California Supreme Court decision in People v. Cage -- commentary by Jeff fisher

The California Supreme Court issued its decision yesterday in the long-awaited case of People v. Cage. (Thanks to Paul Vinegrad for calling my attention to it.) It treats a statement by a young victim to a police officer, in the station-house and the hospital, as testimonial, and his statement to a doctor, which the court regarded as having been asked and given solely for medical purposes, as non-testimonial. The court acknowledges a conflict in reasoning with State v. Mechling, 633 S.E. 311 (W. Va. 2006), but does not purport to overrule People v. Sisavath, 118 Cal.App.4th 1396 (Cal. App. 2004). I'm sorry that I'm too rushed now with other matters to make a longer comment on the case at this time. But I've asked Jeff Fisher to expand on his initial comments, and here is what he has to say:

The California Supreme Court's opinion in Cage provides a platform to consider a very important category of post-Crawford evidence: statements to doctors and other medical personnel. It also highlights some of the confusion developing in the wake of the Davis v. Washington.

John Cage was involved in an argument and physical altercation with family members. A neighbor called the police to report the disturbance, and over one hour later a police officer found John alone in the hospital waiting room awaiting treatment for a serious cut on his face. The officer asked John to describe the incident to him. John told the officer that his mother, Lisa Cage, had cut him with a piece of glass from a table that had broken during the altercation. A doctor was present for "at least part" of that conversation and then took John back for an examination. The doctor's first question was, "what happened?" John repeated to the doctor the same thing that he had told the officer.

The California Supreme Court held that John's statement to the officer was testimonial because it was not materially distinguishable from the statement Amy Hammon gave the police in Hammon v. Indiana (decided in the same opinion as Davis v. Washington). In the more noteworthy portion of the opinion, the Court also held that the statement John made to the doctor was nontestimonial. In dealing with statements to doctors that describe criminal conduct, there are three general approaches a court might take:

(1) Statements describing criminal conduct as causing a physical condition and identifying an alleged perpetrator are testimonial. Courts, including the California Court of Appeal in an opinion that the California Supreme Court here did not call into question, have taken this approach when the doctors have examined victims as a coordinated part of a criminal investigation. See, e.g., People v. Harless, 125 Cal. App. 4th 70 (2004), rev. granted, 109 P.3d 69 (Cal.), rev. dismissed, 119 P.3d 962 (Cal. 2005) (statement to doctor "in the course of the district attorney's investigation of child abuse" testimonial); Medina v. State, 143 P.3d 471 (Nev. Oct. 5, 2006); Hernandez v. State, 946 So.2d 1270 (Fla. App. Jan. 26, 2007).

(2) Statements describing criminal conduct as causing a physical condition are not testimonial but statements identifying an alleged perpetrator are testimonial. Some courts have adopted this position in cases in which doctors were not coordinating their efforts with the police. See, e.g., State v. Slater, 908 A.2d 1097 (Conn. 2006); In re T.T., 815 N.E.2d 789 (Ill. App. 2004); State v. Bartholomew, 127 Wash. App. 1006 (2005). Some states, in fact, provide that statements identifying an alleged perpetrator to doctors do not even satisfy the medical diagnosis hearsay exception. See, e.g., Commonwealth v. DeOliveira, 849 N.E.2d 218, 224 (Mass. 2006).

(3) No statements made to doctors (at least when police are not also part of the interview) are testimonial. Some courts have adopted this position in cases, as in (2), in which doctors were not coordinating their efforts with police. See, e.g., People v. Vigil, 127 P.3d 916 (Colo. 2006); State v. Vaught, 682 N.W. 2d 284 (Neb. 2004); United States v. Peneaux, 432 F.3d 882 (8th Cir. 2005).

The California Supreme Court avoided approach (1) by stating that "[t]here is no evidence that Dr. Russell was acting in conjunction with law enforcement." This seems questionable. When the doctor asked John "what happened," he was already aware that the police were investigating whether John's injury was a result of criminal conduct. And, as the court acknowledged, California law required the doctor to report any evidence of abuse that came to light during his examination of John. But the court was unmoved, contending "[t]he mere fact that doctors must report abuse they see, suspect, or know of does not transform them into investigative agents of law enforcement," and that an investigative purpose is necessary to trigger the Confrontation Clause. It will be interesting to see how future courts deal with the "mandatory reporter" issue. If states can use such laws to gather accusatory statements and can steer witnesses to mandatory reporters without triggering the Confrontation Clause, they can go a long way toward creating systems that evade the confrontation right altogether.

Perhaps even more troubling, the California Supreme Court chose approach (3) over approach (2) for two reasons that appear illegitimate and one that Davis simply leaves unresolved. First, the court focused on the fact that the doctor's question to John was "neutral in form" and not "structured" to generate evidence. But Davis instructs that answers to "open-ended questions" are just as likely to be testimonial as answers to structured interrogation, for "it is in the final analysis the declarant's statements, not the interrogator's questions, that the Confrontation Clause requires us to evaluate." 126 S. Ct. 2274 n.1. And whatever relevance may pertain to a question that is asked, it is hard to imagine a question more designed to elicit a testimonial response than "what happened?" That is the most common question asked of witnesses giving direct testimony in court.

So what about John's statement itself? The California Supreme Court's second reason for saying that the statement is nontestimonial is because it was made for the purpose of medical treatment. The court never explains, however, how the part identifying the person who allegedly cut him was necessary for medical treatment. Nor can one perceive any reason why it might have been relevant to such treatment.

Third, the California Supreme Court asserted that John's statement was nontestimonial because it was given in an "informal" setting. Davis did not dispute that formality is essential to a testimonial utterance. But all we really know on that score is that a statement to a responding police officer or 911 operator is sufficiently formal to be testimonial, while a "casual remark to an acquaintance" is not. It seems to me that answering a doctor's question "what happened" is much closer to the former than the latter. Put another way, it does not seem at all strange to say that John was bearing witness when he told the doctor what happened. But we'll have to await further word from the Supreme Court on this.

Finally, it is worth noting that the California Supreme Court explicitly rejected the view that a statement is testimonial if a reasonable declarant would have expected it to be used prosecutorially. This holding diverges from several post-Davis cases that continue to use this formulation outside of the context of "interrogations." Again, the Supreme Court will have to answer this question sooner or later.