State v. Brown
619 So. 2d 692, 1993 WL 153813 (1993)
Rule of Law:
A defendant who enters a plea of not guilty by reason of insanity impliedly waives the physician-patient privilege for any medical testimony that is genuinely relevant to the defendant's mental or physical condition at the time of the offense.
Facts:
- Thomas J. Brown and Claudette McGowan were in a relationship for over a year.
- Several days before the killings, Brown argued with McGowan over money he accused her of stealing.
- During the argument, Brown threatened McGowan, 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 apartment.
- One of the children, eight-year-old Leslie McGowan, died from injuries sustained in the fall.
- A neighbor discovered Claudette McGowan's body on her bedroom floor, dead from multiple stab wounds.
- Immediately after the incident, Brown told an acquaintance, Sterling Williams, 'Yes, I killed them and I'm going by Al's.'
- Brown was taken to Charity Hospital for treatment of injuries sustained after being beaten by a crowd.
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.
- A jury convicted Brown of manslaughter for the death of Claudette McGowan and first-degree murder for the death of Leslie McGowan.
- The trial court sentenced Brown to twenty-one years at hard labor and life imprisonment, to be served concurrently.
- On initial appeal, the Court of Appeal of Louisiana, Fourth Circuit, affirmed the convictions and sentences.
- The trial court subsequently granted Brown's application for post-conviction relief and ordered an out-of-time appeal due to a procedural deficiency in the first appeal.
- Brown brought the present appeal to the Court of Appeal of Louisiana, Fourth Circuit, asserting three assignments of error.
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Issue:
Does a defendant who enters a plea of not guilty by reason of insanity waive the statutory physician-patient privilege, thereby permitting the admission of testimony from his treating physicians concerning his physical and mental condition and inculpatory statements made immediately after the crime?
Opinions:
Majority - Landrieu, Judge.
Yes. A defendant who pleads not guilty by reason of insanity waives the physician-patient privilege as to information that is genuinely relevant to that defense. By tendering his mental condition as the central issue, the defendant cannot selectively present favorable evidence while using the privilege to shield unfavorable evidence from the jury's consideration. The court, relying on State v. Berry and State v. Aucoin, reasoned that this implied waiver is not limited to court-appointed psychiatrists but extends to any treating physician whose testimony is relevant. Here, Brown claimed a PCP-induced psychosis caused his actions, making the testimony of the emergency room doctors who treated him immediately after the crime highly relevant to his actual mental and physical state. The court also held that admitting the inculpatory statements made to the doctors was not a reversible error, as there was ample other evidence of his guilt, and the statements' probative value in showing his mental state outweighed any prejudicial effect.
Analysis:
This decision reinforces and clarifies the scope of the implied waiver of the physician-patient privilege when a defendant raises an insanity defense in Louisiana. The court explicitly extends the waiver beyond court-appointed psychiatric experts to include any treating physician with relevant information, preventing the defendant from using the privilege as both a sword and a shield. This holding makes it more difficult for defendants to control the flow of medical information, ensuring that the trier of fact has access to a more complete picture of the defendant's mental state at the time of the crime. Consequently, prosecutors gain broader access to potentially incriminating evidence from medical personnel who treated a defendant shortly after an offense.
