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Only States Can Regulate Medicine

Well, give it to Supreme Court Justice Ketanji Brown Jackson: At least this time, her legal scribbling isn’t going viral because she referenced the opinion of a space alien.

Other than that, the high court’s jester continued her unabated streak of providing unintentional comic relief to proceedings on Wednesday, when she handed down a dissent that effectively hinged upon a principle she affirmed the total opposite of by signing onto a dissent by Justice Sonia Sotomayor one year earlier.

She was the only dissenter in an 8-1 ruling by the court, in which both conservative and liberal justices — but not the notorious KBJ — sided with a Christian counselor challenging Colorado’s ban on therapy for those with gender or sexual identity issues, commonly derided by the left as “conversion therapy.”

The case, Chiles v. Salazar, was brought by a Colorado Springs talk therapy practitioner, according to legal outlet Oyez.

“Prior to the enactment of a 2019 Colorado law banning conversion therapy for minors, Chiles counseled clients, including minors, in accordance with their self-identified goals, which sometimes included diminishing same-sex attractions or aligning gender identity with biological sex,” Oyez noted.

“Since the law’s passage, Chiles has refrained from engaging in discussions with minors that she believes could be interpreted as conversion therapy and alleges that this has hampered her ability to provide full counseling services in line with her and her clients’ religious convictions.”

The court concurred, with the opinion being delivered by Justice Neil Gorsuch.

“Colorado may regard its policy as essential to public health and safety. Certainly, censorious governments throughout history have believed the same. But the First Amendment stands as a shield against any effort to enforce orthodoxy in thought or speech in this country,” Gorsuch wrote, saying the law “censors speech based on viewpoint.”

Gorsuch ordered the law to be sent down to a lower court to apply a stricter level of scrutiny when considering whether or not it violated basic constitutional rights, according to The Wall Street Journal.

Jackson, in her dissent, said that it was the states who ought to regulate how medicine was practiced, citing a case from the 1920s at the outset:

“[T]here is no right to practice medicine which is not subordinate to the police power of the States.” Lambert v. Yellowley, 272 U. S. 581, 596 (1926). This was true 100 years
ago, and it should be true today.

Many States have now chosen to exercise their police powers to ban “conversion therapy” based on the medical profession’s broad consensus that this medical treatment (which seeks to change a gay or transgender person’s sexual orientation or gender identity) is ineffective and harmful. This case involves the Colorado Legislature’s policy decision to prohibit licensed medical professionals from offering or providing conversion therapy to minors in that State. …

Related:

BREAKING: Justice Clarence Thomas Issues Blistering Dissent in Tariff Case Following Trump Loss

So, I respectfully dissent. Stated simply, the majority has failed to appreciate the crucial context in which Chiles’s constitutional claims have arisen. Chiles is not speaking in the ether; she is providing therapy to minors as a licensed healthcare professional. The Tenth Circuit was correct to observe that “[t]here is a long-established history of states regulating the healthcare professions.”

Let’s look beyond the speciousness of this argument in re: First Amendment protections. As many pointed out on social media, this directly contradicted her vote in United States v. Skrmetti, in which she joined Justice Sotomayor in her opinion that the state couldn’t regulate medical interventions on minors who identified as transgender. (Justice Kagan, who was the other vote against the 6-3 majority that upheld the law, filed her own dissenting opinion.)

In the Skrmetti case, it’s probably best that she didn’t file a separate dissent, since when she’s left to her own devices, she’s often given to legal theorizing like “What would a Martian do?”

However, this also means that she’s signing onto the reason given for the dissent by Sotomayor — which is that, in this case, the state has no authority to make medical decisions because, under the Constitution, the individuals are a protected class.

From Sotomayor’s dissent in Skrmetti:

To give meaning to our Constitution’s bedrock equal protection guarantee, this Court has long subjected to heightened judicial scrutiny any law that treats people differently based on sex. See United States v. Virginia, 518 U. S. 515, 533 (1996). If a State seeks to differentiate on that basis, it must show that the sex classification “serves important governmental objectives and that the discriminatory means employed are substantially related to the achievement of those objectives.” Ibid. (internal quotation marks omitted). Such review (known as intermediate scrutiny) allows courts to ascertain whether the State has a sound, evidence-based reason to distinguish on the basis of sex or whether it does so in reliance on impermissible stereotypes about the sexes.

Tennessee’s law expressly classifies on the basis of sex and transgender status, so the Constitution and settled precedent require the Court to subject it to intermediate scrutiny. The majority contorts logic and precedent to say otherwise, inexplicably declaring it must uphold Tennessee’s categorical ban on lifesaving medical treatment so long as “‘any reasonably conceivable state of facts’” might justify it. Ante, at 21. Thus, the majority subjects a law that plainly discriminates on the basis of sex to mere rational-basis review. By retreating from meaningful judicial review exactly where it matters most, the Court abandons transgender children and their families to political whims.

Now, to the extent that what medical therapies cannot be banned or permitted by the states because the individuals being treated are of a protected class is a debatable one, but here’s what’s not up for debate: To the extent one buys that, an individual being psychologically treated for what their religion defines as a deviant sexual condition is far more protected than a transgender child being treated using nonreversible procedures and medications.

This is because the first isn’t just mentioned in a constitutional amendment, it’s mentioned in the very First Amendment, and the second class is not mentioned explicitly at all in the Constitution.

But then, what are we to expect — consistency? After all, in a pointed remark aimed at Jackson in her opinion from that infamous Martian case — Trump v. CASA, which effectively ended the practice of most universal injunctions imposed by lower courts — Justice Amy Coney Barrett was forced to note that Jackson’s dissent “is at odds with more than two centuries worth of precedent, not to mention the Constitution itself.”

And now, Jackson is at odds with … Jackson. We’ve finally reached full Ouroboros status.

So, which is worse: Abnegating your own stated opinions on whether or not the federal government or the states regulate medicine in issues where constitutional conflicts arise, or penning another fantastic space alien what-if dissent? That’s unfortunately not a hypothetical question for the SCOTUS jester — who has many more years of self-inflicted embarrassment ahead of her, sadly.

C. Douglas Golden is a writer who splits his time between the United States and Southeast Asia. Specializing in political commentary and world affairs, he’s written for Conservative Tribune and The Western Journal since 2014.

C. Douglas Golden is a writer who splits his time between the United States and Southeast Asia. Specializing in political commentary and world affairs, he’s written for Conservative Tribune and The Western Journal since 2014. Aside from politics, he enjoys spending time with his wife, literature (especially British comic novels and modern Japanese lit), indie rock, coffee, Formula One and football (of both American and world varieties).

Birthplace

Morristown, New Jersey

Education

Catholic University of America

Languages Spoken

English, Spanish

Topics of Expertise

American Politics, World Politics, Culture

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