Learning Outcomes
After reading this article, you will be able to identify when statements made for medical diagnosis or treatment are admissible under the hearsay exceptions tested on the MBE. You will understand the requirements for this exception, the types of statements covered, who may make them, and how courts determine relevance and reliability for exam questions.
MBE Syllabus
For the MBE, you are required to understand the hearsay rule and its exceptions, including when statements made for medical diagnosis or treatment are admissible. In your revision, focus on:
- The definition of hearsay and the general rule of exclusion.
- The exception for statements made for purposes of medical diagnosis or treatment (FRE 803(4)).
- The requirements for admissibility: subject matter, purpose, and declarant.
- Who may make the statement (patient or third party).
- The scope of statements covered (including cause and source of injury).
- The distinction between statements of fault and statements of cause.
- How courts assess reliability and relevance for this exception.
Test Your Knowledge
Attempt these questions before reading this article. If you find some difficult or cannot remember the answers, remember to look more closely at that area during your revision.
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Which of the following statements is most likely admissible under the hearsay exception for medical diagnosis or treatment?
- (A) "The driver who hit me was texting."
- (B) "My leg hurts and I can't move it."
- (C) "I think my neighbor dislikes me."
- (D) "I want to sue the hospital."
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A mother brings her injured child to the emergency room and tells the doctor, "He fell off his bike and hit his head." Is the mother's statement admissible for the truth of the matter asserted?
- (A) Yes, if made for the purpose of medical diagnosis or treatment.
- (B) No, because the mother is not the patient.
- (C) No, because it is hearsay within hearsay.
- (D) Yes, but only if the child confirms it.
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Under the medical diagnosis/treatment exception, which of the following is generally NOT admissible?
- (A) The patient's statement about the location of pain.
- (B) The patient's statement identifying the cause of injury.
- (C) The patient's statement assigning blame for the injury.
- (D) The patient's statement describing symptoms.
Introduction
Hearsay is generally inadmissible unless an exception applies. One important exception, frequently tested on the MBE, is for statements made for purposes of medical diagnosis or treatment. This exception recognizes that patients (and sometimes others) have a strong motive to be truthful when seeking medical help, making such statements sufficiently reliable for use as evidence.
Key Term: Hearsay An out-of-court statement offered to prove the truth of the matter asserted.
The Medical Diagnosis or Treatment Exception
Statements made for the purpose of medical diagnosis or treatment are admissible even if the declarant is available to testify. This exception is found in Federal Rule of Evidence 803(4) and applies to both civil and criminal cases.
Key Term: Medical Diagnosis or Treatment Exception A hearsay exception allowing statements made for, and reasonably relevant to, medical diagnosis or treatment to be admitted for their truth.
Requirements for Admissibility
For a statement to be admissible under this exception, three main requirements must be met:
- Purpose: The statement must be made for the purpose of obtaining medical diagnosis or treatment.
- Subject Matter: The statement must describe medical history, symptoms, pain, or the cause or source of the condition, if reasonably relevant to diagnosis or treatment.
- Relevance: The statement must be reasonably related to the diagnosis or treatment being sought.
Key Term: Reasonably Relevant The statement must be helpful or relevant to the diagnosis or treatment the provider is giving.
Who May Make the Statement?
The declarant is usually the patient, but statements by third parties (such as a parent or caregiver) may also be admissible if made to assist in diagnosis or treatment, especially for young children or incapacitated patients.
Statements of Cause and Fault
Statements describing the cause or source of an injury are admissible if they help the provider diagnose or treat the condition. However, statements assigning fault (e.g., "My boss pushed me down the stairs") are generally not admissible under this exception, unless knowing the identity of the person is necessary for treatment (such as in child abuse cases).
Key Term: Statement of Cause A statement explaining how an injury or condition occurred, admissible if relevant to diagnosis or treatment.
Key Term: Statement of Fault A statement assigning blame for an injury, generally inadmissible under the medical diagnosis/treatment exception unless relevant to treatment.
Statements to Whom?
The statement does not need to be made to a physician. It may be made to any medical professional, hospital staff, or even family members if the purpose is to obtain diagnosis or treatment.
Scope: Physical and Psychological Conditions
The exception covers statements about both physical and psychological symptoms, as long as the information is relevant to the diagnosis or treatment being provided.
Statements for Others
A statement made by someone seeking medical help for another person (such as a parent for a child) is admissible if the information is reasonably relevant to the diagnosis or treatment of the patient.
Statements to Non-Treating Providers
Statements made to medical professionals hired solely for litigation (such as expert witnesses) are generally admissible under this exception if the information is reasonably relevant to diagnosis or treatment.
Worked Example 1.1
A patient arrives at the emergency room and says, "I was hit in the head by a falling brick and now I feel dizzy." The doctor records this information in the medical chart. Is the patient's statement admissible for the truth of the matter asserted?
Answer: Yes. The patient's statement about being hit in the head and feeling dizzy was made for the purpose of medical diagnosis or treatment and is reasonably relevant to the doctor's evaluation and care.
Worked Example 1.2
A child is brought to the hospital by her aunt, who tells the nurse, "She fell off the playground slide and can't move her arm." The nurse notes this in the medical record. Is the aunt's statement admissible?
Answer: Yes. The aunt's statement was made to assist in the child's diagnosis and treatment and is reasonably relevant to the child's care, so it is admissible under the exception.
Worked Example 1.3
A patient tells the doctor, "My neighbor attacked me with a bat because he hates me." Is the entire statement admissible under the medical diagnosis or treatment exception?
Answer: Only the portion describing the attack ("attacked me with a bat") is admissible if relevant to treatment. The statement about the neighbor's motive ("because he hates me") is not admissible under this exception, as it is not relevant to diagnosis or treatment.
Exam Warning
Statements assigning blame or legal responsibility are generally not admissible under this exception. Only statements about cause or source relevant to treatment are allowed.
Revision Tip
When answering MBE questions, focus on whether the statement was made for medical purposes and whether it describes symptoms, history, or cause (not fault), and whether it is reasonably helpful for diagnosis or treatment.
Summary
Statements made for medical diagnosis or treatment are admissible under a hearsay exception if they are reasonably relevant to care, describe symptoms or cause, and are made for the purpose of obtaining medical help. Assigning fault is generally not covered unless it is necessary for treatment.
Key Point Checklist
This article has covered the following key knowledge points:
- Hearsay is generally inadmissible unless an exception applies.
- The medical diagnosis or treatment exception allows statements made for, and reasonably relevant to, diagnosis or treatment.
- The declarant can be the patient or a third party if the statement assists in diagnosis or treatment.
- Statements of cause are admissible if relevant; statements of fault are generally not.
- The statement must be made for the purpose of medical diagnosis or treatment, not for litigation or other reasons.
- The exception applies to statements made to any medical professional, not just doctors.
- The exception covers both physical and psychological conditions if relevant to care.
Key Terms and Concepts
- Hearsay
- Medical Diagnosis or Treatment Exception
- Reasonably Relevant
- Statement of Cause
- Statement of Fault
