*1 No. Chiropractic non- Association, Colorado Colorado
profit OF v. STATE AND O. CORPORATION, LOUIS GEARHART the Colorado State Colorado
Public Health. 795) (467 P.2d April
Decided *2 in error. Ginsberg, Charles Attorney General, W. John P. Duke Dunbar, Moore, Deputy, William Tucker, Assistant, Clifton A. Flowers, Special Assistant, for defendants in error. En Banc. opinion
Mr. Justice delivered the of the Court. Kelley Chiropractic nonprofit a Association, Colorado Colorado corporation, Gearhart, and Louis O. licensed doctor of chiropractic, proceedings instituted in the district court declaratory judgment for a to test the correctness of the State the Colorado construction Health). (the Department of Health (66-8-7) provides: question The statute in occurring atten- medical “In case of death duty or other undertaker of the it shall be dance person having knowledge notify
of such death notify immediately. the district shall The coroner coroner attorney investigation inquest or respecting hold an and then shall proper inquiry he and make whatever deems coroner If either the the cause and manner death. attorney shall coroner deems it advisable, the district by a post mortem to be made, cause examination body physician, deceased to deter- on the of the licensed Any made certificate of death the cause of death. mine registrar and shall with the a coroner filed shall findings concerning disease state his the nature causes, the if from external and, or the manner death opinion was in his certificate shall state whether *3 shall furnish accidental, suicidal, or The coroner felonious. by may the information as be such additional registrar.” state statute to construed the Health care of a chiro-
mean practor one dies under the that where while occurring medical atten- it is a “death judgment, adopted in this court, The trial dance.” construction. complaint (1) the asked that
In their the patient occurs construed that a whose death statute by chiropractor to have died while attended be deemed (2) attendance”; or, alternative, with “medical the that the statute be declared unconstitutional. allegation issue is on
The constitutional based the the statute “* * * arbitrary, unnecessary unreasonable, in- and upon flicting unnecessary unreasonable restrictions and chiropractic profession, and is not the interest the generally, public public health, is not the beneficial to the promote safety, public does not wel- morals and and unduly oppressive and is fare, on individual citizens who chiropractors.” are licensed require (1)
The issues as drawn us to determine may sign whether a a death certificate; and (2), (1) negative, if we answer whether question by statute in equal protection is unconstitutional when tested process provisions due state Const, § and federal Colo. 25; constitutions. Colo. art. XIV, Const, Const, § § art. 5, 25; U.S. amend. gain problems requires To an ex- overview the an statutory provisions relating amination of the several chiropractors (ch. 23), physicians (ch. 91), (ch. 66). certificates C.R.S. 66-8-6(1)(a). “The certificate of death shall following contain the items: “(q) Statement of medical on fact decedent, attendance alive, including
and time of death, the time last seen “(r) including primary Cause of im- contributory complications, mediate causes, and causes or any, if and duration of each. “ (s) Signature physician making and address of or official the medical certificate. [*] v
“(2) personal particulars subsec- statistical (1) (b) (1) (n) tions of this au- section shall be signature may thenticated be who informant, any competent person acquainted with the facts. “(4) signed The medical certificate shall be made and physician, any, last attendance on the de- specify ceased, who shall the time in time attendance, the *4 day he last at alive, saw deceased hour of the death, which death He shall occurred. state the cause of sequence so as to the course of or show disease of causes resulting giving primary and immediate contributory any, causes, and also the causes, unsatisfactory returns, duration of Indefinite and each. indicating only symptoms of disease or conditions reT suiting disease, from will be not sufficient for is- held suing permit; any or burial removal contain- ing only by registrar such terms as defined the state shall physician be returned to the for correction and definition. may of death, Causes which dis- be the result of either carefully or violence, ease shall from defined; and, if prob- violence, its nature shall be stated, and whether * *” ably (Emphasis accidental, suicidal, or homicidal. added.)
Chapter article known as the “Med- repre- ical Act,” Practice must be because it considered healing sents the basic law on the arts. C.R.S. “practice 91-1-6 defines term of medicine.” “Practice of medicine” is the closest term “medical attendance” chapters relating healing to be found in the arts. 91-1-6(1) (a), “practice Under of medicine” ..means, among things, other
“(b) Holding public-within out one’s self to the state this being diagnose, prescribe palliate as prevent any able to treat, or for, pain, injury,
human disease, ailment, de- formity, physical or or mental whether condition, drugs, surgery, manipulation, electricity, any use of or physical, mechanical or other whatsoever; means “(c) Suggesting, recommending, prescribing or admin- istering any operation form of treatment, or palliation, any physical intended or cure relief, injury, or mental disease, ailment, condition or defect person any receiving with the intention of therefor, directly indirectly, any gift compensation either or fee, or whatsoever;
“(e) Using surgeon, M.D., title D.O., doctor, or or word abbreviation to indicate induce.others be- engaged diagnosis lieve that one or treatment persons injury afflicted disease, with or defect of body except expressly permitted or mind, as otherwise relating the laws of this state now or hereafter enacted *5 healing practice arts; the of field of
to limited [*] [*] However, [*] JJ an exception to the practice of medicine, as chiropractic, practice of as well is for the defined, made healing under con- of the arts, as other limited fields specifically in the statutes. limitations defined ditions and assembly general to re- clear its intention makes practice practice a of those to strict licensed 91-1-6(3) (n). pro- healing It limited field of the arts that such vides licentiates, “* * * strictly for to the field shall confine themselves they scope re- of their are licensed and to the which ** spective licenses, argue in error that because chiro- just practor, of or a as a doctor of medicine doctor osteopathy, to have a “cer- has been since 1937 chemistry, ability physiology, anatomy, of tificate permitted bacteriology, pathology” is before he chiropractic, practice an for a license to take examination of doctors medicine he should be treated the same as supplying osteopathy far of under the doctors law, history patients in the death of his deceased the medical is concerned. study limited the several The courses healing are not determinative arts branches any given practice permitted scope license. under [2]): (C.R.S. provides 1963, 23-1-1 The law any person or to “It shall be unlawful for practice chiropractic Colorado, in the state of offer to * * * * * duly unless licensed article, in this as defined ** anyone public out *, who holds himself qualifying proper as doctor submitting licensing and without under this article thereby endangers provided regulations in this article, property, public and welfare.” life, health, 23-1-2(1) “Chiropractic” “* is defined * * arts which is based as that branch premise ab- that disease attributable to the on the functioning system. normal of the human nervous It diagnosing analyzing includes the of human ailments functioning and seeks the elimination of the abnormal system by adjustment manip- the human nervous adjacent ulation, hand, of the articulations and tissue *6 body, particularly spinal of the human column, the and usage procedures the as of indicated which facilitate and adjustment manipulation made the or effective, more sanitary, hygenic, physical the use of nutritional and necessary practice.” remedial measures to such scope Further evidence of the limited of the chiropractic relating of in found 1963, is C.R.S. Chiropractic” to the use of the “Doctor of or title the part, provides letters This “D.C.” that section, “* ** upon license Such shall not confer licensee right practice surgery, prescribe, obstetrics, or to com- pound drugs, or administer or to administer anaesthetics. * sis question favorably
In order to resolve the first to the error, we must decide first that, under 66-8-6(4), “physician,” secondly, is a and, qualified of terms his license he is to “state death, the cause of to show the course of disease sequence resulting or giving pri- of causes mary contributory causes, immediate also any,” particularly if causes, if the cause causes are not solely functioning related “to the abnormal of the human system.” nervous many
An relating examination of sections to the inescapable arts us leads conclusion that “physician” solely the term relates to doctors of medi osteopathy. Fahey, cine and doctors State v. 152Minn. “physician” 220, 188 appear 260. The word N.W. does not Chapter Chiropractic licensing 23, the act. requirements 66-8-6(4) The are such that it equally inescapable prac is that one circumscribed in his involving functioning tice to diseases of the nervous system legally qualified, regardless is not of educational
402 judgments
qualifications,
necessarily
to make the examinations
complete
required
.the death
to be able
Fahey, supra.
v.
certificate. State
remaining question is
the limitation
The
whether
protection”
process.”
chiropractors “equal
or “due
denies
constitutionality places
presumption
burden
The
beyond
unconstitutionality
on
to show
the attackers
People
McKenzie, 169
doubt.
v.
a reasonable
Colo.
P.2d
Dunbar,
Mosko
232;
P.2d
v.
Colo.
Commissioners,
v. Board
122 Colo.
581; Gettman
discrimination osteopathy, chiropodists, dentists, doctors medicine, professions practice their and by all doctors practices scope grace of their state. authority to one limitation of limited law. Where the *7 in the of from a basic class licensee results difference scope practice, connot be said that of authorized it arbitrarily. legislature Smith, Howe v. has acted only Super. is the classifi 212, A.2d It when Pa. distinctions cation is not founded on real and substantial unconstitutional. that it becomes judgment is affirmed. Day dissents. Mr. Justice. Day, dissenting:
Mr. Justice
(cid:127)I dissent. practice scope (cid:127)The.majority that the states — among listing healing professions them of.the member agree.. we have chiropractors— limited law. I But is legislative prohi- in this case not consideration under. chiropractors signing against but death certificates bition regulation a rule and of the Board of Health which ex- my beyond opinion, power. tends, in far the Board’s That persons qualified the rule does a class of exclude purposes evaluate the information for statistics vital may easily legislative quoted be demonstrated acts majority opinion. in the alia,: example, For inter states, C.R.S. ** sign
“Midwives shall not certificates plain language! legislature pro- That’s used no such language against any chiropractors hibitive of its prohibition plain In enactments. the absence of such I disqualifying legislation. no find re- The provided is quired to take the examination for in C.R.S. seq. engaged 91-5-1, et In that everyone agrees in the act those — prac- arts which includes the — chiropractic persons tice of are deemed to be those practicing “any system operation, for the treatment, diagnosis, prescription practice prevention, or for the adjustment palliation, cure, ascertainment, or relief, deformity, correction disease, in- human ailment, jury unhealthy physical or abnormal con- or mental (Emphasis added.) dition.” C.R.S. 91-5-3. scope qualifications
I think the which are re- quired to be demonstrated to be able example, field the true test. For are medical there practitioners scope practice, who have limited the of their perhaps only eyes or ears, and have been en- gaged years. say they Yet who would not could sign qualifications a death certificate in view the basic practice. on their admission to legislation, 23-1-2(1),
In other defines including diagnosing analyzing , anyone holding human Therefore, ailments. a cer- *8 tificate from the State Colorado which declares to public qualified capable diagnosing that he is to and analyzing give and human ailments can the information required 66-8-6(1) (r) in C.R.S. 1963, —“Cause of including primary and causes, immediate con- and
tributory complications, any, duration of and causes or each.” Board section the State 66-8-7,which is the 1963, interpret and attempted rules to
of Health has regulations amended and first enacted was licensing providing of those for the act 1957. new chiropractic was engaging in Colorado my judgment this passed that It is considered declaring a 66-8-7, amendment act, enacted after the analyze diagnose qualified human and to interpretation of “non- hardly comports ailments with an attendance.” medical dealing matters in similar laws
It is axiomatic that the complex Health Public as the voluminous varied and profes- licensing regulating Act and the statutes legislative pari materia to avoid be read in sions should Department power in no inherent conflict. There is regulations promulgate which to rules and of Health granted legislature to nullify has the license which the persons attempted here. to excluded the class Additionally, that C.R.S. be considered it should concerning (t) “Special provides information 68-8-6 * hospitals court This institutions deaths in Denver judicial that there is in notice of the fact can take functioning duly hospital licensed powers con- under the of Health the State Depart- seq. The same et ferred in C.R.S. promulgated rule and has of Health which ment many years ago regulation, attack that case here under operate particular deny attempted to to to license Spears Hos- Clinic hospital. Free said in This court pital Health, 122Colo. P.2d State Board v. statutory authority department was that the operate right open deny institution the practices hospital. in that no medical doctor a hospital, Since to see how the information it is difficult hospital complied particular could be with if those of that *9 permitted sign in attendance are not to fill out and requiring that information. Additionally, regulation the rule and Board of the State incongruous cognizance of Health is when one takes the fact that the coroner who is to be summoned in the usually event of “death without medical attendance” is layman an undertaker, and in some instances a elected partisan county lay- If an election. undertaker or qualified coroner is to make aout death then certificate, say it does not make sense that one who is qualifications to demonstrate the demanded a chiro- practor certify cannot to such information.
I would hold the Health Board rule in conflict granted chiropractors with the license under C.R.S. 23-1-2(1), seq. et and therefore void.