Opinion ID: 2621413
Heading Depth: 1
Heading Rank: 3

Heading: qualifying patients

Text: ¶ 7 We surmise that Tracy's life has not been an easy one. The Skamania detective's visit to her home was part of a child welfare investigation prompted when Tracy's stepdaughter reported that her father had become enraged and smashed a chair. Tracy herself was staying at a domestic violence shelter at the time of the detective's initial visit with Aimee. ¶ 8 Tracy has also struggled with chronic pain since the 1970s. The record suggests that her medical conditions include a hip deformity, migraine headaches, a series of eight corrective surgeries following a ruptured colon and bowel conditions. As a result of these persistent health problems, Tracy has been disabled since 1998. Over the years, Tracy has been prescribed a number of different drugs including Vicodin and Soma. While visiting family in California, Tracy obtained a California doctor's authorization to possess marijuana for medical purposes. ¶ 9 Tracy may have been exactly the kind of patient the voters of this State had in mind when they enacted the medical marijuana initiative, I-692, in 1999. See ch. 69.51A RCW, the State Medical Use of Marijuana Act. Under the act: The people find that humanitarian compassion necessitates that the decision to authorize the medical use of marijuana by patients with terminal or debilitating illnesses is a personal, individual decision, based upon their physician's professional medical judgment and discretion. RCW 69.51A.005. ¶ 10 But only qualifying patients are entitled to use the defense. This limits it to: Qualifying patients with terminal or debilitating illnesses who, in the judgment of their physicians, would benefit from the medical use of marijuana, shall not be found guilty of a crime under state law for their possession and limited use of marijuana; Id. (emphasis added). The act defines qualifying patient as one who: (a) Is a patient of a physician licensed under chapter 18.71 or 18.57 RCW; (b) Has been diagnosed by that physician as having a terminal or debilitating medical condition; (c) Is a resident of the state of Washington at the time of such diagnosis; (d) Has been advised by that physician about the risks and benefits of the medical use of marijuana; and (e) Has been advised by that physician that they may benefit from the medical use of marijuana. RCW 69.51A.010(3) (emphasis added). It appears that the trial judge prevented Tracy from bringing the defense on the ground that she was not a patient of a qualified physician because her California physician was not licensed under chapter 18.71 or 18.57 RCW. [3] It also appears that the trial judge excluded the authorization received from the Oregon doctor on the ground that it was not received until after the fact. [4] ¶ 11 A defendant asserting an affirmative defense, such as the compassionate use defense, bears the burden of offering sufficient evidence to support that defense. State v. Janes, 121 Wash.2d 220, 236-37, 850 P.2d 495 (1993). Tracy bore the burden of producing at least some evidence that she was a qualified patient of a qualified physician before she could assert the compassionate use defense. Cf. Janes, 121 Wash.2d at 237, 850 P.2d 495; State v. McCullum, 98 Wash.2d 484, 488, 656 P.2d 1064 (1983). ¶ 12 We turn to the meaning of qualified physician under the statute. Chapter 18.71 RCW establishes the statutory system which regulates physicians. Relevantly, it does two things. It licenses physicians to practice medicine in Washington, and it authorizes licensed physicians from other jurisdictions to practice medicine in Washington so long as they do not open an office, establish a place to meet with patients, or receive calls within the state. RCW 18.71.021, .030(6). ¶ 13 Becoming a licensed doctor in this state is a formal affair. Requirements include successful completion of an examination administered by the Washington Medical Quality Assurance Commission, or passing an exam in another state and completing specific procedural requirements. RCW 18.71.070, .090, .095. Tracy's California and Oregon doctors are not formally licensed in Washington under chapter 18.71 RCW. The State contends that our inquiry can end here. Since Tracy was not a patient of a qualifying physician, they argue, she is not entitled to present the defense. ¶ 14 Tracy argues that the courts below were not sufficiently expansive in interpreting the voters' intent. She reasons that since out-of-state physicians have licenses recognized under chapter 18.71 RCW, we should treat the physicians as being licensed under chapter 18.71 RCW. Cf. RCW 18.71.021 (No person may practice . . . medicine without first having a valid license to do so.) (emphasis added) (recognizing validity of licenses from other states); RCW 18.71.030(6) (Nothing in this chapter shall be construed . . . to prohibit [ t ] he practice of medicine by any practitioner licensed by another state. . . .) (emphasis added) (explicitly recognizing that other states can license). ¶ 15 But the exception relied upon by Tracy does not include all out-of-state physicians for every purpose; it merely permits out-of-state physicians temporarily within the state, but without an office or similar professional connections, to practice their calling while in Washington. RCW 18.71.030(6). The initiative could have, but did not, define a qualifying doctor as one with a valid license from any state. Instead, it defined qualifying doctors as those licensed under Washington law. This was a deliberate choice, and Tracy gives us no statutory reason to find that the language does not mean what it appears to say. ¶ 16 Only qualifying patients are entitled to the defense under the act. RCW 69.51A.005. Among other things, qualifying patients must be patients of qualifying doctors. RCW 69.51A.010(3). Since Tracy was not a patient of a qualifying doctor, she is not entitled to assert the defense. [5]