act, the City Council made many significant changes in the neglect laws. As the Court in In the Matter of O.L. observed, supra, 116 WLR 2738 and n. 8, it expanded the class of people required to report evidence of abuse of neglect to include
every physician, psychologist, medical examiner, dentist, chiropractor, registered nurse, licensed practical nurse, person involved in the care and treatment of patients, law enforcement officer, school official, teacher, social service worker, *1239 day care worker, and mental health professional.
D.C.Law 2-22, Title I, Section 103(c), 24 D.C. Reg. 3341, codified at
that a child known to [them] in [their] professional capacity has been or is in immediate danger of being a mentally or physically abused child or neglected child, as defined in§ 16-2301(9) ....
D.C. Law 2-22, title I, section 103(c), 24 D.C. Reg. 3341, codified at
The Council also changed the waiver provision. In place of "in any proceeding ... concerning the welfare of such child", it substituted: "In any proceeding ... concerning the welfare of a neglected child."[7] The Court in In the Matter of O.L. concluded that the Council reenacted the waiver provision "in virtually identical fashion to the earlier version", supra, 116 WLR at 2738, but this Court believes that the change from "of such child" to "of a neglected child" is significant and determinative of the Council's intent. The waiver provision not only omits "resulting from a report", but now also is no longer tied, by the use of "such child", to only those children who have been the subject of a required report. The provision applies to any proceeding concerning the welfare of a neglected child, that is to say, to every neglect proceeding.
The Court in In the Matter of O.L. also found support for its narrowing construction in the City Council's decision in the 1977 Act to amend the law to permit a court to order a mental or physical examination of a parent prior to trial. Subsection (e) of
In enacting
It is also helpful to consider the implications of a statutory scheme in which the only way to obtain information about the parent or guardian, not held by a health professional required to make a report, is by ordering an examination. Supposing as in the present case that the patient is hospitalized and is under constant evaluation and examination, it makes little sense to order a new mental or physical examination, or both, if a patient is under day-by-day scrutiny and evaluation or has been fully examined recently. A new examination would be costly and might impose additional and unnecessary intrusions on the patient. Another case might also be supposed in which an examination is ordered but the patient refuses to submit to the examination. In such a case, an evidentiary inference could be drawn or a contempt order entered to coerce submission. But these methods of ascertaining the facts are inferior to use of medical records and expert testimony. The records and the testimony can be produced promptly and can be used to provide a full explanation, tested by cross-examination, of the parent's mental or physical condition.
Because the amendment to
Notwithstanding the provisions of D.C. Code, sections 14-306 and 14-307, neither the husband/wife privilege nor the physician/client or mental health professional/client privilege shall be a ground for excluding evidence in any proceeding brought under this subchapter.
See D.C.Law 2-22, Title IV, § 410, 24 D.C. Reg. 3341 (1977). No requirement is imposed that would limit the information subject to waiver to that held by a health professional required to make a report of abuse or neglect, yet it is obvious that the Council modelled this provision on
In determining whether to terminate parental rights, the primary concern of the court is the welfare of the child before it. The importance of this decision, together with the nature of these proceedings[,] outweigh[s] the competing demands of these privileges.
Id. Unless it is believed that the Council wanted the waiver in
Finally, the Court turns to the statutory context in which
If the plain meaning of
III.
Evidentiary privileges like the physician-patient privilege, granted by the legislature, can be withdrawn by the legislature. If the plain language of a statute withdrawing a privilege is not limited, as in
This conclusion does not mean that waivers should be imposed routinely and in every case. The Court must find that waiver is in the interest of justice, and this standard requires a careful consideration of the need for the information. In the present case, after the Court had ruled that it had the authority to grant the waiver, the parties agreed on what should be disclosed. Thus, the Court was not required to undertake the exercise of discretion required by
NOTES
[1] The opinion in In re D.H. is reproduced in its entirety as an appendix hereto. See pp. 1234-1241, infra.
[2] Although the precise issue of statutory interpretation presented in this case was apparently not raised in In re N.H.,
[3]
[4] Judge Alprin wrote in this connection that,
the most plausible reading of the section is that a professional who makes a required report pursuant to the statute is not barred by the privilege from testifying in any neglect proceeding concerning the circumstances that prompted the report or the contents of the report that was made. That is quite different, however, from construing the statute as authorization for automatic waiver of the privilege in neglect cases where a parent has a history of mental or physical illness.
116 Daily Wash.L.Rptr. at 2738.
[5] The mother also contends that the evidence was insufficient to support a finding of neglect. We conclude, however, that this contention is without merit.
[6] "A lower court decision must be affirmed if the result is correct, despite the fact that the court `relied on a wrong ground or gave a wrong reason.'" Marinopoliski v. Irish,
Counsel for the mother contends that since neither the child nor the mother cross-appealed from the trial court's judgment, they may not challenge its ruling on the limited reach of
[t]he appellee may, without taking a cross-appeal, urge in support of a decree any matter appearing in the record, although his argument may involve an attack upon the reasoning of the lower court or an insistence upon matter overlooked or ignored by it.
[7] Disclosure is to be made to the Metropolitan Police Department or to the Child Protective Services Division of the Department of Human Services.
[8] The language of the statute would be clearer if the legislature had explicitly said in
Notes
[9] See also In re M.M.M.,
[10] We must therefore disagree with the intimation in O.L. I, supra, 116 Daily Wash.L.Rptr. at 2738, quoted in note 4, supra, that application of
[1]
Notwithstanding the provisions of §§ 14-306 and 14-307, neither the husband-wife privilege nor the physician-patient privilege shall be grounds for excluding evidence in any proceeding in the Family Division of the Superior Court of the District of Columbia concerning the welfare of a neglected child: provided, that a judge of the Family Division of the Superior Court of the District of Columbia determines such privilege should be waived in the interest of justice.
[2] The physician-patient privilege is contained in
(a) In the Federal courts in the District of Columbia and District of Columbia courts a physician or surgeon or mental health professional as defined by the District of Columbia Mental Health Information Act of 1978 (D.C. Code, sec. 6-2001 et seq.) may not be permitted, without the consent of the person afflicted, or of his legal representative, to disclose any information, confidential in its nature, that he has acquired in attending a client in a professional capacity and that was necessary to enable him to act in that capacity, whether the information was obtained from the client or from his family or from the person or persons in charge of him.
[3]
whose parent, guardian, or other custodian is unable to discharge his or her responsibilities to and for the child because of incarceration, hospitalization, or other physical or mental incapacity....
[4] At the time that the District of Columbia Commissioners submitted their own proposed bill, see infra, The Evening Star, quoting District Deputy Coroner Linwood L. Rayford, Jr., said that "[t]he proposal favored by the District of Columbia Commissioners is `a slightly altered version' of the Children's Bureau model bill introduced in the last session of the House by Representative Multer (D.N.Y.)". Child Abuse Law Forecast, The Evening Star, Nov. 20, 1964, at C-1, col. 5. Mr. Walter Tobriner, President of the Board of Commissioners of the District of Columbia, on his part acknowledged that the Commissioners' proposed bill had its origins in the Children's Bureau model bill. H.R.Rep. No. 744, Letter by Walter Tobriner, 89th Cong., 1st Sess. (1965).
[5] The reference by Rep. Multer to § 14-308 is a mistake, since that section has nothing to do with the physician-patient privilege. Present codification is unchanged, at
[6] This is not to say that other kinds of harm to children could not have been the subject of a proceeding in the Juvenile Court to invoke its jurisdiction to aid them and their families. That Court had broad jurisdiction in 1966, which extended to, among other kinds of children, those who
[were] homeless or without adequate parental support or care, or whose parents, guardian, or custodian neglect[ed] or refus[ed] to provide support or care necessary for [their] health or welfare.
[7] The full text is quoted supra note 1.
[8] Subsection (e) of
(e)(1) At any time following the filing of a petition which alleges a neglected child as defined by D.C.Code,
(2) Following an adjudication that a child is neglected, the Division may, on its own motion or the motion of any party, order a mental or physical examination of the parent, guardian, or custodian of the child whose ability to care for the child is at issue.
(3) The Division may order additional mental examinations to be performed by independent experts upon a showing by any party that a prior examination is inadequate.
(4) The results of the mental or physical examination shall not be admissible evidence in the factfinding hearing unless the allegations contained in the petition set forth facts which support a petition pursuant to D.C.Code,
(5) The results of the mental or physical examination shall be admissible at a dispositional hearing.
(6) The results of the mental or physical examination shall not be admissible as evidence in any criminal proceedings.