Intro to the Federal Rules of Evidence - 60

5. Statements for purposes of medical diagnosis or treatment (FRE 803(4))
a. Justification
A patient tends to tell a truth.

Courts have been more willing to accept such statements into evidence than in the case of statements made to non-doctors.

b. Present or past symptoms
Statements need not be in connection with a present bodily condition. Statements about past pain, past symptoms, or even past events that have given rise to pain or symptoms, are all admissible, if made to a physician in connection with treatment.

c. Causes / external sources of the pain, symptoms or other condition
“[S]tatements made for purposes of medical diagnosis or treatment and describing … the inception or general character of the cause or external source thereof insofar as reasonably pertinent to diagnosis or treatment.”

Even statements that relate to the cause of the pain, symptoms, or other condition will be admitted, if they seem reasonably related to treatment.

But statements about fault will ordinarily not qualify. For instance, a patient’s statement that he was struck by a car would qualify but not his statement that the car was driven through a red light (ACN). Similarly, a patient’s statement that he was shot would be admissible, but a statement that he was shot by a white man would not be.

d. Statements by third persons
The statement may be one made by a third person, so long as the statement is made for the purpose of getting treatment or diagnosis for the patient.

“He was hit from the rear by a speeding vehicle.”
“I was just passing by when I saw him get hit by a speeding bicycle.”

e. Statements to third persons
Statements to hospital attendants, ambulance drivers, or even members of the family might be included (ACN).

f. Physician who does not treat but testifies
The exception rule applies to statements made to a physician whose examination is made solely in order to enable him to testify at trial (ACN). The rationale is that the evidence will come before the jury anyway, as the basis of his opinion.