Does the Utah Constitution require full disclosure of victims' medical records to defendants? State v. Cramer Explained

In State v. Cramer, the Utah Supreme Court addressed whether defendants have a constitutional right to full disclosure of child victims’ privileged medical records, ultimately affirming that in camera review procedures adequately protect both constitutional rights and privacy interests.

Background and Facts

Albert Cramer served as a Court Appointed Special Advocate for a seven-year-old child housed at the University of Utah Neuropsychiatric Institute. After the child’s adoption, allegations of sexual abuse emerged, leading to Cramer’s charges for two counts of aggravated sexual abuse of a child. Before trial, Cramer moved to compel disclosure of the victim’s UNI medical records, arguing they were critical to his defense since the case depended on the child’s credibility.

Key Legal Issues

The primary issue was whether the Utah Constitution entitles defendants to full disclosure of victims’ privileged medical records, or whether in camera review sufficiently protects constitutional rights. Cramer also challenged the trial court’s denial of his motion for a new trial based on a spectator’s statements to the victim during trial.

Court’s Analysis and Holding

The Supreme Court rejected Cramer’s argument that Utah’s constitution requires broader disclosure than federal law. Applying Pennsylvania v. Ritchie, the court noted that jurisdictions initially favoring direct access, including Massachusetts, had returned to in camera procedures after finding they required disclosure of privileged records that “may contain nothing that would aid the defense.” The court emphasized that in camera review represents “the most effective and sensitive balance between the interests of the criminal defendant and private citizens who expect and rely on the confidentiality of their psychiatric records.”

Regarding the motion for new trial, the court applied abuse of discretion review and found insufficient evidence that the spectator’s statements prejudiced the defendant or caused the victim to change his testimony.

Practice Implications

This decision establishes that Utah follows the federal approach of in camera review for privileged medical records rather than requiring full disclosure. Practitioners should ensure that records reviewed in camera are properly preserved in the appellate record to maintain the ability to challenge materiality determinations on appeal. The court’s emphasis on balancing confrontation rights with privacy interests provides guidance for similar privilege disputes in criminal cases.