Where an action under the Employers' Liability Act, of 1908 was
pending in an inferior territorial court of Arizona prior to
statehood, such action being one of which the federal and state
courts have concurrent jurisdiction, the voluntary appearance of
defendant in the federal
Page 235 U. S. 670
court after statehood without interposing any objection to the
jurisdiction of that court
held to amount to a waiver of
the objection (based upon § 33 of the Arizona Enabling Act) that,
upon the commencement of statehood, the action should have been
transferred to the proper state court, subject to removal to the
federal court upon application made in due form for that
purpose.
Under Rev.Stat. Arizona, § 2535, subd. 6, providing that a
physician or surgeon cannot be examined without consent of his
patient as to any communication made by the patient with reference
to a disease or as to any knowledge obtained by personal
examination of such patient unless such patient has offered himself
as a witness and voluntarily testified in regard to such
communications, evidence of physician respecting the results of a
personal examination of plaintiff was in this case properly
excluded because plaintiff had not testified with reference to
communications made by him to the physician, although he had
voluntarily testified with respect to his injuries and had
introduced other evidence respecting them.
207 F. 817 affirmed.
The facts, which involve the construction of certain provisions
of the Federal Employers' Liability Acts of 1908 and 1910 and of
the Arizona Enabling Act and of a statute of Arizona relating to
the admission of evidence of physicians of the plaintiff in actions
for personal injuries, are stated in the opinion.
Page 235 U. S. 672
MR. JUSTICE PITNEY delivered the opinion of the Court.
This action, brought by Clark against the railway company, was
commenced in January, 1912, in the District Court of the Fifth
Judicial District of the then Territory of Arizona. It was based
upon the Federal Employers' Liability Act of 1908, 35 Stat. 65, c.
149, as amended in 1910, 36 Stat. 291, c. 143. The complaint
alleged that, while defendant was engaging in commerce between the
Territories of Arizona and New Mexico as a common carrier by
railroad, and while plaintiff was employed by defendant in such
commerce, he sustained certain personal injuries through the
negligence of defendant and its employees, for which he claimed
damages in the amount of $40,000. After the action was commenced,
and on February 14, 1912, the Territory of Arizona became a state,
and the further proceedings (improperly, it is said) were conducted
in the District Court of the United States for the District of
Arizona. In that court, plaintiff filed a first and a second
amended complaint, and defendant, having unavailingly moved to
strike the latter from the files upon grounds not necessary to be
specified, answered upon
Page 235 U. S. 673
the merits, without interposing any objection to the
jurisdiction of the court. A trial by jury was had, resulting in a
verdict and judgment for plaintiff, and this was removed by
defendant's writ of error to the United States Circuit Court of
Appeals for the Ninth Circuit, where the judgment was affirmed (207
F. 817). The present writ of error was then sued out.
Two matters only require particular discussion. The Enabling Act
of June 20, 1910, under which Arizona was admitted as a state (36
Stat. 577, c. 310, § 33), provided in effect that actions which, at
the date of admission, were pending in the territorial courts
(other than the supreme court) should be transferred to and proceed
in the proper federal court in cases where, if they had been begun
within a state, the federal court would have had exclusive original
jurisdiction, and that, where the cause of action was one of which
the state and federal courts would have concurrent jurisdiction,
the action should be transferred to and proceed in the appropriate
state court, but in this case might be transferred to the federal
court upon application of any party, to be made as nearly as might
be in the manner provided for removal of causes from state to
federal courts.
The present action being one of which the federal and state
courts have concurrent jurisdiction, it is insisted that, upon the
commencement of statehood, it should have been transferred to the
proper state court, subject to removal to the federal court upon
application made in due form for that purpose; that, in fact, the
files and records in the territorial court were never transferred
to the proper state court, or to any state court, and that a
certain petition of plaintiff, which appears in the record, wherein
he prayed for the removal of the cause from the state to the
federal court, was insufficient and inefficacious for the purpose,
for want of compliance with certain of the requirements of the
removal statute. It is further insisted
Page 235 U. S. 674
that, in the Enabling Act, it was the intention of Congress to
provide for the removal of actions from the state to the federal
courts only in case they might have been removed if the action had
not been commenced until after the admission of the territory as a
state, and that, under the express prohibition contained in the
amendment of § 6 of the Employers' Liability Act, passed April 5,
1910, 36 Stat. 291, c. 143, shortly before the passage of the
Enabling Act, and which declares that "no case arising under this
act and brought in any state court of competent jurisdiction shall
be removed to any court of the United States" (reenacted as § 28,
Judicial Code), actions of this character were not removable under
the general provisions of § 33 of the Enabling Act.
We need spend no time upon these questions, since there is no
ground for denying the jurisdiction of the district court of the
United States over the subject matter, the objections urged are of
such a nature that they might be waived, and the record shows that
they were waived by the action of defendant in permitting the cause
to proceed in the federal court and answering there upon the merits
without objection based upon the grounds now urged or any
jurisdictional grounds. The action being one arising under a law of
the United States, and the requisite amount being in controversy,
the federal district court had original jurisdiction under § 24,
Judicial Code. The removal proceedings were in the nature of
process to bring the parties before that court, and the voluntary
appearance of the parties there was equivalent to a waiver of any
formal defects in such proceedings.
Mackay v. Uinta Development
Co., 229 U. S. 173,
229 U. S. 176.
The case of
United States v. Alamogordo Lumber Co., 202 F.
700, cited by plaintiff in error, is clearly distinguishable, for
timely objection was there made.
The second matter requiring mention is the alleged error of the
trial court in excluding the evidence of two
Page 235 U. S. 675
physicians called by defendant for the purpose of testifying to
the results of a personal examination of plaintiff shortly after he
received the injuries for which damages were claimed. The trial
court based the rulings upon an Arizona statute (R.S. 1901, § 2535,
subdiv. 6), which reads as follows:
"6. A physician or surgeon cannot be examined, without the
consent of his patient, as to any communication made by his patient
with reference to any physical or supposed physical disease, or any
knowledge obtained by personal examination of such patient:
Provided, That if a person offer himself as a witness and
voluntarily testify with reference to such communications, that is
to be deemed a consent to the examination of such physician or
attorney (
sic)."
A material part of the injury complained of was the loss of the
sight of plaintiff's left eye, and because this was set forth in
the pleadings, and upon the trial plaintiff testified personally in
regard to his injuries, mentioning the loss of sight and pain in
the eye, and called as a witness a nurse who attended him after the
accident, and who testified as to the condition of the eye, it is
insisted that plaintiff in effect consented to the examination of
the physicians with respect to his condition. The argument is that
the statute was intended to protect persons in the confidential
disclosures that may be necessary in regard to their physical
condition, but was not intended to close the lips of physicians
where the patient voluntarily publishes the facts to the world. In
support of this, plaintiff in error cites two cases from the New
York Court of Appeals,
Morris v. New York etc. Ry., 148
N.Y. 88, and
Capron v. Douglass, 193 N.Y. 11. But the New
York statute
* is materially
different from that of Arizona.
Page 235 U. S. 676
The purpose of the latter enactment is very clearly expressed in
its language. Without the consent of the patient, the physician's
testimony is excluded with respect to two subjects: (a), any
communication made by the patient with reference to any physical or
supposed physical disease, and (b), any knowledge obtained by
personal examination of such patient. And this privilege is waived,
according to the terms of the proviso, only in the event that the
patient offers himself as a witness and voluntarily testifies "with
reference to such communications." We would have to ignore the
plain meaning of the words in order to hold, as we are asked to do,
that the testimony of other witnesses offered by the patient, or
the testimony of the patient himself with reference to other
matters than communications to the physician, or any averments
contained in the pleadings, but not in the testimony, amount to a
waiver of the privilege. The enactment contemplates that the
physician receives in confidence what his patient tells him, and
also what the physician learns by a personal examination of the
patient. It contemplates that the patient may testify with
reference to what was communicated by him to the physician, and in
that event only it permits the physician to testify without the
patient's consent.
The express object is to exclude the physician's testimony at
the patient's option, respecting knowledge
Page 235 U. S. 677
gained at the bedside, in view of the very delicate and
confidential nature of the relation between the parties. The
statute recognizes that they do not stand on equal terms. The
patient is more or less suffering from pain or weakness, distracted
by it, ignorant of the nature or extent of his injury or illness,
driven by necessity to call in a professional adviser, sometimes
with little freedom of choice; he relies perforce upon the
physician's discretion, as well as upon his skill and experience,
and is obliged by the circumstances of his own condition not only
to make an explanation of his ailment or injury, so far as it may
be within his knowledge and may be communicable by word of mouth,
but also to submit to the more intimate disclosure involved in a
physical examination of his person. The physician, on the other
hand, is in the full possession of his faculties, and of that
knowledge which is power. Manifestly, the patient occupies, for the
time, a dependent position. The chief policy of the statute, as we
regard it, is to encourage full and frank disclosures to the
medical adviser by relieving the patient from the fear of
embarrassing consequences. The question of dealing justly as
between the patient and third parties is a secondary
consideration.
It is a mistake, we think, to regard the patient's disclosures,
whether verbal or physical, as voluntary in the full sense; they
are believed by him to be necessary for the restoration of health
or the preservation of life or limb. But, at least if he has
command of his mind and memory, the patient may somewhat control
the extent of his disclosures by word of mouth, and may be able
afterwards to testify respecting them, while, if he submits himself
to a physical examination at the hands of the physician, he cannot
know in advance the nature or extent of what the physician will
learn, cannot confine the disclosure to the present ailment or
injury, and cannot afterwards testify respecting its results,
excepting as the physician may inform
Page 235 U. S. 678
him of them. And in many cases the physician may, with perfectly
proper motives, withhold from the patient the results of the
physical examination and his deductions therefrom.
We cannot, therefore, without encroaching upon the domain of
legislation, declare that there is no substantial ground for a
distinction between the information the physician gains from verbal
communications made by the patient and the far wider knowledge that
he derives from his personal examination of the patient. Certainly
it cannot be said that when the patient afterwards has occasion to
make averments and adduce evidence respecting the nature of the
ailment or injury, he thereby necessarily publishes to the world
the facts as disclosed to the physician through the physical
examination. In many cases, this must be very far from true; the
patient having no access to the facts as thus disclosed excepting
with the consent of the physician. The language of the statute, as
we think, shows a recognition of this, and also of the fact that,
when the patient himself has occasion to testify respecting his
ailment or disease, he often must do so without knowing the range
or the character of the testimony that might be given by the
physician and without any means of contradicting it. In order to
prevent the patient from being subjected to this disadvantage, the
act gives him the option of excluding the physician's evidence
entirely by himself refraining from testifying voluntarily as to
that respecting which alone their knowledge is equal -- namely,
what the patient told the physician with reference to the
ailment.
The framer of the act was careful to choose language that
recognizes the distinction between (a) communications made by the
patient and (b) knowledge obtained by the doctor through a personal
examination of the patient. The New York statute, which, so far as
we have observed, was the first to establish a privilege with
respect
Page 235 U. S. 679
to the knowledge gained by a physician while attending a patient
in a professional capacity, recognizes no such distinction. Nor
does it define with precision what conduct on the part of the
patient shall constitute a waiver of the privilege. Hence, the
courts of that state deemed themselves at liberty to determine this
question upon general principles derived from the supposed policy
of the law. Not only, therefore, are the decisions of the courts of
that state and of other states having statutes formed upon the same
model valueless as guides to the meaning of the statute here in
question, but the very fact that the Legislature of Arizona
departed from the form of the New York statute indicates that it
did so because it had a different purpose to express. We are unable
to see anything that would justify us in refusing judicial
recognition to a distinction thus laid hold of by the lawmaking
body in defining the extent and conditions of the privilege.
To construe the act in accordance with the contention of
plaintiff in error would not only be a departure from its language,
but would render it inapplicable in all cases where the "physical
or supposed physical disease" is the subject of judicial inquiry,
and where any averment respecting it is made in pleading, or
evidence upon the subject is introduced at the trial in behalf of
the patient. This would deprive the privilege of the greater part
of its value by confining its enjoyment to the comparatively rare
and unimportant instances where the patient might have no occasion
to raise an issue or introduce evidence on the subject, or where
the patient's disease might happen to be under investigation in a
controversy between other parties. We are constrained to reject
this construction.
The other questions that are raised require no special mention.
It is sufficient to say that we find no error warranting a reversal
of the judgment.
Judgment affirmed.
Page 235 U. S. 680
* Extracts from the New York Code of Civil Procedure.
"SEC. 834. A person duly authorized to practise physic or
surgery . . . shall not be allowed to disclose any information
which he acquired in attending a patient, in a professional
capacity, and which was necessary to enable him to act in that
capacity. . . ."
"
* * * *"
"SEC. 836. The last three sections apply to any examination of a
person as a witness unless the provisions thereof are expressly
waived upon the trial or examination by the . . . patient; . . .
The waivers herein provided for must be made in open court on the
trial of the action or proceeding, and a paper executed by a party
prior to the trial, providing for such waiver, shall be
insufficient as such a waiver. . . ."
MR. JUSTICE HUGHES, dissenting:
I am unable to agree to the approval of the ruling which
excluded the physician's testimony. It should be supposed that it
was the legislative intent to protect the patient in preserving
secrecy with respect to his ailments, and not to give him a
monopoly of testimony as to his condition while under treatment.
Here, not only did the plaintiff introduce the evidence of his
nurse, describing in detail his bodily injuries and the medical
treatment, but the plaintiff offered himself as a witness and
voluntarily testified as to his bodily condition. His testimony
covered the time during which he was under the physician's
examination, and it was upon this testimony that he sought to have
the extent of his injuries determined by the jury, and damages
awarded accordingly. To permit him, while thus disclosing his
physical disorders, to claim a privilege in order to protect
himself from contradiction by his physician as to the same matter
would be, as it seems to me, so inconsistent with the proper
administration of justice that we are not at liberty to find a
warrant for this procedure in the statute unless its language
prohibits any other construction.
See Hunt v. Blackburn,
128 U. S. 464,
128 U. S. 470;
Epstein v. Railroad, 250 Mo. 1, 25;
Roeser v.
Pease, 37 Okl. 222, 227;
Forrest v. Portland R.. L. &
P. Co., 64 Or. 240;
Capron v. Douglass, 193 N.Y. 11;
4 Wigmore on Evidence § 2389 (2).
As I read the Arizona statute, it was framed not to accomplish,
but to prevent, such a result. We have not been referred to any
construction of it by either the territorial or state court, and we
must construe it for ourselves. To my mind, its meaning is that, if
the patient voluntarily testifies as to his physical condition at
the time of the examination, he cannot shut out his physician's
testimony as to the same subject. To reach the contrary
Page 235 U. S. 681
conclusion, emphasis is placed on the words "such
communications" in the proviso, and it is insisted that the proviso
was to apply only if the plaintiff testifies as to what he told the
physician. I think that this is altogether too narrow. When the
patient submits himself to an examination, he as truly communicates
his condition to the physician as if he tells him in words.
Although the patient were dumb, his submission to inspection in
order that he might be treated would be nonetheless a communication
of what is thus made known. That is the very ground of the
privilege. Nor does the fact that the statute, with unnecessary
diffuseness, refers in the sentence defining the privilege to "any
communication" or "any knowledge obtained by personal examination"
limit the natural meaning of the proviso. In saying that "if a
person offer himself as a witness and voluntarily testify with
reference to such communications," it is to be deemed "a consent"
to the physician's testifying, the proviso may be, and I think
should be, taken to embrace implied, as well as express,
communications. I can find no reasonable basis for a distinction.
It is said that the plaintiff may not know what the physician has
observed or what testimony he may give. But when the plaintiff
testifies, he invites analysis and contradiction, and in
contemplation of law he asks to have his statement judged by what
is shown to be the truth of the matter. If the plaintiff testifies
as to what he told the physician, it is conceded that the physician
may be examined, and the obvious reason is that the plaintiff is
not to be permitted to insist upon his privilege as to what he
himself is disclosing. This is the policy of the statute, and it
governs equally, as I read it, when the plaintiff testifies as to
his physical condition at the time he submits himself to the
physician's examination. The words "such communications" are broad
enough to cover all communications for the purpose of treatment,
whether by utterance or by what is usually more revealing --
the
Page 235 U. S. 682
yielding of one's body to the scrutiny of the practitioner. To
repeat, it seems to me that the statute was intended to make it
impossible for the plaintiff to claim the privilege when he himself
has testified as to the subject of it.
As in this view competent, and presumably important, evidence
was excluded, I think that the judgment should be reversed.
I am authorized to say that MR. JUSTICE DAY concurs in this
dissent.