Publications

Codification and the Origins of Physician‑Patient Privilege
Journal of Policy History, 2020

This essay examines the origins of physician-patient privilege in the United States. It concentrates on an 1828 New York law that protected medical confidentiality in the courtroom — the first statutory guarantee of physician-patient privilege — as well as the rapid spread of privilege statutes throughout the nineteenth century. Using the published notes of the authors of New York’s influential statute alongside other primary sources, I argue that these early statutes are best explained as the result of nineteenth‑century efforts to codify American law. The medical profession took little note of physician‑patient privilege until much later, indicating that privilege emerged not as a protection of doctors’ professional status, nor as a means of protecting patients in the courtroom, but rather as an inadvertent offshoot of attempts to streamline and simply judicial proceedings. It is perhaps because of these unsystematic origins that physician‑patient privilege still remains such an unevenly applied rule in American courtrooms.

Creating Confidentiality: Physician‑Patient Privilege and Medical Confidentiality in the United States, 1776‑1975
University of Oregon, 2019

My dissertation uncovers the long and complicated history of medical confidentiality and physician-patient privilege — the legal guarantee that doctors cannot be compelled to reveal their patients’ secrets in courts of law. I show that the first privilege statutes emerged at the state level as part of larger efforts to codify and streamline American legal codes in the nineteenth century. I demonstrate that the medical profession was at first ambivalent toward the rise of these early laws, but later came to embrace privilege as a powerful indicator of its own professional status. I argue that the rise of American capitalism in general, and the accompanying rise of the insurance industry in particular, transformed privilege from a minor and seemingly insignificant rule of courtroom evidence into a high‑stakes issue, which then spurred efforts to curtail the scope of privilege in the twentieth century. In tracing this history, my dissertation examines the intersections between two of America’s most powerful professions — medicine and law — and carries implications to the broader history of professionalization. In my analysis of medical confidentiality, I show how professional ethics functioned as a means of legitimizing the medical profession in the nineteenth century.

This history is essential in order to understand medical privilege as policy in the twenty‑first century, especially since the privilege continues to be a contested and unevenly applied rule in American courts. Most state courts, for example, recognize various degrees of privilege, while federal courts do not. Throughout my dissertation, I show that the current mosaic of laws governing medical testimony in the courtroom were cobbled together in response to numerous contradictory impulses and never intended as ironclad protections of patients’ right to privacy. Therefore, if privilege is to be a valuable safeguard of patients’ privacy in the twenty‑first century, the nation would need new statutes that reflect this priority.

Presentations

Panels Organized

Medical Ethics in the Courtroom,
American Association of the History of Medicine, Minneapolis, 2016

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Papers Presented

• Creating Confidentiality: The Origins of Physician Patient Privilege in the United States,
  Law and Society Association, Toronto, 2018
• Codification and the Origins of Physician Patient Privilege,
  American Association of the History of Medicine, Minneapolis, 2016
• Codification and the Origins of Physician Patient Privilege,
  Southern Association of the History of Medicine and Science, Las Vegas, 2016
• Creating A Precedent: Medical Confidentiality and the Duchess of Kingston’s Case,
  University of Oregon Graduate Student Conference, Eugene, 2014