Michael A. STIDHAM, Appellant, v. Thomas L. CLARK, Judge, Fayette Circuit Court, Appellee, and Dr. Edwin Bunch; Ray Larson, Commonwealth Attorney, Fayette County, Kentucky; and Cynthia T. Rieker, Assistant Commonwealth Attorney, Fayette County, Kentucky (Real Parties in Interest), Appellees.
No. 2000-SC-0968-MR.
Supreme Court of Kentucky.
May 16, 2002.
71 S.W.3d 719
Thomas L. Clark, Lexington, Counsel for Appellee Thomas L. Clark, Judge, Fayette Circuit Court.
Reuben G. Walker, Jr., Walker, Emmons, Shannon & Baird, P.S.C., Richmond, Counsel for Real Party in Interest Appellee Dr. Edwin Bunch.
Raymond Larson, Commonwealth Attorney, Lexington, Counsel for Real Party in Interest Appellee Ray Larson, Commonwealth Attorney, Fayette County, Kentucky.
Cynthia T. Rieker, Assistant Commonwealth Attorney, Fayette County, Lexington, Counsel for Real Party in Interest Appellee Cynthia T. Rieker, Assistant Commonwealth Attorney, Fayette County, Kentucky.
COOPER, Justice.
Appellant Michael A. Stidham appeals from the denial of his petition for a writ of prohibition filed against Appellee Thomas L. Clark, Judge of the Fayette Circuit Court, to prohibit him from authorizing the release to a Fayette County grand jury of records pertaining to Appellant‘s treatment by Dr. Edwin Bunch, a licensed psychiatrist. The Court of Appeals denied the petition in a one-sentence order that stated no reason for the denial. However, an earlier order denying Appellant‘s motion for emergency relief under CR 76.36(4) stated that “[t]he petitioner has not made an adequate showing that the respondent judge has abused his discretion in permitting the discovery of the questioned documents....” Because the disclosure of information claimed to be privileged is not discretionary but requires a finding that the information falls either within or outside the scope of the privilege or within a specified exception to the privilege, and because the record does not reflect that the Commonwealth met the applicable burden of proof necessary to even warrant an in camera review of Dr. Bunch‘s records, we reverse.
The grand jury seeks to review Dr. Bunch‘s records to determine if Appellant has violated
General rule of privilege. A patient, or the patient‘s authorized representative, has a privilege to refuse to disclose and to prevent any other person from disclosing confidential communications, made for the purpose of diagnosis or treatment of the patient‘s mental condition, between the patient, the patient‘s psychotherapist, or persons who are participating in the diagnosis or treatment under the direction of the psychotherapist, including members of the patient‘s family. (Emphasis added.)
KRE 507(c) identifies three exceptions to the general rule of privilege, none of which apply to this case.
The Commonwealth asserted in response to the motion to quash that (1) Dr. Bunch‘s records are not privileged records of psychotherapeutic treatment of a mental condition but unprivileged records of medical treatment of a physical condition, or, in the alternative, (2)
Information communicated to a practitioner in an effort unlawfully to procure a controlled substance, or unlawfully to procure the administration of any controlled substance, shall not be deemed a privileged communication.
Judge Clark concluded that whether any or all of the entries in Dr. Bunch‘s records were privileged could only be determined by an in camera inspection of the entire 296-page record. Following that inspection, Judge Clark rendered an opinion and order finding that the records contain information pertaining to Dr. Bunch‘s treatment of both Appellant‘s chronic pain, which was deemed to be medical treatment of a physical condition, and his treatment of psychological and emotional problems caused by that pain, which was deemed to be psychotherapeutic treatment of a mental condition. The judge also found that the records pertaining to the treatment of Appellant‘s mental condition contain no information falling within the parameters of
I. PSYCHOTHERAPIST-PATIENT PRIVILEGE.
Our analysis begins with the almost universally accepted rule that testimonial privileges are generally disfavored and
Unlike the testimonial privileges recognized in federal courts that, pursuant to Federal Rule of Evidence (FRE) 501, are the product of common law development,3 Kentucky‘s testimonial privileges are codified in Article V of the Kentucky Rules of Evidence (KRE). KRE 501 includes no provision for common law development of testimonial privileges:
Except as otherwise provided by Constitution or statute or by these or other rules promulgated by the Supreme Court of Kentucky, no person has a privilege to:
(1) Refuse to be a witness;
(2) Refuse to disclose any matter;
(3) Refuse to produce any object or writing; or
(4) Prevent another from being a witness or disclosing any matter or produc-
ing any object or writing. (Emphasis added.)
KRE 507 combined three pre-existing statutory privileges (all repealed concomitantly with the adoption of Kentucky Rules of Evidence), i.e., the psychiatrist-patient privilege (
II. KRS 218A.280 .
Nevertheless, we also agree with the Commonwealth that
By analogy, Mullins v. Commonwealth, Ky., 956 S.W.2d 210 (1997), was a case in which the defendant‘s wife initially reported to the police that her husband had engaged in acts of sodomy with their 14-year-old babysitter. At trial, however, both the defendant and his wife claimed the husband-wife privilege, KRE 504. Though that privilege contains an exception for wrongful conduct perpetrated against the person of a minor child of either party to the marriage, KRE 504(c)(2)(B), it contains no exception for wrongful conduct perpetrated against the person of an unrelated minor child. However,
But even though
III. BURDEN OF PROOF.
Because privileges operate to exclude relevant evidence, “[t]he party asserting the privilege has the burden to prove the privilege applies.” United States v. Plache, 913 F.2d 1375, 1379 (9th Cir.1990). Neither a blanket assertion of the privilege nor a bare showing that the recipient of the communication is a psychotherapist would be sufficient. In re Grand Jury Proceedings (Gregory P. Violette), supra, at 73. Here, however, the burden was satisfied by proof that Dr. Bunch‘s records contained (1) communications by Appellant (2) to his psychiatrist (3) for the purpose of diagnosis or treatment (4) of a mental condition. Id. As the opponent of the privilege, the Commonwealth was then required to establish that the privilege had been waived or that entries in the record either were not within the scope of the privilege or were within a specified exception to the privilege. Cf. United States v. Horvath, 731 F.2d 557 (8th Cir. 1984); Lawson, supra, § 5.05, at 229-30. The issue then becomes what is the quantum of proof necessary to overcome an otherwise established claim of privilege?
Professor Lawson also criticizes the “prima facie case” standard and posits that the issue of whether a communication is privileged is simply a factual dispute with respect to the admissibility of evidence and should be resolved by application of KRE 104(a), the same as any other question of admissibility.
In other situations in which the fate of an item of evidence depends upon proof of facts (for example, that the original of a writing has been lost or destroyed, that the maker of an out-of-court statement acted under consciousness of death in making the statement, etc.), the quantum of proof needed to satisfy the burden of proof is preponderance of the evidence. Is there any reason for a different standard of proof when the facts to be proved involve the crime/fraud exception to the lawyer-client privilege? No one has identified any such reason and none has surfaced in the case law, which may account for the fact that neither the Kentucky Rules of Evidence nor the Federal Rules distinguish between privileges and other rules in their treatment of the problem of preliminary factual issues upon which admissibility of evidence may depend.
Lawson, supra, § 5.10, at 242. We agree, but what of the very language of KRE 104(a)?
Questions of admissibility generally. Preliminary questions concerning the qualification of a person to be a witness, the existence of a privilege, or the admissibility of evidence shall be determined by the court, subject to the provisions of subdivision (b) of this rule. In making its determination it is not bound by the rules of evidence except those with respect to privileges. (Emphasis added.)
And of KRE 1101(c)?
Rules on privileges. The rules with respect to privileges apply at all stages of all actions, cases, and proceedings.
It was noted in Zolin, supra, that FRE 104(a), which is identical to KRE 104(a), establishes only that “materials that have been determined to be privileged may not be considered in making the preliminary determination of the existence of a privilege.” Id. at 573, 109 S.Ct. at 2631 (emphasis added). The Court then reasoned that materials claimed to be privileged have not been determined to be privileged until the issue of the applicability of the privilege or the exception is resolved, id. at 568, 109 S.Ct. at 2628, thus rejecting the rigid “independent evidence” require-
IV. IN CAMERA REVIEW.
We also agree that it would be impossible to identify which entries in Dr. Bunch‘s records are privileged and which are not without an in camera review. We specifically reject Appellant‘s novel contention that judges who are not medically trained are not competent to separate medical records from psychotherapy records. We also regard that assertion as a non-issue. Communications made for the purpose of medical treatment are not privileged at all, and communications made for the purpose of psychotherapeutic treatment are not privileged to the extent that they fall within the scope of
We do agree, however, that a bare allegation of a criminal purpose is insufficient to warrant an in camera review that might “permit opponents of the privilege to engage in groundless fishing expeditions with [trial] courts their unwitting (and perhaps unwilling) agents.” Zolin, 491 U.S. at 571, 109 S.Ct. at 2630. However, we also agree that “a lesser evidentiary showing is needed to trigger in camera review than is required ultimately to overcome the privilege.” Id. at 572, 109 S.Ct. at 2631. Zolin established the following standard for determining when in camera review may be used to determine whether communications or materials claimed to be privileged fall either outside the scope of the privilege or within a specified exception to the privilege:
[B]efore a ... court may engage in in camera review at the request of the party opposing the privilege, that party must present evidence sufficient to support a reasonable belief that in camera review may yield evidence that establishes the exception‘s applicability.... [T]he threshold showing to obtain in camera review may be met by using any relevant evidence, lawfully obtained, that has not been adjudicated to be privileged.
Id. at 574-75, 109 S.Ct. at 2632. Once that showing is made, the decision whether to engage in in camera review rests within the sound discretion of the trial court, considering such factors as the volume of materials the court is asked to review, the relative importance of the alleged privileged materials to the case, and the likelihood that the evidence produced by an in camera review, together with other available evidence then before the court, will establish that the privilege has been waived or that the communication or material is either outside the scope of the privilege or within a specified exception to the privilege. Id. at 572, 109 S.Ct. at 2631. We agree and now adopt that standard as applicable to requests for in camera re-
The Commonwealth asserts that there exists sufficient threshold evidence to warrant the in camera review conducted in this case, specifically, a Kentucky All Schedule Prescription Electronic Reporting (KASPER) report, see
The Commonwealth has attached to its brief a copy of a letter dated March 6, 2000, purportedly from Dr. Bunch addressed to eight other physicians indicating that Dr. Bunch is in possession of a KASPER report dated March 3, 2000, reflecting that Appellant “has been given narcotic prescriptions by various physicians” in violation of his “narcotics contract” with Dr. Bunch. We need not decide whether this letter, standing alone, constitutes “evidence sufficient to support a reasonable belief that in camera review may yield evidence” of a violation of
V. CONCLUSION.
Accordingly, we reverse the Court of Appeals and hereby prohibit Appellee Judge Clark from providing to the grand jury any evidence obtained during his in camera review of Dr. Bunch‘s records. However, nothing herein precludes another in camera review upon receipt of threshold “evidence sufficient to support a reasonable belief that in camera review may yield evidence” of a criminal purpose to violate
LAMBERT, C.J.; GRAVES, JOHNSTONE and WINTERSHEIMER, JJ., concur.
KELLER, J., concurs by separate opinion, with STUMBO, J., joining that concurring opinion.
KELLER, Justice, concurring.
I concur fully in the majority opinion, and I write separately only to eliminate any confusion I may have helped foster through my previous suggestion that Kentucky law governing the practice of medicine may create a general physician-patient privilege.1 While I agree with the majority opinion that no testimonial privilege exists in Kentucky for communications made between patient and physician for the purpose of medical treatment, I would still characterize such communications as confidential because “physicians ... have an ethical obligation not to disclose infor-
In Kentucky, the State Board of Medical Licensure has, under its statutory authority to “[p]romulgate a code of conduct governing the practice of medicine and osteopathy, which shall be based on generally recognized principles of professional ethical conduct,”3 adopted the American Medical Association‘s Code of Medical Ethics,4 including that Code‘s provisions concerning patient confidentiality,5 and physicians licensed in the Commonwealth are subject to sanctions — including license suspension or revocation6 — if they breach patient confidences.7 In my opinion, these provisions prohibit the extra-judicial disclosure by a physician of confidential patient communications and information8 unless such disclosure is otherwise authorized9 or required10 by law.
STUMBO, J., joins this concurring opinion.
Notes
Confidentiality. The information disclosed to a physician during the course of the relationship between physician and patient is confidential to the greatest possible degree. The patient should feel free to make a full disclosure of information to the physician in order that the physician may most effectively provide needed services. The patient should be able to make this disclosure with the knowledge that the physician will respect the confidential nature of the communication. The physician should not reveal confidential communications or information without the express consent of the patient, unless required to do so by law. Id.
