State v. Fontana
| Decision Date | 28 July 1967 |
| Docket Number | No. 39919,39919 |
| Citation | 277 Minn. 286,152 N.W.2d 503 |
| Parties | STATE of Minnesota, Respondent, v. Albert Alfred FONTANA, Appellant. |
| Court | Minnesota Supreme Court |
Syllabus by the Court
1. Minn.St. 595.02(4), which accords privilege to communications between physician or surgeon and patient, applies without distinction between private physician-patient relationships and relationships between state-employed physician and patient confined in state hospital.
2. Defendant in a homicide prosecution did not waive the privileged character of physician-patient relationship accorded by § 595.02(4) by placing in issue defense of insanity and by furnishing testimony of other medical experts with reference thereto.
3. Although an appellate court is reluctant to reverse, particularly under circumstances where, on retrial, a jury would be expected to reach the same result, the fact that defendant has been deprived of Stewart R. Perry, Minneapolis, for appellant.
due process in denial of statutory right designed for his protection requires reversal.
Douglas M. Head, Atty. Gen., St. Paul, George M. Scott, County Atty., Harlan Goulett, Asst. County Atty., Minneapolis, for respondent.
Defendant was convicted of murder in the second degree, Minn.St. 609.19, following a prosecution for murder in the first degree, § 609.185(1). Insanity was the defense. This appeal seeks reversal and remand for a new trial. It is alleged that the trial court erred in permitting the state to introduce testimony of a state-employed physician as to the mental capacity of defendant. The question presented for review is whether the physician-patient privilege accorded by § 595.02(4) applies between a state-employed physician and a patient committed to a state hospital for treatment and safekeeping.
It is unnecessary to expand upon the facts since it is not denied that defendant shot and killed his wife. It is sufficient only to note that on Easter Sunday morning, March 29, 1964, defendant accosted his estranged wife, Elizabeth, and their two children after church services. He pleaded with her to allow him to return to their home. When his wife refused to be reconciled, defendant drew a gun, saying, 'I hate to do this,' and killed her. He immediately went to the church rectory and confessed the crime to the pastor, who apparently contacted the police.
Defendant was indicted on the felony charge of murder in the first degree, § 609.185(1), and when no plea was entered on arraignment, it was ordered that he be examined by a board of examiners. § 631.18. The board found defendant to be 'in a state of insanity so as to be incapable of understanding the criminal proceedings against him and in cooperating in his defense.' He was accordingly committed to the 'Asylum for the Dangerously (Insane) (Minnesota Security Hospital) for safekeeping and treatment.'
While at this institution defendant was initially examined by Dr. Carl A. Schwartz, who was employed as a psychiatric consultant by the hospital. Dr. Schwartz prescribed medication for defendant. He considered defendant to be his patient and defendant confided to Dr. Schwartz at the time of the initial examination. Defendant was also treated by others at the hospital, and his case was presented for study by the entire staff there. On June 30, 1964, defendant was found to have sufficiently recovered so as to be competent to stand trial. He entered a plea of not guilty on arraignment. His sole defense was insanity. At the trial Dr. Schwartz was called as a witness for the state. Objection to his testimony regarding defendant was made on the grounds of privileged communications. This objection was overruled and Dr. Schwartz was allowed to give his expert opinion as to whether defendant was legally insane at the time of the killing. He testified:
'I believe that Mr. Fontana was aware that he was doing something wrong, knew the nature of the act and that after he had completed it, he realized that he had done something wrong.'
1. It is asserted that there was prejudicial error in allowing this testimony. Minn.St. 595.02(4), which accords the privilege upon which defendant relies, provides:
'A licensed physician or surgeon shall not, without the consent of his patient, be allowed to disclose any information or any opinion based thereon which he acquired in attending the patient in a professional capacity, * * * and no oral or written waiver of the privilege hereinbefore created shall have any binding force or effect except that the same be made upon the trial or examination where the evidence is offered or received.'
This statute makes no distinction between 'public' and 'private' physician-patient relationships. Nor does there appear to be any good reason for making such a distinction. The purpose behind the statute is to inspire confidence in patients to make full disclosure of symptoms and conditions to physicians. Such confidence in the physician is deemed necessary to the efficacy of treatment. The law secures the patient's confidence by prohibiting physicians from disclosing secrets which would embarrass their patients. 1 Since the patients are the beneficiaries of the statute, it should make no difference whether they are 'private' patients or wards of state hospitals. This is especially so in the case of state hospitals for the mentally ill where complete confidence in the attending physicians is sine qua non to the cure. Moreover, it does not seem to us that the state should have to rely on the privileged testimony of a state-employed psychiatrist to prove that patient- defendants were not insane at the moment of their crimes. State-employed psychiatrists are employed by the state not to help in structuring a prosecution but to treat and help rehabilitate the mentally ill.
2. It is the principal contention of the state that defendant affirmatively waived the physician-patient privilege by asserting the defense of insanity at the time of the commission of the offense and by introducing the testimony of four physicians who had examined him or treated him previously. It is unnecessary to review the substance of their testimony. It is sufficient to say that while they expressed their doubts as to his mental capacity, none of them had a definite opinion based upon criteria expressed in the Minnesota M'Naghten rule as found in Minn.St. 611.026. 2 The most meaningful testimony as to defendant's mental condition came from the Reverend Richard McCarthy who talked to defendant immediately after the crime. He testified, As to whether defendant knew his act was wrong, Father McCarthy testified, 'I couldn't positively say, * * * but in my own mind, in my own judgment, this would be a judgmental thing, now, I would have assumed that he knew it was wrong.' Since the state was without the benefit of an independent psychiatric examination, it offered the testimony of Dr. Schwartz. In this posture of the proof, the state contends, not without reason, that there is no justification for a rule under which a patient may permit a physician favorable to his case to testify regarding his ailments and then assert a privilege when any other physician who treated him seeks to contradict such testimony.
The uses and abuses of the privilege expressed in § 595.02(4) have been discussed by this court in numerous cases. In civil cases the view has been expressed that the medical privilege should exist as a shield and not as a sword. Nelson v. Ackermann, 249 Minn. 582, 83 N.W.2d 500; Snyker v. Snyker, 245 Minn. 405, 72 N.W.2d 357. It has been held that the introduction of a physician's testimony by a patient waives the privilege to the extent of permitting the opponent to cross-examine the physician as to any information acquired during the course of treatment. Maas v. Laursen, 219 Minn. 461, 18 N.W.2d 233, 158 A.L.R. 215. If a patient, after joint treatment by two or more physicians, introduces the testimony of one of the physicians, most courts find a waiver of the privilege...
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