The Wisconsin Rules of Evidence - The "Statements for Purposes of Medical Diagnosis or Treatment" Hearsay Exception

By John DiMotto

Wisconsin Statutes section 908.03(4) sets forth the "Statements for Purposes of Medical Diagnosis or Treatment" exception to the general prohibition on the admissibility of hearsay. It encompasses:

"Statements made for purposes of medical diagnosis or treatment and describing medical history, or past or present symptoms, pain or sensations, or the inception or general character of the cause or external source thereof insofar as reasonably pertinent to diagnosis or treatment."

In order for the exception to apply, not only must the statements be made for purposes of medical diagnosis or treatment but they must describe:

1) medical history, or

2) past or present symptoms, or

3) pain or sensations, or

4) inception of the cause or external source, or

5) general character of the cause or external source

insofar as the statements are reasonably pertinent to the diagnosis or treatment.

It is critical that what is being said is "reasonably pertinent to the diagnosis or treatment. The fact that statements are made, in and of themselves, does not make them admissible. For example if a patient is seeing his/her doctor for a sprained ankle and the doctor asks the patient how it happened and the patient says that he/she tripped and fell on a bump in the sidewalk and then adds, "oh by the way, one year ago I was sexually assaulted while on a date by John Doe", the report of the sexual assault would not be admissible under 908.03(4) because it could not be successfully argued that it was reasonably pertinent to the diagnosis or treatment of a sprained ankle. There must be a link between the statement and the diagnosis or treatment.

The reason for admissibility under 908.03(4) is that the declarant's motive is for obtaining improved health. This guarantees trustworthiness since a physician relies on what a person says to diagnose and treat. In fact, in a child abuse case, the identity of the perpetrator is deemed reasonably necessary to provide treatment to the child. see State v. Nelson, 138 Wis.2d 418 (1987). For this reason, the statement may come from the patient himself/herself (first party) or from the mother of a child (third party). see State v. Huntington, 216 Wis.2d 671 (1998). This exception is a firmly rooted one. This exception, however, does have limits. For example, while it applies to physicians and psychologists it does not extend to counselors or social workers. see Huntington.

It is believed that when people speak with their doctor that they will be honest and candid since their health, their life is at stake. The law recognizes this as a fact and as such endows these statements with sufficient reliability that they can be admitted regardless of the presence or even availability of the declarant.

In my next post, I will address the Business and Public Records exceptions.