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"Alphabiotics" Practitioner Loses Chiropractic License

Stephen Barrett, M.D.

The Washington State Court of Appeals has upheld an administrative decision to discipline former chiropractor John D. Brown for unprofessional conduct for practicing with an expired license. In 2000, the Commission of Chiropractic Quality Assurance charged that Brown had performed chiropractic manipulations but called his practice "alphabiotics." which he claimed is a sacrament of the Alphabiotic Church, of which he said he is a priest. He testified that he was performing alphabiotic "alignment" and not a chiropractic adjustment. However, the Commission concluded that "alphabiotics" treatments are indistinguishable from chiropractic and that certain techniques he used are associated with risk of stroke. It also concluded that his failure to warn of the risk of stroke -- and an inadequate response when one of his patients suffered a stroke during an adjustment -- were below the state standard of care required for chiropractors. The Commission levied a $30,000 fine and revoked Brown's license for ten years.

Alphabiotics is said to have been started in the 1920s by Virgil B. Chrane, D.C., and "established as a unique new profession" in 1971 by his son Virgil Chrane, Jr., D.C., whose son Michael practices in Dallas, Texas. The Alphabiotics International Web site defines alphabiotics as "a truth and love based metaphysical belief system that concerns itself with the interrelationship between the lesser self, the better self, and Life; i.e. the Omniscient, Omnipresent, Omnipotent Supreme Consciousness." In February 2002, the site listed about 75 "alphabioticists" who have been "granted certification by the International Alphabiotic Association." A disclaimer on the site stated (in part):

An alphabioticist's commitment is above and beyond crass commercialism and secular therapeutics. It's a calling and a search for truth. They do not presume to tell anyone what to believe, think or do. They are not into control, but enlightenment. Neither do they attempt to diagnose, heal, treat or cure anyone of anything. Rather, alphabioticists instruct, enable, and empower others to deal with stress and be more awake and aware - in order that they might resolve their own challenges and make their lives work better.

Alphabioticists do not presume to dispense medical advice or prescribe the use of any procedure, process or technique as a form of treatment for any medical injury, illness or disease, either directly or indirectly. Their sincere intent is to offer help and information of a vital nature, to enable others to take greater self-responsibility.

In the event someone uses Alphabiotic information as if it were therapeutic-medical-advice, they would be prescribing for themselves, which is their God-given right, but Alphabioticists, Alphabiotics, the Alphabiotic Academy, Alphabiotics International, and the International Alphabiotic Association assume no responsibility for such actions. . . .

Medical therapeutics and Alphabiotics are based on completely different principles; so different that each of the two systems are almost incomprehensible to the believers in the other's concepts.

Ordinary medical therapeutics is based in physical biology, which is in turn based in an atheistic philosophy called materialism. Materialism holds that only material things, those things that can be weighed and measured are real. In practice, it brooks no recognition of a spiritual, non-physical dimension.

Alphabiotics admits to another reality. It recognizes a Spiritual Presence in human beings; an Intelligent, inner Life Force, which is not physically measurable. Alphabioticists see this inner Presence as being infinitely wise and purposeful and recognize that it is an expression of a greater Unified-Field, called God. Alphabiotics is grounded in quantum mechanics, relativity physics, and a spiritual theology. Alphabioticists see physical disease as a result of wrong choices and a mis-direction of normal Life energy flow.

A chiropractic adjustment involves a very specific procedure done to correct an improper relationship between spinal vertebrae. Chiropractic adjustments are only done after a very precise spinal analysis, properly done by a competent and qualified chiropractor, who has had years of intense training. There are many variables that must be taken into account for a chiropractic adjustment to be administered correctly. . . .

The Alphabiotic Process, though accomplished by hand, is totally different from a chiropractic adjustment. The Alphabioticists hand placements are on the head, not on the neck. It is not a manipulation or adjustment procedure designed to reposition spinal vertebrae. Vertebral adjusting, to an Alphabioticist, is a violent invasion of the body's natural defense mechanisms. To compare a chiropractic adjustment to the Alphabiotic Process is ridiculous. It is never given to heal any disease or medical condition. The intent, purpose, and reason for the Alphabiotic process is as different from a chiropractic adjustment, or a medical manipulation, as night and day, in and out, black and white, up and down, good and bad.

The reason we even mention the difference between chiropractic and Alphabiotics is because Alphabioticists have been legally attacked by chiropractors over 20 times in the last 30 years. We believe ignorance is the reason. Please Note: Alphabiotics has been victorious each time. Know also, that Alphabiotics is a "legally protected" word.

And, only one group, the Alphabiotic Academy, is authorized to teach Alphabiotics and only one group, Alphabiotics International, is legally authorized to certify Alphabioticists. Certified Alphabioticists are listed only in the Directory on this official Alphabiotic Web Site. If anyone says he or she is qualified as an Alphabioticist, check to see if that person is listed in our Directory, and ask to see an official, up-to-date Continuing Education Certificate (these are issued annually, to qualified Alphabioticists, only by Alphabiotics International).

Chiropractic scam artists, who could not do the Alphabiotic Process properly if their lives depended on it, are around who teach a bastardized, extremely dangerous, and totally wrong version of the Alphabiotic Process. They present it as a therapy designed to get sick people well. They are con-men, and their motive is to deceive and rob people. We know of no one who has mastered the Alphabiotic Process in less than 2 to 5 years of very intense, focused effort and training. Beyond that, a spiritual intent is the critical factor in properly administering the Process. Con-men do not have that kind of intent. . . .

An affidavit from Virgil Benson Chrane included on the disclaimer page states (in part):

Alphabiotic ministers do not claim to be diagnosticians, healers or therapists. They do not render treatments for injuries or diseases. Theirs is a greater concern and a higher calling than therapeutics. . . .

The major difference between chiropractic and Alphabiotics, in my considered opinion, is the difference that exists between atheism and theism. Alphabiotic ministers do not want to be chiropractors or any other kind of therapist; they have little confidence in secular treatment systems, which by-and-large are atheistic practices that deny the existence of God. Beyond that, Alphabiotic ministers are sworn by sacred oath not to practice Alphabiotics as if it were a therapy. They have pledged their sacred honor in this regard.

Alphabiotics.com states that alphabiotics "can't be fully explained" but "must be experienced to be fully understood." However, the Washington Commission of Chiropractic Quality Assurance concluded that it is a chiropractic variant in which treatment is limited to neck adjustment. Here's the full text of the appeals court decision:


IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

JOHN D. BROWN, D.C.,

Appellant,

v.

STATE OF WASHINGTON,
DEPARTMENT OF HEALTH,
CHIROPRACTIC QUALITY
ASSURANCE COMMISSION,

Respondent

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No. 47789-7-I

DIVISION ONE
UNPUBLISHED OPINION

FILED:

Appeal from Superior Court of King County
Docket No: 002103310
Judgment or order under review
Date filed: 12/12/2000
Judge signing: Hon. Sharon Armstrong


PER CURIAM

John Brown appeals the trial court's decision affirming the Commission of Chiropractic Quality Assurance's (Commission) final order. The order revoked his license to practice as a chiropractor, imposed a $30,000 fine, ordered him to cease and desist from all actions falling within the chiropractic practice, and prohibited him from representing himself as a licensed chiropractor. Brown contends that (1) the Commission did not have jurisdiction over him because his license had expired, (2) the findings of fact are not supported by substantial evidence, and (3) the freedom to practice his religion prevents the State from regulating his practice. We affirm the Commission's order because it had jurisdiction to hear this matter, the administrative record contained substantial evidence, including the Commissioners' expertise, to support its findings, and the State has authority to regulate Brown's practices to protect the public health, safety, and welfare.

FACTS

In January 1966, John Brown got his chiropractic license from the State of Washington. His license expired on July 3, 1993, and Brown has not renewed it. In February 1997, Patient A was suffering from headaches, and on the recommendation of her sister, Alison Falco, she went to the Alphabiotic New Life Center which Brown operates.

Patient A testified that Brown told her he had been a chiropractor for 20 years, but did not tell her that his license was expired. She also testified that she would not have sought his treatment if she had known he was unlicensed, that he referred to himself as 'doctor,' and that he had business cards that read 'Dr. John D. Brown, Developmental Alphabioticist.' Brown told her that the difference between chiropractic and alphabiotics was that only neck alignments were performed in alphabiotics.

On February 10, 1997, Patient A went to Brown for treatment of her headaches, and she filled out and signed a form containing biographical information. She testified that she did not read all of it. She also admitted signing a form entitled 'Comprehension,' but said that she did not read it thoroughly. She stated that Brown handed her the forms without explaining their content, that she did not believe she was joining a religious organization, and that she would not have joined if she had known she was being asked to.

During treatment, Brown had Patient A lie on an inclined table while he placed his hands under her neck and turned her head from side to side. Brown placed one hand on her chin and one hand under her neck, turned her head to one side, and then forcefully pulled her head up to the table. He repeated this procedure after turning her head to the other side. Patient A testified that it was very similar to prior chiropractic treatment she received in New York.

Patient A testified that after paying Brown $20 for the treatment, she felt fine and her headaches and neck stiffness decreased. Brown did not warn her of the risk of stroke from the procedure he performed. She also stated that she did not believe she was making a donation, and there were no religious discussions, prayers, readings, or materials associated with her visit.

Patient A returned to Brown's facility four more times. He performed the same procedure each time, she paid $20 per visit, and there were no religious discussions. Following her fifth visit, Patient A suffered minor dizziness and neck pain. When she told Brown about it, he recommended she return for another treatment.

When she returned for her final treatment on March 12, 1997, Brown performed the same procedure. But this time, when he turned Patient A's head to the right and pulled her head up, she experienced immediate vertigo and nausea. She told Brown, and he told her to rest for a minute. Brown left the room, and when he returned, she was still suffering vertigo and nausea. Brown had to help her sit up because she was unable to do so alone. She vomited, sweated profusely, and could not feel her feet or left leg. She asked Brown to call Falco. He did so, but did not tell her it was urgent. When Falco arrived, she and another woman helped Patient A into the restroom where she lost control of her bowels and continued to vomit. Brown knocked on the bathroom door and said, 'You really need to get her home.' He did not mention that she could have had a stroke, did not call 911, and did not advise Falco to take her to the emergency room. Falco and Robert Freeman, Patient A's brother-in-law, took her home and, after consulting a physician, took her to the emergency room. Patient A was diagnosed with a stroke caused by dissections of both vertebral arteries which her physicians believe Brown's procedure caused. She was hospitalized for eleven days, did not work for a month, could only work part-time for two months, has had to reduce the intensity of her job, and has lost income. Patient A brought a civil action against Brown.

Falco and Freeman corroborated Patient A's testimony. They both testified to the procedures Brown performed on them, which they described as the same as those he performed on Patient A. They also testified that Brown referred to himself as a doctor and told them he had been a practicing chiropractor for 20 years without mentioning his expired license. They also signed his forms without reading them thoroughly, paid for their treatments, and had no religious discussions with Brown.

Brown did not deny any of these facts, except to state that he was not performing any form of treatment on Patient A, Falco, and Freeman, and that his pulling on the head was not forceful. He testified that he was performing the alphabiotic alignment process, and not a chiropractic adjustment. He also testified that the alphabiotic alignment process is a sacrament of the Alphabiotic Church and that Patient A, Falco, and Freeman were members of the church and acknowledged in the forms they signed that they were not receiving chiropractic or other treatment. He also said there were no materials in his office referring to chiropractic practice, and that all materials, diplomas, and documents referred to alphabiotics. He stated that he was trained in alphabiotics in Texas by Dr. Virgil Chrane and others. After an eight-month training period, he was awarded a Doctor of Alphabiotics degree; that is the degree he refers to when he uses the title 'Doctor.' Brown stated that he learned the alphabiotic alignment process from Chrane, who was also a chiropractor.

On March 9, 1999, the Commission issued a statement of charges alleging that Brown committed unprofessional conduct by, among other things, practicing chiropractic medicine without a license, representing to his patients that he was a chiropractor when his license was expired, failing to exercise reasonable care when performing a chiropractic manipulation of Patient A's spine, failing to warn Patient A that she could suffer a stroke as a result of the manipulation, and failing to take proper emergency care procedures when Patient A displayed stroke symptoms. On January 27, 2000, there was an adjudicative hearing before a panel of four Commission members, which included three licensed chiropractors. Brown chose to represent himself at the hearing.

On March 14, 2000, the Commission issued its findings of fact, conclusions of law, and final order. It found that Brown's treatment was a chiropractic procedure, that he practiced chiropractic medicine without a license, that he misled Patient A into believing he was licensed, and that his treatment of Patient A was severely negligent. The Commission concluded Brown committed professional malpractice in violation of RCW 18.130.180(4),(7),(8)(a),(13), RCW 18.24.112(1), and RCW 18.25.011, revoked his license for 10 years, imposed a $30,000 fine, issued a cease and desist order prohibiting him from performing chiropractic procedures until his license is reinstated, and prohibited him from representing himself as a licensed chiropractor. Brown appealed the Commission's final order to superior court which affirmed the Commission. This appeal followed.

DISCUSSION

The Commission concluded that Brown violated RCW 18.25.011 and RCW 18.130.180. RCW 18.25.011 provides that '{i}t is a violation of RCW 18.130.190 for any person to practice chiropractic in this state unless the person has obtained a license as provided in this chapter.' RCW 18.130.180 pertains to 'conduct, acts, or conditions {that} constitute unprofessional conduct for any license holder or applicant under the jurisdiction of this chapter{.}' Brown maintains that the Commission lacked jurisdiction over his case because RCW 18.130.180 only applies to licensed chiropractors and his license was expired. He asserts that the Commission cannot both argue that he was in violation by practicing without a license and that as a license holder his conduct was unprofessional. We disagree.

The State argues that if the Commission is unable to investigate unlicensed persons for unprofessional conduct under RCW 18.130.180 until they seek reinstatement, evidence and witnesses will become stale or lost. Because the Secretary of the Department of Health has the same authority to investigate those practicing without a license as the Commission has to investigate unprofessional conduct, Brown argues that a Health Department investigation would preserve evidence and witnesses. The evidence the Secretary discovers could then be used to deny reinstatement. But this fact does not deprive the Commission of jurisdiction over persons with expired licenses.

The State contends that the Commission has jurisdiction over Brown under WAC 246-11-090(1) and that case law from other jurisdictions agrees. WAC 246-11-090(1) provides:

The board has jurisdiction over all licenses issued by the board and over all holders of and applicants for licenses as provided in RCW 18.130.040(2)(b) and (3). Such jurisdiction is retained even if an applicant requests to withdraw the application, or a licensee surrenders or fails to renew a license [1].

Brown asserts that the Legislature did not give the Commission jurisdiction to make findings of unprofessional conduct under RCW 18.130.180 and RCW 18.130.050(2) [2] against an unlicensed person because the regulation conflicts with the statutes. This contention is without merit. RCW 18.130.050(2) gives the Commission authority to investigate and hold hearings on 'all . . . reports of unprofessional conduct.' Because the statute does not distinguish between expired and active licenses, it gives the Commission jurisdiction over any person who has held a license and appears to have engaged in unprofessional conduct.

In Wang v. Board of Registration in Medicine [3 ], the Massachusetts Supreme Court faced the same issue. The physician contested the disciplinary board's jurisdiction because his license had expired before the board initiated proceedings against him. The Wang court concluded that the agency retained jurisdiction over the physician because, like RCW 18.130.050(2), a state statute authorized the board to ''investigate all complaints relating to the proper practice of medicine by any person holding a certificate of registration.'' [4] Even though the physician failed to renew his license, it could be revived upon completion of the renewal process. Thus, the Wang court held that even though the physician did not have a license that could be revoked, the board had jurisdiction to revoke his 'inchoate right to reestablish his status as a licensed physician in Massachusetts simply by completing the renewal process [5]. The Wang court also concluded that, while the board could wait to initiate proceedings until the physician filed for renewal,

{w}e cannot say, however, as a matter of law, that the board must wait for Wang's renewal application to initiate disciplinary proceedings rather than doing so when his misconduct became known to the board. The board's purpose is protection of the public interest, and when the board exercises its statutory function of conducting disciplinary proceedings, it is pursuing that purpose. . . .[6]

The Wang court reasoned that

'{i}t is logical and sensible that, where such grave charges of . . . unprofessional or dishonorable conduct are alleged, the Board has the right to preserve {any} evidence . . . of these charges; otherwise witnesses may disappear and the passage of time itself may well dim or even eradicate the memory of the witnesses and thus preclude the construction of an adequate record.'. . .[7]

Brown argues that Wang is inapposite because Wang held his license when his unprofessional conduct occurred. He contends we should follow the Connecticut Supreme Court's decision in Stern v. Connecticut Medical Examining Board [8 ]. His argument is not persuasive. First, both Wang's and Brown's licenses had expired when disciplinary proceedings began. Second, the statutory scheme in Stern is different from ours. In Connecticut, when a physician does not renew his license within 90 days, it automatically becomes void under Connecticut law [9]. In both Washington and Massachusetts, the statutes provide that a license that is not renewed 'shall be automatically revoked, but shall be revived upon completion of the renewal process [10]. As in Wang, a chiropractor with an expired license in Washington has an inchoate right to reestablish his status as a licensed chiropractor simply by completing the renewal process [11]. For the same public policy reasons the Wang court relied on, we hold that the Commission had jurisdiction over Brown.

Brown next contends that he was denied due process because the Commission's findings of fact 2.14 and 2.15 are not supported by substantial evidence in the administrative record. We review agency orders in adjudicative proceedings under the Administrative Procedure Act, and review is confined to the administrative record [12]. The reviewing court must give due deference to the agency's knowledge and expertise [13]. But the findings of fact must also be supported by substantial evidence, which is ''evidence in sufficient quantum to persuade a fair-minded person of the truth of the declared premises.'' [14] Finding of fact 2.14 provides in part: Based on its own expertise, the Commission finds that the procedure performed by the Respondent on Patient A, which he calls the Alphabiotic Alignment Process, is indistinguishable from the chiropractic adjustment known as the Chrane condyle lift, which was taught by Virgil Chrane while he was still practicing as a chiropractor. The Commission finds that the Chrane condyle lift is a useful but potentially dangerous chiropractic adjustment, and that one of the significant risks of the Crane condyle lift is dissection of vertebral arteries and resulting stroke. . . .

Specifically, Brown asserts that there is insubstantial evidence to find that (1) Chrane taught the Chrane condyle lift and (2) the Chrane condyle lift is potentially dangerous and may cause a stroke. Again, we disagree. Brown's first assertion fails because the record contains substantial supporting evidence. Panel members questioned Brown about the Chrane condyle lift and about his training under Chrane. Brown also testified that Chrane was a chiropractor before he founded the Alphabiotic New Life Church in 1972. Based on this evidence and on the Commission's own expertise, there was substantial evidence to support the finding. And even if the finding were somehow infirm, it is not necessary to the Commission's conclusion that Brown performed a chiropractic procedure and that his conduct was unprofessional.

Brown's second assertion fails because the Commission has statutory authority to use its expertise to find that the chiropractic procedure is dangerous. RCW 34.05.461(5) provides that '{w}here it bears on the issues presented, the agency's experience, technical competency, and specialized knowledge may be used in the evaluation of evidence.' In Washington Medical Disciplinary Board v. Johnston, the Supreme Court stated that the board's conclusion that the respondent violated accepted surgical standards without specific evidence in the record on the standards was proper [15].

Since the board is composed strictly of licensed physicians, RCW 18.72.040, and since RCW 34.04.100(4) permits agencies to utilize the specialized knowledge of their members in evaluating evidence presented to them, we believe it is logical and proper for the State Medical Disciplinary Board to draw its own conclusions as to acceptable surgical standards. As to such specialized matters, we give deference to administrative expertise [16].

In Davidson v. Department of Licensing [17], Dr. Davidson argued that the board could not rely on its own expertise to find that a vibrator massage was improper chiropractic treatment and that his conduct was in part sexually motivated. In response, the Davidson court stated that

{i}t is well settled that when acting in a judicial capacity, an administrative board cannot base its findings and conclusions upon undisclosed documentary evidence or personal knowledge of the facts. However, an administrative agency, or its authorized agents, may use their experience and specialized knowledge to evaluate and draw inferences from the evidence presented to them. Moreover, courts of numerous jurisdictions, including Washington, have held that in a medical disciplinary proceeding an administrative board comprised of medical practitioners is competent to determine the propriety of medical conduct without the aid of expert testimony. These courts have recognized that expert testimony regarding the propriety of medical conduct could be disregarded by a board of this type and in all probability would have little effect on the decisionmaking process [18].

Similarly, the finding here that the Chrane condyle lift is potentially dangerous and can pose a risk of stroke is well within the Commission's expertise and authority. Three of the Commission's four panel members were licensed chiropractors who had the specialized knowledge of chiropractic techniques to evaluate the procedure at issue. Like the tribunals in Johnston and Davidson, the Commission members were 'competent to determine the propriety of medical conduct.' [19] We do not substitute our judgment for that of the Commission. The Commission's finding is supported by substantial evidence.

Brown next argues that finding of fact 2.15 is not supported by substantial evidence in the record. Finding of fact 2.15 provides in part: The Commission further finds the Respondent's performance of the Chrane condyle lift, without advising patients of the risk of stroke, and without adequate training to recognize such strokes, was below the standard of care required of chiropractors in the state of Washington. The Respondent acknowledged his response to Patient A's symptoms was insufficient, and that he should have called for emergency help. . . .

Brown's first assertion, that the Commission improperly found he lacked sufficient training to recognize strokes, fails because the record contained substantial supporting evidence. The Commission questioned him about the training he received from Chrane and the qualifications necessary to be admitted to Chrane's school of alphabiotics. Brown testified that he allowed his chiropractic license to expire because he would need 'a major amount of schooling' to qualify as a chiropractor. He also admitted that he was 'lax' and 'amiss' in failing to get Patient A assistance. And when questioned about what symptoms he would need to see before suggesting that a patient go to the emergency room, he testified he did not know. This was substantial evidence supporting the Commission's finding that Brown lacked training to recognize strokes.

Brown also contests the finding that his conduct was below the standard of care required for chiropractors in Washington. He asserts that the risk of stroke from the Chrane condyle lift is not common knowledge among chiropractors because the procedure is not taught in chiropractic schools, there are no studies on the subject, and there is no prior Commission ruling about the procedure. But because the Commission may use its experience and specialized knowledge to evaluate the evidence, this portion of the finding was within its competence. It is proper for a Commission made up of experts in the field to make findings about acceptable chiropractic standards [20].

Finally, Brown maintains that state regulation of his conduct infringes on his right to free exercise of religion. In rejecting his contention in conclusion of law 3.3, the Commission stated:

Under the First Amendment to the United States Constitution and Article I, section 11 of the Washington State Constitution, which both protect the free exercise of religion, the right to believe is absolute, but the right to act is not. . . . The legislature has selected measures to protect the public health, including requiring those employing the techniques and procedures of chiropractic to be license by the state and to abide by state regulation. As demonstrated by the facts of this case, the use of chiropractic techniques, when unregulated by the state, can result in harm to the public health. Therefore, the Commission concludes that its regulation of the Respondent's actions, to the extent they involve the practice of chiropractic and the use of chiropractic techniques, does not impermissibly burden the Respondent's free exercise of his religion [21].

Brown maintains that affirming the Commission's order abolishes the Alphabiotic Church because the Commission found Brown's conduct, which he asserts is the essential sacrament and teaching of the Alphabiotic church, was a chiropractic technique. The issue is whether Brown's activities constitute chiropractic techniques, and if so, whether they are sufficiently dangerous to warrant government regulation.

Brown seeks protection under the free exercise clause of both the Washington State Constitution [22] and the Federal Constitution. Free exercise of religion includes both the freedom to believe and the freedom to act [23]. While the former is absolute, the latter is not [24]. An individual's conduct is subject to regulation for society's protection [25]. 'The freedom to act must have appropriate definition to preserve the enforcement of that protection, and, in turn, exercise of the power to regulate must not unduly impose on protected freedom.' [26] Any burden on free exercise of religion must withstand strict scrutiny. Once the complaining party establishes that government action has a coercive effect on his or her practice of religion, the government must show that the restrictions serve a compelling state interest and are the least restrictive means for achieving that interest [27]. Compelling interests are those based upon the necessities of national or community life such as threats to public health, peace, and welfare [28].

An individual engaging in a commercial activity must adhere to health and safety regulations that support the compelling interest in protecting the public, even if this results in a burden on the individual's freedom of religion [29]. In State v. Verbon [30], the Supreme Court held that prosecuting a preacher for practicing medicine without a license did not violate his constitutional right to religious freedom. Brown argues that Verbon is distinguishable because Verbon's practice of medicine was merely a tenet of the church and not one of its sacraments. We find this assertion unpersuasive because Brown's conduct involves chiropractic procedure. Like Verbon, Brown was engaged in the practice of medicine in violation of the law because he performed chiropractic treatments without a license. Brown would not be prohibited from performing the procedure so long as he was licensed and followed the law. Because he has available an avenue to resume performing this alignment, his freedom to practice his religion is not significantly burdened.

In Backlund v. Board of Commissioners [31], the Supreme Court concluded that there is a compelling interest in the requirement that physicians purchase professional liability insurance which overrides a physician's religious beliefs. Brown argues that Backlund is distinguishable because the doctor had a choice of not working at a particular hospital, and thus the hospital did not infringe on his religious beliefs. We find this argument unpersuasive because it is not part of the court's decision. The Backlund court held that there was a compelling government interest in requiring Backlund to purchase liability insurance. As in this case, it only needed to reach this issue if it concluded that his religious beliefs were burdened.

Here, the Commission found the government interest in protecting the public from Brown's dangerous practices compelling, and we agree. Even acknowledging that Brown has a sincere religious belief and that the Commission's order is a burden on the free exercise of religion, the government has a compelling interest in protecting its citizens from the kind of dangerous practice that caused Patient A's stroke. The trial court properly affirmed the Commission's order.

Affirmed.

For the Court
Hon. Sharon Armstrong:


  1. (Emphasis added.)
  2. RCW 18.130.050(2) provides: The disciplining authority has the following authority: (2) To investigate all complaints or reports of unprofessional conduct as defined in this chapter and to hold hearings as provided in this chapter{.}
  3. 537 N.E.2d 1216 (Mass. 1989).
  4. Id. at 1218 (quoting Mass. Gen. Laws ch. 112, sec. 5).
  5. Id. at 1219.
  6. Id.
  7. Id. (quoting Cross v. State Board of Dental Examiners, 552 P.2d 38-41 (Colo. 1976)) (alternation in original).
  8. 45 A.2d 1080 (Conn. 1988).
  9. Conn. Gen. Stat. sec. 19a-88(f) (1987).
  10. Wang, 537 N.E.2d at 1219 (quoting Mass. Gen. Laws ch. 112, sec. 2).
  11. See RCW 43.70.280; RCW 18.122.140; WAC 246-12-040.\
  12. Clausing v. State, 90 Wn. App. 863, 870, 955 P.2d 394, review denied, 136.Wn.2d 1020 (1998).
  13. See RCW 34.05.461(5); WAC 246-10-117; Wash. Med. Disciplinary Bd. v. Johnston, 99 Wn.2d 466, 482, 663 P.2d 457 (1983); In re Discipline of Brown, 94 Wn. App. 7, 13-14, 972 P.2d 101, review denied, 138 Wn.2d 1010 (1999).
  14. Clausing, 90 Wn. App. at 871 (quoting Olmstead v. Dep't of Health, Med. Section, 61 Wn. App. 888, 893, 812 P.2d 527 (1991)).
  15. 99 Wn.2d 466, 482, 663 P.2d 457 (1983).
  16. Id. (citation omitted).
  17. 33 Wn. App. 783, 657 P.2d 810, review denied, 99 Wn.2d 1011 (1983).
  18. Id. at 785-86 (citations omitted).
  19. Id.
  20. Johnston, 99 Wn.2d at 482.
  21. (Citations omitted.)
  22. Article I, section 11 of the Washington State Constitution provides in part: :Absolute freedom of conscience in all matters of religious sentiment, belief and worship, shall be guaranteed to every individual, and no one shall be molested or disturbed in person or property on account of religion; but the liberty of conscience hereby secured shall not be so construed as to excuse acts of licentiousness or justify practices inconsistent with the peace and safety of the state. . . .:
  23. State v. Balzer, 91 Wn. App. 44, 52, 954 P.2d 931, review denied, 136 Wn.2d 1022 (1998) (citing Cantwell v. Conn., 310 U.S. 296, 303, 60 S. Ct. 900, 84 L. Ed. 1213 (1940)).
  24. Id.
  25. Id.
  26. Id. (citing Cantwell, 310 U.S. at 304).
  27. Munns v. Martin, 131 Wn.2d 192, 199, 930 P.2d 318 (1997).
  28. Id. at 200 (citing First Covenant Church v. City of Seattle, 120 Wn.2d 203, 226-27, 840 P.2d 174 (1992)).
  29. Balzer, 91 Wn. App. at 56 (citing Munns, 131 Wn.2d at 201).
  30. 167 Wash. 140, 148-49, 8 P.2d 1083 (1932).
  31. 106 Wn.2d 632, 724 P.2d 981 (1986), appeal dismissed, 481 U.S. 1034 (1987).

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This article was posted on February 12, 2002.