Opinion ID: 1835295
Heading Depth: 1
Heading Rank: 5

Heading: whether the board's decision was arbitrary and capricious or affected by error of law?

Text: The dispute in this case involves the construction of ARSD 20:43:04:05.01(3), supra. Dr. Nelson contends that the meaning of the term analgesia as used in the rule is ambiguous; that the ambiguity should be construed in his favor; that Board's interpretation of the meaning of the term analgesia is contrary to the evidence; and that its decision is arbitrary, capricious or affected by error of law, contrary to SDCL 1-26-36. Board construed the term analgesia to include the administration of nitrous oxide to a patient, regardless of the dosage. Dr. Nelson asserts that the term does not refer to the administration of a substance, but to the state of sedation where there is insensibility to pain without loss of consciousness. He contends that the rule does not prohibit delegation of the administration of nitrous oxide as long as: 1) the dosage of nitrous oxide is below the level at which a state of analgesia is achieved, and 2) the attending dentist exercises the direct supervision and full responsibility required by ARSD 20:43:04:05, which deals with delegable procedures. The Board concluded that nitrous oxide is an analgesic drug, and that the term analgesia as used in the rule is a generic term which includes the administration of nitrous oxide in any dosage; therefore, the administration of nitrous oxide is a non-delegable procedure. The construction of an administrative rule is a question of law which is fully reviewable by the court without deference to the agency determination. Appeal of Schramm, supra; Permann v. South Dakota Dept. of Labor, Unemp. Ins. D., 411 N.W.2d 113 (S.D.1987); Coe v. Bd. of Regents of the Univ. of Wis., 140 Wis.2d 261, 409 N.W.2d 166 (Wisc.App.1987). Although the final construction of a rule is a question of law, an agency is usually given a reasonable range of informed discretion in the interpretation and application of its own rules when the language subject to construction is technical in nature or ambiguous, or when the agency interpretation is one of long standing. Matter of Southeastern Minn. Cit. Action Coun., 359 N.W.2d 60 (Minn.App.1984); Iowa Fed. of Labor v. Dept. of Job Serv., 427 N.W.2d 443 (Ia.1988); Matter of Stone Creek Channel Improvements, 424 N.W.2d 894 (N.D.1988). Administrative rules are subject to the same rules of construction as statutes. Hartpence v. Youth Forestry Camp, 325 N.W.2d 292 (S.D.1982). Where there is an ambiguity in an agency rule, a court must give effect to the agency's intention in promulgation of the rule, and must look to the object of the rule and the evil or mischief which it is designed to remedy and apply a reasonable construction which best accomplishes the purpose of the rule. Longo v. McIlmurray, 115 Mich.App. 479, 321 N.W.2d 701 (1982). The purpose of the rule must be determined from the rule as a whole, as well as other rules relating to the same subject. Appeal of AT & T Information Systems, 405 N.W.2d 24 (S.D.1987). When a statute or rule does not define a term, it should be construed according to its accepted usage and a strained, unpractical, or absurd result should be avoided, SDCL 2-14-1; Iowa Fed. of Labor v. Dept. of Job Serv., supra . With the rules of construction in mind, we examine ARSD 20:43:04:05.01(3). The rule prohibits delegation of The injection of any medication; the administration of analgesia, except for topical anesthetic; and the removal of blood by any means;.... This sentence addresses procedures which are intrusive to the body or involve sedation or both. It mandates that the dentist perform the procedures, except the administration of topical anesthetic. The purpose of the rule is obviously to protect the patient from harm which may be caused by the performance of those procedures by an unqualified person. Companion rules address the qualifications needed to administer nitrous oxide. ARSD 20:43:04:10 defines conscious sedation as the use of drugs for controlling pain or apprehension, or both, without rendering a patient unconscious. Dr. Nelson contends that he uses nitrous oxide only for controlling apprehension in children and that the dosages administered do not sedate the patient to a state of analgesia, i.e., insensibility to pain. However, ARSD 20:43:04:12 requires that before a dentist uses nitrous oxide, even in conscious sedation, he must complete a university course of at least 16 hours or have used nitrous oxide in his practice for three years prior to the effective date of the rule. ARSD 20:43:04:05 [] concerns procedures which may be delegated. At the time of this action the last sentence of the rule stated: Procedures that may be delegated include the administration of topical anesthetic. That sentence, considered in light of ARSD 20:43:04:05.01(3) and the other cited rules, allows but one conclusion: that the only sedation or medication which may be administered in a dentist's chair by an assistant, whatever the dosage, is a topical anesthetic. Dr. Nelson is correct that the narrow medical definition of the term analgesia is insensibility to pain without loss of consciousness. Webster's New Collegiate Dictionary, 1976 ed. This definition implies a state of sedation rather than the administration of a substance. However Board, which includes five dentists, used its expertise in concluding what the term analgesia means or should mean to a dentist. Board's memorandum opinion, (which was incorporated into the findings of fact and conclusions of law) stated that the term analgesic in the dentistry profession has been synonymous with nitrous oxide for many years. Findings of fact must be based on evidence in the record, but construing the meaning of a term in a rule is a matter of law. In matters of construction, a board should be allowed a reasonable range of informed discretion, as long as its construction is reasonable and not inconsistent with the rules. The term analgesia contained in ARSD 20:43:04:05.01(3) is susceptible of more than one interpretation by reasonable people, and therefore is ambiguous. State ex rel. Staples v. Young, 142 Wis.2d 348, 418 N.W.2d 333 (Wis.App.1987). As is true with most medical terms, it is technical in nature. In this case, Board's construction is consistent with the rules, and Board is entitled, within reasonable limits, to construe a term which is ambiguous or technical. Dr. Nelson argues that because his license to practice dentistry was subject to suspension, the rules are penal in nature and should be strictly construed in his favor. A statute or rule is penal in nature if a forfeiture is imposed for a transgression and where the extent of the liability imposed is not measured or limited by the act or omission. Hancock v. State, 213 Neb. 807, 331 N.W.2d 526 (1983). The rule of strict construction of a penal statute has been abrogated in South Dakota, at least so far as Title 22 is concerned. SDCL 22-1-1 states: The rule of the common law that penal statutes are to be strictly construed has no application to this title. All its criminal and penal provisions and all penal statutes are to be construed according to the fair import of their terms, with a view to effect their objects and promote justice. We see no reason to depart from this statutory standard in the construction of administrative rules which may have a penal effect. We are acutely aware that a professional license, reputation, and livelihood are at stake whenever suspension is a possibility. Under those circumstances, a professional is due every consideration. However, those considerations should not lead to a construction so strict that the object and purpose of a rule are thwarted. To give effect to the object and purpose of the rule in question, the only fair construction of the term analgesia is the one determined by Board. We cannot conclude that any of Board's findings were clearly erroneous, or that its decision was arbitrary, capricious, or affected by error of law; therefore, the trial court's judgment is reversed and remanded for reinstatement of Board's order. MILLER, C.J., and MORGAN and SABERS, JJ., concur. HENDERSON, J., concurs with writing. STEELE, Circuit Judge, for WUEST, J., disqualified.