Case Name: Heidi J. JUDD, personally and as the natural parent and guardian of Athan Montgomery, for and on behalf of Athan Montgomery, Plaintiff and Appellant, v. Gregory DREZGA, M.D. and Tooele Valley Regional Medical Center, Defendants and Appellee
Court: Utah Supreme Court
Jurisdiction: Utah
Decision Date: 2004-11-05
Citations: 103 P.3d 135
Docket Number: No. 20010646
Parties: Heidi J. JUDD, personally and as the natural parent and guardian of Athan Montgomery, for and on behalf of Athan Montgomery, Plaintiff and Appellant, v. Gregory DREZGA, M.D. and Tooele Valley Regional Medical Center, Defendants and Appellee.
Judges: ~ 41 Justice DURRANT and Justice PARRISH concur in Associate Chief Justice WILKINS opinion.
Reporter: Pacific Reporter 3d
Volume: 103
Pages: 135–153

Head Matter:
2004 UT 91
Heidi J. JUDD, personally and as the natural parent and guardian of Athan Montgomery, for and on behalf of Athan Montgomery, Plaintiff and Appellant, v. Gregory DREZGA, M.D. and Tooele Valley Regional Medical Center, Defendants and Appellee.
No. 20010646.
Supreme Court of Utah.
Nov. 5, 2004.
Ralph L. Dewsnup, Paul M. Simmons, Salt Lake City, for plaintiff.
Michael D. Zimmerman, James D. Gardner, David W. Slagle, Brian P. Miller, Salt Lake City, for defendant.
Mark L. Shurtleff, Att'y Gen., Brent A. Burnett, Reed M. Stringham, Asst. Att'ys Gen., Salt Lake City, for amicus State of Utah.
Merrill F. Nelson, Elliott J. Williams, Andrew G. Deiss, David C. Gessel, Salt Lake City, for amici Intermountain Health Care, Inc., Utah Hospitals and Health Systems Ass'n, and Utah Medical Ass'n.

Opinion:
WILKINS, Associate Chief Justice:
11 Plaintiff Heidi J. Judd, personally and as the parent and guardian of Athan Montgomery, appeals the trial court's reduction of a jury's general damage award from $1,250,000 to $250,000. We affirm.
BACKGROUND
T2 In 1997, Athan Montgomery was born with severe brain damage as a result of Dr. Gregory Drezga's incompetence in his failed attempt to deliver Athan with the use of forceps. Athan's mother, Heidi J. Judd, sued Dr. Drezga on Athan's behalf. Athan, who is now six, was three at the time of trial. The jury, having heard the evidence presented on behalf of Athan and Dr. Drezga, awarded Athan $22,735.30 for amounts already expended to maintain his life, and $1,000,000 as the amount necessary to maintain his life during his expected-although shortened-life span. The jury also awarded Athan $1,250,000 of so-called "noneconomic" damages in recognition of the difference between a life as a normal, healthy boy, and a life as he must now live it: severely brain damaged, with drastically reduced life experiences and expectations.
3 In 1986, the legislature enacted a statutory limitation on some forms of damages recoverable by victims in medical malpractice actions. Utah Code Ann. § 78-14-7.1 (2002). The limitation applies only to victims who have first established the malpractice of the medical professional, as well as the extent of the damage done by the professional. Moreover, for injuries occurring before July 1, 2001, as Athan's did, the limit applies only to those who have sustained over $250,000 in damages. Id. § 78-14-7.1(1)(a). No limitation applies to persons whose life experience is diminished or inconvenienced by a lesser amount, as determined by a jury. Upon motion by Dr. Drezga, the trial court reduced the jury's award to $250,000 pursuant to section 78-14-7.1(1)(a).
4 The damages that the statute limits are commonly referred to by various names, but amount to the same measure: pain and suffering, noneconomic loss, or general damages. The terms "noneconomic loss" and "general damages" merely euphemize what the damages truly represent-diminished capacity for the enjoyment of life. The measure is actually the difference between what life would have been like without the harm done by the medical professional, and what it is like with that additional burden. In Athan's case, the difference is dramatic in terms of his abilities, his joys, his opportunities, and his life expectancy. These damages are often called "noneconomic" because they are a measure of the cost neither of medical and other necessary care the malpractice caused nor of decreased earning ability. Those damages are considered more finite, measurable, and "economic" because they are more easily calculated on the basis of projected life expectancy, expected medical difficulties, and reduced earning capacity. Economic damages on the other hand, are not restricted, presumably because they are less likely to be exaggerated by a jury, and also because they are "hard" amounts, subject to careful calculation.
15 Athan's quality of life damages, the $1,250,000 awarded by the jury that heard the evidence about his condition and presumably compared it to a "normal" life experience, are the only portion of his recovery that the legislature has limited. The legislature imposed this cap because it was convinced that doing so would limit malpractice insurance costs for medical professionals, thereby helping to control excessively high medical care costs and health insurance premiums paid by most citizens and assuring a continued supply of medical care to all. This was a policy choice made by the legislature, as is its duty.
T6 Judd asks us to consider whether the legislature's limitation on Athan's recovery of quality of life damages from Dr. Drezsga is constitutionally infirm. In other words, she asks us to review the protections afforded all citizens, including Athan, by our state constitution, and conclude that these protections are sufficient to protect Athan from the seemingly arbitrary 80% reduction in the compensation available to improve a life diminished in opportunity, satisfaction, and accomplishment by the uncontested incompetence of Dr. Drezga.
17 Specifically, Judd asks us to strike down the cap on quality of life damages on any one or more of five Utah constitutional grounds. She claims that, first, the cap violates the protections of the open courts provision of article I, section 11; second, the cap violates Athan's right to the uniform operation of laws under article I, section 24; third, the cap violates the guarantee of due process under article I, section 7; fourth, the cap violates Athan's right to a jury trial in civil cases as guaranteed by article I, section 10; and finally, the cap violates the separation of powers protections of article V, section 1.
1 8 On appeal, Dr. Drezga does not contest the trial judge's conclusion that his negligence was so clearly evident that the question of his malpractice on Athan need not even be considered by the jury. He also does not contest the award to Athan of $1,022,7835.30 for economic damages. Nor does he contest the amount of the damages found by the jury to compensate for Athan's diminished life experience-the quality of life damages of $1,250,000. Instead, Dr. Drezga argues that the trial court correctly reduced Athan's quality of life damages based on the statutory cap on such damages imposed by the legislature, and on our historic deference to the decisions of the legislature on questions of public policy. Dr. Drezga is joined in his defense by the Attorney General of Utah, the Utah Medical Association, the Utah Hospitals and Health Systems Association, and Intermountain Health Care.
ANALYSIS
I. STANDARD OF REVIEW
T 9 We review the trial court's reduction of Athan's judgment for correctness given the constitutional questions Judd raises. Grand County v. Emery County, 2002 UT 57, ¶ 6, 52 P.3d 1148.
II. OPEN COURTS CLAUSE
€10 This court has held, since our decision in Berry ex rel. Berry v. Beech Aircraft Corp., 717 P.2d 670 (Utah 1985), that citizens of Utah have a right to a remedy for an injury. Article I, section 11 of the Utah Constitution provides: "All courts shall be open, and every person, for an injury done to him in his person, property or reputation, shall have remedy by due course of law, which shall be administered without denial or unnecessary delay." Utah Const. art. I, § 11. As part of our Berry jurisprudence, we have fashioned a test by which we can discern whether the legislature had sufficient reason to diminish or eliminate a previously existing right to recover for an injury. Despite articulate and passionate arguments to the contrary, we find no open courts violation in the cap on quality of life damages imposed by Utah Code section 78-14-7.1 as applied to Athan's damages. Athan's cause has been allowed before and ruled upon by the courts, and his remedy has been diminished, but not eliminated. The protections of the open courts provision have not been offended.
{11 Our past jurisprudence has clearly and firmly established the following test for violations of the Open Courts Clause:
[Sjection 11 is satisfied if the law provides an injured person an effective and reasonable alternative remedy "by due course of law" for vindication of his constitutional interest. The benefit provided by the substitute must be substantially equal in value or other benefit to the remedy abrogated....
. [If there is no substitute or alternative remedy provided, abrogation of the remedy . may be justified only if there is a clear social or economic evil to be eliminated and the elimination of an existing legal remedy is not an arbitrary or unreasonable means for achieving the objective.
Berry, 717 P.2d at 680. The Attorney General invites us to disavow our Berry line of cases, and to recognize that by adopting the Berry approach we have assumed powers -and duties not properly held by the court, but reserved for the legislature. This we decline to do. However, we recognize an obligation of deference to legislative judgments in a Berry review, and to the extent this differs from our prior application of Berry, those prior applications are disavowed. Accordingly, we now address the question at hand-whether the cap on quality of life damages violates the Open Courts Clause.
A. Substitute Remedy
{12 Proceeding to our application of the Berry test, it is self-evident that the cap on quality of life damages, which does nothing more than reduce Athan's recovery, does not provide a substitute remedy substantially equal to that abrogated. Accordingly, we must consider the second portion of the Berry test as it pertains to the damage cap-whether the damage cap represents a reasonable, nonarbitrary method of reducing increasing health care costs and other dangers that the legislature views as clear social or economic evils.
B. Clear Social or Economic Evil
1 13 Recovery of quality of life damages in Athan's case is limited to $250,000 by Utah Code section 78-14-7.1(1)(a). Utah Code Ann. § 78-14-7.1(1)(a) (2002). The legislature's stated purpose in enacting the cap is as follows:
The legislature finds and declares that the number of suits and claims for damages and the amount of judgments and settlements arising from health care has increased greatly in recent years. Because of these increases the insurance industry has substantially increased the cost of medical malpractice insurance. The effect of increased insurance premiums and increased claims is increased health care cost, both through the health care providers passing the cost of premiums to the patient and through the provider's practicing defensive medicine because he views a patient as a potential adversary in a lawsuit. Further, certain health care providers are discouraged from continuing to provide services because of the high cost and possible unavailability of malpractice insurance.
In view of these recent trends and with the intention of alleviating the adverse ef-feets which these trends are producing in the public's health care system, it is necessary to protect the public interest by enacting measures designed to encourage private insurance companies to continue to provide health-related malpractice insurance....
Id. § 78-14-2 (2002). Although the empirical truth of these findings is a matter of some dispute, we will not undertake the same investigation as the legislature, reviewing its data-gathering methods and conclusions to determine whether the stated legislative findings are perfectly correct. A court is ill-suited to undertake investigation of such a nature. Our inquiry under the "clear social or economic evil" portion of the Berry test is more limited.
14 Both parties have cited various studies and articles, that ostensibly support their position that there is or is not a crisis in the health care industry caused in part by increased malpractice insurance premiums stemming from the possibility of unlimited awards for quality of life damages. Judd would have the court determine, based on this information, that the crisis does not actually exist, thereby rendering the cap unconstitutional under the Berry test. Although Judd's arguments are well taken, and the court may remain unconvinced of the wisdom of limiting quality of life damages for severely injured victims like Athan, our power does not extend so far as to permit imposition of our views on such policy disputes.
115 Our job as this state's court of last resort is to determine whether the legislature overstepped the bounds of its constitutional authority in enacting the cap on quality of life damages, not whether it made wise policy in doing so. Although there are indications that overall health care costs may only be minimally affected by large damage awards, there is also data that indicates otherwise. See, e.g., Lee v. Gaufin, 867 P.2d 572, 585-89 (Utah 1993) (noting pricing and investment decisions by insurers, inflation, ete., as factors contributing to increased health care costs). But see Office of Tech. Assessment OTA-BP-H-1 19, Impact of Legal Reforms on Medical Malpractice Costs 64 (1993) [hereinafter Impact of Legal Reforms] (recognizing that "caps on damage awards were the only type of State tort reform that consistently showed significant results in reducing the malpractice cost indicators"). When an issue is fairly debatable, we cannot say that the legislature overstepped its constitutional bounds when it determined that there was a crisis needing a remedy. Accordingly, we next consider whether the elimination of Athan's right to collect unlimited quality of life damages is a reasonable, nonarbitrary method for achieving the legislature's stated purpose of controlling medical malpractice premiums and health care costs.
C. Nonarbitrary, Reasonable Nature of Cap
16 We cannot conclude that the cap on quality of life damages is arbitrary or unrea sonable. The legislature's determination that it needed to respond to the perceived medical malpractice crisis was logically followed by action designed to control costs. Although malpractice insurance rates may not be entirely controlled by such matters, they are undoubtedly subject to some measure of fluctuation based on paid claims. Impact of Legal Reforms, supra, at 73 (noting that "caps on damages . lead to lower insurance premiums"). "Thus, one nonarbi-trary manner of controlling such costs is to limit amounts paid out. Intuitively, the greater the amount paid on claims, the greater the increase in premiums. Limiting recovery of quality of life damages to a certain amount gives insurers some idea of their potential liability. Id. at 64 ("Minimizing these large awards may allow insurers to better match premiums to risk."). While we recognize that such a cap heavily punishes those most severely injured, it is not unconstitutionally arbitrary merely because it does so. Rather, it is targeted to control costs in one area where costs might be controllable.
{17 Despite this court's concerns about the wisdom of depriving a few badly injured plaintiffs of full recovery, the cap is also constitutionally reasonable. Rather than cap all damages, like the cap struck down in Condemarin v. University Hospital, 775 P.2d 348 (Utah 1989), the limitation on recoverable damages in this case is narrowly tailored, by limiting quality of life damages alone. While Judd notes that Utah has not seen large damage awards in significant numbers, this position ignores at least one important factor. Although quality of life damages are very real, they are also less susceptible to quantification than purely economic damages. As amici point out, "[the estimated value of future costs forms the basis of the [insurance] rate-setting process." The difficulty of predicting quality of life damages must be considered by insurers when setting rates and planning reserves. At least in some measure, then, predicting and controlling future costs can result in lower insurance rates. Taken as one of a number of measures enacted to help control health care costs, the cap on quality of life damages is thus a reasonable approach.
118 Having determined that the damage cap is designed to eliminate a social or economic evil, and that it is a reasonable, nonar-bitrary means for doing so, we conclude that Utah Code section 78-14-7.1 does not violate article I, section 11 of the Utah Constitution.
III. UNIFORM OPERATION OF LAWS
119 Judd next argues that section 78-14-7.1 violates the Utah Constitution's uniform operation of laws provision found in article I, section 24. This provision guards against discrimination within the same class and helps ensure that statutes establishing or recognizing rights for certain classes do so reasonably given the statutory objectives. Malan v. Lewis, 693 P.2d 661, 670-71 (Utah 1984). We employ heightened serutiny under article I, section 24 when reviewing legislation that "implicates" rights under article I, section 11. Lee, 867 P.2d at 581. Sustaining legislation against an article I, section 24 challenge alleging that one's rights under the Open Courts Clause are constitutionally discriminated against requires the court to find that the challenged legislation "(1) is reasonable, (2) has more than a speculative tendency to further the legislative objective and, in fact, actually and substantially furthers a valid legislative purpose, and (8) is reasonably necessary to further a legitimate legislative goal." Id. at 583. Although it causes great hardship for a small, severely injured group of plaintiffs, we find that the damage cap is reasonable, and it substantially furthers and is reasonably necessary to the legislative goal of decreasing health care costs and ehsmjing the continued availability of health care.
120 Judd's arguments before this court identify three important ways that the cap on quality of life damages might be unconstitutionally discriminatory. First, Judd notes that the limitation applies only to victims of medical malpractice, not to victims of other torts. Second, Judd points out that only medical malpractice victims with significant quality of life damages, as opposed to special damages, are affected. Last, Judd recognizes that the cap impacts only those who are most severely injured. We evaluate the damage cap under the heightened serutiny standard with reference to these classifications.
121 In connection with our discussion of the Open Courts Clause, supra ¶ 10-18, we determined that the damage cap was a reasonable method of implementing the legitimate legislative purpose of limiting health care costs and ensuring the continuing availability of health care resources. That discussion bears on this section as well. However, in order to sustain the damage cap under article I, section 24, a higher standard must be met. The cap on quality of life damages must be reasonably necessary to achieve the goals, and, in fact, actually and substantially further them.
1 22 As we recognized above in connection with our analysis under the Open Courts Clause, we do not proceed in our analysis under article I, section 24 as if we were called upon to answer these questions in the first instance. Instead, we carry out our role as the state's court of last resort, called upon to identify the boundaries of the constitution, giving appropriate deference to the policy choices of the citizens' elected representatives. Our review of the arguments and information presented by the parties and am-icl reveals that the cap meets the standard for constitutionality set by article I, section 24.
1 23 With regard to controlling health care costs, a report authored by Congress's Office of Technology Assessment evaluated six different empirical studies and concluded that "caps on damage awards were the only type of State tort reform that consistently showed significant results in reducing the malpractice cost indicators." Impact of Legal Reforms, supra, at 64. This reveals that such caps may be considered reasonably necessary to implement the legislature's policy of controlling malpractice insurance costs, and thus health care costs. However, the caps appear not only to be reasonably necessary, but to have an actual and substantial impact. This can be seen from a review of the actions and experiences of other states.
124 A study addressing California's experience with damage caps reported that "caps on noneconomic damages tend to be particularly effective in reducing costs because of the extreme variability of damage award[s] attributable to pain and suffering." LECG, Inc., California's MICRA Reforms: How Would a Higher Cap on Non-Economic Damages Affect the Cost of and Access to Health Care? 7 (1998) [hereinafter California's MICRA Reforms]. As the aforementioned Office of Technology Assessment report indicated, "[even though caps on damages directly affect only a small minority of cases, this minority often accounts for a disproportionate share of total malpractice payments. In addition, it is the large, unexpected claim that makes it difficult for insurers to plan reserves." Impact of Legal Reforms, supra, at 64. Thus, Judd's unreasonableness argument, premised on the fact that there are relatively few claims in Utah subject to the cap, is not sufficiently compelling. It appears that the enactment of a cap allows sufficient quantification of quality of life damages to have a substantial impact on insurance rates.
1 25 The Board of Trustees of the American Medical Association has reported to its House of Delegates that the presence of a cap on noneconomic damages in California has stabilized local malpractice insurance rates at some of the lowest levels in the nation. American Medical Ass'n, Report 35 of The Board of Trustees 6 (2002). That same report compared the malpractice insurance rates paid by physicians in California to those paid by physicians in Nevada, where there was no cap on damages. Nevada physicians paid considerably more for comparable insurance than did California physi-clans-ranging from 42.8% higher premiums in the family and general practice field to 98% more in obstetrics and gynecology. Id. at 6-7. In short, there is sufficient evidence that caps on quality of life damages do have an actual impact on the cost of malpractice insurance.
126 The legislature also identified ensuring the continuing availability of health care resources as one of its purposes. Utah Code Ann. § 78-14-2 (2002). This concern appears to be equally as valid as, and related to, controlling costs. Nevada's recent experience illustrates the effect of high malpractice insurance rates on the availability of health care resources. In July 2002, Las Vegas's only Level 1 trauma center closed. William Booth, Las Vegas Trauma Center Closes as Doctors Quit, Wash. Post, July 4, 2002, at A2. The closure of the trauma unit was precipitated by the resignation of virtually all of the facility's surgeons, who left because. of the soaring cost of insuring themselves against malpractice, Id. After the closure, the nearest trauma center was 188 miles away from Las Vegas. Id. Nevada's experience, while extreme, is not unique. Doctors in other states reportedly have moved or given up their practices, at least in part because of rising malpractice insurance rates. See Mary Brophy Marcus, Healthcare's "Perfect Storm", U.S. News & World Rep., July 1, 2002, at 39. While there is little indication that Utah faces an acute problem like Nevada's, the constitution does not compel the legislature to ignore such matters. '
{27 While the damage cap does indeed discriminate against medical malpractice victims with the most severe noneconomic injuries, it does so reasonably, given the statute's purpose. In order to control costs and provide for the continuing availability of health care resources, the legislature was faced with a number of choices. By deciding which reforms to enact, it necessarily discriminated. However, the classifications established by the statute meet the heightened serutiny test. |
128 Although the classifications deny some victims a full recovery while allowing such a recovery to others, the classifications are not unconstitutional. While medical malpractice victims are deprived of a measure of their remedy where other tort vie-tims are not, enacting damage caps on all tort victims would be imprudent and over-broad given that the legislature's goal was to control health care costs. Additionally, although medical malpractice victims, those with primarily noneconomic, or quality of life, damages, are punished by the limitation when compared with those whose injuries are largely economic, this discrimination is permissible given the cap's purpose of controlling costs. As noted above, "caps on noneconomic damages tend to be particularly effective in reducing costs because of the extreme variability of damage award[s] attributable to pain and suffering." California's MICRA Reforms, supra, at 7. Thus, it appears there is support for the proposition that a 'large measure of the problem identified by the legislature results from fluctuation in cases with high noneconomic damages, and a cap which targets just those problems is therefore not unconstitutional. Because the crisis identified by the legislature is primarily precipitated by the potential for large, unpredictable judgments, establishing a cap that prevents only those types of judgments is reasonably necessary to achieve the legislative purpose, despite punishing the most severely injured victims.
T 29 When attempting to resolve problems of policy, the legislature is inevitably forced to draw lines. In this instance the legislature has chosen to enact a cap, limiting the right to recover quality of life damages to $250,000. This cap severely injures young Athan, who will live a life greatly diminished by Dr. Drézga's negligence. But that is a policy choice made by the legislative branch, and we cannot say that it is unconstitutional. The legislature's purpose in enacting the damage cap is a valid and legitimate one. The cap is a reasonably necessary means of achieving that purposie, and it actually and substantially furthers it. Therefore, the damage cap is permissible under article I, section 24 of the Utah Constitution.
IV. DUE PROCESS
130 Next, Judd challenges the legislatively-imposed cap on quality of life damages on the ground that it violates Athan's right to due process under article I, section 7 of the Utah Constitution. Generally, we apply a rational basis test in substantive due process cases. Wells v. Children's Aid Soc'y of Utah, 681 P.2d 199, 206 (Utah 1984). However, this rational basis test is replaced by a more stringent test in cases where the rights impacted by the legislation are deemed to be "fundamental." Id. Judd argues that we should use such heightened scrutiny in Athan's case. However, because article I, section 11 rights are not properly characterized as "fundamental," we will apply the rational basis test. See Condemarin, 775 P.2d at 359-60 (citing Berry, 717 P.2d at 677).
131 In harmony with our discussion in the sections above, we conclude that the cap on Athan's recovery of quality of life damages satisfies the rationality standard demanded by article I, section 7. The legislative concern with rising health care costs and fears about the continued availability of services are legitimate governmental issues. Finding that there was a problem to be remedied, the legislature enacted the damage cap as a targeted measure designed to minimize increases in costs and decreases in services. Far from the absolute cap invalidated in Condemarin, the cap on quality of life damages has no impact on a victim's recovery of damages for actual expenses, loss of earning capacity, or other economic measures of injury. Rather, it is limited to the one area where caps have proven effective-quality of life damages, which are difficult to predict but nevertheless must be accounted for by insurers. California's MICRA Reforms, supra, at 7. Far from being an arbitrary and unreasonable legislative response, then, section 78-14-7.1 represents the measured application of legislative tools to a real problem and is therefore constitutional under article I, section 7.
V. RIGHT TO A JURY TRIAL
132 The Utah Constitution guarantees parties the right to a jury trial in a civil case. Utah Const. art. I, § 10; Int'l Harvester Credit Corp. v. Pioneer Tractor & Implement, Inc., 626 P.2d 418, 420-21 (Utah 1981). Judd argues that the cap on quality of life damages infringes this right because it prevents Athan from recovering an amount equal to the jury's determination of damages. We hold that the damage cap does not violate Athan's right to a jury trial.
183 There are essentially two lines of cases addressing whether a cap on damages deprives a victim of the right to a jury trial. Both lines of thinking are analytically simple and reasonable. One position is that the jury's right to determine damages extends not only to a factual assessment of their amount, but also to an actual award of those damages. See, e.g., Sofie v. Fibreboard Corp., 112 Wash.2d 636, 771 P.2d 711, 720-23 (1989) (holding damage cap unconstitutional because it invaded jury's right to determine damages). The other position is well-embodied in the case of Etheridge v. Med. Ctr. Hosp., which notes that "although a party has the right to have a jury assess his damages, he has no right to have a jury dictate through an award the legal consequences of its assessment." 237 Va. 87, 376 S.E.2d 525, 529 (1989). We subscribe to the latter view.
134 As the Etheridge case correctly notes, it is the jury's duty to determine the amount of damages a plaintiff in fact sustained, but it is up to the court to conform the jury's findings to applicable law. Id. We recognize that damages are a question of fact, and that questions of fact are distinctly within the jury's province. Ricks v. Budge, 91 Utah 307, 64 P.2d 208, 213 (1937). However, the jury is always guided and constrained by the court through appropriate instructions. Id. ("While the law cannot . determine with absolute certainty what damages, if any, plaintiff may be entitled to, still those are questions which a jury under proper instructions from the court must determine." (emphasis added)). The damage cap enacted by the legislature represents law, similar to an element of a claim to which the trial court must comport the jury's factual determinations.
T35 Perhaps the most important reason behind the right to a jury trial is "to assure a fair and equitable resolution of factual issues." 50A C.J.S. Juries § 19 (1997). Athan's jury fulfilled this role when it determined, based on its view of the evidence, that his quality of life was diminished to the extent of $1,250,000. However, the law as enacted by the legislature does not provide for such an award, and the trial court was compelled to apply the law to the jury's verdict and reduce the award to $250,000. So structured, the damage cap does not violate Athan's right to a jury trial because it allows the jury to determine the facts in the first instance, before requiring the court to apply relevant law to the jury's verdict.
VI. SEPARATION OF POWERS
36 Judd next argues that the damage cap violates article V, section 1 of the Utah Constitution, the separation of powers provision. The cap does so, Judd says, because it essentially allows the legislature to determine judicial controversies by fixing damages. We disagree.
137 We have recognized that judicial power is " 'the power to hear and determine controversies between adverse parties and questions in litigation. " Timpanogos Planning & Water Mgmt. Agency v. Cent. Utah Water Conservancy Dist., 690 P.2d 562, 569 (Utah 1984) (quoting Citizen's Club v. Welling, 83 Utah 81, 27 P.2d 23, 26 (1933)). Judicial power is, however, constrained by the law enacted by the legislature. As one former member of this court put it, "[the power to declare what the law shall be is legislative. The power to declare what is the law is judicial." Ritchie v. Richards, 14 Utah 345, 47 P. 670, 675 (1896) (Barteh, J., concurring).
138 There is a legitimate and long-established role for legislative involvement in jury trials. For example, the legislature establishes standards of proof, elements of torts and crimes, and otherwise controls much of the law upon which jury instructions are based. Given that extensive role in so many aspects of the jury trial process, it is incorrect to view the right to a jury determination of the facts of a case to be so broad as to prohibit any legislative involvement in the types and extent of damages that may be awarded. The damage cap represents law to be applied, not an improper usurpation of jury prerogatives. Consequently, it does not violate the separation of powers provision of the constitution.
CONCLUSION
139 We affirm the trial court's ruling limiting Athan's recovery of quality of life damages to $250,000 because the constitution does not prohibit it, despite its consequences to Athan. >
40 The cap is designed to reduce health care costs, increase the availability of medical malpractice insurance, and secure the continued availability of health care resources-all legitimate legislative goals given the clear social and economic evil of rising health care costs and a shortage of qualified health care professionals. In attempting to meet its goals, the legislature has not unreasonably or arbitrarily limited recovery. Rather, it has chosen to place a limit on the recovery of "noneconomic" quality of life damages-one area where legislation has been shown to actually and substantially further these goals. Applying each individual test, we conclude that the open courts, uniform operation of laws, and due process provisions of our constitution are not offended by the damage cap. Additionally, neither the right to a jury trial nor the constitutional guarantee of separation of powers is offended by the cap. Affirmed.
~ 41 Justice DURRANT and Justice PARRISH concur in Associate Chief Justice WILKINS opinion.
. The dissent argues not that there is no intelligent support for the position taken by the legislature, but that there is more, better, or more intelligent support for alternative views. The defect in this approach is not in arguing that one set of views ought to prevail over the other, but in arguing that the views of a majority of members of this court should prevail over those of the majority of the legislature.
. Arguing against the presence of a clear social or economic evil, Judd extensively cites this court's discussion in Lee regarding the so-called medical malpractice crisis. Lee involved a review under the Uiah Constitution's uniform operation of laws provision of a limitations provision thai applied without regard to a victim's minority at the time of the injury. 867 P.2d at 576-77. The reason for the court's declaration of unconstitutionality in Lee was that "[the legislative means for solving the insurance problem by cutting off the malpractice claims of minors simply does not further the legislative objective." Id. at 588. That question is different from the one now facing this court, and our review in Lee of the effect of that limitations provision does not apply. We will address the uniform operation of laws provision in connection with the problem now before us later in this opinion.
. Article I, section 10, however, identifies only the right to jury trial in capital cases as "inviolate," and gives the legislature some authority to regulate other jury trials, at least as to the number of jurors.