## Facts

- Curtis Edward Etheridge repeatedly sexually abused his minor daughter and son over several years.
- As to the daughter (age 12 during the charged period), the State presented evidence of multiple episodes of vaginal intercourse, including incidents in a secluded area and one in the child’s bedroom, accompanied by warnings not to disclose the conduct.
- As to the son (age 13), the State presented evidence that Etheridge directed the boy to undress, overcame initial refusal by insisting, engaged in anal intercourse, and threatened harm if the boy told anyone.
- The son disclosed the abuse to a friend, prompting involvement by social services; the children were removed from the home and Etheridge was charged.
- At trial, a public health nurse testified that, during treatment for a sexually transmitted disease after charges were filed, Etheridge made incriminating statements about sexual contact with his children.
- A jury convicted Etheridge of multiple sexual offenses against the daughter and, as to the son, crime against nature, indecent liberties, and second-degree sexual offense; the court imposed consecutive sentences including two life terms.

## Issues

1. Whether the physician–patient privilege barred admission of Etheridge’s incriminating statements to a public health nurse, or whether statutory child-abuse exceptions permitted the evidence.
2. Whether statutory confidentiality provisions for venereal disease information required an in camera voir dire, and whether an open-court voir dire warranted reversal.
3. Whether Miranda and the Fifth Amendment required exclusion of Etheridge’s statements to the nurse.
4. Whether evidence of “force” for second-degree sexual offense was sufficient where the victim was the defendant’s minor child, including whether parental authority and fear can constitute constructive force.

## Decision

- The North Carolina Supreme Court affirmed all convictions and sentences.
- The court held the physician–patient privilege did not bar the nurse’s testimony in a child-abuse prosecution under applicable statutory exceptions, regardless of whether treatment occurred before or after charging.
- The court found no reversible error from conducting the admissibility voir dire in open court; any request for an in camera proceeding was waived and no prejudicial effect was shown.
- The court held Miranda did not apply because there was no custodial interrogation by law enforcement or its agent; the nurse asked routine medical questions during treatment requested by Etheridge.
- The court held the evidence supported constructive force for the offense against the son and limited prior case law rejecting “general fear” as force to factually similar, non-parental contexts.

## Legal Principles

- In prosecutions involving child abuse, the physician–patient privilege is unavailable to the extent statutory child-abuse provisions require or permit disclosure of relevant medical information.
- Statutory child-abuse exceptions to medical confidentiality apply without regard to whether the medical encounter occurs before or after the defendant is formally charged.
- Objections to the manner of handling statutorily sensitive medical information (such as requesting an in camera voir dire) may be waived by failure to timely object, and reversal requires a showing of prejudice.
- Miranda safeguards apply to custodial interrogation by law enforcement or its agents; routine medical questioning by a treating provider, absent state agency and custody, does not trigger Miranda.
- In parent–child sexual abuse cases, a parent’s authority, domination, threats, and the child’s resulting fear can supply constructive force even without overt physical violence; apparent “submission” may satisfy the force element.

## Conclusion

The court upheld Etheridge’s convictions, ruling that statutory child-abuse exceptions allowed admission of incriminating medical statements, Miranda did not bar statements made to a public health nurse during routine treatment, and the parent–child relationship can establish constructive force through parental authority and the child’s fear.


State v. Etheridge, 319 N.C. 34, 352 S.E.2d 673 (1987)