COLUMBIA LIBRARIES OFFSITE HEALTH SCIENCES STANDARD HX64077470 RA1 1 .B1 4 W89 To establish an inde RECAP John D. Works To establish an independent health service. m ii vi^ mi Columbia 3ftntoetgit|> mtijeCttptfJtogork COLLEGE OF PHYSICIANS AND SURGEONS LIBRARY Digitized by the Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/toestablishindepOOwork TO ESTABLISH AN INDEPENDENT HEALTH SERVICE When a question like this confronts us the people of this country had Letter look to their liberties. " The Commonwealth of Massachusetts is not a medical body, has no right to a medical opinion, and should not dare take sides in medical controversies." — Prof. William James. Jesus of Nazareth was persecuted and finally crucified for preaching the Gospel and practicing his religions belief by healing the sick. To do the same to-day in the twentieth century in the great State of New York, if he were here, would make him a "criminal subject to fine and imprisonment by the laws of that State. SPEECH HON. JOHN D. WORKS OF CA.LIinOR]Sn:.A. SENATE OF THE UNITED STATES MONDAY AND TUESDAY, APRIL 29 AND 30, 1912 4^ 4\ 41017—10900 WASHINGTON 1912 • JoitttBbia XJnirt "K President's Office G. \to intrude his powers into the field of opinion, and to restrain the pro- fession or propagation of principles on supposition of their ill tendency, is a dangerous fallacy which at once destroys all religious liberty," it is declared " that it is time enough for the rightful purposes of civil government for its officers to interfere when principles break out into overt acts against peace and good order." In these two sentences is found the true distinction between what properly belongs to the church and what to the State. The effect of the decision seems to be that religious belief can not be punished; but when, under the guise of exercising one's religion, an overt act " against peace and good order " is committed the overt act is punishable by the State. This was a case where the defendant was prosecuted for polj-gamy, and he defended on the ground that polygamy was allowed and recognized by his church. I shall show, I think, to the entire satisfaction of the Senate that the healing of the sick as an act of religious duty can not be regarded as an overt act "against peace and good order," or otherwise in violation of law or public policy. But, looking at it in the light of the fourteenth amendment to the Constitu- tion, and treating it as a question of the abridgment of the 41017—10009 65 privileges of the citizen, the case of American School of Mag- netic Healing v. McAnnulty is interesting and instructive. The case was one where the Postmaster General had excluded from the mails certain printed matter advertising the plaintiff as a magnetic healer. After pointing out that one means of healing was believed in by some and different means by others, and that no one could determine how far one was right and the other was wrong, the court said : Again, there are many persons who do not believe in the homeo- pathic school of medicine, and who think that such doctrine, if prac- ticed precisely upon the lines set forth by its originator, is absolutely inefficacious in the treatment of diseases. Are homeopathic physicians subject to be proceeded against under these statutes and liable at the discretion of the Postmaster General, upon evidence satisfactory to him. to be found guilty of obtaining money under false pretenses and their letters stamped as fraudulent and the money contained therein as payment for their professional services sent back to the writers of the letters? And, turning the question around, can physicians of what is called the "old school" be thus proceeded against? Both of these different schools of medicine have their followers, and many who be- lieve in the one will pronounce the other wholly devoid of merit. But there is no precise standard by which to measure the claims of either, for people do recover who are treated according to the one or the other school. And so it is said, Do people recover who are treated under this mental theory? By reason of it? That can uot be averred as matter of fact. Many think they do Others are of the contrary opinion. Is the Postmaster General to decide the question under these statutes? The laws under consideration, without exception, place it within the power of a board of health composed of medical practitioners, usually of one school of medicine, to determine who shall practice healing. The question of their right does not depend in the least upon their knowledge of medicine or medical practice, because they make no claim to any such knowledge. Manifestly a medical practitioner can not pass upon their fitness to heal in their way, because he is as ignorant of their way of healing as they are of his. Such laws, there- fore, in practical effect, declare that no one but a medical prac- titioner shall be allowed to practice the art of healing. Whether the act says so or not, that is its effect, and known and in- tended to be so. It is a denial of the right to practice except in one way. All other modes of healing are prohibited, and the right of the citizen to resort to any other is denied. As a result, there can be no advance in knowledge in other modes of healing that is not a violation of law. Mr. President, when a question like this confronts us the people of this country had better look to their liberties. Prof. James, from whose address I have already quoted, opposed one of such bills because it was " a movement in favor of igno- rance." He says, with emphasis, that — - The Commonwealth of Massachusetts is not a medical body, has no right to a medical opinion, and should not dare to take sides in medical controversies. Truer words were never spoken, and they are just as true of the Federal Government as they are of the State of Massachu- setts. This should be enough to impel the lawmaking power to hold its hand. But if it does not, then the courts must determine whether such a law. affecting the rights of the citizen in a matter of the highest import, affecting the most sacred of his affairs, can be enacted and enforced under a Constitution like ours under the fundamental law of a Nation of freemen, •i 1 1 7— 1 0969 5 66 The case of State v. Biggs (133 N. C.) is a most interesting and instructive one on this subject. The defendant was prose- cuted under one of the acts that I have described making it a crime to practice medicine without a license and specifically defining the meaning of the words " practicing medicine." The opinion was delivered by Mr. Justice Clarke, of the supreme court of that State. I take the liberty of quoting portions of the opinion : What is " the practice of medicine and surgery " is as well under- stood, and its limits, as the practice of dentistry. The courts hare also held that of the many schools of " medicine and surgery " the legislature could not prescribe that any one was orthodox and the other heterodox, but that those professing the different systems — " allo- pathic," "homeopathic," " Thompsonian," and the like — should be ex- amined upon a course such as is taught in the best colleges of that school of practice, but that it is not essential that a member of each or of any special school should be upon the board of examiners. ******* * * • Under the guise of " construction " of those well-under- stood terms the " practice of medicine and surgery " the act essays to provide that the expression " practice of medicine and surgery " shall Be construed to mean the management " for fee or reward " of any case of disease, physical or mental, real or imaginary, with or without drugs, surgical operation, surgical or mechanical appliances, or by any other method whatsoever ; that is, the practice of surgery and medicine shall mean practice without surgery or medicine if a fee is charged. If no fee is charged, then the words surgery and medicine " drop back to their usual and ordinary meaning, as by long usage known and accustomed. Where, then, is the protection to the public if such treatment is valid when done without fee or reward? Yet unless the act confers and is intended solely to confer protection upon the public it is invalid. The legislature can not forbid one man to practice a calling or profession for the benefit or profit of another. ****** * * * * Then It is forbidden to relieve a case of suffering, " physical or mental," in any method unless one is an M. D. It is not even admissible to " minister to a mind diseased " in any method or even dissipate an attack of the " blues " without that label duly cer- tified. Is not this creating a monopoly, and the worst of monopolies, that diseases shall not be cured or alleviated, whether real or imagi- nary, mental or physical, though without medicine or surgery, " if for a fee," unless one has undergone an examination on " anatomy, physi- ology, surgery, pathology, medical hygiene, chemistry, pharmacy, materia medica, therapeutics, obstetrics, and the practice of medicine " ? ******* * * * rp^g p U t,ii c have a right to know that those holding them- selves out as members of that ancient and honorable profession are competent and duly licensed as such. The legislature can exert its police power to that end, because it is a profession whose practice re- quires the highest skill and learning. But there are methods of treat- ment which do not require much skill and learning, if any. Patients have a right to use such methods if they wish, and the attempt to re- quire an examination of the character above recited for the application of such treatment is not warranted by any legitimate exercise of the police power. * * * The term " practice of medicine and surgery " embraces probably the larger, and certainly by far the most profitable, part of the " treatment of diseases," but is not coextensive with the latter term, and can not be made so unless " surgery and medicine " are adopted as the State system of treatment, a monopoly, and all other methods are made indict- able. On the other hand, the State Medical Society would hardly wish to broaden out so as to take in all methods of treatment of disease, for this would be to take in practitioners and practices which they would not wish to recognize. All the law so far has done or can do is to require that those practicing on the sick with knife and drugs shall be examined and found competent by those " of like faith and order." Dr. vJiver Wendell Holmes, in an address before the Medical So- ciety in Massachusetts, said : " If the whole materia medica was sunk to the bottom of the sea it would be all the better for mankind and all the worse for the fishes." An eminent medical authority iu 41017— 10969 67 this State has said that out of -4 serious eases of disease 3 could not be cured by the best remedies, 3 others might be benefited, and the rest would get well anyway. Stronger statements could be cited from the most eminent medical authorities the world has known. Medicine is an experimental, not an exact, science. All the law can do is to regulate and safeguard the use of powerful and dangerous remedies, like the knife and drugs, but it can not forbid dispensing with them. When the Master, who was Himself called the Good Physician, was told that other than His followers were casting out devils and curing diseases, He said, " Forbid them not." The case last referred to did not relate to the religious side of the question. The defendaut made no claim that gave rise to any such questiou. But the courts of this country have jeal- ously guarded the religious rights and opinions of the people as ■within the protection of the Constitution. The case of the Church of the Holy Trinity v. United States (143 U. S., 457), while not involving a constitutional question, is an interesting one as showing the attitude of the highest court in the country in matters of religion. The plaintiff in the case had, by contract, employed a for- eigner as its minister or rector. The question was whether such a contract was in violation of the statute forbidding the •' importation and migration of foreigners and aliens under con- tract or agreement to perform labor in the United States." It was conceded that the case was within the letter of the statute, but it was held not to be within its spirit. The court, looking to the title of the act and the evils evidently intended to be met by it, decided that its object was to " stay the influx of cheap unskilled labor " into this country. In commenting upon this situation Mr. Justice Brewer had this to say on the religious phase of the question : But beyond all these matters no purpose of action against religion can be imputed to any legislation, State or national, because this is a religious people. This is historically true. From the discovery of this continent to the present hour there is a single voice making this affirmation. And, after referring to numerous historical instances showing the reliance of our people upon Divine guidance and support in dealing with grave problems and important events, the learned justice says further: Coming nearer to the present time, the Declaration of Independence recognizes the presence of the Divine in human affairs in these words : " We hold these truths to be self-evident, that all men are created equal ; that they are endowed by their Creator with certain inalienable rights ; that among these are life, liberty, and the pursuit of happi- ness." " We, therefore, the representatives of the United States of America, in general Congress assembled, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the name and by authority of the good people of these Colonies, solemnly publish and declare," etc. "And for the support of this declaration, with a firm reliance on the protection of Divine Providence, we mutually pledge to each other our lives, our fortunes, and our sacred honor." If we examine the constitutions of the various States we find in them a constant recognition of religious obligations. Every constitu- tion of every one of the 44 States contains language which either directly or by clear implication recognizes a profound reverence for re- ligion and an assumption that its influence in all human affairs is essential to the well-being of the community. This recognition may be in the preamble, such as is found in the constitution of Illinois, 3 870: '■ We, the people of the State of Illinois, grateful to Almighty God for the civil, political, and religious liberty which He hath so long per- mitted us to enjoy, and looking to Him for a blessing upon our en- deavors to secure and transmit the same unimpaired to succeeding generations," etc. 41917—10969 68 He proceeds at length to quote from the constitutions of the various States, showing their intention to encourage free and unrestrained reliance upon religion in the affairs of men. Then he says : There is no dissonance in these declarations. There is a universal language pervading them all, having one meaning ; they affirm and reaffirm that this is a religious Nation. These are not individual say- ings, declarations of private persons; they are organic utterances; they 5 speak the voice of the entire people. While, because of a general rec- ognition of this truth, the question has seldom been presented to the courts, yet we find that in Updegraph v. The Commonwealth (11 S. & R., 394, 400) it was decided that " Christianity, general Christianity, is, and always has been, a part of the common law of Pennsylvania ; * * * not Christianity with an established church, and tithes, and spiritual courts, but Christianity with liberty of conscience to all men." And in The People v. Ruggles (8 Johns, 290, 294, 295) Chan- cellor Kent, the great commentator on American law, speaking as chief justice of the Supreme Court of New York, said : " The people of this State, in common with the people of this country, profess the gen- eral doctrines of Christian it y as the rule of their faith and practice ; and to scandalize the author of these doctrines is not only, in a reli- gious point of view, extremely impious, but even in respect to the obligations due to society is a gross violation of decency and good order. * * * The free, equal, and undisturbed enjoyment of reli- gious opinion, whatever it may be, and free and decent discussions on any religious subject is granted and secured ; but to revile, with mali- cious and blasphemous contempt, the religion professed by almost the whole community is an abuse of that right. Nor are we bound by any expressions in the Constitution, as some have strangely supposed, either not to punish at all or to punish indiscriminately the like at- tacks upon the religion of Mahomet or of the Grand Lama, and for this plain reason, that the case assumes that we are a Christian people, and the morality of the country is deeply ingrafted upon Christianity and not upon the doctrines or worship of those impostors." And in the famous case of Vidal v. Girard's Executors (2 How., 127, 198) this court, while sustaining the will of Mr. Girard, with its provision for the creation of a college into which no minister should be permitted to enter, observed : " It is also said, and truly, that the Christian religion is a part of the common law of Pennsylvania." Mr. Tiedeman, in his work, State and Federal Control of Persons and Property, says : The complete abrogation of all State interference in matters of religion Is of slow growth and can only be attained with the growth of public opinion. The one great trouble is that so many sects or churches believe that theirs is the only religion and that every claim of religious belief that conflicts with theirs is un-Christian and no religion at all. It is this spirit and the intolerance that springs from it that stands in the way of every change of religious belief or the establishment of any new or reform movement of a religious character. That is just what the Christian Scientists are com- bating to-day. While they agree with the orthodox churches in all the essentials of the Christian religion, they are denounced as an ungodly people because they go further than the old churches in attempting to obey the whole command : " Preach the gospel and heal the sick." Tbat they believe in all the essentials of the Christian re- ligion is fully shown by the tenets of the church, as follows : 1. As adherents of Truth, wo take the inspired Word of the Bible as our sufficient guide to eternal Life. 2. We acknowledge and adore one supreme and infinite God. We acknowledge His Son, one Christ ; the Holy Ghost or divine Comforter ; and man in God's image anQ likeness. 3. We acknowledge God's forgiveness of sin in the destruction of sin and the spiritual understanding that casts out evil as unreal. But the belief in sin is punished so long as the belief lasts. 4. We acknowledge .Tesus's atonement as the evidence of divine, effi- cacious Love, unfolding man's unity with God through Christ Jesus the 41917— 109C9 69 Way-shower ; and we acknowledge that man is saved through Christ, through Truth, Life, and Love, as demonstrated by the Galilean Prophet in healing the sick and overcoming sin and death. 5. We acknowledge that the crucifixion of Jesus and His resurrec- tion served to uplift faith, to understand eternal Life, even the allness of Soul, Spirit, and the nothingness of matter. 6. And we solemnly promise to watch and pray for that Mind to be in us which was also in Christ Jesus : to do unto others as we would have them do unto us ; and to be merciful, just, and pure. Believing, as they do, that the healing of disease is a Christian duty imposed upon them by the command of the Master, a law that forbids it or abridges their right and privilege to heal the sick is a plain violation of both of the constitutional inhibitions above mentioned. Mr. Tiedeman says further on this subject : Sec. 63. Police regulation of religion — constitutional restrictions : If there were no provisions in the American Constitution especially appli- cable to the matter of police regulation of religion, the considerations which would deny to the State the control and prevention of vice would also constitute insuperable objections to State interference in matters of religion. But the rivalry and contention of the religious sects not only demanded constitutional prohibition of the interference of the National Government, but gave rise to the incorporation of like prohi- bitions in the various State constitutions. The exact phraseology varies with each constitution, but the practical effect is believed in the main to be the same in all of them. These provisions not only pro- hibit all church establishments, but also guarantee to each individual the right to worship God in his own way, and to give free expression to his religious views. The prohibition of a religious establishment not only prevents the establishment of a distinctively State church, but likewise prohibits all preferential treatment of the sects in the bestowal of State patronage or aid. A law is unconstitutional which gives to one or more religious sects a privilege that is not enjoyed equally by all. " Whatever establishes a distinction against one class or sect is, to the extent to which the distinction operates unfavorably, a persecu- tion, and if based on religious grounds a religious persecution. The ex- tent of the discrimination is not material to the principle, it is enough that it creates an inequality of right or privilege." And the reasons that brought about this constitutional inhibi- tion against interference with religious belief and observance is thus clearly pointed out by the same author : * * * Most of the immigrants to American colonies were refugees from religious oppression, driven to the wilds of America in order to worship the God of the universe according to the dictates of their conscience. The Puritans of New England, the Quakers of Pennsyl- vania, the English Catholics of Maryland, and the Huguenots of the Carolinas sought on this continent that religious liberty which was not to be found in Europe. I should not say " religious liberty," for that is not what they sought. They desired only to be freed from the re- straint of an intolerant and imposing majority. They desired only to settle in a country where the adherents of their peculiar creed could control the affairs of state. Notwithstanding their sad experience in the Old World, when they settled in America they became as intolei^ant of dissenters from the faith of the majority as their enemies had been toward them. Mr. President, I need not, in a body like this, consume time in discussing fundamental questions affecting the liberty and free- dom of the individual and the necessary restraints imposed upon him because of his association with others, composing civil or governmental organizations. But the claim of right to restrain such liberties for the good of the community or the public has given rise to many problems and has unjustly deprived many of their liberties. The police power, so called, is sometimes neces- sary for the protection of the pttblic, but it has quite as fre- quently been made the engine of oppression to the destruction, without just cause, of the most sacred rights of the individual 41917—10909 TO citizen. Generally the courts stand in the way of the unlawful use of this power, but the extent to which it has been enforced by the courts at times has been most alarming. There is no case, perhaps, in which an unlawful and oppressive use of this great power has occurred to a greater extent than in the cases I am now considering. The doctors assume, and are able to make lawmakers believe, that the effort to heal disease in any way but theirs is against public policy and should, as a police regulation, be suppressed, by law. That is the ground upon which all of the restrictive laws that I have been discuss- ing are attempted to be sustained. Unfortunately such laws are neither enacted nor construed by the courts from knowledge or upon evidence proving the ineffi- cacy of the mode of healing sought to be prevented. More unfortunately still, in the minds of many the question resolves itself into a religious one that in the intolerant religious mind is controlled neither by reason nor justice. With such, if a thousand respectable and reliable people should testify to their healing through such means they would not be credited as against one competent medical practitioner who should say that disease could not be cured that way, or the word of one theologian who should insist that the attempt to heal in any such way is un-Christian and ungodly. I hope the Senate of the United States will be actuated by a higher and broader sense of the rights and liberties of the citi- zen and judge the question by the rules of right, justice, and reason. Judge Cooley, In his admirable work on Constitutional Limi- tations, thus defines the police power of a State : The police of a State, in a comprehensive sense, embraces its whole system of internal regulation, by which the State seeks not only to pre- serve the public order and to prevent offenses against the State, but also to establish for the intercourse of citizens with citizens those rules of good manners and good neighborhood which are calculated to prevent a conflict of rights, and to insure to each the uninterrupted enjoyment of his own so far as is reasonably consistent with a like enjoyment of rights by others. Of course the exercise of this power usually arises in respect of the use of property. But it does present itself upon the ques- tion of religious liberty. In speaking of the constitutional inhi- bition against laws affecting religious beliefs and observance, Judge Cooley says further: Those things which are not lawful under any of the American con- stitutions may be stated thus : 1. Any law respecting an establishment of religion. The legislatures have not been left at liberty to effect a union of church and state, or to establish preferences by law in favor of any one religious persuasion or mode of worship. There is not complete religious liberty where any one sect is favored by the State and given an advantage by law over other sects. Whatever establishes a distinction against one class or sect is, to the extent to which the distinction operates unfavorably, a persecution ; and if based on religious grounds, a religious persecution. The extent of the discrimination is not material to the principle ; it is enough that it creates an inequality of right or privilege. * * * 4. "Restraints upon the free.exercise of religion according to the dictates of the conscience. No external authority is to place itself !>etween the finite being and the infinite when the former is seeking to render the homage that is due, and in a mode which commends itself to his con- science and judgment as being suitable for him to render, and acceptable to its object. 41917— 100G9 71 5. Restraints upon the expression of religious belief. An earnest be- liever usually regards it as his duty to propagate his opinions, and to bring others to his views. To deprive him of this right is to take from him the power to perform what he considers a most sacred obligation. Mr. Fremiti, in his work on Police Power, in speaking under sx subhead entitled " Restraint of religious activity in bebalf of the public welfare,'' has this to say : There are two kinds of legislation that would fall under this head- measures for the repression of practices deemed disorderly or danger- ous and the regulation of religious societies, chiefly with reference to their property rights. This legislation . will also be considered sepa- rately. The essence and value of the constitutional guaranty lies in two points : First, that religious belief as such and its peaceful and orderly manifestation in worship and precept may not be treated as a menace to the peace and welfare of the community or as a possible cause of disorder; and, second, that, whatever restraint is placed upon religious activity, through rules of property or otherwise, must be applied to all denominations alike in order to avoid the preference and discrimination which the constitutions forbid. Mr. Presideut, it will be found that the police power can not be invoked to restrain religious belief or action except where the acts committed in the name of religion are in some way a menace to the peace and welfare of the community or, as is said in Reynolds v. United States, already referred to, " against peace and good order." In Ex parte Jentzseh (112 Cal., 468), the Supreme Court of California, in passing upon a law of that State closing barber shops on Sunday, has this to say: Upon the question thus presented of the proper limits of the police power, much might be written, and much, indeed, will have to be written, ere .iust bounds are set to its exercise ; but, in this case, neither time permits nor necessity demands the consideration. Still, it may be suggested, in passing, that our Government was not de- signed to be paternal in form. We are a self-governing people, and our just pride is that our laws are made by us as well as for us. Every individual citizen is to be allowed so much liberty as may exist without impairment of the equal rights of his fellows. Our institu- tions are founded upon the conviction that we are not only capable of self-government as a community but, what is the logical necessity, that we are capable to a great extent of individual self-government. If this conviction shall prove ill founded we have built our house upon sand. The spirit of a system such as ours is therefore at total variance with that which, more or less veiled, still shows in the paternalism of other nations. It may be injurious to health to eat bread before it is 21 hours old, yet it would strike us with surprise to see the legis- lature making a crime of the sale of fresh bread. We look with dis- favor upon such legislation as we do upon the enactment of sumptuary laws. We do not even punish a man for his vices unless they be practiced openly, so as to lead to the spread of corruption or to breaches of the peace or to public scandal. In brief, we give to the individual the utmost possible amount of personal liberty, and, with that guaranteed him, he is treated as a person of responsible judg- ment, not as a child in his nonage, and is left free to work out his destiny as impulse, education, training, heredity, and environment direct him. So, while the police power is one whose proper use makes most potently for good, in its undefined scope and inordinate exercise lurks no small danger to the Republic, for the difficulty which is experienced in defining its just limits and bounds affords a temptation to the legis- lature to encroach upon the rights of citizens with experimental laws, none the less dangerous because well meant. There are cases in which the true distinction is clearly made between the proper exercise of religious duties, according to one's conscience, and the commission of unlawful acts under the guise of religious beliefs. It must be conceded that no one school should be allowed to commit a crime or any act against peace, 41917—10069 72 good order, or morals, and then justify himself nnder the claim that the act was in accordance with his religious beliefs. This distinction is clearly drawn in Davis v. Beason (133 T;. S., 333, 342), where the Supreme Court of the United States, through Mr. Justice Field, made this clear and convincing state- ment of the rule on the subject : Tbe term " religion " has reference to one's views of his relations to his Creator, and to the obligations they impose of reverence for his being and character, and of obedience to His will. It is often con- founded with the eultus, or form of worship of a particular sect, but is distinguishable from the latter. The first amendment to the Constitu- tion, in declaring that Congress shall make no law respecting the estab- lishment of religion, or forbidding the free exercise thereof, was in- tended to allow everyone under the jurisdiction of the United States to entertain such notions respecting his relations to his Maker and the duties they impose as may be approved by his judgment and conscience, and to exhibit his sentiments in such form of worship as he may think proper, not injurious to the equal rights of others, and to prohibit legislation for the support of any religious tenets, or the modes of wor- ship of any sect. The oppressive measures adopted and the cruelties and punishments inflicted by the Governments of Europe for many ages to compel parties to conform, in their religious beliefs and modes of worship, to the views of the most numerous sect and the folly of at- tempting in that way to control the mental operations of persons and enforce an outward conformity to a prescribed standard led to the adoption of the amendment in question. It was never intended or supposed that the amendment could he in- voked as a protection against legislation for the punishment of acts inimical to the peace, good order, and morals of society. With man's relations to his Maker and the obligations he may think they impose, and the manner in which an expression shall be made by him of his belief on those subjects, no interference can be permitted, provided always the laws of society, designed to secure its peace and prosperity and the morals of its people, are not interfered with. However free the exercise of religion may be. it must be subordinate to the criminal laws of the country, passed with reference to actions regarded by general consent as properly the subjects of punitive legislation. There have been sects which denied as a part of their religious tenets that there should be any marriage tie, and advocated promiscuous intercourse of the sexes as prompted by the passions of its members. And history dis- closes the fact that the necessity of hus&an sacrifices, on special occa- sions, has been a tenet of many sects. Should a sect of either of these kinds ever find its way into this country, swift punishment would follow the carrying into effect of its doctrines, and no heed would be given to the pretense that, as religious beliefs, their supporters could be pro- tected in their exercise by the Constitution of the United States. Prob- ably never before in the history of this country has it been seriously contended that the whole punitive power of the Government for acts, recognized by the general consent of the Christian world in modern times as proper matters for prohibitory legislation, must be suspended in order that the tenets of a religious sect encouraging crime may be carried out without hindrance. In construing the restrictive laws of State legislatures the State courts have sometimes held that they should not be con- strued as prohibiting the practice of healing by other than medical practitioners, because the intention to legislate against the liberties of the citizen should not be assumed. In the case of Nelson v. State Board of Health (22 Ky., Law Rep., 438) the attempt was made to prevent an osteopath from practicing his profession in that State because he had not procured a license to practice from the board of health. The court held that the osteopath was not within the terms of the statute, because he was not practicing medicine, and said : If the act applied to appellant, he can in no case practice his system in this State, for, however well qualified he may be, he can not be ex- amined for license as a physician, and he could not, without abandon- ing his practice as an osteopath, obtain a diploma from a medical 41917—10969 id college. If the statute applies to him. it also applies to trained nurses aqd all others of that class who for compensation administer to the- wants of the sick. The result of such a construction of the statute would be to compel everyone, whether willing or unwilling, to employ a registered physician to care for him when he is sick, or to trust himself entirely to gratuitous services, however much he might prefer skillful nursing to medical treatment. It is doubtful if the legislature has the right under the Constitution thus to restrict the free choice of the citizen in a master concerning only himself and not the people at large. Taking the statute as a whole, we do not think that this was within the legislative intent, or that the act was designed to do more thaa regulate the practice of medicine by physicians and surgeons. The case of State v. Mylod (20 R. I., 632) is to the same effect. In that case it was said: It follows therefore that the acts complained of are excluded from the operation of said Cap. 165 unless the words " practice of medi- cine," taken in their ordinary or popular meaning, "includes them, or unless it appears from said chapter that the legislative intent was to give to said words a meaning broader and more inclusive than the popular one. Medicine, in the popular sense, is a remedial substance. The practica of medicine, as ordinarily or popularly understood, has relation to the art of preventing, curing, or alleviating disease or pain. It rests largely in the sciences of anatomy, physiology, and hygiene ; it requires a knowledge of disease, its origin, its anatomical and physiological fea- tures, and its causative relations ; and, further, it requires a knowledge of drugs, their preparation and action. Popularly it consists in the discovery of the cause and nature of disease and the administration at remedies or the prescribing of treatment therefor. Prayer for those suffering from disease, or words of encouragement or the teaching that disease will disappear and physical perfection be attained as a result of prayer or that humanity will be brought Into harmony with God by right thinking and a fixed determination to look on the bright side of life, does not constitute the practice of medicine in the popular sense. * S * * • * * * * * While it true that the study and treatment of mental dls= ease constitute one of the departments or branches of medicine ia which the influence of the mind over the body is recognized, yet mere words of encouragement, prayer for divine assistance, or the teaching of Christian Science as testified, in the opinion of the court, does not constitute the practice of medicine in either of its branches in the statutory or popular sense. To give to the words " practice of medicine " the construction claimed for them by the State, in the opinion of the court, would lead to un- intended results. The testimony shows that Christian Scientists are a recognized sect or school. They hold common beliefs, accept the same teachings, recognize as true the same theories and principles. If the practice of Christian Science is the practice of medicine, Christian ■Science is a school or system of medicine, and is entitled to recognition by the State board of 'health to the same extent as other schools or systems of medicine. Under said Cap. 165 it can not be discrimi- nated against, and its members are entitled to certificates to practice medicine provided they possess the statutory qualifications. The stat- ute, in conferring upon the State board of health authority to pass upon the qualification of applicants for such certificates, does not confer upon said board arbitrary power. The board can not determine which school or system of medicine in its theories and the practices is right ; it can only determine whether the applicant possesses the statutory qualification to practice in accordance with the recognized theories of a particular school or system. It would be absurd to hold that under said Cap. 165, which pro- vides against discrimination, the requirements necessary to entitle an applicant to a certificate were such that the members of a particular school or system could not comply with them, thus adopting a con- struction which would operate not as a discrimination only, but as a prohibition. On the other hand, to hold that a person who does not know or pretend to know anything about disease, or about the method of ascertaining the presence or the nature of disease, or about the nature, preparation, or use of drugs or remedies, and who never ad- ministers them, may obtain a certificate to practice medicine, is to hold that the operation of the statute is to defeat the beneficial purposes for which it was enacted. 41917—10969 74 The case of State r. MeKnight (131 N. C.) was another action affecting the right of an osteopathic practitioner to prac- tice without a license. The court in that case used this lan- guage : The State has not restricted the cure of the body to the practice of medicine and surgery — " allopathy," as it is termed — nor required that before anyone can be treated for any bodily ill the physician must have acquired a competent knowledge of allopathy and be licensed by those skilled therein. To do that would be to limit progress by estab- lishing allopathy as the State system of healing and forbidding all others. This would be as foreign to our system as a State church for the cure of souls. All the State has done has been to enact that when one wishes to practice " medicine or surgery " he must, as a protec- tion to the public — not to the doctors — be examined and licensed by those skilled in " surgery and medicine." To restrict all healing to that one kind — to allopathy — excluding homeopathy, osteopathy, and all other treatments, might be a protection to doctors in " surgery and medicine," but that is not the object of the act, and might make it unconstitutional, because creating a monopoly. The State can only regulate for the protection of the public. There is also " divine science " (which some one has said is neither divine nor a science), and there may be other methods still. Whether these shall be licensed and regulated is a matter for the lawmaking power to determine before any question in that respect can come before the court. Certainly a statute requiring examination and license " before beginning the practice of medicine or surgery " neither regulates nor forbids any mode of treatment which absolutely excludes medicines and surgery from its pathology. Mr. President, this confirms what I have already said — that where the statute provides in terms for the regulation of the practice of medicine and surgery schools of practitioners who do not resort to the use of drugs or the knife are not affected and therefore not interested in its enforcement. But the trouble is that in many of these laws the definition of " practicing medi- cine " includes all kinds of healing or treatment, thus avoiding the effect of the decided cases on the subject. So in such cases the question becomes one of the constitutionality of the law. No one should question the constitutional right of the States to regulate the " practice of medicine and surgery." Certainly I do not. Anyone who practices the use of drugs or the knife should establish his competency in that respect. The legislature of a State would undoubtedly have the right, also, to regulate the practice of Christian Science by providing for the establish- ment of a board of examiners to determine their fitness and com- petency to practice that mode of healing. But the board should. of course, have knowledge of the qualifications necessary for such practice. Christian Scientists would welcome such a law, as they desire that only persons competent and conscientious should practice their mode of healing. What they and different schools of medi- cine object to is that they shall be examined as to their com- petency to practice a means of healing in which they do not believe and in which they do not claim to be efficient or com- petent. The result of such a law is to compel an examination as to their competency to practice a system of healing, not with any view of determining their fitness to practice what they make claim to practice. That means simple prohibition just as effectually as if the ^statute provided in terms that a Christian Scientist shall not practice healing or the amelioration of suffering. This dis- tinction was recognized in the State v. Wilcox (64 Kans., 789), 41917— 109G9 75 in which the court, having held that the State had the power to regulate the practice of medicine, said further : The act is not invalid because it provides that " Nothing in this act shall be construed as interfering with any religious beliefs in the treat- ment of diseases, providing that quarantine regulations relating to con- tagious diseases are not infringed upon. (Sec. 6, Gen. Stat., 1901, par. 6674.) The express exclusion of the element of religious belief in the application of the law was hardly necessary. Religious freedom is guaranteed by the Constitution, and without mention in the statute would have been implied, and we can see nothing in this provision which makes an illegal discrimination against or in favor of any class of physicians. This lauguage is significant. It expressly recognizes the fact that religious freedom exercised in the way of healing can not be abridged under the Constitution. Mr. President, the question of both the constitutionality and justice of some of the bills enacted by State legislation intended to restrict or prohibit the practice of healing by Christian Sci- entists have been commented upon by the governors of some of the States in veto messages. Thus Gov. Mickey, of Nebraska, has this to say in one of his veto messages : The constitution of the State of Nebraska declares that " all persons have a natural and indefeasible right to worship Almighty God accord- ing to the dictates of their own consciences," and further adds, " nor shall any interference with the rights of conscience be permitted." la the Christian Science religion the idea of worship and of divine healing are so intermingled that it is impossible to draw the line of demarcation, and hence interference with the one or the other is an interference with " the rights of conscience " and thus becomes an infringement of the constitutional guaranty of religious freedom. And Gov. Peabody, of Colorado, used this language in a mes- sage vetoing such a bill : Guided by the late experience of similar legislation In other States, the conclusion is irresistible that all such legislation has a tendency to restrict the citizen in the employment of whomsoever he pleases in the treatment of his diseases, and it also has a tendency to build up, under the protection of the State, a trust or combination of certain schools of medicine to the exclusion of all others equally meritorious. Gov. Thomas, of the same State, in a like case, used this clear and emphatic language: The department of surgery excepted, medicine is not a science. It is a series of experiments, more or less successful, and will become a science when the laws of health and disease are fully ascertained and understood. This can be done, not by arresting the progress of experi- ment and binding men down to hard and fast rules of treatment, but by giving free rein to the man who departs from the beaten highway and discovers hidden methods and remedies by the wayside. * * * The true intent and purpose of the bill is to restrict the profession of medicine to the three schools therein mentioned, and then limit the number of practitioners to- suit the judgment of the composite board. People desiring medical or surgical service may employ its licentiates or die without the consolation of the healer. This is but to say that a medical trust is to be established which shall regulate demand and supply by absolute control of the product which forms its basis, the general assembly furnishing the appliances whereby the trust shall become effectual. The integrity and usefulness of every profession must be guaranteed to society, which may establish standards for the members thereof and for the observance of which its sanction should be given. Beyond this, each profession takes care of itself, and legislative interference Is tyranny, open or disguised. * * * The fundamental vice of the bill is that it denies absolutely to the individual the right to select his own physician. This is a right of conscience, and as sacred as that which enables the citizen to worship God as he may desire. It is, indeed, the same right manifesting itself in a parallel direction. It is a part of the law of this land, and no 41917—10969 70 civil power is strong enough to deprive the citizen of its exercise. He may, indeed, select a healer of doubtful reputation or conceded incom- petence, but that is his affair just as much as is his choice of a minister or attorney. His action may prove injurious, possiblv fatal, to himself or to some members of his family. It is better so "than to delegate to any tribunal the power to say " thou shalt not employ this man " or " thou shalt employ this one." That this bill produces such a result indirectly makes it the more objectionable. It is not the out- spoken and aggressive assault upon individual libertv that men should fear, but the indirect or resultant blow that is masked and falls unex- pectedly. The bill, like all kindred forms of paternalism, assumes that the citizen can not take care of himself. The State must lead him as a little child, lest he fall into trouble unawares. He must be guarded and chided, limited here and licensed there, for his own protection. Such a system, born of the union of church and state, crumbles into ashes in. the crucible of experience. It can not flourish, though dis- guised in the garments of an alleged public necessity. The privilege of choosing one's own physician is a positive essential to the public health. Yet this bill assumes to thrust the coarse machinery of the criminal law into one of the most sacred relations of human life, to drag the chosen physician, if unlicensed, from the sick couch to the prison cell, and to substitute for him some one who, however exalted and honorable, may not command the confidence or secure the sympathy of his patient. These comments are not extreme, for it must be remembered that those who believe in and patronize the various arts of healing that are ostracized by this bill form a very large part of every community, nor are they confined to the ignorant and superstitious portions of society. They number in their ranks thousands of the most refined, intelligent, and conscientious people. They recognize in many modern forms of relief to the suffering a religious or spiritual element that appeals to their best and tenderest sympathies. The benefits they claim and the cures they narrate are not imaginary. Shall the Government enact by statute that these people shall not "longer enjoy their benefits or put them into daily practice? Shall it officially declare these people to be criminally wrong and the three schools legally right? By what authority does it so declare? A distinguished physician of Massachusetts has recently declared with force that " the Commonwealth has no right to a medical opinion and should not dare to take sides in a medical controversy." It would be as consistent to take sides in a theological or philosophical discus- sion. The one would be condemned by all men ; the other is equally foreign to the province of government. It may regulate but can not prohibit the calling of the citizens ; it may prevent the commission of wrongs but can not deprive the individual of the right to choose his own advisers. Mr. President, I am about to conclude what I have to say. I have taken up too much of the time of the Senate. But I could not remain silent when the liberties of the people and the con- stitutional rights of the States are threatened. There has been no legislation more dangerous or pernicious than the entire sys- tem of laws, State and National, that are being forced upon the people of this country by the political doctors, who are consider- ing only their own selfish interests without regard to the public welfare. I have considered not only the' bill now before the Senate but legislation in the States, because they are a part of one general effort to procure legislation that will establish for- ever one school of medicine to the exclusion of all others. If this effort is successful it will create the worst, the most intolerant, and the most dangerous monopoly and trust the country has ever known. It will be the more intolerant and offensive, as well as more powerful, because it is a trust created by law and supported by all the powers of the Government. The author of the bill has graciously consented to amend it so as to provide that there shall be no discrimination in favor of or against any school of medicine. He could very well do this. It is a perfectly harmless and useless provision and will pro- tect no one. Does anyone suppose tbat Ibis bureau, made iude- 41917— 109 GO 77 pendent by this bill, with an allopathic doctor at its head, and without doubt a member of the American Medical Association, will give any consideration to any mode of healing that does not use drugs, or not discriminate against them, and in favor of the regular school of medicine? Can anyone think so when we look back over the past few years and see how these very same doctors of the regular school have been using every possible means to procure such laws as will not only discrim- inate against but actually exterminate them? Now, it is pro- posed to take the medical bureaus and others in any way con- nected with the preservation of the public health out of tho departments and bring them under one control, independent and autocratic. What may be expected to happen? Why, with this unlimited power in his bands, with the right to make rules and regulations for the government of his department, he will do, by his rules and regulations, just what he and his fellow doctors have for years been trying to get the States to do by law, declare the practice of Christian Science and other modes of healing that they have condemned as a menace to the public health and suppress such practice. You say he is not allowed to discriminate or to interfere with the practice of medicine ! Why, Mr. President, if he is honest, and has been honest in promoting restrictive and prohibitive legislation in the States against such practices, he will say : " I must protect the public health. That is the prime duty impose'd upon me by this law. To do it I must destroy the tendency to put away drugs and resort to quacks and charlatans. They are not entitled to pro- tection. I will do my duty and suppress them in every way possible." If anyone supposes that ways will not be found to accomplish this result, with a doctor in control and at the head of a bureau that is independent of control by any higher power, he does not appreciate the capacity of the regular school of medicine to maintain itself by the destruction of other means of healing. Mr. President, as I have said, this whole movement is by and in the interest of doctors of the regular school. No one else is demanding this law. They have manipulated political con- ventions and procured a plank in the platform of both of the great political parties, declaring in favor of establishing a de- partment of health, with its head a member of the Cabinet. They have besieged the White House and pleaded for assistance from the President. They have infested the Halls of Congress for years past in the effort to secure the passage of laws that would place them in power and give them absolute control of the medical activities of the Government. In pressing forward this bold scheme they have tried to deceive the public, and have largely succeeded, by claiming that such legislation is in the public interest. They insist that their mode of healing is the only safe or reliable one, and that to resort to any other is to endanger the public health. Their efforts have of late been directed chiefly against Chris- tian Scientists and their mode of practice. They insist that the practice of their mode of healing is a fraud on the people and a menace to the public health. Why, Mr. President, I could by a mere call fill this Capitol Building with conscientious and re- liable men and women, people of high character and unques- 41917—10969 (b tioned sincerity, who would bear witness to their healing by this means and their faith in its efficacy. Thousands of these many of them within my own personal knowledge, have been healed of what the doctors call incurable diseases, and many of them after the doctors had given up their cases as hopeless. Naturally these people protest against any law that will de- prive them, or anyone else, of the right to resort to this remedy for their relief. In the name of these people, in the name of those believing in other modes of healing, in the name of a liberty-loving people, I protest against any law or regulation that will deny them the right or abridge their liberty to give or accept relief of their choice, or their religious rights. 41917—10960 o COLUMBIA UNIVERSITY LIBRARIES This book is due on the date indicated below, or at the expiration of a definite period after the date of borrowing, as provided by the rules of the Library or by special ar- rangement with the Librarian in charge. DATE BORROWED DATE DUE DATE BORROWED DATE DUE C28II 140IM100 / ■-- &U1.E14 W89 Works To establish sn independent health |