State v. Brown
1993 WL 153813, 619 So. 2d 692 (1993)
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Rule of Law:
A criminal defendant who enters a plea of not guilty by reason of insanity implicitly waives the physician-patient privilege for testimony from treating physicians that is genuinely relevant to the defendant's mental and physical condition at or near the time of the offense.
Facts:
- Thomas J. Brown dated Claudette McGowan, and he was a frequent visitor to her apartment where she lived with her three children.
- Several days before the incident, Brown was seen arguing with McGowan, accusing her of stealing money, and stating, "if I want to do you anything, all I have to do is pick you up and throw you off the third floor."
- On August 25, 1987, several neighbors witnessed Brown throw McGowan's three children from the third-floor balcony of her housing project apartment.
- One of the children, eight-year-old Leslie McGowan, died from injuries sustained in the fall.
- Johnny Thornton discovered Claudette McGowan's body on the bedroom floor of her apartment; she had died from multiple stab wounds.
- A short time later, Brown admitted to Sterling Williams, "Yes, I killed them."
- A crowd subsequently beat Brown, and he was taken to Charity Hospital for treatment of his injuries.
- At the hospital, Brown told one doctor that he had killed McGowan and hurt her children because they belonged to her, and told another doctor that he had stabbed her and thrown the children off the balcony.
Procedural Posture:
- Thomas J. Brown was indicted by a grand jury on two counts of first-degree murder.
- At his arraignment in the trial court, Brown entered a dual plea of not guilty and not guilty by reason of insanity.
- The defense filed a pre-trial motion to exclude testimony from Brown's treating physicians at Charity Hospital based on the physician-patient privilege, which the trial court denied.
- A twelve-member jury found Brown guilty of manslaughter on count one and guilty of first-degree murder on count two.
- The trial court sentenced Brown to 21 years for manslaughter and life imprisonment for murder, to be served concurrently.
- Brown's initial appeal to the Court of Appeal of Louisiana, Fourth Circuit resulted in an affirmation of his conviction, which was later found to be procedurally deficient.
- The trial court granted Brown's application for post-conviction relief and ordered an out-of-time appeal to the Court of Appeal of Louisiana, Fourth Circuit.
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Issue:
Does the physician-patient privilege prevent treating physicians from testifying about a defendant's condition and inculpatory statements when the defendant has entered a plea of not guilty by reason of insanity based on alleged intoxication?
Opinions:
Majority - Landrieu, Judge
No. By entering a plea of not guilty by reason of insanity, the defendant waives the physician-patient privilege for medical evidence relevant to determining that issue. The court reasoned that by tendering his mental condition to the jury, particularly a defense of phencyclidine-induced psychosis, Brown waived his right to claim the privilege. Citing State v. Berry and State v. Aucoin, the court established that this waiver is not limited to court-appointed psychiatrists but extends to any physician whose testimony is genuinely relevant to the mental and physical state tendered as a defense. The treating physicians' testimony about Brown's condition and statements immediately following the crime was highly relevant to his claim of drug-induced insanity. The court concluded that the probative value of this evidence in assessing his mental state outweighed any prejudicial effect of admitting his inculpatory statements, especially since other evidence already established he committed the acts.
Analysis:
This case clarifies and reinforces the scope of the implied waiver of the physician-patient privilege in Louisiana when a defendant pleads insanity. It establishes that the waiver is not confined to testimony from mental health experts but extends to any treating physician, such as an ER doctor, whose observations are relevant to the defendant's condition at the time of the crime. The decision significantly impacts defense strategy, as defendants must now anticipate that raising an insanity or intoxication defense will open the door to testimony from all medical personnel who treated them post-offense. This precedent strengthens the prosecution's ability to rebut such defenses with immediate, firsthand medical evidence of the defendant's state of mind.
