This rule is based upon Uniform Rule of Evidence 503 and the former statute, Hawaii Rev. Stat. §621-20.5 (1976, Supp. 1979) (repealed 1980) (originally enacted as L 1972, c 104, §1(o); am L 1978, c 52, §1), which codified Hawaii's physician-patient privilege.

The rule makes clear that privileged communications may relate to the diagnosis or treatment of "physical, mental, or emotional condition[s], including alcohol or drug addiction." Designed to encourage free disclosure between physician and patient, the privilege belongs only to the patient and may be invoked by the physician "only on behalf of the patient."

Subsection (d)(4) conforms to the 1978 amendment to the predecessor statute, Hawaii Rev. Stat. §621-20.5 (1976) (repealed 1980).

The federal common law does not recognize the privilege. In Gretsky v. Basso, 136 F. Supp. 640, 641 (D. Mass. 1955), the court upheld admission of hospital patients' records against a claim of privilege, ruling: "[T]his is a federal administrative proceeding and state evidentiary restrictions [do] not apply." In Felber v. Foote, 321 F. Supp. 85, 87-88 (D. Conn. 1970), the court said: "[T]he common law knew no privilege for confidential information imparted to a doctor.... Whatever protection there is against disclosure of a patient's communications to his physician is afforded solely by the law of the individual states."

Physician-patient privilege applicable in criminal cases. 66 H. 448, 666 P.2d 169.

Under subsection (d), doctor’s communications with U.S. Attorney, engaged in pursuant to federal district court order requiring that patient be subjected to physical examination, were not privileged. 89 H. 188, 970 P.2d 496.