Miller v. Board of Psychologist Examiners

DEITS, C. J.,

concurring.

I agree with the majority that we must reverse the order of the Board of Psychologist Examiners (board). However, I disagree with the majority that, in concluding that the conduct in this case was prohibited, the board relied on a plausible interpretation of Ethical Principle 4.02.1 In my view, Ethical Principle 4.02 did not put petitioner on notice that her conduct was prohibited and, accordingly, the board in effect applied to petitioner an unannounced standard of conduct. I would reverse the board’s order on that ground and remand for reconsideration.

As noted by the majority, the legislature has authorized the board to formulate a code of professional conduct for psychologists. ORS 675.110(12). Pursuant to ORS 675.110(12) and (15), which give the board rulemaking authority, the board promulgated OAR 858-010-0075(1), adopting the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct as the code of professional conduct for psychologists in Oregon. To the extent that the board’s interpretations of that code are plausible and not inconsistent with other sources of law, we will defer to the board’s interpretations. See, e.g., Don’t Waste Oregon Com. v. Energy Facility Siting, 320 Or 132, 142, 881 P2d 119 (1994). To be entitled to deference, however, those interpretations must be plausible. See id. In a related vein, and as the majority acknowledges, 193 Or App at 720-21, the board may not impose sanctions for conduct that the code does not proscribe. See Cochran v. Board of Psychologist Examiners (A105672), 171 Or App 311, 320-21, 15 P3d 73 (2000) (Edmonds, J., concurring) (“[B]y granting authority to *725the Board to impose sanctions for ethical violations, the legislature intends that practitioners be on notice about what conduct the board’s code of ethics requires before sanctions are imposed[.]”). Put simply, the board lacks authority to impose discipline based on an implausible interpretation of the code, because practitioners can be deemed to be on notice only of interpretations that are plausible.

A plausible interpretation of a rule is one that is “consistent with the wording of that rule, considered in its context.” Don’t Waste Oregon Com., 320 Or at 142. In my view, considering the wording of Ethical Principle 4.02 in its context, the board’s interpretation was implausible.

Ethical Principle 4.02, in its entirety, provides:

“4.02 Informed Consent to Therapy
“(a) Psychologists obtain appropriate informed consent to therapy or related procedures, using language that is reasonably understandable to participants. The content of informed consent will vary depending on many circumstances; however, informed consent generally implies that the person (1) has the capacity to consent, (2) has been informed of significant information concerning the procedure, (3) has freely and without undue influence expressed consent, and (4) consent has been appropriately documented.
“(b) When persons are legally incapable of giving informed consent, psychologists obtain informed permission from a legally authorized person, if such substitute consent is permitted by law.
“(c) In addition, psychologists (1) inform those persons who are legally incapable of giving informed consent about the proposed interventions in a manner commensurate with the persons’ psychological capacities, (2) seek their assent to those interventions, and (3) consider such persons’ preferences and best interests.”

Ethical Principle 4.02, by its terms, refers only to issues surrounding obtaining informed consent at the initiation of treatment. It does not address issues of continuing consent during ongoing treatment; withdrawal of consent on behalf of a person without capacity to consent; or how to resolve issues that might arise when two parents who have joint custody *726differ about the propriety of treatment. In my view, it is not plausible to interpret Ethical Principle 4.02 as applying to subjects that it does not address.

The majority acknowledges that Ethical Principle 4.02 itself does not address the issues at hand. 193 Or App at 721. The majority nonetheless concludes that the board’s interpretation of Ethical Principle 4.02 was plausible. I disagree with both of the points that the majority relies upon to reach that conclusion.

First, the majority observes that agencies are not required to spell out every possible situation to which rules will apply; instead, agencies may promulgate broad bases under which particular conduct will be assessed. Id. To the extent that that observation is correct, it does not apply here.2 Ethical Principle 4.02 is not a broad rule of conduct under which the board may assess whether particular conduct falls within it. Rather, it is a highly specific rule that addresses a particular topic: obtaining informed consent at the initiation of treatment. There is an important analytical difference, in my view, between broad rules that may be interpreted as applying to a variety of conduct, and particularized rules that clearly apply only to the conduct they mention.

An examination of the cases that the majority relies on supports my position. In Board of Medical Examiners v. Mintz, 233 Or 441, 444, 378 P2d 945 (1963), the Board of Medical Examiners found that the petitioner had represented to two patients that he would perform abortions on *727them and provided them drugs for that purpose. The board concluded that the petitioner’s conduct violated what is now ORS 677.190(l)(a), which allows the board to revoke or suspend licenses in cases of “[u]nprofessional or dishonorable conduct.” The Supreme Court rejected the trial court’s conclusion that ORS 677.190(1) was “inoperative” because the board had not adopted rules defining the broad term “unprofessional or dishonorable conduct.” Mintz, 233 Or at 446. The court noted that “the variety of forms which unprofessional conduct may take makes it infeasible to attempt to specify in a statute or regulation all of the acts which come within the meaning of the term.” Id. at 448. The court suggested that the standards of “unprofessional or dishonorable conduct” were not so indefinite as to be unascertainable, because licensees could determine the contours of the standards by referring to the standards generally accepted by other practitioners; for disciplinary purposes, the standards can be established through expert testimony. Id. at 448-49. Mintz is an example of a case where regulatory wording, by virtue of its breadth, could reasonably form the basis for discipline based on a range of unspecified conduct.

In Sun Ray Dairy v. OLCC, 16 Or App 63, 73, 517 P2d 289 (1973), we held that, in the absence of rules that implemented a statute governing OLCC’s authority to deny licenses, the court was unable to ascertain the standards against which an application for a liquor license was to be measured. That case illustrates wording that was so broad as to be standardless. As the majority notes, the Sun Ray Dairy court observed that it is sufficient for agencies to promulgate “broad bases upon which decisions regarding issuance of liquor licenses will be made.” Id. at 74. That observation pertains to broad bases, however, and says nothing that would justify reading one relatively narrow basis for a licensing decision as applicable to a type of conduct not within its purview.

Finally, in Spray v. Bd. of Medical Examiners, 50 Or App 311, 317-19, 624 P2d 125, modified on recons, 51 Or App 773, 627 P2d 25, rev den, 291 Or 117 (1981), we indicated that a specific broad category of misconduct — unacceptable medical treatment — could be made generally unethical, with particular instances of that kind of misconduct assessed against *728generally accepted practices as ascertained by expert testimony in particular contested cases. Again, however, Spray involved a broad category of misconduct that need not be exhaustively defined in advance; it did not allow expansive interpretation of a narrower category in order to capture unspecified conduct as a basis for sanction. In sum, nothing in the cases cited by the majority supports interpreting Ethical Principle 4.02 more broadly than its terms provide.

The second problem with the majority’s reading of the rule is its reliance on context to inform its interpretation of Ethical Principle 4.02.1 do not dispute that it is appropriate to look to other parts of the same regulatory code when trying to determine whether an agency’s construction of its rule is plausible. See, e.g., Don’t Waste Oregon Com., 320 Or at 142. What I dispute is that Ethical Principle 4.09 changes the plain meaning of Ethical Principle 4.02. Ethical Principle 4.09 provides, in part:

“(c) Prior to termination for whatever reason, * * * the psychologist * * * provides appropriate pretermination counseling, suggests alternative service providers as appropriate, and takes other reasonable steps to facilitate transfer of responsibility to another provider if the patient or client needs one immediately.”

The topic of Ethical Principle 4.09 is plain: the proper procedures that a psychologist must follow after a decision to terminate service has been made. Ethical Principle 4.09 is silent, however, about how the decision to terminate is to be made. Moreover, Ethical Principle 4.09 addresses none of the factors that the board announced in its “interpretation” of Ethical Principle 4.02: divorced parents, joint custody, or the right to reject treatment. Although reading Ethical Principle 4.09 could provide a psychologist with an ethical way to terminate therapy that has been initiated using the informed consent procedures outlined in Ethical Principle 4.02, it does nothing to inform a psychologist about the circumstances under which termination of service is required. In fact, by its terms, Ethical Principle 4.09 applies to termination of service “for whatever reason.” I disagree with the majority that Ethical Principle 4.09 provides context to support the board’s reading of Ethical Principle 4.02.

*729In my view, the board in this case did not plausibly interpret Ethical Principle 4.02, the only existing rule that petitioner was charged with violating. Instead, it announced a new rule and applied it to petitioner. Because the board’s interpretation of its rule was implausible, I would reverse the board’s order in this case.

For the reasons stated above, I concur.

The majority relies on three cases to support the assertion that codes of professional conduct need not be so detailed as to spell out every contingency. Insofar as the majority relies on Spray v. Bd. of Medical Examiners, 50 Or App 311, 624 P2d 125, modified on recons, 51 Or App 773, 627 P2d 25, rev den, 291 Or 117 (1981), the holding of that case is limited to those professional ethical principles that incorporate the violation of generally accepted standards of treatment as a basis for sanction. Board of Medical Examiners v. Mintz, 233 Or 441, 378 P2d 945 (1963), predates Megdal v. Board of Dental Examiners, 288 Or 293, 605 P2d 273 (1980), and the approach taken in Mintz — ascertainment of ethical standards on a case-by-case basis through expert testimony in contested cases — -was disavowed in Megdal. Megdal, 288 Or at 305-07. Finally, Sun Ray Dairy v. OLCC, 16 Or App 63, 517 P2d 289 (1973), concerned standards for granting or denying a liquor license, not ethical standards related to a professional license, and so its analysis is inapposite. In my view, under Megdal, the board must, with reasonable specificity, outline what conduct is sanctionable in advance of imposing discipline.