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Nevada Upholds Challenged Physician Discipline Statutes


A Nevada statute, NRS 630.301(9), provides that a physician may be disciplined for “engaging in conduct that brings the medical profession into disrepute, including, without limitation, conduct that violates any provision of a code of ethics adopted by the” State of Nevada Board of Medical Examiners. Also NAC 630.040 defines “malpractice” for the purposes of NRS Chapter 630 as “the failure of a physician, in treating a patient, to use the reasonable care, skill, or knowledge ordinarily used under similar circumstances.”

 

Two doctors brought an action against the State of Nevada and State of Nevada Board of Medical Examiners for a legal determination by the court and injunctive relief. The action asserted a facial challenge to the constitutionality of NRS 630.301(9) and NAC 630.040, the professional discipline statutes and regulations.

 

The Clark County Eighth Judicial District Court denied injunctive relief and held that none of the challenged statutes or regulations was unconstitutionally vague, overly broad, or ambiguous. The district court also awarded attorney fees to the State of Nevada and State of Nevada Board of Medical Examiners.

 

The Supreme Court of Nevada affirmed the district court. The court held that neither NRS 630.301(9) nor NAC 630.040 was unconstitutionally vague or ambiguous. A statute is unconstitutionally vague if (1) it is worded such that a person of ordinary intelligence would not have fair notice of prohibited conduct, or (2) its standards are so weak that discriminatory enforcement is either authorized or encouraged.

 

The court held that NRS 630.301(9) was not unconstitutionally vague or ambiguous. The doctors argued that NRS 630.301(9) was vague and ambiguous because it referenced a code of ethics, which the Board of Medical Examiners had not adopted. The court reasoned that the plain language of the statute was clear that while a violation of a code of ethics adopted by the board may be one ground for discipline, the limit of this provision was a physician's engagement in conduct that brings the medical profession into disrepute. Applying definitions from Black's Law Dictionary and Merriam–Webster's Collegiate Dictionary, the court determined that the statute clearly defined conduct that brings the medical profession into disrepute as conduct that results in a loss of the public's regard for the medical profession.

 

The court held that NAC 630.040 was not overly broad, unconstitutionally vague, and ambiguous. The doctors argued that NAC 630.040 was overly broad, unconstitutionally vague, and ambiguous because it did not explain how the “reasonable care” standard was determined and it encapsulated new, novel, or experimental treatments. The court reasoned that although the term “reasonable care” standing alone might be vague, its meaning is well established in light of authority in the tort and medical malpractice context. Furthermore, a statute that conveys a definite warning as to proscribed conduct when measured by common understanding and practices will satisfy due process. Such a statute does not need to detail each and every act or conduct that is prohibited.

 

The Supreme Court of Nevada affirmed the district court’s denial of injunctive relief on the grounds that none of the challenged statutes or regulations was unconstitutionally vague, overly broad, or ambiguous.

 

One justice dissented noting, “This appeal raises important statutory interpretation issues regarding physician discipline and may have a widespread effect on the practices and reputations of all physicians in this state, not just appellants. Because of this, and the vital role that physicians hold in our society, oral argument appears warranted here, and I would not resolve this appeal as submitted for decision on the briefs.”

 

See: Goldsmith v. State, 2014 WL 2527233 (Nev., June 2, 2014) (not designated for publication).

 

 

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