Court Opinion

ID: 9647723
Source: CourtListenerOpinion
Date Created: 2023-08-23 13:48:22.787348+00
Date Added: 2024-06-11T18:11:52.416051
License: Public Domain

JONES, Justice,
dissenting.
In my view, common sense and public policy considerations apply to the stattitory enactments in this case. Because “common sense” and “public policy” considerations are foreign to the view as expressed by the majority, I dissent.
Aside from the literal language of the statutes (set out in the majority opinion) which I believe are sufficient to authorize chiropractors to use medical laboratories, there are other considerations to be applied in determining the legislative intent of KRS Ch. 333. Particularly is this so as it related to the question of whether chiropractors are “other persons ” authorized to use medical laboratories. While the wording of an act as passed by the legislature is of major importance, the application of common sense is not to be excluded. Kentucky Region Eight v. Commonwealth of Kentucky, Ky., 507 S.W.2d 489 (1974).
On the question of who is an “other person authorized by law,” the majority view is eloquent by its silence. The majority opinion simply holds that, only a licensed physician, [podiatrist, or a dentist] shall manipulate a patient for the collection of specimens. . . . The majority of my colleagues either ignore the phrase, “or other person authorized by law” (emphasis added), or treat it as surplusage. They in effect give the chiropractors of this Commonwealth a bone stripped of meat.
Statutory law is an expression of the will of the General Assembly. When a court is faced with interpreting a statute, as is the case here, it must determine what the legislature intended by enacting the statute, as well as the purpose behind it. Where the language of the statute is clear and unambiguous and expresses the intent of the *823legislature, then the statute must be interpreted by the court as written. Griffin v. City of Bowling Green, Ky., 458 S.W.2d 456 (1970).
In light of these legal principles it is apparent that the phrase “other person authorized by law” would not have been included in the statute if the legislature had not intended for someone other than a doctor, dentist, or podiatrist to use the facilities of a medical laboratory. The phrase in plain, concise, everyday meaning, is that persons in addition to those mentioned may use laboratory findings.
I am of the opinion that as a matter of public policy, chiropractors should be permitted to make a diagnosis as to the best of their professional skill. Their patients are entitled to the best treatment chiropractors are able to give, and this includes diagnosis in order to determine whether the patient is susceptible to chiropractic treatment or if it would be harmful to him. An opportunity should be given the chiropractor to weed out those patients who would not benefit from his treatment or might be harmed by his treatment. If the diagnosis indicates that a patient might be harmed by chiropractic treatment, the chiropractor should be permitted to refer him to the proper branch of the healing arts. I believe the following example would indicate the problem: Patient A may consult his chiropractor complaining of a pain in his lower back. The pain could be caused by subluxation, a condition which only a chiropractor is statutorily authorized to treat by adjustment. On the other hand, Patient A’s complaint could be a pain caused by an organic disorder. His complaint might be as consistent with a kidney disorder as it is with a sub-luxation. A simple diagnostic test of A’s urine to determine the presence or absence of blood or pus will aid the chiropractor. If the latter condition were present, that would indicate to the chiropractor that there is no subluxation. Patient A could then be referred to a physician.
The chiropractic profession has been recognized in this Commonwealth for nearly fifty years. At its 1928 session the General Assembly passed an act to create a Board of Chiropractic Examiners, to regulate the practice of chiropractic, to provide penalties for violation of the act, and to prohibit the practices of any other mode or system under the name of chiropractic. Ky. Acts, 1928, Ch. 123, pp. 416-421. That act was approved on March 8, 1928. It is interesting to note that the most significant change in the statutes dealing with chiropractors came about in 1976. For nearly half a century the definition of chiropractic remained the same. The 1928 act, Sec. 5, defines chiropractic as follows:
“Chiropractic is defined as the science of locating and adjusting the subluxations of the articulations of the human spine and its adjacent tissues.”
In the act of 1976, House Bill 758, approved March 30, 1976, (KRS 312.015(2)) chiropractic is defined:
“Subject to the limitations of Subsection 4 of this section, ‘chiropractic’ means the science of diagnosing and adjusting the subluxations of the articulations of the human spine and its adjacent tissues . .” (Emphasis added).
It is obvious that the majority view equates “locate” with “diagnose” or “diagnosis.” Ah, there’s the rub that finds me at variance with my colleagues’ interpretation. Locate is defined in Webster’s Third International Dictionary as follows:
“1. to determine or indicate the place of: define the site or limits of . . .;
2. (a) to set or establish in a particular spot or position;
3. (a) to seek out and discover the position of . . .;
3. (c) to determine the position of.”
Diagnose is defined by Webster, supra, as:
“1. to identify (as a disease or condition) by symptoms or distinguishing characteristics;
2. to determine the causes of or the nature of by diagnosis.”
Diagnosis is defined as:
“1. the art or act of identifying a disease from its signs and its symptoms

*8242. an investigation or analysis of the nature or cause of the condition, stipulation or problem.”
While this matter was pending in the circuit court, the Kentucky State Board of Chiropractic Examiners promulgated an administrative regulation authorizing doctors of chiropractic to use the findings of a medical laboratory examination. The regulation provides:
“Chiropractors may examine, analyze and diagnose the patient and his diseases by the use of any physical, chemical, or thermal method reasonably appropriate to the case. Chiropractors qualified by training and skill for diagnosis and analysis of patients by use of radiographs, blood analysis or other methods or examination may utilize the services of persons authorized by law to perform the procedures involved in such methods of examination. Provided, however, that the Board may upon notice and hearing find any licensee unfit to use specified methods of examination, and provided further that the board by duly promulgated regulations may prohibit or restrict use of specified methods of examination which the board determines are appropriately so regulated.” K.A.R. 21:020, § 3.
Thereafter Jefferson County Medical Society, Bureau of Health Services, and the Kentucky State Board of Medical Licensure filed their motion and supporting brief for summary judgment. Subsequently, in reading a brief filed by the Kentuckiana Center for Education, they learned of the existence of the regulation. Then they filed with the trial court an amended cross claim requesting the trial court to declare the regulation void. The Kentucky Association of Chiropractors, Inc., filed a motion to amend the judgment as it pertained to the regulation. It also requested the court to include a finding as to what portions of the regulation are inconsistent with the statutes governing the practice of chiropractic. On January 27, 1976, in its amended judgment, the trial court refused to amend the original judgment.
It is the general rule in Kentucky that administrative regulations properly filed and adopted have the same effect as statutes directly enacted by the General Assembly from which the administrative agency is delegated its authority. Rietze v. Williams, Ky., 458 S.W.2d 613 (1970). The regulations adopted by any state agency must be confined to the function that the agency is authorized to administer.
Former KRS 312.075 repealed by the legislature in 1976 is now KRS 312.019. Subsection 9 grants the board rule-making power relative to governing the practice of chiropractic as long as the rules promulgated by the board are not inconsistent with the provisions of the statutes.
This regulation was submitted to the Legislative Research Commission for review in accordance with KRS 13.085 on May 15, 1975. The Administrative Regulation Review Subcommittee approved the regulation on July 3, 1975, thereby affirming the Legislative Research Commission’s finding that the regulation conformed to the statutory authority under which it was promulgated.
Chiropractic is not a cult. The evidence reveals that there are ten outstanding colleges of chiropractic in the United States. Each of these offer courses in diagnostic procedures. Each applicant who desires to be a licensed chiropractor “shall have satisfactorily completed not less than sixty (60) semester credit hours of study from a college or university accredited by the Southern Association of Colleges and Universities or an accrediting agency recognized by the Southern Association of Colleges and Universities or any successor to the powers of either and is a graduate of a chiropractic college accredited by the Association of Chiropractic Colleges, or the council on chiropractic education or their successors, and which maintains a standard of reputability approved by the board.” KRS 312.085.
Each applicant for a license to practice chiropractic is required to take an examination.
“(2) The examination shall consist of a written test including questions of essay *825or objective type designed to measure the applicants’ knowledge of the subjects of anatomy, physiology, pathology, neurology, histology, hygiene, bacteriology, chemistry, chiropractic orthopedics, diagnosis, the use and effects of x-ray and chiropractic principles and practices as taught in chiropractic schools and colleges. A portion of said examination shall consist of a practical demonstration of clinical competency to be evaluated by the board by such methods as it may designate prior to the examination.” (Enact. Acts 1962, ch. 179, § 11; 1976, ch. 359, § 12.) KRS 312.115(2).
The critical shortage of health care delivery personnel in this Commonwealth would seem to mandate the complete and full utilization of all of those persons reasonably equipped by training and experience. The purpose behind KRS Ch. 333 is to protect the health and welfare of the people in Kentucky by requiring medical laboratories to provide reliable and competent information to health professionals. KRS 333.010. The interests of the public health and safety of the citizens of this Commonwealth require that chiropractors be given the right to use those diagnostic tools which they are reasonably equipped to perform through training and experience.
In my view, to deny chiropractors the use of clinical laboratories for the analysis of the blood or urine of their patients would be a disservice to the patients by not assuring them of the best professional diagnosis available to the chiropractor, and would contradict the obvious legislative intent of the General Assembly.
The majority opinion seems to relegate the profession of chiropractic to the mere manipulation of the spine. Such a position is archaic, intellectually naive, and without scientific merit.
For the foregoing reasons, I dissent.
I am authorized to say that LUKOW-SKY, J., joins in this dissent.