Court Opinion

ID: 9418580
Source: CourtListenerOpinion
Date Created: 2023-08-02 22:32:32.869207+00
Date Added: 2024-06-11T17:22:06.318664
License: Public Domain

Mr. Justice Sutherland,
dissenting.'
The general design ot the federal Constitution is to give to the federal government control over national and international matters, leaving to the several states the control of local affairs. Prior to the adoption of the Eighteenth Amendment, accordingly, the direct control of the manufacture, sale and use of intoxicating liquors for all purposes was exclusively under the police powers of the states; and there it still remains, save insofar as it has been taken away by the words of the Amendment. These words are perfectly plain and cannot be extended beyond their import without violating the fundamental rule that the government of the United States is one of delegated powers only and that “ the powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.” The pertinent words of the Amendment are: “. . . the maruifacture, sale, or transportation of intoxicating liquors ... for beverage purposes is hereby .prohibited.” Plainly, Congress in submitting the Amendment, and the, several states in ratifying it, meant to leave the question of the prohibition of intoxicating liquors for other than beverage purposes to the determination of the states, where it had always been. The limiting words of the Amendment are not sus*598ceptible of any other meaning; and to extend them beyond the scope of that meaning really is to substitute words of another and different import.
It is important also to bear in mind that “ direct control of medical practice in the States is beyond the power of the Federal Government.” Linder v. United States, 268 U. S. 5, 18. Congress, therefore, cannot directly restrict the professional judgment of the physician or interfere with its free exercise in the treatment of disease. Whatever power exists in that respect belongs to the states exclusively. ■
The sole question which we are called upon to consider is whether the district court erred in denying the motion of the defendants to dismiss plaintiff’s bill; and upon that question, of course, we are bound to accept as true all allegations of the bill which are well pleaded.
The suit was brought by a physician of distinction and, as the court below said, “ of wide and unusual experience in the practice of medicine.” He alleges that it is his opinion, based on experience, observation and medical study, that the use of spirituous liquors as medicine is, in certain cases, necessary in order to afford relief from known ailments; and that in the use of such liquors as medicine it is, in certain cases, including some now under his own observation and subject to his professional advice, necessary, in order to afford relief, that more than one pint of such liquor in ten days should be used internally and, in certain cases, necessary that it should be used without delay, notwithstanding that within a preceding period of less than ten days one pint of such liquor has already been used. He further alleges that in prescribing drugs and medicines the determination of the quantity involves a consideration of the physical condition of the patient and their probable effect in each specific case.
In addition to these allegations, we have the fact that Congress, acting upon a report of one of its committees *599made after exhaustive hearings, declared by statute that the prescription of malt liquors should be prohibited and the prescription of spirituous and vinous liquors should be permitted. Justifying such legislation, the committee had reported that the overwhelming evidence was to the effect that malt liquors [not also spirituous and vinous liquors] had no substantial medicinal value. It is now said by the majority, at one point, that the preponderating opinion of practicing physicians is against the use of all three and, at another point, that only a minor fraction hold the other view. I am quite unable to assent to these generalizations. On the contrary, the impossibility of determining, from anything now before this court, what is the preponderating opinion upon the subject, is very clear. An examination of the hearings before the House Judiciary Committee, cited as authority for the foregoing statements, shows that the inquiry there was directed to the question of the medical value of malt liquors and that the question of the medical value of the other liquors was not under consideration. The hearings contain a few casual references to the other liquors; but I feel justified in saying that they reflect no light upon the state of medical opinion as to the value of such liquors as medicines. It is stated in the brief for the appellees that a questionnaire, sent out to one-third of the physicians of the United States, brought a reply from enough to make 21.5 per cent, of the whole number of physicians in the country, and that a little more than one-half of those replying voted “Yes” on the use of whiskey as a therapeutic agency, some of them, however, taking exception to the word “ necessary,” saying that no drugs were absolutely necessary. The American Medical Association, whose resolution of 1917 is referred to, have filed in this case a brief as amicus curiae, challenging the conclusion which is drawn from that resolution and vigor*600ously attacking the Act now under review _as arbitrary and unreasonable. In 1924 the House of Delegates of the Association adopted a resolution expressing its disapproval of those portions of the Act “ which interfere with the proper relation between the physician and his patient in prescribing alcohol medicinally.” It seems plain, therefore, that the most that can be said is that the question is of a highly controversial character; and, since it reasonably cannot be doubted that it is a fairly debatable one, the legislative finding, necessarily implicit in the Act, that vinous and spirituous liquors are of medicinal value, must be accepted here. Radice v. New York, 264 U. S. 292, 294; Rast v. Van Deman & Lewis, 240 U. S. 342, 357; Price v. Illinois, 238 U. S. 446, 452.
The majority opinion rests chiefly upon Everard’s Breweries v. Day, 265 U. S. 545, which, it is said, was decided by a unanimous court and, if adhered to, disposes *of the present case. While, of course, in the light of the present ruling, I cannot say that, if the court had entertained that view of the scope of its decision at the time of its rendition, it would not have been rendered; I do say it is very certain that it would not have been by a unanimous court. In the opinion in that case there is some general discussion of the power of Congress in respect of the adoption of appropriate means to enforce the Eighteenth Amendment, but the decision rests upon the ground that Congress, upon conflicting evidence, had determined that malt liquors possessed no substantial medicinal value and judicial inquiry upon that question was, therefore, foreclosed. In direct response to the contention that the Act was an “ arbitrary and unreasonable prohibition of the use of valuable medicinal agents,” it was said (pp. 561-562):
“ When the bill was pending in Congress the Judiciary Committee of the House of Representatives held an extended public hearing, in which it received testimony, ' *601among, other things, on the question whether beer and other intoxicating malt liquors possessed any substantial medicinal properties. Hearings before House Judiciary Committee on H. R. 5033, Serial 2, May 12, 13,16, 17, 20, 1921. On the information thus received the Committee recommended the passage of the bill. ,H. R., 67th Cong., 1st sess., Rep. No. 224. And in the light of all the testimony Congress determined, in' effect, that intoxicating 'malt liquors possessed no substantial and essential medicinal properties which made it necessary that their use for medicinal purposes should be permitted, and that, as a matter affecting the public health, it was sufficient to permit physicians to prescribe spirituous and vinous intoxicating liquors in addition to the non-intoxicating malt liquors whose manufacture and sale is permitted , under the National Prohibition Act.”
And finally (p. 563):
“We find, on the whole, no ground for disturbing the determination of Congress on the question of fact as to the reasonable necessity, in the enforcement of the Eighteenth Amendment, of prohibiting prescriptions of intoxicating malt liquors for medicinal purposes. See Radice v. New York, 264 U. S. 292.”
• And so here, the legislative finding, implicit in the' statute now under'review, to the contrary effect, in respect of spirituous and vinous liquors, likewise should be accepted as controlling, and the Everard’s Breweries case rejected as inapplicable.
As the record now stands, theréfofe, we must begin this inquiry with the assumption that vinous and spirituous liquors are in fact valuable medicines;.and it necessarily follows that, at least as an end as distinguished from a means to an end, the prescription of such liquors'in good faith for medicinal use cannot be prohibited by Congress, since that body lawfully cannot legislate beyond the grants of the Constitution. The report of the committee *602and the hearings will be searched in vain to find any suggestion that the quantity designated by the statute is adequate or that the committee or Congress gave any consideration to that question. The only fact in this record bearing upon that subject is the allegation, under oath, of appellant that in his professional opinion, based on experience, observation and medical study, more than that quantity, in certain cases, including some under his own observation and advice, is necessary. And, certainly, there is no basis for asserting the contrary in any fact or circumstance to be found outside the record of which this Court can take judicial notice.
The naked question, then, simply comes to this: Conceding these liquors to be valuable medicines, has Congress power, under the constitutional provision prohibiting traffic in intoxicating liquors for beverage purposes, to limit their prescription in good faith, and consequently their necessary use, for medicinal purposes, to a quantity which, under the allegations taken as true, is inadequate for such purposes? To me the answer seems plain. If Congress cannot altogether prohibit the prescription for medicinal use, it cannot limit the prescription to an inadequate quantity, for, obviously, in that case, to the extent of the inadequacy, the prohibition is as complete, and the usurpation of power as clear, as though the prohibition were unqualified. If the power exists to limit the quantity to a pint in ten days, it exists to limit the quantity to a tablespoonful or a teaspoonful or a few drops during the same or any other arbitrary period of time, with the result in substance and effect that the definite limitation of the prohibitory power .by the words “ for beverage purposes ” vanishes altogether.
It is said that high medical authority is in conflict as to the medicinal value of spirituous and vinous liquors and [hence] it would be strange if Congress lacked power to determine that the necessities of the liquor problem re*603quire a reasonable limitation of the permissible prescriptions. This observation does more than beg the question, — it indulges an assumption the exact contrary of that which the record conclusively establishes, for the limitation of quantity is not only unsupported by any legislative finding that it is reasonable, but it is in flat opposition to the only facts appearing in the record which bear upon the question of what is a permissible prescription, and, therefore, is without rational basis, resting alone upon the arbitrarily exercised will of Congress. I do not see how’ it can be held otherwise without completely ignoring the case as made and constructing and considering another and different case.
Nor is the opinion of the majority aided by the long list of state enactments cited to demonstrate that the presefit statute is not arbitrary, for, since the control of the medical practice is outside the province of the federal government and wholly within that of the states, Linder v. United States, supra, the powers of Congress in that field are not to be assimilated to those of the states.
By the legislation now under review, the authority of Congress is so exercised that the reserved power of the states to control the practice of medicine is directly invaded, to the illegitimate end that the prescription and use of liquors for medicinal purposes is prohibited. It is true that Congress has wide discretion in the choice of means to carry the granted power into effect; but the means not only must be appropriate to the end but must be such as “ are not prohibited, but consist with the letter and spirit of the Constitution.” McCulloch v. Maryland, 4 Wheat. 316, 421. A grant of power to prohibit for specified purposes does not include the povrer to prohibit for other and. different purposes. . Congressional legislation directly prohibiting intoxicating liquor for concededly medical purposes, therefore, does not consist with the letter and spirit of the Constitution, and viewed as a *604means of carrying into effect the granted power is in fraud of that' instrument, and especially of the Tenth Amendment. The words of Mr. Madison (Writings of James Madison, vol. 6, p. 367) are pertinent: “Nor cam it ever be granted that a power to act on a case when it actually occurs, includes a power over all the means that may tend to prevent the occurrence of' the case. Such a latitude of construction would render unavailing every practical definition of particular and limited powers.”
The effect of upholding the legislation is to deprive the states of the exclusive power, which ’ the Eighteenth Amendment has not destroyed, of controlling medical practice and transfer it in part to Congress. See Hammer v. Dagenhart, 247 U. S. 251, 275-276. It goes further, for if Congress can prohibit the prescription of liquor for necessary medical purposes as a means of preventing the furnishing of it for beverage purposes, that body, by a parity of reasoning, may prohibit the manufacture and sale for industrial or sacramental purposes, or, indeed, as the most effective possible means .of preventing the traffic in it for beverage purposes, may prohibit such manufacture and sale altogether, with the result that, under the pretense of adopting appropriate means, a carefully and definitely limited power will have been expanded into a general and unlimited power. “ The purposes intended must be attained consistently with constitutional limitations and not by an invasion of the powers of the States. This.court has no more important function than that which devolves upon it the obligation to preserve inviolate the constitutional limitations upon the exercise of authority, federal and state, to the end that each may continue to discharge, harmoniously with the other, the duties entrusted to it by the Constitution.” Hammer v. Dagenhart, supra, p. 276.
I do not doubt the authority of Congress to regulate the disposal of intoxicating liquors for medicinal use so as to prevent evasions of the law against the traffic in such *605liquors for beverage purposes, and to that end to surround the prescription by the physician with every appropriate safeguard against fraud and imposition; but as this record now stands it cannot prohibit the legitimate prescription of spirituous and vinous liquors for medicine as this statute attempts to do; “ Federal power is delegated,, and its prescribed limits must not be transcended even though the end seem desirable.” Linder v. United States, supra, p. 22. Because this statute by fixing inadequate prescriptions prohibits to the extent of such inadequacies the legitimate prescription of spirituous and vinous liquors for medicinal purposes, it exceeds the powers of Congress, invades those exclusively reserved to the states, and is not appropriate legislation to enforce the Eighteenth Amendment. The decree below should be reversed.
Mr. Justice McReynolds, Mr. Justice Butler and Mr. Justice Stone concur in this opinon.