502 U.S. 346 (1992)
In the early morning hours of April 16, 1988, four-year-old S. G. was sexually assaulted in her home, where her babysitter Tony DeVore was awakened by her scream and went to the bedroom to witness petitioner leaving the room before he departed the house, and DeVore knew petitioner as a friend of S. G.’s mother Tammy Grigsby.1 DeVore then questioned S. G., who stated that petitioner had put his hand over her mouth, choked her, threatened to whip her if she screamed, and touched her in the wrong places, specifically identifying the vaginal area as the location of the touching.2
Approximately thirty minutes later, Grigsby returned home and found her daughter scared and hyperactive, prompting her to question S. G. about the events, after which S. G. repeated claims that petitioner had choked and threatened her and stated that petitioner had put his mouth on her front part; Grigsby noticed bruises and red marks on S. G.’s neck that had not been there previously and called the police.3 Officer Terry Lewis arrived about forty-five minutes after the scream and questioned S. G. alone in the kitchen, receiving a similar account that included the detail that petitioner had used his tongue on her private parts.4
Roughly four hours after the incident, S. G. was taken to the hospital, where emergency room nurse Cheryl Reents and Dr. Michael Meinzen examined her, and in response to their questioning S. G. provided an account essentially identical to those given earlier to DeVore, Grigsby, and Lewis.5 S. G. never testified at petitioner’s trial despite two attempts by the State to call her as a witness, as she experienced emotional difficulty on being brought to the courtroom and left without testifying each time, while the defense made no attempt to call her and the trial court neither made nor was asked to make a finding that S. G. was unavailable to testify.6
Petitioner was convicted by a jury of aggravated criminal sexual assault, residential burglary, and unlawful restraint after the trial court overruled his hearsay objections and admitted the out-of-court statements through the testimony of DeVore, Grigsby, Lewis, Reents, and Meinzen under Illinois exceptions for spontaneous declarations and statements made in the course of securing medical treatment, and the Illinois Appellate Court affirmed the conviction on the ground that the trial court had properly applied the state-law hearsay exceptions, the Illinois Supreme Court denied discretionary review, and the United States Supreme Court granted certiorari limited to the constitutional question whether permitting the challenged testimony violated petitioner’s Sixth Amendment Confrontation Clause right.7
Whether the Confrontation Clause of the Sixth Amendment requires that, before a trial court admits testimony under the spontaneous declaration and medical examination exceptions to the hearsay rule, the prosecution must either produce the declarant at trial or the trial court must find that the declarant is unavailable?8
Roberts stands for the proposition that unavailability analysis is a necessary part of the Confrontation Clause inquiry only when the challenged out-of-court statements were made in the course of a prior judicial proceeding.9
No. The statements offered through DeVore, Grigsby, and Lewis qualified under the spontaneous declaration exception while those offered through Reents and Meinzen qualified under the medical examination exception, and these out-of-court declarations were made in contexts that provide substantial guarantees of their trustworthiness, unlike the prior judicial testimony in Roberts, so that the same factors that contribute to the statements’ reliability cannot be recaptured even by later in-court testimony from S. G.10 An unavailability rule would impose substantial additional burdens on the fact-finding process without improving its accuracy, as the prosecution would be required to repeatedly locate and keep continuously available each declarant even when neither party has interest in calling the witness.11
Permitting the challenged testimony did not violate petitioner’s Sixth Amendment Confrontation Clause right.12
Related opinions on this issue
Justice Thomas wrote separately to suggest that the Confrontation Clause jurisprudence has evolved in a manner perhaps inconsistent with the text and history of the Clause.13 He indicated that the Court has assumed all hearsay declarants are witnesses against the defendant, an assumption not warranted by the history or text.14 Thomas proposed that the Clause extends to any witness who actually testifies at trial but is implicated by extrajudicial statements only insofar as they are contained in formalized testimonial materials such as affidavits, depositions, prior testimony, or confessions.15
He joined the Court’s opinion except for its discussion of the narrow reading of the phrase proposed by the United States.16