Lead Opinion
In the Food, Drug, and Cosmetic Act (FDCA), 21 U.S.C. § 301 et seq. (1976 & Supp. V 1981), Congress has required the Secretary of Health and Human Services or her delegate, the Commissioner of the Food and Drug Administration (FDA),
In this case we review FDA’s decision to take no action — either investigatory or reg
I. Background
During the last six years at least five states, including Texas and Oklahoma, have enacted statutes adopting lethal injection as a means of human execution.
Because the lethal injection statutes authorize state prison officials to make unapproved use of drugs distributed in interstate commerce, appellants petitioned FDA to enforce the Act against the states.
1. Affix a boxed warning to the labels of the drugs specified for use in a lethal injection by statutes or prison policies in Texas, Oklahoma, Idaho and New Mexico that these drugs are not approved for use as a means of execution, are not considered safe and effective as a means of execution, and should not be used as a means of execution[;]
2. Prepare and send to the manufacturers of the drugs and to prisons and departments of corrections in Texas, Oklahoma, Idaho and New Mexico * * * notices advising that the drugs specified in those states’ execution statutes or prison policies for use in an execution as well as any other drug or drugs are not approved for use as a means of execution, are not considered safe and effective as a means of execution, and should not be used as a means of execution;
3. Place in the Drug Bulletin an article advising that the drugs specified for use in a lethal injection by statutes or prison policies in Texas, Oklahoma, Idaho and New Mexico are not approved for use as a means of execution, are not considered safe and effective as a means of execution, and should not be used as a means of execution;
4. Adopt a policy and procedure for the seizure and condemnation from prisons or state departments of corrections of drugs which are destined or held for use as a means of execution; [and]
5. Recommend the prosecution of manufacturers, wholesalers, retailers and pharmacists who knowingly sell drugs for the unapproved use of lethal injection and prison officials who knowingly buy, possess or use drugs for the unapproved use of lethal injections.
Letter to the Secretary at 18-19, JA 31-32. In addition, appellants requested an evidentiary hearing on any issue of controlling fact. Id. at 19, JA 32.
On July 7, 1981 the Commissioner of FDA, by letter, refused to take any of the actions requested in appellants’ petition. Letter from the Commissioner at 2, JA 87. Rather than investigate appellants’ claims, the Commissioner asserted that FDA’s jurisdiction did not extend to the regulation of state-sanctioned use of lethal injections. Id. Indeed, because these were “duly authorized statutory enactments [that furthered] * * * proper State functions,” the Commissioner indicated that, even if it had jurisdiction, FDA would not gather any evidence or pursue any enforcement. Id. at 3, JA 88. He noted two reasons for refusing to investigate or to enforce: (1) the case law on the unapproved use of drugs otherwise approved by FDA was not uniform, and (2) FDA had a policy of not initiating enforcement action against unapproved uses of approved drugs absent “serious danger to the public health.” Id. The Commissioner could find no such “danger” where a state had properly enacted a capital punishment law. Id.
On September 16, 1981 appellants filed suit in the District Court seeking to compel FDA to fulfill its statutory obligation to investigate and to regulate the unapproved use of approved drugs in human execution systems. After limited discovery, both appellants and FDA filed cross-motions for summary judgment.
On August 30, 1982 the District Court granted summary judgment to FDA. The court declined to decide the jurisdictional issue, but went on to hold that “decisions of executive departments and agencies to refrain from instituting investigations and enforcement proceedings are essentially unreviewable by the courts.” Dist.Ct.Op. at 10, JA 224 (emphasis in original). Thus FDA’s “decision to refrain from interfering with the implementation of state capital punishment statutes constitutes a defensi
Larry Leon Chaney and the other seven prisoners then filed this appeal.
II. FDA’s Jurisdiction Over Lethal Injections
The Commissioner of FDA refused to investigate appellants’ allegations or to assess and respond to the evidence they presented. Instead, he asserted that FDA did not have jurisdiction to interfere with state governments’ use of prescription drugs for the purpose of causing death by injection. We disagree.
In determining whether FDA has jurisdiction over a particular drug or practice, the Supreme Court has counselled us to inquire “not merely * * * into statutory purpose,” but also into the “various sorts of supervision [needed] to effectuate the goals of the Act * * *.” Toilet Goods Ass’n, Inc. v. Gardner,
On appeal, FDA does not focus its energies on the argument that the unapproved use of drugs for lethal injection is outside the general jurisdictional provisions of the Act. Instead, FDA argues that state-sanctioned use of lethal injections comes within a commonly recognized еxception to the Act’s broad and protective coverage: the “practiee-of-medicine” exemption. FDCA’s legislative history expresses a specific intent to prohibit FDA from regulating physicians’ practice of medicine.
The problem with the Commissioner’s analogy is his starting point: that the practice of medicine is exempt because physicians are licensed by the states. There is scant legislative history on the subject,
The better explanation for the practice-of-medicine exemption is that Congress did not want to interfere with physicians’ treatment of their patients. New uses for drugs are often discovered after FDA approves the package inserts that explain a drug’s approved uses. Congress would have created havoc in the practice of medicine had it required physicians to follow the expensive and time-consuming procedure of obtaining FDA approval before putting drugs to new uses.
If FDA were correct that physicians’ use of drugs is not within FDA’s jurisdiction simply because physicians are licensed by the states, then it would necessarily follow that FDA could have no authority to regulate drugs that state-licensed physicians administer to prison inmates in experimental clinical investigations and no authority to regulate drugs that state-licensed veterinarians use to put animals to their death. But FDA has in fact regulated drugs used in prison clinical investigations, see 21 C.F.R. § 50.44 (1983), and in veterinary practices, see United States v. Beauthanasia-D. Regular, [1979 Transfer Binder] Food Drug Cosm.L.Rep. (CCH) 138265 (D.Neb.1979). In both situations FDA has rejected arguments that it does not have authority to regulate unapproved uses of approved drugs.
FDA did suggest cursorily in both its brief on appeal, brief for appellee at 26 n. 25, and its initial Letter from the Commissioner, JA 86-88, that the use of drugs for lethal injections, even if not covered by the practice-of-medicine exception, falls outside the jurisdictional ambit of the FDCA. The dissent to this opinion has graciously elaborated FDA’s alternative argument; while acknowledging the inapplicability of the practice-of-medicine exception, the dissent argues that “FDA jurisdiction depends upon the existence of misbranding under § 331(k), which cannot be established under the facts of this case.” Dissent at 1198.
Section 331(k) prohibits any action taken upon a “food, drug, device, or cosmetic, if such act is done while such article is held for sale (whether or not the first sale) after shipment in interstate commerce and results in such article being adulterated or misbranded.” 21 U.S.C. § 331(k). The dissent contends that no misbranding could have occurred in the present case because the drugs that prisons hold for use in lethal injections cannot be deemed to be “held for sale” under any “conceivable interpretation of the English language.” Dissent at 1199.
This rhetorical flourish masks what is in essence a “plain meaning” argument, and we do not fulfill our interpretive role when we look only to the statutory language. Inquiry into the statutory scheme and legislative history of the FDCA and subsequent amendments reveals a specific congressional intent to prevent misbranding of drugs at each stage of the distribution process from manufacturer to patient. Accord United States v. Evers,
In apparent recognition of the broad scope of the term “held for sale,” the dissent must strain to argue that Section 331(k) nonetheless does not apply because the рrison officials in this case are not the penultimate actors at whom this section is aimed, but rather the ultimate consumers of the drug and thus beyond the strictures of the Act. This view blinks reality. The ultimate consumer is not the last person to purchase the drug, but the last person to consume the drug — usually a patient, as United States v. Evers notes,
FDA admits that it has jurisdiction over all state laws “that purport[] to legitimize the lawful shipment of an unapproved drug in interstate commerce, or that purport[] to permit its misbranding after shipment * * Brief for appellee at 20 n. 21. The states’ lethal injection statutes purport to mandate the use of certain prescription drugs for a purpose not listed on their label. The activity of the states falls within the jurisdictional ambit of Section 331 of the FDCA, and the practice-of-medicine exception does not immunize this activity from the FDCA’s prohibition of misbranding. FDA therefore must have jurisdiction to regulate such activity.
III. Enforcement Discretion
Of course, FDA determined that even if it had jurisdiction it would choose, in its
A. Judicial Review of Enforcement Discretion
Section 10 of the Administrative Procedure Act (APA), 5 U.S.C. § 701(a) (1982), governs judicial review of agency action. Under Section 10, all final agency action is subject to judicial review unless such review is precluded by statute or committed to agency discretion by law. 5 U.S.C. § 701(aXl) & (2).
The determination of whether there “is law to apply” turns on such pragmatic considerations as whether judicial supervision is necessary to safeguard plaintiffs’ interests, whether judicial review will unnecessarily impede the agency in effectively carrying out its congressionally assigned role, and whether the issues are appropriate for judicial review. Natural Resources Defense Council, Inc. v. SEC, supra,
Where the unapproved use of an approved new drug becomes widespread or endangers the public health, the Food and Drug Administration is obligated to investigate it thoroughly and to take whatever action is warranted to protect the public. * * * When necessary the Food and Drug Administration will not hesitate to take whatever action * * * may be required to bring possible harmful use of an approved drug under control.
* * * Thus, where a manufacturer or his representative, or any person in the chain of distribution, does anything that directly or indirectly suggests to the physician or the patient that an approved drug may properly be used for unapproved uses for which it is neither labeled nor advertised, that action constitutes a direct violation of the Act and is punishable accordingly.
Policy Statement, 37 Fed.Reg. at 16504. This policy statement which FDA still considers binding and to have substantive effect, see Memorandum in Support of Motion to Dismiss at 4-5 & nn. 10, 12, JA 131-132, comes within the APA’s definition of a rule
The District Court did not review the APA’s provisions governing judicial review or discuss the case law establishing the strong presumption of reviewability.. Rather, it relied on cases articulating the venerable proposition that courts should not unduly interfere with prosecutorial discretion.
The District Court correctly noted that the “absence of a statutory exemption for state-mandated activity does not logically compel or even suggest * * * that the Commissioner has no discretion to refrain from initiating requested investigative and/or enforcement proceedings * * *.” Dist.Ct.Op. at 15, JA 229 (emphasis in original). But neither does it mean that the Commissioner has absolute discretion in enforcement decisions or that these decisions are insulated from judicial review. The presumption is in favor of judicial review, and nothing in this case is sufficiently cornpelling to rebut this presumption. We must conclude that FDA’s inaction here is subject to judicial review.
B. Scope of Judicial Review
When reviewing informal agency action of this type a court must conduct a “searching and careful” review of the “whole record” to determine if the agency has been “arbitrary or capricious.” See 5 U.S.C. § 706(2)(A) (1976); FPC v. Transcontinental Gas Pipe Line Corp.,
First, the Commissioner statеd that the “scope of his legal authority” to regulate lethal injections in state capital punishment systems is “highly uncertain.” Brief for appellee at 14. But this argument simply repeats his meritless contention that FDA did not have jurisdiction in the first place.
Second, the Commissioner asserts that the use of drugs in lethal injections does not pose a “serious danger to the public health.” Brief for appellee at 15. But he cites no evidence to support this proposition. Rather, he irrebuttably presumes that “duly authorized statutory enactments * * * [which further] proper State functions” cannot, as a matter of law, pose such a danger to the public. Letter from the Commissioner at 3, JA 88. This claim is remarkable in light of the uncontroverted evidence appellants submitted to FDA, whiсh shows that drugs used in lethal injections pose a substantial threat of torturous pain to persons being executed. Royal Commission on Capital Punishment, 1949-1953 Report (1953), Exhibit 1 to Letter to the Secretary, JA 34-40. Furthermore, this claim flies in the face of the Commissioner’s admission that FDA has jurisdiction over all state laws “that purport ] to legitimize the lawful shipment of an unapproved new drug in interstate commerce or that purport[] to permit its misbranding after shipment * * *.” Brief for appellee at 20 n. 21. If some state laws can pose a “serious danger to the public health,” no state law can be presumed, in the face of substantial evidence to the contrary, not to do so. Rather, FDA can rationally distinguish between laws that do endanger the public health and laws that do not only upon the basis of available evidence. In this case all the evidence shows that lethal injection laws do endanger users of drugs, and thus the public health.
Judge Tamm, writing for this court over a decade ago, once noted that “assertions of discretion inevitably raise questions of degree which must be appraised in the context of the relevant provisions of law and the nature of the particular action sought to be reviewed: ‘[T]he question is not whether agency action is by law committed to agency discretion but to what extent agency action is so committed.’ ” Medical Committee for Human Rights v. SEC, supra,
Appellants have presented substantial and uncontroverted evidence to support their claim that execution by lethal injection poses a serious risk of cruel, protracted death. See Royal Commission on Capital Punishment, 1949-1953 Report (1953), Exhibit 1 to Letter to the Secretary, supra, JA 34-40. Even a slight error in dosage or administration can leave a prisoner conscious but paralyzed while dying, a sentient witness of his or her own slow, lingering asphyxiation. See brief for appellants at 10-11. In light of these risks, FDA’s impermissible refusal to exercise enforcement discretion over the use of drugs for lethal injection — a use well within the jurisdictional ambit of the FDCA, see Part II supra —may also implicate the Eighth Amendment’s prohibition of cruel and unusual punishment.
In a civilized society, if we assume as we must that the state may take the life of a person as punishment, decency demands that the life be taken without cruelty. The Eighth Amendment embodies society’s requirement that the means of punishment not be barbarous or torturous, see Gregg v. Georgia,
Though this failure to meet statutory responsibilities is alone sufficient to invalidate the FDA’s inaction in this case, we note that by failing to exercise its statutory responsibilities FDA also places serious burdens on appellants’ right to a death that is not cruel. As a result of the FDA’s inaction, appellants face the risk of a cruel execution and are deprived of the FDA’s expert judgment as to the effectiveness of the drugs used for lethal injection, the latter fact making any direct challenge they might bring to this method of execution more difficult. Thus, even though FDA is not responsible for the execution of these prisoners, its failure to meet its statutory responsibility may well place constitutionally impermissible burdens on the Eighth Amendment rights of appellants.
Vacated and remanded.
Notes
. See 21 C.F.R. § 5.10 (1983) (delegating authority to the Commissioner of FDA).
. The statute defines the term “new drug” to mean “[a]ny drug * * * not generally recognized, among experts * * *, as safe and effective for use under the conditions prescribed, recommended, or suggested in the labeling thereof * * 21 U.S.C. § 321(p)(1) (1976).
The Supreme Court has interpreted drugs to be “safe and effective” when there is an “expert consensus” founded upon “substantial evidence,” as defined at 21 U.S.C. § 355(d). See United States v. Rutherford,
. FDA may enforce the statute by obtaining court-ordеred injunctions, 21 U.S.C. § 332(a), fines and imprisonment, id. § 333, and seizures, id. § 334(a). FDA may also promulgate regulations and hold hearings, conduct examinations and investigations, require record keeping, make inspections, and issue public reports. Id. §§ 371-375.
In the area of unapproved uses of approved drugs, FDA has indicated that it will take, depending upon the facts of each case, any of the following actions: requiring a labeling change,
. Originally only Larry Leon Chaney and Doyle Skillem were on the petition. The remaining six appellants joined the petition by letter of January 12, 1981.
. See Letter dated December 19, 1980 from counsel for appellants to Secretary, Department of Health and Human Services (hereinafter Letter to the Secretary) at 18-19, JA 31-32. A United States District Court has previously approved FDA’s assertion that drugs used in animal euthanasia must be “safe and effective” and has approved the relevant criteria for making such determinations. See United States v. Beuthanasia-D. Regular, [1979 Transfer Binder] Food Drug Cosm.L.Rep. (CCH) h 38265, at 39129 (D.Neb.1979).
. Letter to the Secretary, supra note 5, at 3, 5, JA 16, 18.
. See, e.g., Idaho Code § 19-2716, as amended by Idaho H.B. No. 752, Amendment to Section 1 (2d Sess., 46th Leg.) (March 31, 1982); N.M. Stat. 31-14-11; Okla.Stat. Tit. 22, § 1014; Tex. Crim.Pro. Code § 43.14; Wash.Rev. Code § 10.95.180.
. Brief for appellants at 3.
. Brief for appellee at 3 n. 3.
. Filing of a citizen’s petition is authorized and governed by 21 U.S.C. § 360g(a) & (f) and 21 C.F.R. § 10.30 (1983).
. Hearings may be held in the agency’s discretion. 21 C.F.R. § 10.30(h)(2) (1983).
. See note 37 infra.
. The first bill to pass either house of Congress that was substantially similar to the present Act included within its definition of “drug” the qualification that it did not apply to “the regulation of the legalized practice of the healing art.” S. 5, 74th Cong., 1st Sess. § 201(b), 79 Cong.Rec. 8351 (1935). In explaining this proviso the committee reports emphasized that the bill was “not intended as a medical practices act and [would] not interfere with the practice of the healing art by chiropractors and others in the States where they are licensed by law to engage in such practice.” S.Rep. No. 361, 74th Cong., 1st Sess. 3 (1935); S.Rep. No. 646, 74th Cong., 1st Sess. 1 (1935). While the definition of “drug” as ultimately enacted did not include this рroviso, see 21 U.S.C. § 321(g) (1976), the legislative history makes clear that Congress did not want to limit a physician’s ability to treat his patients.
. See S.Rep. No. 361, supra note 13, at 3, 5; S.Rep. No. 646, supra note 13, at 1, 2.
. The “new drug” provisions of FDCA require the filing of a new drug application, including full reports of investigations with respect to the drug’s safety and effectiveness; a full list of the articles used as components of the drug; a full statement of the composition of the drug; a full description of the methods used in, and the facilities and controls used for, the manufacturing, processing, and packing of such drugs; samples of the drugs and the articles used as components; and specimens of the labeling proposed to be used. 21 U.S.C. § 355(b). An applicant may have to wait up to six months for action and participate in hearings. Id. § 355(c) & (c)(2). Hence, these “new drug” provisions simply do not fit the reality of the clinical situation.
. The case law under this and related statutes is consistent with our reading of the legislative history. See United States v. Evers,
Indeed, FDA’s prior interpretation of the relevant legislative history matches our own. Throughout the debate leading to enactment [of the Act], there were repeated statements that Congress did not intend the Food and Drug Administration to interfere with medical practice and references to the understanding that the bill did not purport to regulate the practice of medicine as between the physician and the patient. Congress recognized a patient’s right to seek civil damages in the courts if there should be evidence of malpractice, and declined to provide any legislative restrictions upon the medical profession.
Policy Statement, 37 Fed.Reg. at 16503 (emphasis added).
. See Protection of Human Subjects; Prisoners Used as Subjects in Research, 45 Fed.Reg. 36388 (May 30, 1980) (rejecting argument in context of drug investigations with stаte prisoners); Answer of Defendant in D.D.C. Civil Action No. 81-2265, at H 20, JA 91 (admitting that FDA has previously taken the position that new drug applications demonstrating the safety and effectiveness of chemicals used to put dogs to sleep must be filed).
. FDA’s contention that the Act embodies congressional deference to state law in “several other respects” is further evidence of its misreading of congressional intent. FDCA is based upon the Commerce power, and the fact that the Act does not apply to wholly intrastate activity simply reflects the limits of Congress’ powers, not deference to all state-mandated activity. Likewise, FDA’s claim that “the Act generally defers to state law in areas that do not directly conflict with it,” brief for appellee at 18, is a curious way of stating the obvious proposition that a state may at times regulate in areas in which Congress has elected not to regulate. But the Supremacy Clause of the Constitution still preempts any state law, like a lethal injection statute, that conflicts with federal law. See Arkansas v. Kansas & Texas Coal Co.,
. Accord United States v. Sene X Eleemosynary Corp.,
. United States v. Evers, supra note 16, does not support a restrictive reading of the “held for sale” language in this case. In Evers the court held that a physician did not violate the FDCA when he held certain approved drugs for treatment of his patients and simultaneously advertised and advocated a treatment program that involved an unapproved use of those drugs. Although the physician had both held drugs for sale and advоcated unapproved use of the drugs without proper instructions, the court found no violation on the basis of the unique facts of the case. The persons for whose benefit the physician held the drugs— his patients — were not the persons to whom the physician owed the statutory duty to give adequate instructions. The practice-of-medicine exception exempted the physician from the duty not to advocate an unapproved use to his patients. The duty ran to other physicians who might hear his advertisement of the unapproved treatment process and might therefore use the drugs without adequate instructions. Thus the physician neither “held for sale” to the doctors to whom he owed a statutory duty not to misbrand, nor owed a duty to the patients to whom he “held for sale.” Under these unique facts, no violation was made out.
Evers is clearly distinguishable from the present case. In this case the persons to whom the prisons owe a statutory duty are the same persons for whom the prisons hold the drugs for sale — the prisoners. The FDA cannot, under these circumstances, succeed in its claim that it lacks jurisdiction.
. FDA’s determination that it does not have jurisdiction over drugs used in lethal injections is entitled to only the most limited deference because it is inconsistent with longstanding FDA and court interpretation of the Act. See FEC v. Democratic Senatorial Campaign Committee,
. The APA defines “agency action” to include “the whole or a part of an agency rule, order, license, sanction, relief, or the equivalent or denial thereof, or failure to act," 5 U.S.C. § 551(13) (1982) (emphasis added), and gives courts the power to “compel agency action unlawfully withheld or unreasonably delayed,” id. § 706(1). Thus the APA authorizes courts to review agency decisions to refrain from taking action. See, e.g., Dunlop v. Bachowski,
. The dissent claims that these cases, or at least the portions cited, do not involve the committed-to-agency-discretion exception of 5 U.S.C. § 701(a)(2), which is at issue in this case, but rather the precluded-by-statute exception of § 701(a)(1), which is not. See Dissent at 1193. This claim is flatly inaccurate. In Natural Resources Defense Council, Inc. v. SEC,
More importantly, the neat demarcation that the dissent seeks to draw between the precluded-by-statute and committed-to-agency-discretion exceptions to review tends to muddy the analysis in this areа. Under § 10 claims of nonreviewability are disfavored, whatever their source. The Supreme Court’s analysis in Abbott Laboratories v. Gardner, supra, is instructive. In deciding whether pre-enforcement review of an FDA regulation was appropriate, the
The dissent also seeks to deflect the force of the principle stated in Natural Resources Defense Council, supra, and WWHT, Inc., supra, with the argument that these cases are inapposite to the present controversy because they involved the reviewability of rulemaking, not enforcement, decisions. See Dissent at 1194— 1195. But it is the dissent that misses the mark. We do not rely on these cases to support the proposition that because rulemaking decisions can be reviewed enforcement decisions perforce can be reviewed. Rather, we simply follow the consistent construction of § 10 of the APA articulated in Natural Resources Defense Council and WWHT, Inc. This consistent construction establishes a strong presumption of reviewability in cases under § 10. The courts in Natural Resources Defense Council and in WWHT, Inc. evaluated the reviewability of the rulemaking decisions at issue in light of this strong presumption. Similarly, we take cognizance of the strong presumption as we undertake our evаluation of the reviewability of the exercise of enforcement discretion at issue in the present case.
. The statute has detailed provisions that specifically contemplate judicial review. See, e.g., 5 U.S.C. § 332(a) (jurisdiction of courts over injunction actions); id. § 346a(i) (judicial review of regulations which establish tolerances for pesticide chemicals); id. § 348(g) (judicial review for controversies over food additives); id. § 355(h) (judicial review of new drug orders); id. § 360(g) (judicial review of premarketing provisions).
. The dissent makes light of the importance of Overton Park to the resolution of this controversy. Dissent at 1193. Overton Park must, however, occupy a central place in our analysis: it defines the meaning of the committed-to-agency-discretion exception of § 701(a)(2) that is at issue here. To dilute the power of the Court’s command that we give § 701(a)(2) an extremely narrow construction,
. The Court in Dunlop explicitly rejected the Secretary’s claim that the nonenforcement decision was an unreviewable exercise of prosecutorial discretion, and expressly adopted the reasoning of the lower court on this point.
These considerations apply with equal force to the present controversy. The FDCA provisions are intended not only to protect the general welfare, but also specifically to protect the individuals on whom drugs are used. Since appellants in this case are involuntary users of the drugs, they stand in a position analogous to the unsuccessful union official in Bachowski v. Brennan; if the agency refuses to act, appellants are left unprotected.
To blunt the precedential force of Bachowski v. Brennan, the dissent mischaracterizes the holding as an exceedingly narrow one, based on extraordinary circumstances that justified departure from the usual rule disfavoring review: “The court of appeals finds it necessary carefully to distinguish the type of enforcement responsibility given the Secretary under the L-MRDA from the more typical case in which a decision not to enforce is unreviewable. * * Thus Dunlop reaffirms the principle of general unreviewability of enforcement decisions.” Dissent at 1193. The Court of Appeals in Bachowski, of course, intended just the opposite. The opinion takes pains to limit the applicability of notions of deference to prosecutorial discretion in the area of review of agency enforcement decisions. No language in the opinion even hints that the court viewed the case before it as atypical or extraordinary in any way. Nor does any language in the opinion state or even imply that the court acknowledged a general presumption against review; only with the addition of italics does the language quoted in the dissent even begin to hint at such a meaning. See Dissent at 1193.
. See 5 U.S.C. § 551(4) (1982) (a “ ‘rule’ means the whole or a part of an agency statement of general or particular applicability and future effect designed to implement * * * law or policy”). An agency statement that is binding and that has substantive effect is a rule. See Guardian Federal S. & L. Ass’n v. Federal S. & L. Ins. Corp.,
. That the Policy Statement accompanied an unadopted rule is not decisive. FDA has admitted that the Policy statement is an authoritative statement of agency views as to what the statute under which it operates requires. Memorandum in Support of Motion to Dismiss at 4-5 & nn. 10, 12, JA 131-132; Letter from the Commissioner at 2, JA 87. This admission, moreover, eviscerates any potential argument that FDA renounced the guidelines in the policy statement when it withdrew the proposed rule that accompanied the statement. The withdrawal indicates not that FDA rejected the contents of the policy statement, but only that FDA decided that the proposed rule was not a preferred method of putting the policy goals into effect.
. See notes 1-3, 24 supra and accompanying text. FDCA’s prohibitions are phrased in mandatory terms. See, e.g., 21 U.S.C. § 333(a) (any person who violates § 331 “shall” be imprisoned or fined); id. § 336 (at minimum, Secretary must provide suitable written notice or warning of minor violations). The statute’s legislative history indicates that Congress intended for courts to review and to grant appropriate relief against “any act or omission on the part of the Department in the administration of the act.” S.Rep. No. 646, supra note 13, at 10.
. See, e.g., United States v. Evers, supra note 16; United States v. Beuthanasia-D. Regular, supra note 5; Hoffmann-LaRoche, Inc. v. Weinberger,
. 2 K. Davis, Administrative Law Treatise §§ 7:26-7:28, 28:16 (2d ed. 1979 & 1982 Supp.). It is a well established precept that courts can review agеncies for conformance to their rules
. Dist.Ct.Op. at 10-11, JA 224-225. The judicial reluctance to interfere with prosecutorial discretion arises from the lack of specific action to review, the lack of a record, separation of powers principles, the prosecuting agency’s need to control its own resources, solicitude for the accused, and adverse effects on voluntary settlement. But both courts and commentators have convincingly demonstrated that these concerns do not justify committing agency enforcement action completely to administrative discretion or totally precluding judicial review. See Dunlop v. Bachowski, supra note 22,
. See, e.g., Marshall v. Jerrico, Inc.,
. See note 22 supra.
. NLRB v. Sears, Roebuck & Co.,
Kixmiller v. SEC,
Moreover the two FDCA cases that the District Court cites do not hold that courts cannot review FDA’s complete refusal to investigate and regulate an entire class of drugs. In Nat’l Milk Producers Federation v. Harris,
. In light of the strong presumption favoring judicial review articulated in Citizens to Preserve Overton Park, Inc. v. Volpe,
. Under the APA a negative, but final, disposition of an authorized petition for agency action is a final order subject to judicial review. See 5 U.S.C. § 551(6) (1982).
. The District Court reviewed the statement only to determine whether FDA had completely abdicated its statutory responsibilities. See Dist.Ct.Op. at 15, JA 229. This kind of review is applied to agency action taken pursuant to statutes which specifically preclude judicial review. Courts undertake such review only to ensure that the agency does not flagrantly ignore specific statutory mandates. See, e.g., Leedom v. Kyne,
By contrast, when reviewing agency action under the “arbitrary and capricious” test, courts must assure themselves that the agency “ ‘has exercised a reasoned discretion, with reasons that do not deviate from or ignore the ascertainable legislative intent.’ ” Lead Industries Ass’n, Inc. v. EPA,
. The case was decided below on a motion for summary judgment. Therefore, appellants’ factual allegations that lethal injection does not cause a “quick and painless” death and that it “poses a substantial threat of torturous and unnecessary pain to persons being executed” must be assumed to be true. Complaint 18, JA 9. See Wolston v. Reader’s Digest Ass’n, Inc.,
. See Part II supra.
. This policy statement asserted a broad responsibility to “investigate * * * and to take whatever action is warranted to protect the public.” Policy Statement, 37 Fed.Reg. at 16504. It specifically recognized that the Act “did not purport to regulate the practice of medicine as between the physician and the patient.” Id. at 16503. It mentioned nothing about exempting all state-licensed activity.
. The Commissioner has not asserted, at any point, that budgetary constraints would prevent FDA from investigating and taking appropriate action. While we have no occasion to address this hypothetical explanation, we do note that other courts have rejected it in situations where Congress (or the agency) has promised that action will be taken. See, e.g., Adams v. Califano, D.D.C. Civil Action No. 70-3095 (Dec. 29, 1977); Hoffmann-LaRoche, Inc. v. Weinberger, supra note 30; American Public Health Ass’n v. Veneman, supra note 30.
. We do not imply that FDA must gather evidence concerning the health effects of all alleged statutory violations to survive judicial scrutiny. We simply hold that FDA cannot irrebuttably presume that a particular practice does not pose a “serious danger to the public health” because that practice is sanctioned by state law. FDA must give rational reasons why the practice itself can be presumed to pose no danger to the public if it is to deny a petition without investigating the allegations, particularly where the petition presents substantial evidence to the contrary.
. On appeal government counsel contend that lethal injection statutes cannot threaten the public health because, by definition, they apply only to a small number of persons convicted of capital offenses, and such persons have extensive legal protection under other laws. See brief for appellee at 15-16. As a preliminary matter, we note that courts properly affirm only on the basis of the agency’s reasons, and not on the subsequent rationalizations of counsel. Burlington Truck Lines, Inc. v. United States,
. This conclusion is particularly compelling since FDA refused to take any action with regard to an entire category of allegedly pro
. See generally Vorenberg, supra note 32.
. There is ample precedent to support the District Court in affirmatively ordering agency action. See, e.g., Adams v. Richardson, supra note 22,
Dissenting Opinion
dissenting:
The majority converts a law designed to protect consumers against drugs that are unsafe or ineffective for their represented use into a law not only permitting but mandating federal supervision of the manner of state executions. This implausible result is achieved by rewriting the law with regard to enforcement discretion and ignoring it with regard to FDA jurisdiction. I dissent from what seems to me a clear intrusion upon powers that belong to Congress, the Executive Branch and the states. I would affirm for the reasons set forth in the district court’s opinion.
I. Enforcement Discretion
Even if it were correct that the Food, Drug, and Cosmetic Act makes the challenged drug use illegal, the majority’s disposition of this case would not be supportable under well established law governing judicial review of agencies’ enforcement discretion. Generally speaking, enforcement priorities are not the business of this Branch, but of the Executive — to whom, and not to the courts, the Constitution confides the responsibility to “take Care that the Laws be faithfully executed,” U.S. Const, art. II, § 3. Preserving that sound allocation of responsibility was one of the purposes, and has been perhaps the primary application, of that provision of the Administrative Procedure Act which excludes from judicial review “agency action ... committed to agency discretion by law.” 5 U.S.C. § 701(a)(2) (1976). As this court has accurately stated, “[a]n agency’s decision to refrain from an investigation or an enforcement action is generally unreviewable.” Kixmiller v. SEC,
[I]n the shaping of its remedies within the framework of regulatory legislation, an agency is called upon to exercise its specialized, experienced judgment. Thus, the decision as to whether or not an order against one firm to cease and desist from engaging in illegal price discrimination should go into effect before others are similarly prohibited depends on a variety of factors peculiarly within the expert understanding of the Commission.... [T]he Commission alone is empowered to develop that enforcement policy best calculated to achieve the ends contemplated by Congress and to allocate its available*1193 funds and personnel in such a way as to execute its policy efficiently and economically.
Moog Industries v. FTC,
The majority opinion gives its view of enforcement discretion the appearance of reality by quoting from Supreme Court cases that assert a “strong presumption” of reviewability rebuttable only by “clear and convincing” legislative intent to negate review. Maj.Op. at 1183-1184 n. 23. These excerpts are misleading, since they are taken from cases or portions of cases that do not involve review of enforcement discretion. Indeed, all but one of them come from cases or portions of cases that do not even deal with the “committed to agency discretion” provision of the APA (§ 701(a)(2)), but rather with the provision that denies review “to the extent that .. . statutes preclude judicial review” (§ 701(a)(1)). The citation to Dunlop v. Bachowski,
agree[d] with the Court of Appeals, for the reasons stated in its opinion,502 F.2d 79 , 86-88 (CA 3 1974), that there is no merit in the Secretary’s contention that his decision is an unreviewable exercise of prosecutorial discretion.
Id. at 567 n. 7,
The other Supreme Court cases cited by the majority also do not support its position. Abbott Laboratories v. Gardner,
Cases in this circuit no more support narrowing the “agency discretion” exception by an across-the-board application of a “presumption of reviewability” than do the decisions of the Supreme Court.
Nor are the panel opinions of this and other circuit courts cited by the majority any more probative of the novel assertion of a “presumption of reviewability” of enforcement decisions. None of them sets forth such a startling proposition, and all of them display special circumstances overcoming the usual presumption of nonreviewability. Thus, the case requiring an agency to enforce the restrictions of the Davis-Bacon Act (Carpet, Linoleum & Resilient Tile Layers, Local Union No. 419 v. Brown,
The short of the matter is, that far from there being a “presumption of reviewability” with regard to enforcement determinations, the well known presumption is precisely the contrary. As the author of the majority opinion noted in dissenting from our en banc decision in Curran v. Laird, supra:
This “presumption of reviewability” is often regarded as reversed for certain types of Executive actions. Actions relating to the conduct of foreign or military affairs have not normally been reviewed by the courts, absent exceptional circumstances.... Thus we would not normally review the failure of the Executive to exercise emergency powers granted it for the purpose of meeting the military needs of the nation.
Proceeding, then, from the premise that an agency’s exercise or (a fortiori) nonexercise
The opinion places its major reliance upon what it calls the FDA’s “Policy Statement,” the relevant portion of which is set forth at page 1186. Even if an agency’s failure to follow its rules regarding enforcement policy is reviewable (which may not be the case, see e.g., United States v. Snell,
More fundamentally, however, the quoted statement is not an agency rule, and is indeed not even an authoritative policy statement. The majority’s opinion gives it the title “Policy Statement” (which it never bore), see Maj.Op. at 1176 & n. 3, and uses that conclusory designation throughout. In fact, however, the statement was part of the policy justification set forth in a Notice of Proposed Rulemaking, with respect to a proposal that was never adopted. The paragraphs quoted by the majority, id. at 1186, and particularly the first of them, recite principles that are more specifically embodied in the subsequently recited text of the proposed amendment to 21 C.F.R., see 37 Fed.Reg. at 16504. It is remarkable to suggest that, although the text of the rule was rejected, the substance of that text was authoritatively adopted by the mere recital of it in the Notice of Proposed Rulemaking. Even if one is to accept (as I am not inclined to) the expansive dictum in two of our cases referred to by the majority that the term “rule” is “broad enough ‘to include nearly every statement an agency may make,’ ” Center for Auto Safety v. NHTSA,
[I]t is the substance of what the [agency] has purported to do and has done which is decisive.
The opinion seeks to remedy this patent deficiency by observing that the “FDA still considers [the so-called Policy Statement] binding and to have substantive effect,” Maj.Op. at 1186. That is not so. The majority’s citation to support that conclusion is to a portion of the agency’s Memorandum in Support of the Defendant’s Motion to Dismiss, which (in turn referring to the Commissioner’s letter response to the Appellants’ request) only concedes that the Notice sets forth the agency’s position on “the legal status of approved labeling for prescription drugs.” Jt.App. at 131 n. 10. That legal status has nothing to do with the rigid and detailed enforcement obligations which the opinion suggests the agency has imposed upon itself.
Thus, there is ultimately no special factor to support the extraordinary assertion of authority to control the agency’s enforcement discretion in the present case — nothing, except the majority’s disagreement with the agency’s determination that no serious danger to the public health exists. But we are not the only public officials endowed with intelligence and worthy of trust, and our system of laws has committed the relative evaluation of public health concerns to others. Moreover, even if the clear erroneousness of an agency’s reason for not conducting enforcement activities were a proper basis for our intervention (which it is not), there is no clear error here. Without belittling the humane concerns associated with the present complaint, it must be acknowledged that the public health interest at issue is not widespread death or permanent disability, but (at most) a risk of temporary pain to a relatively small number of individuals (200, which the majority swells to 1,100 by including prisoners under sentence of death in states that have not adopted lethal injection statutes). Moreover, it is not a matter of pain versus no pain, but rather pain of one sort substituted for pain of another — and in all likelihood substitution of a lesser pain, since that is the principal purpose of the lethal injection statutes,
As for the “anachronistic ring” which the majority hears in all this (Maj.Op. at 1188 n. 36): If the clear statements of this court, see Kixmiller and Action on Safety and Health, supra, become downright anachronisms in nine years, we should perhaps stop publishing our opinions. I fancy, however, that the sound which the majority heard was not an anachronistic ring at all, but the stifled cry of smothered stare decisis, or perhaps the far-off shattering of well established barriers separating the proper business of the executive and judicial branсhes.
II. Jurisdiction
If, however, the discretion issue is found against the FDA, it becomes necessary to establish the existence of FDA authority to take the requested action. The majority opinion fails to carry this point as well. It properly demolishes the agency’s reliance upon state action, see Maj.Op. at 1179-1181, but does not address the more serious obstacle: FDA jurisdiction depends upon the existence of misbranding under § 331(k), which cannot be established under the facts of this case.
The majority opinion concludes and summarizes its discussion on the jurisdictional point as follows:
The states’ lethal injection statutes purport to mandate the use of certain prescription drugs for a purpose not listed on their label.... FDA therefore must have jurisdiction to regulate such activity-
Maj.Op. at 1182 (emphasis added). This progression of thought does not follow unless the opinion establishes the intermediate proposition that “using prescription drugs for a purpose not listed on their label
The majority opinion points out, quite corrеctly, that § 331(k) was added to the Act with the intent of expanding its application. Given the fact that the Act’s primary application was to commercial transactions, it was a vast expansion to extend it to sales within a state after the first sale following shipment in interstate commerce. Nonetheless, that expansion was still limited to misbranding which occurs “while such article is held for sale.” This is a statute that bears criminal penalties, and it is simply not possible to disregard this qualification entirely, as the majority would do. It is sometimes improper to “look only to the statutory language,” Maj.Op. at 1181; but it is always improper — and opens the gates much more widely to judicial abuse — to ignore intentional statutory language entirely. Thus, I would acknowledge that the expansive intent of the amendment may be invoked to extend the statutory text to all “holding” that occurs while the drug is in the stream of commerce from manufacturer to ultimate consumer, see United States v. Wiesenfeld Warehouse Co.,
None of the cases relied upon by the majority to support the principle of expansive interpretation involves an expansiveness beyond the field of actual sale. United States v. Sene X Eleemosynary Corp.,
The majority opinion attempts, once again unsuccessfully, to condemn the agency out of its own mouth. The majority asserts that “[i]n both [prison clinical investigations and veterinary practices] FDA has rejected arguments that it does not have authority to regulate unapproved uses of approved drugs.” Maj.Op. at 1180. But examination of the citations shows that in the first of these situations the Commission was prоceeding not under the more general portions of the statute at issue here, but under its specific authority to regulate clinical testing of drugs, see 21 U.S.C. §§ 355(i), 357(d); 21 C.F.R. § 50.44 (1982); and that the second situation involved assertion not of authority to regulate use, but of authority to require proper labeling of drugs sold for a particular use. See United States v. Beuthanasia-D. Regular, [1979 Transfer Binder] Food Drug Cosm.L.Rep. (CCH) 1f 38265 (D.Neb.1979). Of course even if the FDA had- acknowledged what the opinion suggests, we are not in the habit of permitting an agency, to expand its authority by simply acknowledging the legitimacy of such expansion. Except for special provisions such as that alluded to above pertaining to clinical or investigative drug use, there is nothing in the statute giving the Commission “authority to regulate unapproved use of approved drugs.”
sk * *
The majority discerns that “the FDA is clearly refusing to exercise enforcement discretion because it does not wish to become embroiled in an issue so morally and constitutionally troubling as the death penalty.” Maj.Op. at 1192. I doubt that. As discussed above, there were plenty of well supported reasons for the Commission to refuse to act. If speculations as to motivation are to be indulged in, I would suggest that the agency was properly refusing to permit its powers and the laws it is charged with enforcing from being wrongfully enlisted in a cause that has less to do with assuring safe and effective drugs than with preventing the states’ constitutionally permissible imposition of capital punishment. This court should have done the same. It is our embroilment, rather than the FDA’s abstention, that is remarkable.
I would affirm on the basis of the opinion below.
. The majority asserts (footnote 25) that the Supreme Court itself has not interpreted Over-ton Park in this fashion, since it cited that case in Dunlop to support the proposition that the Secretary of Labor’s exercise of enforcement discretion was renewable. The majority overlooks, however, that both the portion of Dunlop in which the citation appears and the portion of Overton Park to which the citation refers, deal with the possible bar to review posed — not by § 701(a)(2), the “committed to agency discretion” provision — but by § 701(a)(1), which relates to statutory preclusion of judicial review. As explained above, I do not dispute that the latter provision requires a clear expression of legislative intent.
. The majority’s response (footnote 23) fashions a mixture out of this dissent’s quite separate assertions regarding Supreme Court case law, on the one hand, and the case law of this and other courts of appeals, on the other hand. I stand by the assertions, unmingled, and must leave it to the reader to dialyze the majority opinion.
. When particular agency action can be set aside by the courts only for a narrow category of alleged infractions (e.g., complete abdication of enforcement responsibility, see Adams v. Richardson, supra) it is possible to describe that situation by saying either that the agency action is not generally reviewable or that it is reviewable but “the scope of review [is] very narrow,” WWHT, Inc. v. FCC, supra,
. It is interesting to note that Professor Davis’s statement discussed in text applied only to decisions to prosecute. Even in the limited sense in which that statement is to be understood (availability of review in some instances) it is not extended to “prosecutors’ decisions not to prosecute,” as to which “the law is still somewhat unclear.” 2 K. Davis supra, § 9.6 at 244.
. See Gimlin, Administering the Death Penalty, Editorial Research Rep., Weekly Reminder Service, August 19, 1977:
The public hanging, with its circus atmosphere, disappeared in America early in this century. But then the electric chair, installed as a more humane device for snuffing out life, has produced a host of grim stories from witnesses at the death scene. The gas chamber, usually regarded by penal officials as an improvement over the electric chair, requires a sealed room and a strapped-in victim ....
Oklahoma and Texas have since moved in a new direction, providing for execution by lethal injection. “I think and I hope this will provide some dignity with death,” Texas Gov. Dolph Briscoe said last May when he signed the injection bill into law, ... Briscoe could have added that for years veterinarians have considered the lethal injection the most “humane” way of putting hopelessly crippled or diseased animals out of their misery.
The Report cited repeatedly by the majority, Royal Commission on Capital Punishment, 1949-1953 Report (1953), said that “intravenous injection, if practicable, would fulfill our three requisites [of humanity, certainty and decency] better than any other method.” Id. at 257. The Report doubted, however, the method’s practicability, on the basis of medical knowledge and technique thirty years ago, and therefore rejected it for the time being, but recommended, “unanimously and emphatically, that the question should be periodically examined, especially in the light of progress made in the science of anaesthetics, with a view to a change of system being proposed to Parliament
. The majority opinion seeks to preclude consideration of the realities of the matter by asserting that the Commissioner “irrebuttably presume[d] that ‘duly authorized statutory enactments * * * [which further] proper State functions’ cannot, as a matter of law, pose such a danger to the public.” Maj.Op. at 1190. That is not so. What the Commissioner wrote was that “[w]e cannot conclude that those dangers [of a serious risk to the public health or a blatant scheme to defraud] are present under State lethal injection laws, which are duly authorized statutory enactments in furtherance of proper State functions.” Letter to the Commissioner at 3, Jt.App. at 88 (emphasis added). If, in that excerpt, the phrase “lethal injection” were omitted, or the word “which” were replaced with the words “since they,” it would be possible to assert that the Commissioner was maintaining that no serious health hazard was presented only by virtue of the fact that these were state laws. As written, however, the excerpt refers to the specific nature of these laws (“lethal injection laws”) — and therefore does not exclude from the Commissioner’s calculus the factors discussed in text. The descriptive phrase, “which are duly authorized, etc.,” reflects an important element in the Commissioner’s analysis, but not necessarily the only dis-positive one. To interpret the statement as an assertion that whatever is provided by state law will not be challenged by the FDA would render it quite incompatible with the Commissioner’s statement in the preceding paragraph that “[w]e do not say, of course, that provisions of State law that are contrary to the Federal Food, Drug, and Cosmetic Act are lawful.” Id.
There is no authority for the majority’s assertion that the Commissioner’s statement of “no serious danger to the public health” is not enough, but that he must “give rational reasons” why that is so. Maj.Op. at 1190 n. 43. Indeed, I know of no authority for the proposition that an agency must provide any ground for its refusal to comply with a request for exercise of its enforcement discretion, much less that it must provide the analysis underlying that ground. This seems to me one of those novel procedural requirements we have been told not to invent. Vermont Yankee Nuclear Power Corp. v. NRDC,
