Opinion ID: 2445782
Heading Depth: 1
Heading Rank: 3

Heading: Subtexts of Freed

Text: I also believe there are two strong subtexts of Freed (which ostensibly concerned statutory construction) bearing mention. [12] The first is whoas between the Legislature and this Courtmay regulate the admission of expert evidence in the courtroom. This question is implicated, in particular, since the majority has repeatedly couched the relevant evidentiary principles as procedural in nature, see Majority Opinion at 217; Freed, 601 Pa. at 250-51, 253, 971 A.2d at 1212, 1214, and this Court has maintained that Article V, Section 10(c) of the Pennsylvania Constitution reposits exclusive control of procedural matters in this Court. See, e.g., Commonwealth v. McMullen, 599 Pa. 435, 444, 961 A.2d 842, 847 (2008). The second subtext is that Freed was issued in the wake of what has been termed a medical malpractice crisis. The disconcerting circumstances include: prohibitive malpractice insurance costs; hospital and practice closings; physician departures from the Commonwealth (albeit with the numbers and causes being in dispute); the phenomenon of some physicians altering their practices to avoid complex, high-risk interventions; and multiple remedial attempts by the Legislature to advance stabilization, including the creation and maintenance of government-run administrative schemes of supplemental insurance and regulation. See, e.g., 40 P.S. §§ 1303.101-1303.1115. In my view, consistent with that of the General Assembly, the matter of medical malpractice reform presents a social policy issue with direct impact on citizen access to health services and quality of care matters. See generally 40 P.S. § 1303.502 (Ensuring the future availability of and access to quality health care is a fundamental responsibility that the General Assembly must fulfill as a promise to our children, our parents and our grandparents.). [13] Nevertheless, after Freed, it would seem that there is a very strong case to be made that the 2002 MCARE Act's requirements for the admission of expert testimony in medical malpractice cases violate Article 10(c) and should be suspended. Indeed since this Court has promulgated an entire body of evidentiary rules via its procedural rulemaking powers, see Pa.R.E. 101(b) under a strong approach to the exclusivity (and in light of Freed's pronouncement), there would seem to be little doubt that MCARE requirements (as well as all other legislative inroads into evidentiary matters) are unconstitutional. Notably, such a strong approach appears to have prevailed in 1997, when this Court suspended numerous provisions of prior medical malpractice reform legislation as intruding on the Court's exclusive powers under Section 10(c). See, e.g., 40 P.S. § 1301.813-A (Dilatory or frivolous motions, claims and defenses) (suspended). [14] However, the Court's efforts to define the limits of exclusivity of its procedural rulemaking powers solely in terms of the nebulous line between substance and procedure have yielded a number of facially implausible holdings. See, e.g., Laudenberger v. Port Auth. of Allegheny County, 496 Pa. 52, 66-67, 436 A.2d 147, 155 (1981) (treating the promulgation of a rule awarding monetary damages for delay in civil cases as procedural rulemaking); Commonwealth v. Morris, 565 Pa. 1, 30, 771 A.2d 721, 738 (2001) (holding that a stay of a capital prisoner's execution is substantive). [15] In the face of such decisions, one jurist has commented that [t]he demarcation between laws bearing on substantive rights and those that are `purely procedural' is notoriously vexing and has fostered disagreement amongst generations of jurists. Wexler v. Hecht, 847 A.2d 95, 111 (Pa.Super.2004) (Johnson, J., dissenting). Moreover, this Court regularly abides various inroads by the Legislature into procedural matters, with the regular enforcement of procedural provisions of the Post Conviction Relief Act presenting a ready example. See, e.g., 42 Pa.C.S. § 9545. Thus, there would appear to be some indistinct line between procedural matters treated by the Court as being within its exclusive province and procedural matters as to which the Court will share the authority. There are several difficulties with a broad and intransigent notion of exclusivity. First, many matters of procedure touch heavily on substance, so that the most effective way to achieve some sort of substantive impact is to adjust the procedure. This Court's directed interventions in the professional liability arenaincluding venue restrictions, see Pa.R.Civ.P. No. 1006(a.1), and certificate-of-merit requirements, see Pa.R.Civ.P. No. 1042.3provide ready examples. Thus, under the strong approach, although the Court exclusively controls important means to effect substantive improvements, it lacks tools necessary to make fully informed and proactive social policy decisions. See Official Comm. of Unsecured Creditors of Allegheny Health Educ. and Research Found. v. PriceWaterhouseCoopers, LLP, ___ Pa. ___, ___, 989 A.2d 313, 333 (2010) (referencing the broader tools available to the legislative branch in making social policy judgments, such as policy hearings and comprehensive investigations). [16] This state of affairs often places the Court in a reactive role when it comes to broader social policy matters impacted by judicial procedures. For example, the Court encountered significant pressure to adjust civil practice after it substantially invalidated the legislative medical malpractice reform efforts in 1997. See, e.g., House Resolution No. 385 (adopted Dec. 12, 2001) (captioned: Urging the Supreme Court of Pennsylvania to reinstate certain provisions of Act 135 of 1996 amending the Health Care Services Malpractice Act to provide for medical malpractice tort reform.). It should not be talking out of turn to relate that the thwarted legislative medical malpractice reform efforts, as well as the representative branch's continued entreaties, were factors in the Court's ultimate promulgation, in 2003, of a certificate of merit requirement, see Pa.R.Civ.P. No. 1042.3, parallel that which the Legislature had attempted to implement in 1996. See 40 P.S. § 1301.821-A (suspended). The medical malpractice venue restriction embodied in Rule of Civil Procedure 1006(a.1) followed an analogous path, albeit within a more compressed timeframe: a substantively identical provision was first enacted by the Legislature in 2002, which this Court incorporated into the civil procedural rules in 2003. See Pa.R.Civ.P. No. 1006, Explanatory CommentJan. 27, 2003. As starkly demonstrated by these circumstances, there is a substantial lag factor, in procedural adjustments having social policy ramifications, consequent to the Court's limited role and resources. [17] In such circumstances, it is very difficult to discern how the Legislature can effectively address social policy issues if all remedial measures touching on court procedures are to be vetted through the Court, perhaps for the better part of a decade. The medical malpractice arena is a unique area of litigation in which it is necessary to balance the interests of physicians and injured patients. On the one hand, physicians, by virtue of their occupation, are required to lay hands on patients, and medical decision-making may be complex and some procedures carry high risks. In their efforts to help others, physicians' personal assets are potentially at risk. Some patients who face an inevitable decline in their health, or who suffer setbacks after making informed choices, may nevertheless look for a source of blame. The phenomena of frivolous lawsuits and professional witnesses increase the cost and potential exposure for physicians and insurers. See, e.g., Cooper v. Schoffstall, 588 Pa. 505, 522-25, 905 A.2d 482, 493-95 (2006). Although medical malpractice litigation may be steeped in science, physicians are exposed to a more-likely-than-not determination by five-sixth of twelve lay jurors who need not necessarily even agree on the ultimate question of liability. See Fritz v. Wright, 589 Pa. 219, 223, 907 A.2d 1083, 1085 (2006) (adopting the any majority rule governing jury verdicts). On the other hand, injured patients also have substantial, constitutionally protected, interests. Medical negligence does occur, and where the requirements of tort law are met, injured patients are entitled to just compensation. See PA. CONST. art. I § 11 (embodying the right a remedy). Injured patients may face difficulties in obtaining expert witnesses, particularly in specialty areas, on account of a reluctance on the part of other practitioners to judge a peer negatively. In cases in which evidence of negligence is not readily available or where the amount of potential recovery is not substantial, injured patients may have difficulty obtaining representation and advancing a lawsuit. Litigation phenomena such as that of the professional witness work in both directions. See Cooper, 588 Pa. at 522-25, 905 A.2d at 493-95. More generally, plaintiffs face many of the same unavoidable uncertainties inherent in the justice system as do defendants. In light of such important, conflicting interests, and the impact of malpractice litigation on access to and quality of medical care, it is very clear that the necessary regulation of the medical malpractice litigation arena requires difficult social policy judgments appropriate to the legislative branch. In Laudenberger, this Court determined that it was authorized to adjust substantive matters via its rulemaking powers to further procedural ends. See Laudenberger, 496 Pa. at 66-67, 436 A.2d at 155. I continue to believe this principle should work in both directions. [A]s I have previously expressed, both in gray areas between substance and procedure, and in matters that have not yet been occupied by this Court via its own procedural rules, I would allow some latitude to the Legislature to make rules touching on procedure, so long as such rules are reasonable and do not unduly impinge on this Court's constitutionally prescribed powers and prerogatives. McMullen, 599 Pa. at 458, 961 A.2d at 856 (Saylor, J., concurring and dissenting). [18] With Article V, Section 10(c), the framers of the Pennsylvania Constitution gave the Court the authority to defend itself from unwarranted encroachments. I do not believe, however, that the framers intended to preclude the Court from intelligently distinguishing between such intrusions and legitimate efforts on the part of the Legislature to accomplish its own responsibilities in advancing beneficial social policy in the Commonwealth. Indeed, the Constitution specifically sets out the suspension requirement in much narrower terms than the rulemaking power. See PA. CONST. art. V, § 10(c) (All laws shall be suspended to the extent they are inconsistent with rules prescribed under these provisions.  (emphasis added)). As demonstrated in numerous historical anecdotes, the Court has the ability to respect statutes where there are no contrary rules, or to promulgate rules consistent with the will of the policy-making branch. Given its superior tools and resources, the Legislature may very well have a better view of the broader picture to which the majority lays claim. Majority Opinion at 215. The alternative is for this Court to continue to assume a central role in substantive social policy reform efforts, carrying the unfortunate byproduct of direct involvement in inherently political processes and decisions.