Withrow v. Larkin

Background

Dr. Duane Larkin, a Michigan physician who obtained a Wisconsin license by reciprocity, practiced abortions in Milwaukee. The Wisconsin Examining Board, empowered by state law to investigate misconduct, temporarily suspend licenses, and refer criminal or revocation charges, opened an investigative hearing alleging name misuse, fee splitting, and unlicensed practice. The Board’s investigative sessions were closed to the public; Larkin and his lawyer attended but were not allowed to cross-examine witnesses. A federal court barred the Board from holding a contested suspension hearing and a three-judge court initially declared the suspension statute unconstitutional as applied broadly, later narrowing relief to Larkin alone.

Reasoning

The central question was whether it violates due process for the same board to investigate possible misconduct and then decide whether to suspend a license. The Court reviewed prior decisions and administrative practice and held that combining investigation and adjudication does not automatically create an unconstitutional risk of bias. The Justices emphasized a presumption of honesty in officials, noted that investigative findings of probable cause are not inconsistent with a fair later hearing, and pointed out that Larkin’s counsel had access to the investigative record and an opportunity to explain evidence. Because the District Court abused its discretion in issuing a broad preliminary injunction, the Supreme Court reversed and remanded for further proceedings.

Real world impact

The decision permits state medical boards to proceed from investigation to contested suspension hearings unless particular facts show an intolerable risk of unfairness. It reverses the automatic rule against such combined functions, makes preliminary injunctions harder to obtain, and sends the case back for further steps consistent with this opinion.