People v Alexander
Key claim: Expert testimony diagnosing a child victim with ‘medical torture’ was improper because it was unhelpful, lacked a reliable foundation, and invaded the jury’s province on the crime of torture, but the unpreserved error was harmless given other strong evidence of guilt.
Abstract
Michigan Supreme Court opinion decided 2026-07-15. Michigan Supreme Court Lansing, Michigan
Syllabus Chief Justice: Justices: Megan K. Cavanagh Brian K. Zahra Richard H. Bernstein Elizabeth M. Welch Kyra H. Bolden Kimberly A. Thomas Noah P. Hood
This syllabus constitutes no part of the opinion of the Court but has been Reporter of Decisions: prepared by the Reporter of Decisions for the convenience of the reader. Kimberly K. Muschong
PEOPLE v ALEXANDER
Docket No. 168009. Argued on application for leave to appeal April 9, 2026. Decided
July 15, 2026.
Defendant, Gwendolyn Josephine Alexander, was convicted following a jury trial in the
Wayne Circuit Court, Mariam Saad Bazzi, J., presiding, of one count of torture, MCL 750.85, one
count of second-degree child abuse, MCL 750.136b(3), one count of second-degree child abuse in
the presence of another child, MCL 750.136d(1)(b), and one count of third-degree child abuse,
MCL 750.136b(5). Defendant’s six-year-old son, MA, was transported to an emergency room
after a police officer conducting a welfare check observed bruising, swelling, and scarring on his
body. The treating physician observed swelling around MA’s ankles and hyperpigmented scars
on his ankles and wrists, and she rendered a diagnosis of nonaccidental lesions and possible child
abuse. Defendant admitted to police that she and her partner and codefendant, Errown Scott, had
tied MA up with a belt around his wrists for hours at a time. At trial, MA testified that Scott had
on several occasions, in defendant’s presence, restrained him using zip ties. Dr. Dena Nazer, an
expert in child abuse pediatrics and general pediatrics, testified that she had diagnosed MA with
“medical torture,” which she explained was a clinical diagnosis reserved for children exposed to
at least two physical assaults accompanied by at least two forms of psychological maltreatment.
On cross-examination, Dr. Nazer acknowledged that the legal definition of “torture” and the
medical definition of the term “medical torture” were not necessarily the same and that she was
unable to testify about the legal definition of the term “torture.”
The Court of Appeals, K. F. KELLY, P.J., and CAVANAGH and RIORDAN, JJ., affirmed
defendant’s convictions, but it vacated her sentences because of a guidelines scoring error and
remanded for resentencing. ___ Mich App ___ (November 20, 2024) (Docket No. 364063).
Defendant sought leave to appeal in the Supreme Court, which ordered oral argument on the
application, directing the parties to address whether Dr. Nazer invaded the province of the jury by
using the phrase “medical torture” to label her diagnosis of MA. ___ Mich ___; 21 NW3d 211
(2025).
In a unanimous opinion by Chief Justice CAVANAGH, in lieu of granting leave to appeal,
the Supreme Court held:
Dr. Nazer’s expert testimony concerning the diagnosis of medical torture was improper because the testimony was unhelpful to the jury, lacked a reliable foundation, and invaded the province of the jury in determining whether defendant was guilty of the crime of torture. However, defendant was not entitled to relief because, in light of the strong evidence properly admitted, she failed to establish that the unpreserved error affected the outcome of the proceedings.
1. Dr. Nazer’s testimony was inadmissible under MRE 702 because it was unhelpful to
the jury in determining a fact in issue and it lacked a reliable foundation. Expert testimony is only helpful and therefore admissible if it involves a matter that is beyond the common understanding of the average juror, and testimony that lacks a reliable foundation is similarly unhelpful to the jury. An expert’s medical opinion might be helpful, in some cases, to explain a particular injury or the mechanism of a particular injury. However, Dr. Nazer’s diagnostic testimony did not explain the nature, extent, or timing of MA’s physical symptoms in a way that would help the jury determine whether MA suffered great bodily injury, an element of the crime of torture. Further, when an opinion is based solely on what the victim relays to a doctor, in the absence of any evidence qualifying the doctor as an expert in assessing credibility, the opinion lacks a reliable foundation. Dr. Nazer’s testimony concerning the psychological maltreatment component of the medical torture diagnosis was based on little more than Dr. Nazer’s crediting MA’s account of events, and it was therefore unreliable.
2. Dr. Nazer’s testimony was also improper because it invaded the province of the jury
and ran afoul of the principles laid out in People v McFarlane, 325 Mich App 507 (2018), which held that the trial court erred when it allowed a child abuse pediatrician to testify that she had diagnosed the infant victim with “abusive head trauma” and that the injuries amounted to child abuse. An expert witness may not express an opinion on the defendant’s intent or criminal responsibility. Whether a defendant is guilty or innocent is tantamount to a legal conclusion, and an expert witness may not testify about the requirements of law that apply to the particular facts in the case or phrase an opinion in terms of a legal conclusion. As in McFarlane, the expert testimony diagnosing MA with medical torture came too close to findings that are left exclusively to the jury. The lay meaning of torture—the infliction of intense pain to punish, coerce, or afford sadistic pleasure—maps closely to the intent element of the crime of torture, i.e., that the defendant intended to cause cruel or extreme physical or mental pain and suffering. Dr. Nazer’s diagnosis of medical torture likely impressed upon the jury an opinion on defendant’s criminal responsibility for the crime for which she was on trial—torture. That the diagnosis was labeled medical rather than legal was immaterial because, regardless of the label given, the diagnostic terminology clearly posed a danger of confusing the doctor’s medical diagnosis with the legal determination.
3. Defendant failed to establish that the unpreserved evidentiary error constituted plain
error affecting her substantial rights. Although Dr. Nazer’s testimony was improper under MRE 702, it was questionable whether admission of the testimony was a clear or obvious error. Moreover, even without Dr. Nazer’s problematic testimony, other compelling evidence, untainted by the medical torture diagnosis, remained, including medical testimony about MA’s injuries, MA’s testimony that he had been zip-tied, and defendant’s admissions; therefore, even assuming that the error was plain, defendant did not show that it affected the outcome of the proceedings.
Affirmed.
Michigan Supreme Court Lansing, Michigan
OPINION Chief Justice: Justices: Megan K. Cavanagh Brian K. Zahra
Why this matters
Expert testimony diagnosing a child victim with ‘medical torture’ was improper because it was unhelpful, lacked a reliable foundation, and invaded the jury’s province on the crime of torture, but the unpreserved error was harmless given other strong evidence of guilt.