Gross v. New York, 73 N.Y.2d 860 (1989): Autopsies as the Practice of Medicine

73 N.Y.2d 860 (1989)

The performance of an autopsy constitutes the practice of medicine under New York Education Law § 6521, thereby subjecting medical examiners to the jurisdiction of the State Board for Professional Medical Conduct.

Summary

Gross, New York City’s Chief Medical Examiner, faced professional misconduct charges related to autopsy performance. An Administrative Officer (AO) initially dismissed the charges, deeming autopsies outside the scope of “practice of medicine” as defined in Education Law § 6521, thus asserting a lack of jurisdiction by the State Board for Professional Medical Conduct. The Board of Regents reversed the AO’s decision. Gross then initiated an Article 78 proceeding, arguing the Board lacked subject matter jurisdiction. The Court of Appeals affirmed the Appellate Division’s dismissal of Gross’s petition, holding that autopsies do constitute the practice of medicine, and the AO’s decision was subject to administrative review.

Facts

Petitioner Gross, as New York City’s Chief Medical Examiner, was accused of professional misconduct in conducting autopsies. These charges were brought under Education Law § 6509 (2). An Administrative Officer (AO), designated within the disciplinary hearing committee, ruled that performing an autopsy did not constitute the “practice of medicine” as defined by Education Law § 6521. The AO consequently dismissed the charges based on a lack of subject matter jurisdiction by the State Board for Professional Medical Conduct.

Procedural History

1. The AO dismissed the charges against Gross.
2. The Commissioner of Health and the Regents Review Committee reviewed and reversed the AO’s decision, remanding the case for further proceedings.
3. Gross initiated an Article 78 proceeding under Education Law § 6510-a (4), seeking relief in the nature of prohibition.
4. The Appellate Division dismissed Gross’s petition.
5. The Court of Appeals affirmed the Appellate Division’s dismissal.

Issue(s)

1. Whether the performance of autopsies constitutes the “practice of medicine” as defined in Education Law § 6521, thus granting the State Board for Professional Medical Conduct jurisdiction over such activities.
2. Whether the decision of the Administrative Officer (AO) to dismiss the charges against Gross was subject to review by the Commissioner of Health and the Board of Regents.

Holding

1. Yes, because Education Law § 6521 defines the practice of medicine as “diagnosing, treating, operating or prescribing for any human disease, pain, injury, deformity or physical condition,” and an autopsy is the ultimate diagnostic procedure to determine the cause and means of death.
2. Yes, because neither Public Health Law § 230 nor Education Law § 6510-a precludes the reversal of an AO’s rulings through administrative review, and absent a specific legislative mandate, an AO’s order erroneously dismissing charges is not final.

Court’s Reasoning

The Court reasoned that Education Law § 6521, defining the practice of medicine, lacks any limitation suggesting it applies only to living patients. It emphasized that an autopsy is fundamentally a diagnostic procedure used to determine the cause and manner of death. Therefore, it falls squarely within the definition of “diagnosing… any human disease, pain, injury, deformity or physical condition.” The court stated, “Clearly, an autopsy is the ultimate diagnostic procedure through which are determined the cause and means of death. Accordingly, since the practice of medicine includes the performance of autopsies, subject matter jurisdiction obtains.”

Regarding the reviewability of the AO’s decision, the Court found no statutory basis to prevent the Commissioner of Health and the Board of Regents from reviewing and reversing the AO’s ruling. While Public Health Law § 230 (10) (e) defines the AO’s authority to make legal rulings, it does not grant those rulings finality. The court noted, “Absent a specific legislative mandate to the contrary, we perceive no basis for attributing finality to an order made by an Administrative Officer which erroneously dismisses charges of professional medical misconduct.” This ensures that errors in initial legal rulings can be corrected through established administrative processes.