Restriction on Veterinary Advice Given via Telemedicine Violates First Amendment
From yesterday’s decision in Hines v. Pardue, by Fifth Circuit Judge Don Willett, joined by Judges Cory Wilson:
Dr. Ronald S. Hines is a retired, physically disabled, Texas-licensed veterinarian who enjoys spending his golden years giving online pet-care advice to animal lovers around the world—often for free. Dr. Hines does not physically examine animals, perform surgeries, apply casts, splints, or bandages, administer vaccinations, or prescribe prescription medication. He merely sends emails. This would be no problem if the patients were people instead of pets. For humans, Texas law allows telemedicine without first requiring a face-to-face examination to establish a physician-patient relationship. Not so with animals, which require an in-person visit. Exam-free telehealth, turns out, is fine for your Uncle Bernard, but not for your Saint Bernard.
No one ever complained about Dr. Hines’s online pet-care advice or alleged that it harmed a single animal. However, because Dr. Hines does not physically examine animals before sharing his expertise, the State of Texas considered some of his emails criminal offenses, going so far as penalizing him with a year of probation, fining him $500, and forcing him to retake the jurisprudence section of the veterinary licensing exam….
Today, we uphold Dr. Hines’s First Amendment rights. We specifically conclude that the State of Texas is directly regulating Dr. Hines’s speech and that this regulation fails to survive even intermediate scrutiny….
First things first, we must determine what the physical-examination requirement primarily regulates. The State does not dispute that Dr. Hines’s speech is implicated. It contends that the physical-examination requirement restricts Dr. Hines’s speech incidentally to the general regulation of conduct. So, we consider whether the requirement regulates Dr. Hines’s speech directly or only incidentally to the regulation of his conduct. On the one hand, all Dr. Hines does is send emails—pure speech. But on the other, the law regulates his speech as part of the practice of veterinary medicine. {We are mindful that under “[Supreme Court] precedents, [s]tates may regulate professional conduct, even though that conduct incidentally involves speech.”} …
[C]ircuit courts have, until recently, applied the so-called professional-speech doctrine to licensing regulations like this one. These courts, including our own, treated laws regulating professionals’ speech as a separate category from non-professional speech, entitling them to less protection and exempting them from traditional First Amendment scrutiny. The Supreme Court, however, rejected this doctrine in NIFLA v. Becerra (2018), and instructed courts to apply the “traditional conduct-versus-speech dichotomy.” But “[a]s it stands today, the relevant First Amendment doctrine is a mind-numbing morass of tangled precedents developed in contexts very different from professional licensing.”
The “notoriously foggy” speech-conduct dichotomy makes “finding the line between speech and conduct … not as simple as asking whether the prohibition is literally one against verbal or written ‘speech,’ on the one hand, or one against ‘conduct’ (i.e., nonverbal action) on the other.” In as-applied challenges—especially those involving “generally applicable regulation[s] of conduct,” such as the regulation here—a particular act constitutes protected speech, rather than unprotected conduct, if that act “consists of communicating a message.”
For example, a generally applicable regulation proscribing breaching the peace regulated speech, rather than conduct, when an individual was arrested and convicted for wearing a jacket that said “F*** the Draft” inside a courthouse. The Supreme Court found the conviction to “clearly rest[ ] upon the asserted offensiveness of the words [the plaintiff ] used to convey his message to the public.” Because “[t]he only ‘conduct’ which [California] sough
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