Court Opinion

ID: 9586967
Source: CourtListenerOpinion
Date Created: 2023-08-21 23:16:58.838119+00
Date Added: 2024-06-11T17:32:57.870851
License: Public Domain

ZIMMERMAN, Justice
(concurring in Part):
I join, in principle, parts III and IV of the opinion of Justice Durham. I write to elaborate my view on the due process issue. I express no opinion on the other points discussed in her opinion.
In Berry, this Court firmly staked itself out as finding substantive protections in article I, section ll’s guarantee to “every person” of a “remedy by due course of law” for “an injury done to him [or her] in his [or her] person, property or reputation.” Today’s decision is a logical successor to Berry. It is true, as Justice Durham notes, that in Berry we chose not to describe as “fundamental” article I, section ll’s guarantee. Maj. op. at 360; Berry ex rel. Berry v. Beech Aircraft Corp., 717 P.2d 670, 677 (Utah 1985); Utah Const, art. I, § 11. However, in declining to so characterize the guarantee of a remedy of inju-*367ríes, I do not think we intended to denigrate the importance of the rights protected from legislative abridgment by article I, section 11. Instead, we simply avoided being bound into the analytical straitjacket that has been fashioned out of the federal equal protection clause for “fundamental” rights and the tempting parallel construction of the Utah Constitution’s uniform-operation-of-the-laws provision. U.S. Const, amend. XIV, § 1; Utah Const, art. I, § 24; cf. Garfield, Privacy, Abortion, and Judicial Review: Haunted by the Ghost of Lochner, 61 Wash.L.Rev. 293, 345-46, 360 (1986) (reviewing the historical development of rigid forms of analysis dependent on the classification of rights as either fundamental or not fundamental); Note, Lack of Statewide Equality in Court Delays Held Not a Denial of Equal Protection, 1967 Utah L.Rev. 566 (advocating use of the “fundamental rights” straitjacket as a means to find an equal protection violation in a lack of statewide uniformity in court delay). In fact, I see little reason why the analytical framework used to test the constitutionality of legislation under article I, section 24 must ape the rigid two- (or three-) level analysis of the federal equal protection cases. See, e.g., Mountain Fuel Supply Co. v. Salt Lake City Corp., 752 P.2d 884, 888-90 (Utah 1988). On this point, Justice Stewart and I appear to be in agreement. But there is no reason to consider that issue in great detail today because this case is properly analyzed under the due process balancing approach that Berry indicated is applicable when considering article I, section 11 questions.1
The present case has given me a better appreciation of the wisdom of including article I, section ll’s guarantee in Utah’s basic charter. The constitution’s drafters understood that the normal political processes would not always protect the common law rights of all citizens to obtain remedies for injuries. See Berry, 717 P.2d at 676; cf. Developments in the Law: The Interpretation of State Constitutional Rights, 95 Harv.L.Rev. 1324, 1498-1502 (1982) (protection of majority from politically powerful minorities as an approach to state constitutional interpretation); Note, State Economic Substantive Due Process: A Proposed Approach, 88 Yale L.J. 1487, 1498 (1979) (perfunctory judicial review is inadequate to protect against special interest legislation). At any one time, only a small percentage of the citizenry will have recently been harmed and therefore will need to obtain a remedy from the members of any particular defendant class. The vast majority of the populace will have no interest in opposing legislative efforts to protect such a defendant class because the majority will not readily identify with those few persons unlucky enough to have been harmed. And those few persons directly affected will, in all likelihood, lack the political power to prevent the passage of legislation that, in essence, requires every member of the citizenry who is injured by members of the defendant class to bear some or all of the cost of those injuries.
Admittedly, the interests of a majority of the populace are commonly overridden in the legislative process, and, indeed, such *368overriding may be essential to the responsible operation of a representative deliberative body. However, the very act of drafting a constitution such as ours, which does not bestow unlimited power on the legislature and which does reserve certain rights to the people, constitutes a recognition that there must be some limits on the legislature, that some interests of the people deserve special protection in the maelstrom of interest group politics that is the legislative process. Among the interests to which the Utah Constitution’s drafters assigned a degree of sanctity are those mentioned in article I, section 11.
To accord these rights the respect the drafters intended requires that we approach challenges to legislation alleged to infringe article I, section 11 differently than we otherwise view claims of unconstitutionality that are directed at ordinary economic legislation. Because the interests at stake are specifically protected by the constitution, the presumption of validity that normally attaches to legislative action must be reversed once it is shown that the enactment under scrutiny does, in fact, infringe upon the interests enumerated in article I, section 11. The burden then is upon the proponents of the legislation’s validity to demonstrate that its restrictions on those rights are carefully drawn and supported by weighty considerations. Cf. Note, supra, 88 Yale L.J. at 1501-10 (proposing a method of review requiring the legislation’s proponent to articulate the ends served by legislation and to bear the burden of proof of the nexus between means and ends). And in weighing the proffers of the legislation’s defenders, we should not use as our analytical model the permissive and perfunctory standard of reasonable relation advocated by the appel-lees and the dissenters. Instead, we should give the legislation and its justifications careful scrutiny to assure that redress of legally cognizable injuries is not unreasonably impaired. Cf, e.g., United States v. Carotene Products Co., 304 U.S. 144, 152 n. 4, 58 S.Ct. 778, 783 n. 4, 82 L.Ed. 1234 (1938) (while adopting a perfunctory standard of review under the federal due process clause for economic regulation in general, the Court explained that legislation impairing rights specifically protected by the federal constitution would require more careful review); Pfost v. State, 219 Mont. 206, 217-20, 713 P.2d 495, 502-03 (1985) (open courts provision makes the right to seek tort remedies a “fundamental interest” for purposes of equal protection analysis); Ernest v. Faler, 237 Kan. 125, 132, 697 P.2d 870, 875 (1985) (“[T]he right of a person injured by the tortious act of another to a remedy for his injuries is one of the basic constitutional rights.”); see also Estabrook v. American Hoist & Derrick, Inc., 127 N.H. 162, 171, 498 A.2d 741, 746 (1985), overruled in part on other grounds, Young v. Prevue Products, Inc., 130 N.H. 84, 88, 534 A.2d 714, 717 (1987).
I do not suggest that we should strike down any such legislation if a less restrictive alternative is conceivable, as might be required by a “fundamental rights” equal protection analysis. Rather, I agree with the approach taken in Berry of weighing the particular infringement on the article I, section 11 interests at issue against the justifications offered for the restriction. Berry, 717 P.2d at 680, 683. This balancing process may not be as apparently neat and precise as the rigid equal protection classification tests that have developed under the federal constitution, but it is an approach better calculated to recognize the realities that a legislature must face in attempting to deal with perceived social and economic problems.
Returning to the present case, there can be no question that the legislation at issue, which severely restricts the right of every citizen to recover even actual out-of-pocket losses, both from a narrow category of health care providers who are the actual malefactors and from their governmental employer, substantially infringes upon those interests specifically protected by article I, section 11. See Berry, 111 P.2d at 676 & n. 3. For that reason, the burden of demonstrating the constitutionality of the statute shifts to its proponents. The supporters of the legislation have not carried their burden. The justifications advanced for the legislature’s having abridged the *369important right of citizens to recover even out-of-pocket losses occasioned by injuries to their persons in a narrow category of circumstances for the benefit of a narrow category of defendants are extraordinarily weak. In fact, at oral argument both the attorney general and the lawyer for the hospital and physicians involved admitted that they had no empirical evidence that damage awards in Utah have threatened the stability of any unit of government and that the concerns that led to the legislation were based on anecdotal evidence. Cf. Pfost, 713 P.2d at 503-05 (rejecting the Montana legislature’s attempt to justify with speculative findings a cap on the tort liability of government entities).
In joining, in principle, parts III and IV of Justice Durham’s opinion, I wish to avoid any implication her opinion may contain that flat caps on damages lacking any differentiation between actual and general or punitive damages may be constitutional. In my view, when the people are deprived of a right to recover actual out-of-pocket expenditures that have been or will be incurred because of the tortious conduct of another, the infringement upon the right to recover for harm to the person is far more severe and requires far more justification than when general damages for pain and suffering or punitive damages are restricted.
STEWART, Justice
(Separate Opinion):
Plaintiffs raise only two issues, and both arise under the equal protection provisions of the United States and Utah constitutions. Those issues are:
1. Does the Legislature’s abrogation of the common law right of action for negligence against employees of a govern-mentally owned health care facility violate constitutional provisions guaranteeing equal protection under the law?
2. Does the damage limitation provision of the Utah Governmental Immunity Act, when applied to a governmentally owned health care facility, violate the equal protection provisions of the Utah or United States Constitution?
In my view, Article I, section 24 of the Utah Constitution, the Utah equal protection provision, is dispositive because, unlike federal equal protection law, Utah law allows greater protection to individuals in cases of this type. Malan v. Lewis, 693 P.2d 661 (Utah 1984).
I agree with Justice Durham that the damages limitation is unconstitutional, but only as applied to the University Hospital. However, I do not agree with her legal analysis. First, I see no reason whatsoever to rely on a due process analysis, since it has not been raised. Furthermore, contrary to her view, there are real and important differences between equal protection and the Utah open courts clause analyses, and they are different from a due process analysis. See Berry ex rel. v. Beech Aircraft Corp., 717 P.2d 670 (Utah 1985). Telescoping the due process, equal protection, and open courts analyses, as Justices Durham and Zimmerman do, blurs important analytical concepts intended to give different substance and effect to each constitutional provision and to the policies each is designed to serve. Justice Zimmerman fails to recognize that it is essentially equality before the law that equal protection principles further, and not the rationality of legislative ends and means as such.
Beyond all that, I believe that application of a substantive due process analysis is inappropriate. The era of federal substantive due process essentially ended shortly after Nebbia v. New York, 291 U.S. 502, 54 S.Ct. 505, 78 L.Ed. 940 (1934). That era stands as the high water mark of an ill-fated and, I believe, illegitimate exercise of judicial power in the realm of legislative power. I strongly oppose any effort to put this Court on that track for a variety of reasons, including my view of separation of powers. Although substantive due process has not been wholly abandoned in some states, including Utah, it has by and large only been employed in cases of extreme arbitrariness, and this is not such a case.
Finally, I essentially agree with Chief Justice Hall’s opinion as far as federal law is concerned. However, I believe he decides the damages limitation provision in a *370manner contrary to the analytical framework adopted in Malan v. Lewis, 693 P.2d 661 (Utah 1984). For example, to presume the constitutionality of a statute when the statute deprives one of a right established by Article I, section 11 of the state constitution is to fail to give any greater weight to a constitutional right than to a noncon-stitutional interest, such as a general social or economic interest. Furthermore, it is plain that Malan applies a higher standard of review than the minimal standard that the Chief Justice applies.
In sum, I conclude that the damage limitation in Utah Code Ann. § 63-30-341 on tort recovery as applied to the University Hospital is unconstitutional. However, the ban on suits against government employees in their individual capacities is, in my view, constitutional. I reach these conclusions on the basis of Article I, section 24 of the Utah Constitution, the Utah equal protection provision.
I. THE FACTS
Crelia Condemarin, plaintiff and appellant, entered Cottonwood Hospital during the early morning hours of May 19, 1982, after several hours of labor. Indications of a potential high-risk delivery, including a previous caesarean delivery, premature membrane rupture, and suspected prematurity, led her treating physician at Cottonwood to quickly transfer her to the University Hospital in Salt Lake City, where she was admitted at 5:45 a.m. by the resident on duty in the obstetrical unit, Dr. Gayle Carter. Condemarin, who spoke no English, was intermittently monitored for the next couple of hours by the hospital’s medical staff. At 7:00 a.m., Carter went off duty. At 8:05 a.m., Condemarin was prepared for an emergency caesarean section because fetal monitors indicated that the baby was being deprived of oxygen. Some minutes later, plaintiff Leonel Condemarin was born.
Attending physicians concluded that he had suffered fetal distress and was severely asphyxiated at birth. The asphyxia resulted in neurological damage including impairments of hearing and sight, seizure disorder, and spasticity. Leonel’s current physician concluded that the child will have a normal life span as a severely retarded and handicapped individual.' The physician further concluded that Leonel’s physical and mental defects are related to the asphyxia at birth.
Plaintiffs -initiated this action, alleging negligent treatment by the medical staff at the University Hospital. Each individual defendant was an employee of the University Hospital or the University of Utah. The action against Dr. R.M. Larkin, the attending physician in obstetrics at the time, has been dismissed. Plaintiffs moved for summary judgment in the trial court seeking to have portions of the Utah Governmental Immunity Act declared unconstitutional. The motion was denied by the trial judge, and this Court granted a petition for an interlocutory appeal.
II. LIMITATION OF DAMAGES
The first issue I address is the constitutionality of the limitation on damages that may be awarded against a governmentally owned hospital for which immunity has been waived.2 Sovereign immunity, the *371principle that the state cannot be sued in its own courts without its consent, was a well-settled principle of American common law when Utah became a state. Madsen v. Borthick, 658 P.2d 627, 629 (Utah 1983). In 1966, Utah enacted the Utah Governmental Immunity Act, § 63-30-1 to -38, which was intended to limit the harsh results produced by sovereign immunity, a doctrine that has continued to exist despite strong criticism. The central concept of the doctrine is that immunity should exist for governmental activities that are integral to the governing process so that they will not be jeopardized.
In Greenhalgh v. Payson City, 530 P.2d 799 (Utah 1975), this Court held that municipal ownership, maintenance, and operation of a hospital was a proprietary activity, and not a “governmental function” under § 63-30-3 of the Governmental Immunity Act as it then read, and that the city was not immune from liability for negligent injury.3 The Court stated:
A primary [factor to be considered] is whether the activity is something which is done for the general public good and which is generally regarded as a public responsibility. Coupled with this, other matters considered are whether there is any special pecuniary benefit to the City; and also, whether it is of such a nature as to be in competition with free enterprise.
530 P.2d at 801 (footnote omitted). The Court focused on the fact that since the hospital competed with others, its operation was a proprietary function. Subsequently, the Legislature amended § 63-30-3 specifically to exempt from liability governmen-tally owned hospitals, nursing homes, and other such health care facilities.4
In 1980, this Court decided Standiford v. Salt Lake City Corp., 605 P.2d 1230 (Utah 1980), which provided a new analysis for deciding when governmental immunity should be applied to a governmental activity. The Court observed that the proprietary-governmental distinction is “ ‘one of the most unsatisfactory known to the law.’ ” Id. at 1233 (quoting Davis, Administrative Law, Ch. 9, “Tort Liability of Governments and of Officers,” at 179). The Court concluded that reliance on the proprietary-governmental function distinction diverted the courts from the central concern — “namely, whether a governmental entity, like individuals and private entities, should be liable for an injury inflicted by it” as a matter of policy. Id. at 1234.
Standiford formulated the following test for determining whether governmental immunity applies: “whether the activity under consideration is of such a unique nature that it can only be performed by a governmental agency or that it is essential to the core of governmental activity.” Id. at 1236-37. By restricting somewhat the scope of governmental immunity, the test implemented the legislative intent to allow “more innocent victims injured by tortious conduct on the part of public entities access to the courts for redress.” Id. at 1237. Beyond that, the test articulates the core *372value protected by governmental immunity — providing protection to the public treasury and tax revenues against overwhelming losses so that the essential functions of government will not be imperiled. The test also identifies where the constitutional right of a person to have a remedy for personal injury begins under Article I, section 11 of the Utah Constitution as against a governmental agency, and where the governmental right to immunity from such lawsuits stops.
The operation of the University Hospital is not a governmental function in the constitutional sense, although governmental operation of some community hospitals might, in my view, be a governmental function. There are a number of hospitals in the Salt Lake area, some of which are tertiary care hospitals, that compete with the University Hospital. The activities such hospitals perform need not be, and are not, performed only by a governmental agency; that is true even though the hospital is a teaching hospital. Privately owned hospitals also perform teaching functions.
Frank v. State, 613 P.2d 517 (Utah 1980), does not require a different conclusion. It held that the University Hospital performed a governmental function for purposes of determining applicability of the Immunity Act. The Court reached that conclusion by looking to the amendment to § 63-30-3 for guidance in resolving the immunity question, rather than applying the Standiford test. It must be noted, however, that the amendment does not declare that governmentally owned hospitals are governmental functions; rather, the amendment, using precise language, only declares governmentally owned health facilities to be immune from suit “except as otherwise provided” by the Immunity Act. Thus, the Legislature did not declare gov-ernmentally owned health facilities to be engaged in governmental functions,5 and this Court’s statement that the hospital was engaged in a governmental function mischaracterized the language of the statute. In any event, the statute cannot resolve a constitutional issue.
Thus, the issue that emerges is whether the Legislature ran afoul of Article I, section 24 of the Declaration of Rights of the Utah Constitution by limiting the liability of an institution owned by government which performs nongovernmental activities. Article I, section 24 states, “All laws of a general nature shall have uniform operation.” It extends to every person the right to enjoy the equal protection of the law. The purpose of that- provision, as explained in Malan v. Lewis, 693 P.2d at 669, is to assure that “persons similarly situated should be treated similarly, and persons in different circumstances should not be treated as if their circumstances were the same.” “When persons are similarly situated, it is unconstitutional to single out one person or group of persons from among a larger class on the basis of a tenuous justification that has little or no merit.” Id. at 671.
The first step in applying Article I, section 24 is to determine the appropriate standard of review for evaluating the lawfulness of the discriminatory classifications. Not all such classifications are unconstitutional. In Malan, we did not apply the three-tier test applied under federal equal protection law, but we did indicate that the strictness of our approach would vary with the nature of the right or interest discriminated against. 693 P.2d at 674 n. 17. The right involved here is the right to a full remedy for a personal injury, a right protected by Article I, section 11 of the Utah Constitution, which 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....
The term “remedy,” as used in the open courts clause, means the full, fair, and complete remedy provided by the common law. See Smith v. Department of Ins., 507 So.2d 1080 (Fla.1987); Wright v. Central Du Page Hospital Assoc., 63 Ill.2d 313, 347 N.E.2d 736 (1976); Kansas Malpractice *373Victims Coalition v. Bell, 243 Kan. 333, 757 P.2d 251 (1988). Cf. Kenyon v. Hammer, 142 Ariz. 69, 688 P.2d 961 (1984) (en banc). See generally Berry ex rel. v. Beech Aircraft Corp., 717 P.2d 670 (Utah 1985). Whether or not the right involved here is thought to be “fundamental,” as the term is used under the Fourteenth Amendment, it is certainly an important right that ought not to be discriminatorily abrogated or diminished unless there is a strong countervailing public interest. See Smith, 507 So.2d at 1089.
Notwithstanding the importance of the right, I would not, and Malan did not, invoke the federal strict scrutiny standard. See Zablocki v. Redhail, 434 U.S. 374, 98 S.Ct. 673, 54 L.Ed.2d 618 (1978); Shapiro v. Thompson, 394 U.S. 618, 89 S.Ct. 1322, 22 L.Ed.2d 600 (1969). While the least restrictive alternative test employed by the strict scrutiny standard focuses on a valid consideration in determining the constitutionality of a discriminatory statute, strict application of that test in cases such as this would hobble legislative power in an unreasonable fashion in an area where strong competing interests have to be accommodated by legislative policy making.
On the other hand, the Court in Malan also made clear that the great latitude allowed the Legislature in making classifications under the minimal scrutiny standard is not appropriate when a constitutional right is discriminated against. 693 P.2d at 671. Nor should the Court indulge highly speculative hypotheses as to a statute’s purpose in applying the presumption of constitutionality. See id. See also Allied Stores v. Bowers, 358 U.S. 522, 79 S.Ct. 437, 3 L.Ed.2d 480 (1959); Williamson v. Lee Optical Co., 348 U.S. 483, 75 S.Ct. 461, 99 L.Ed. 563 (1955); Baker v. Matheson, 607 P.2d 233 (Utah 1979).
The appropriate standard, in my view, has more bite than the minimum scrutiny standard but does not purport to require the Legislature to find the least restrictive manner of furthering its purpose. But neither does it allow, on the other hand, such wide latitude as to virtually abandon judicial review. The statutory classifications must be reasonable, Malan, 693 P.2d at 672, and the statute that creates the classification must in fact reasonably and substantially further the legislative purpose. See id. at 673. The determination of reasonableness must take into account the extent to which the constitutional right — in this case the right to sue for a full recovery under Article I, section 11 — is diminished and the extent to which the burden imposed actually furthers the legislative goals, as well as the importance of those goals.
The cap on liability imposed by § 63-30-34 creates at least two classes of hospital patients. One class consists of patients negligently injured at a govern-mentally owned hospital who are entitled to limited recovery, and another class is composed of patients negligently injured at a private institution who are entitled to full recovery. The critical issue is whether denying the constitutional right to some and not to others actually and substantially protects the public treasury from unreasonable depletion. Clearly, it is not the purpose of the Governmental Immunity Act to prohibit all public expenditures for governmental tort liability, and in fact, the Act does not do so. Moreover, there is no basis for concluding that according patients at the University Hospital a full remedy for tort liability will threaten the financial stability of government or of the hospital, or even result in an undue drain on resources. While there will be some additional expenditures incurred by the hospital’s liability for full damages, there is no reason to believe that that cost cannot be covered as present liabilities.
The University Hospital is a teaching hospital associated with the University of Utah School of Medicine and it is essentially supported by non-state funds. The affidavit of Dale Gunnell, the associate administrator of the hospital, filed with the Attorney General’s memorandum in opposition to plaintiffs’ motion for partial summary judgment, discloses that of a total operating budget of $80,000,000 (apparently for the year 1984), only 3.5 percent of the hospital’s operating budget came from legislative appropriations. The legislation *374which authorized construction of the University of Utah Medical Center provided only $1.5 million of the cost of construction, while $4 million came from “private subscriptions and contributions.” See Utah Code Ann. § 58-31-46 (1981). The affidavit states: “This level of funding is exceptionally low for a University-based teaching hospital, and the hospital is, practically, self-supporting.” Although it is true that students at the University of Utah School of Medicine receive some of their training at the University Hospital, they also receive training at other private hospitals. The University Hospital competes directly with other hospitals that are not subject to a limitation on tort recovery and therefore must stand the expense, either through insurance or otherwise, of full legal liability for damages negligently caused to patients. The patient pays for hospital services rendered in each instance; the burden of unrecompensable injuries is the same to both types of patient; and in this case the financial burden to the University Hospital and the financial burden to the private hospital for negligent actions is the same.
There is no reason to conclude that the University Hospital would have any more difficulty in assuming those costs than the other major hospitals in Salt Lake City and its environs. Perhaps those costs will ultimately be passed on to the patients patronizing the hospital and their insurance companies, as occurs with other hospitals. Neither the hospital nor the Attorney General in this case even begins to demonstrate that requiring the hospital to shoulder the full cost of liability will have a substantial effect on the state’s treasury.' There is no evidence that in Utah personal injury judgments are unduly large or that they have increased greatly in their number. Indeed, since the government bears only a fraction of the total cost of the operation of the entity, it is clear that the vast bulk of the activity is self-financed by fees and charges.
In sum, the damage limitation, which operates only on those most seriously and severely injured, is an intrusion on a constitutional right that is not justified by whatever marginal enhancement of the legislative purpose flows from the statute. See Malan, 693 P.2d at 673. That conclusion is supported by a number of cases from other jurisdictions. See Coburn v. Agustín, 627 F.Supp. 983, 991-96 (D.Kan.1985); Jones v. State Bd. of Medicine, 97 Idaho 859, 871, 555 P.2d 399, 411 (1976), cert. denied, 431 U.S. 914, 97 S.Ct. 2173, 53 L.Ed.2d 223 (1977); Farley v. Engelken, 241 Kan. 663, 672, 740 P.2d 1058, 1064-65 (1987); Sibley v. Board of Supervisors of La. State Univ., 477 So.2d 1094, 1107-09 (La.1985); Carson v. Maurer, 120 N.H. 925, 932, 424 A.2d 825, 830 (1980); Arneson v. Olson, 270 N.W.2d 125, 135-36 (N.D.1978).
For the foregoing reasons, I conclude that § 63-30-34 is unconstitutional as it applies to the University Hospital because it violates Article I, section 24 of the Utah Constitution. Whether that section may be constitutional as applied to municipal hospitals and other health care facilities is a question I leave for another day.
III. SUITS AGAINST EMPLOYEES
Plaintiffs also complain that they are deprived of their right to sue University Hospital employees, including doctors and nurses, under the Utah open courts provision. See Berry ex rel. v. Beech Aircraft Corp., 717 P.2d 670 (Utah 1985). The argument here is that at common law plaintiffs could sue the hospital employees in their individual capacities, but they are prevented from doing that under the amendments to the Immunity Act. Plaintiffs also argue that the deprivation constitutes a denial of equal protection of the laws.
At the outset, it should be noted that although plaintiffs have been deprived of a remedy against the doctors and nurses individually, they do have a full remedy against the hospital. In Berry, we stated that Article I, section 11 was not violated if “the law provides an injured person an effective and reasonable alternative remedy_” 717 P.2d at 680. In Payne v. Myers, 743 P.2d 186 (Utah 1987), this Court held that the amendment to § 63-30-4 did not violate Article I, section 11 because of
*375the remedy the plaintiffs had against the hospital.
That conclusion means that the discriminatory aspect of § 63-30-4 does not deny a constitutional right under Article I, section 11 and, therefore, the standard of review under the equal protection analysis is less stringent than the standard applied to the cap on damages. The validity of the discrimination made by § 63-30-4 turns on whether the classification is arbitrary in light of the presumed purposes of the statute. Since the hospital is primarily a teaching hospital, it is, in my view, reasonable to shift liability from the employees of the institution so as to protect them and, in effect, require the institution to assume the full liability, where it almost invariably ends up anyway. In my view, therefore, § 63-30-4 is not unconstitutional.

. I cannot agree with the Chief Justice that due process-type balancing analysis is inappropriate here. Plaintiffs have certainly raised the article I, section 11 issue in this case by arguing that the legislation infringes rights protected by that provision. While plaintiffs may. have phrased some portions of this argument in terms of equal protection concepts, we are certainly not limited to so analyzing the issue. Berry teaches that it is precisely due process concepts, rather than those of equal'protection, that are involved when rights protected by article I, section 11 are claimed to have been abridged. 717 P.2d at 675-81. Therefore, it is appropriate for us to use due process analytical methods when treating such claims, whatever approach the parties may have taken to the issues.
Justice Stewart is at pains to renounce any suggestion of "substantive due process,” apparently seeing in a balancing approach the spectre of a discredited era in Supreme Court jurisprudence. This concern is unjustified. See, e.g., Garfield, Privacy, Abortion, and Judicial Review: Haunted by the Ghost of Lochner, 61 Wash.L.Rev. 293 (1986); Note, State Economic Substantive Due Process: A Proposed Approach, 88 Yale L.J. 1487 (1979). If there is any doubt that equal protection concepts can be and are used to produce the same results on essentially the same grounds as a more straight-forward due process analysis, those doubts should be dispelled by comparing Justice Stewart’s separate opinion with mine.

. At the time this lawsuit arose, Utah Code Ann. § 63-30-29 (1978) imposed a $100,000 limitation on the amount recoverable from a governmental entity. Section 63-30-34, in effect at that time, required a trial court to reduce a judgment against a governmental entity in excess of the limitation to the amount of the limitation or the policy limit of insurance secured by the entity, whichever was greater. These provisions were repealed in 1983 and replaced by the current provision set forth in footnote 2, infra. For convenience, I refer only to § 63-30-34 throughout this opinion. My analysis, in any event, is the same under either the current statute or its predecessor.

. Utah Code Ann. § 63-30-34 (Supp.1988) provides:
(1) Except as provided in Subsection (3), if a judgment for damages for personal injury against a governmental entity, or an employee whom a governmental entity has a duty to indemnify, ‘exceeds $250,000 for one person in any one occurrence, or $500,000 for two or more persons in any one occurrence, the court shall reduce the judgment to that amount, regardless of whether or not the *371function giving rise to the injury is characterized as governmental.
(2) Except as provided in Subsection (3), if a judgment for property damage against a governmental entity, or an employee whom a governmental entity has a duty to indemnify, exceeds $ 100,000 in any one occurrence, the court shall reduce the judgment to that amount, regardless of whether or not the function giving rise to the damage is characterized as governmental.
(3) The damage limits established in this section do not apply to damages awarded as compensation when a governmental entity has taken or damaged private property without just compensation.

. At the time of the decision in Greenhalgh, § 63-30-3 read:
Except as may be otherwise provided in this act, all governmental entities shall be immune from suit for any injury which may result from the activities of said entities wherein said entity is engaged in the exercise and discharge of a governmental function.

. Section 63-30-3 currently reads in part:
Except as may be otherwise provided in this chapter, all governmental entities are immune from suit for any injury which results from the exercise of a governmental function, gov-ernmentally-owned hospital, nursing home, or other governmental health care facility, and from an approved medical, nursing, or other professional health care clinical training program conducted in either public or private facilities.

. See note 4 supra.