1. A board of special inquiry appointed pursuant to § 17 of
the Immigration Act of 1917 as amended, 8 U.S.C. § 153, is
bound to accept as final a certificate that an alien is a mental
defective of a class excluded from admission to the United States
by § 3, 8 U.S.C. § 136(d), where such certificate has
been issued by a medical appeal board after a fair hearing in
conformity with § 16, 8 U.S.C. § 152, and regulations of
the Public Health Service prescribed pursuant thereto. P.
336 U. S.
809.
2. A report of a medical appeal board appointed pursuant to
§ 16 of the Immigration Act of 1917 as amended, 8 U.S.C.
§ 152, to review a finding of two medical officers that an
alien seeking admission to the United States is mentally defective
does not comply with the applicable law and regulations where it
fails to show that the appeal board based its findings and
conclusion "on its medical examination of the alien," and merely
shows that it considered the appeal and, after "taking into
consideration" the certificate of the medical officers who made the
original examination and the testimony of an alienist employed by
the alien, concurred
Page 336 U. S. 807
in the report of the medical officers who made the first
examination. Pp.
336 U. S.
809-812.
(a) The appeal board could not rest its finding that the alien
was a mental defective on the certificate of the original examining
officers, since the Act and regulations prescribe an independent
review and reexamination. P.
336 U. S.
812.
(b) The statement of the appeal board that it had "considered
the appeal" cannot be treated as a certification that the alien had
been given an independent medical examination. P.
336 U. S.
812.
3. Assuming, without deciding, that defects in the appeal
board's report could be cured by additional data in the record, the
data in the record in this case is not sufficient to cure the
defect. Pp.
336 U. S.
812-815.
170 F.2d 1009 reversed.
In a habeas corpus proceeding challenging the validity of the
detention of an alien under an exclusion order issued by a board of
special inquiry under the Immigration Act of 1917 as amended, the
District Court discharged the writ and ordered the alien remanded
to the immigration authorities. 82 F. Supp. 36. The Court of
Appeals affirmed. 170 F.2d 1009. This Court granted certiorari. 336
U.S. 924.
Reversed and remanded, p.
336 U. S.
815.
MR. JUSTICE BLACK delivered the opinion of the Court.
The American Foreign Service at Stockholm issued to petitioner
an immigration visa to come to the United
Page 336 U. S. 808
States as a Swedish quota immigrant. On the ground that she was
a mental defective, authorities of the Immigration and
Naturalization Service declined to admit her into this country and
ordered her detention at Ellis Island pending deportation to
Sweden. She filed this habeas corpus proceeding contending that she
was not a mental defective and challenging in several respects the
legality of the exclusion order. The District Court discharged the
writ and ordered petitioner remanded to the immigration
authorities. 82 F. Supp. 36. The Court of Appeals affirmed, one
judge dissenting. 170 F.2d 1009. Certiorari was granted because
important questions were raised concerning administration of the
immigration laws.
Section 3 of the Immigration Act of 1917 excludes from admission
into this country certain classes of aliens deemed undesirable.
Among those excluded are persons "who are found to be and are
certified by the examining surgeon as being mentally . . .
defective. . . ." 39 Stat. 874, 875, 8 U.S.C. § 136(d).
Section 16 of the Act [
Footnote
1] provides that mental examinations of arriving aliens shall
be made by not less than two United States Public Health Service
medical officers especially trained in the diagnosis of insanity
and mental defects. The same section authorizes an appeal to a
special board of medical officers of the Public Health Service for
any alien who is certified by the two medical officers as a mental
defective. Finally § 17 of the Act, as amended, 8 U.S.C.
§ 153, provides that boards of special inquiry shall be
appointed by the Immigration and Naturalization Service, subject to
approval of the Attorney General. These boards of special inquiry
are granted "authority to determine whether an alien who has been
duly held shall be allowed to land or shall be deported." It was a
board of special inquiry of this kind that ordered petitioner
excluded from the United States.
Page 336 U. S. 809
First. Two medical officers of the Public Health
Service signed a certificate that petitioner was a mental
defective. On appeal, a board of three Public Health medical
officers affirmed the finding of this certificate. Later, when her
case was under consideration by a board of special inquiry of the
Immigration and Naturalization Service, petitioner asked for time
to produce additional evidence to show that she was not a mental
defective. The board refused to hear such evidence, holding that it
was bound by § 17 of the Immigration Act to accept as final
the medical certification that she was a mental defective.
Petitioner contends that this holding was error which invalidates
the exclusion order. We hold that the Court of Appeals correctly
rejected this contention.
Section 17 provides, with an exception not here relevant,
that
"The decision of a board of special inquiry shall be based upon
the certificate of the examining medical officer and . . . shall be
final as to the rejection of aliens affected with . . . any mental
. . . disability which would bring such aliens within any of the
classes excluded from admission to the United States under section
three of this Act."
We agree with the following statement of the Court of
Appeals.
"A certificate by the medical board, if its action conformed to
the statute and regulations and its decision was made after a fair
hearing, was plainly intended to be conclusive."
170 F.2d 1009, 1012. This conclusion is particularly compelling
in the light of the legislative history referred to in that court's
opinion. We therefore turn to the medical certificates to consider
the contention that they were not issued as the result of the kind
of examinations required by the statute and regulations, and that
the certificates themselves failed to conform to those
requirements.
Second. Petitioner attacks the validity of both the
initial medical certificate and that of the appellate medical
board, contending that they provide an inadequate basis for
excluding her from the United States. The
Page 336 U. S. 810
importance of these medical certificates is underscored by our
holding that Congress has made the findings and conclusions in the
certificates final on the question of whether an alien is so
mentally defective that admission into the country must be denied.
Congress has taken note of the crucial importance of this medical
determination by prescribing certain minimum procedural
requirements that the Public Health Service must follow, such as
special qualifications of examining doctors, the minimum number of
doctors that must examine the applying alien, and the right of an
alien to have an initial adverse certificate reviewed by a special
board of doctors. In order that further safeguards might be
provided, Congress authorized the Surgeon General of the Public
Health Service to prescribe additional regulations governing the
procedure to be observed in the exercise of that Service's
exclusive authority over medical questions.
Pursuant to this statutory authority, the Surgeon General issued
regulations which detail the manner in which medical examinations
shall be held and the type of certificates by which examining
doctors and boards shall report their findings and conclusions. As
shown by the dissenting opinion below, serious challenges have been
made to the sufficiency of the certificate of the medical appeal
board, as well as to the initial medical certificate in which two
doctors certified petitioner to be a mental defective. [
Footnote 2] The shortcomings of the
initial certificate, however, probably could have been rendered
harmless
Page 336 U. S. 811
by a proper examination and certificate by the medical board of
appellate review. Since our conclusion is that the appellate review
failed to meet the requisite standards prescribed by statute and
regulations, we need not consider the challenges directed against
the original certificate standing alone.
Regulations of the Public Health Service provide the way in
which medical appeal boards shall be convened and detail a
procedure for the boards to follow. The regulations impose a duty
on such boards "to reexamine an alien;" they further provide that
"reexamination shall include . . . a medical examination by the
board;" that the "findings and conclusions of the board shall be
based on its medical examination of the alien;" and that "[t]he
board shall report its findings and conclusions to the Immigration
Service. . . ." [
Footnote 3]
The report of the medical appeal board here shows only that it
"considered the
Page 336 U. S. 812
appeal . . . and after taking into consideration the certificate
of March 11, 1948, and the testimony given by Dr. Carlton Simon,
reports that it concurs with the above dated certificate."
The report of this medical board therefore wholly failed to show
any compliance with the requirement of § 34.13(g) that the
board base its "findings and conclusions . . . upon its medical
examination of the alien. . . ." We think the record makes clear
that the appeal board made no such medical examination as was
required by the regulations.
The report itself shows that the appellate board based its
conclusion on two considerations: (1) the initial certificate of
the two public health doctors; (2) testimony given by Dr. Carlton
Simon. But the appellate board could not rest its finding that
petitioner was a mental defective on the original certificate
without denying petitioner the independent review and reexamination
which Congress and the Surgeon General had prescribed. Nor could
the appellate board relieve itself of its duty to make an
independent reexamination by relying on the testimony of Dr. Simon.
Moreover, Dr. Simon testified that petitioner was not a mental
defective. His testimony was that she was "normal." It hardly seems
necessary to add that the statement of the appellate board that it
had "considered the appeal" cannot be treated as a certification
that petitioner had been given an independent medical examination.
We therefore hold that the appellate board's certificate is an
inadequate basis on which to rest the exclusion order of the board
of special inquiry.
The Government contends, however, that additional data in the
record shows that the board did reexamine the petitioner. We may
assume without deciding that the defects in the appellate board's
report could be cured by additional record data, but we find no
such data in the record sufficient to cure the defect. The data
on
Page 336 U. S. 813
which the Government relies is contained in a stenographic
report of evidence given by petitioner and Dr. Simon, petitioner's
witness. Petitioner's evidence, like that of Dr. Simon, was an
emphatic denial of any condition which could justify her
classification as a mental defective. The stenographic report thus
falls far short of showing that the medical appeal board made an
independent medical examination of petitioner's mental qualities.
That report tends to confirm the fact that the board's conclusions
were rested only on the report of the initial examination by the
two Public Health Service doctors and on a report of the physician
of the ship on which petitioner came to this country. This makes
necessary a short statement concerning this report by the ship's
doctor and the circumstances under which the record discloses that
report was made.
Apparently, the second day after petitioner had commenced her
voyage to America the ship's doctor visited her. He found her weak
and dizzy. She stated that "she could not stand the sea," and would
not go to the dining room. The doctor's impression after his first
visit was that she was seasick. The next day, according to the
doctor's report, she admitted hallucinations, stating that at night
she heard cries and saw faces, said she had given the consul "wrong
information," and thought this sinful. At this time, the ship's
doctor wrote down his "impression of incipient psychosis" and
transferred her to the isolation ward of the ship's hospital. The
next day, according to the doctor, petitioner stated that she had
been treated for insanity at her home in Sweden for a six-month
period two years before. On the last day of the sea trip, the
ship's doctor reported that she had cleared up "remarkably," that
she had no recollection of "a lot of strange things she had said
before," was sleeping well, denied having any hallucinations, and
looked "considerably better."
Page 336 U. S. 814
In her evidence before the medical board, petitioner stated that
she spoke "terribly bad English;" that, prior to boarding the ship,
she had been to a number of parties and was very tired when she
came aboard; that, after coming aboard and during the voyage she
had taken bromides and sleeping tablets, and that, in her
condition, she just slept and said "yes" to every question the
doctor asked.
From the foregoing, it appears that the data relied on by the
Government was totally inadequate to show that the appellate
medical board "reexamined" petitioner. The sum total of that data
is testimony given by petitioner and her medical specialist to the
effect that petitioner was mentally normal, plus petitioner's
admissions that, while seasick and under the influence of drugs,
she had said things that prompted the ship's doctor at one time to
suspect "incipient psychosis."
So far as the medical findings and evidence here show, the daily
reports made by the ship's doctor while petitioner was a passenger
constitute the only affirmative evidence that petitioner is or was
a mental defective. The Public Health regulations plainly prohibit
the issuance of exclusion orders resting on nothing but a single
episode reported by a non-Public-Health doctor. For Congress has
provided that, before aliens suspected of mental defects are
excluded, findings and conclusions shall be made by Public Health
doctors based on their own examinations made in compliance with
procedural safeguards defined or authorized by Congress. Medical
certificates barring aliens are even then to be issued "only if the
presence of such . . . defect is clearly established." 42 Code
Fed.Regs. § 34.4 (Supp. 1947). And such certificates
"shall in no case be issued with respect to an alien having only
mental shortcomings due to ignorance, or suffering only from a
mental condition attributable to remedial physical causes, or from
a psychosis of a
Page 336 U. S. 815
temporary nature caused by a toxin, drug, or disease."
42 Code Fed.Regs. § 34.7. So far as appears from the
appellate certificate here, the board made no examination to
determine whether the ship episode, as reported by the physician,
was the result of petitioner's ignorance of English plus temporary
debility, or was the result of a mental defect justifying
exclusion. Even the report of the ship physician contained no
finding on this point, and it is not amiss to add that the verified
petition for habeas corpus contains an undenied allegation that the
ship's doctor has now stated that, "in his opinion, the alien is
not mentally defective."
Our holding that the appellate board's medical certificate and
additional data are inadequate to support the exclusion order makes
it unnecessary to decide other questions relating to applicability
of the Administrative Procedure Act to hearings before the board of
special inquiry. 60 Stat. 237, 239, 5 U.S.C. §§ 1001,
1004.
The judgment is reversed, and the cause is remanded to the
District Court for entry of an order affording petitioner a proper
hearing and medical examination before the appropriate Public
Health authorities.
Reversed and remanded.
[
Footnote 1]
39 Stat. 885, as amended, 8 U.S.C. § 152.
[
Footnote 2]
During the hearings before the Board of Special Inquiry, counsel
for petitioner stated to this board
"that, from an examination of the record, it appears that the
only positive finding of mental defectiveness appears in the record
of the ship's surgeon. . . ."
Counsel insisted that petitioner was suffering from no "mental
disturbance whatsoever." In her behalf, he asked for an opportunity
to produce further medical testimony. In response to this request,
the board's chairman asked counsel whether petitioner would be able
to bear the expenses of her continued detention should the board
grant her request for an opportunity to produce further medical
testimony. Counsel replied that he believed she could. The board
immediately thereafter closed the hearing, made its findings, and
ordered her excluded.
The dissenting opinion stated:
"I would reverse the order and direct that the writ be sustained
because of inadequacy of the original certificate of the examining
surgeons and total failure of the reviewing Board of Medical
Officers to comply with the regulations."
170 F.2d 1009, 1014.
[
Footnote 3]
"(c) Re-examination shall include:"
"(1) A medical examination by the board;"
"(2) A review of all records submitted;"
"(3) Use of any laboratory or diagnostic methods or tests deemed
advisable; and"
"(4) Consideration of statements regarding the alien's physical
or mental condition made by a reputable physician after his
examination of the alien."
"
* * * *"
"(e) An alien being reexamined may introduce as witnesses before
the board such physicians or medical experts as the board may, in
its discretion, permit at his own cost and expense. . . ."
42 Code Fed.Reg. § 34.13 (Supp. 1947).
MR. JUSTICE REED, with whom THE CHIEF JUSTICE and Mr. MR.
JUSTICE BURTON join, dissenting.
This Court affirms the decision that a proper medical finding of
a physical defect which excludes an alien from entrance into the
United States is final, and not subject to further inquiry. With
the Court's ruling on this point, I agree.
(1) The reversal of the dismissal of the writ of habeas corpus
is founded on the Court's premise that the report of the reviewing
board of medical officers
"shows that the appellate board based its conclusion on two
considerations:
Page 336 U. S. 816
(1) the initial certificate of the two public health doctors;
(2) testimony given by Dr. Carlton Simon [a psychiatrist chosen by
the alien]."
The Court then concludes that
"the appellate board could not rest its finding that petitioner
was a mental defective on the original certificate without denying
petitioner the independent review and reexamination which Congress
and the Surgeon General had prescribed."
That is to say, the report, as the Court phrases it, "makes
clear that the appeal board made no such medical examination as was
required by the regulations." [
Footnote
2/1] My reading of the opinion is that the Court thinks the
record affirmatively shows a failure to comply with the statute and
regulation § 34.13(g) and (h) as to findings and examination.
[
Footnote 2/2]
Page 336 U. S. 817
There is a suggestion that a medical appeal board must certify
that the alien had been examined. [
Footnote 2/3] I assume, however, that, if the Court
intended to require specific certification by the medical board of
the steps leading to its findings and conclusions, it would have
made such a holding definitive.
Page 336 U. S. 818
I disagree with the Court's interpretation of the report. A
strong presumption exists that public officials perform their duty.
If the report had added the phrase, "in accordance with the
regulations," after the word "considered," there could be no doubt
as to the sufficiency of the report. The presumption of regularity
until rebutted requires courts to adopt such an interpretation.
[
Footnote 2/4] The statement of the
board of medical officers that it "has considered the appeal" means
to me that the board has proceeded conformably to the statute and
regulations.
(2) There is a graver error in the Court's holding, however,
which may interfere with sound administrative procedure. Although
petitioner was represented by counsel, no objection to the form of
the report was made during the administrative process. This case
heretofore has centered around the issue of finality disposed of by
the Court. Even in the several hearings of her effort to get relief
by habeas corpus, petitioner has never asserted, in this or any
other court, that she was not examined by the physicians of the
medical review board. This is made plain by the Court's statement
of the generalized objections on other grounds to the report of the
medical review board,
see opinion at
note 2 and from the affidavits and objections
appearing in the record. The dissenting judge, 170 F.2d 1009, did
not refer to the failure to examine petitioner. He spoke only of
the failure of the Board of Special Inquiry and the medical board
to require adequate and revealing certificates and reports. Even
the petition for certiorari does not present the question. The
brief does not discuss it.
Page 336 U. S. 819
The administrative remedy must be exhausted by fair effort to
correct administrative errors before resort to habeas corpus or
other judicial remedies. [
Footnote
2/5] To permit occasional reversal of administrative orders on
points not brought to the attention of the agency hampers
administrative routine and, if adopted as a rule of law, would
disorganize administrative procedure. Afterthought cannot take the
place of required objection. This is not a case where rules of
practice and procedure defeat the ends of justice. [
Footnote 2/6] There is nothing in this record to
indicate that disabilities of petitioner, or difficulties of
procedure or practice, the emergence of a new rule of law, or any
other change of circumstance has affected the course of
petitioner's pleas. She has had advantage of every method of relief
known to the law, but has not seen fit to bring forward the ground
upon which this Court reverses.
It is obvious that, had objection been made to the form of the
report of the Board of Medical Officers at the hearing
Page 336 U. S. 820
before the Board of Special Inquiry, April 6, 1948, a prompt
elaboration of the report could have been obtained or, if no
examination such as is required by the regulations had already been
made, it could have been done promptly. Proper administrative
procedure requires that objection to certificates be made at the
earliest opportunity, which, in this case, was during the
administrative hearing before the Board of Special Inquiry. A
litigant's unexplained failure to raise an issue does not justify
capricious judicial intervention on behalf of an individual.
I would affirm the judgment below.
[
Footnote 2/1]
The report reads as follows: "Pursuant to the request of the
District Director of Immigration and the order of the Medical
Officer in Charge, the following Board of Medical Officers of the
U.S. Public Health Service, has considered the appeal regarding
subject-named alien May Gunborg Johnson and after taking into
consideration the certificate of Mar. 11, 1948 and the testimony
given by Dr. Carlton Simon, reports that it concurs with the above
dated certificate."
[
Footnote 2/2]
39 Stat. 885, as amended, 8 U.S.C. § 152:
"Sec. 16. The physical and mental examination of all arriving
aliens shall be made by medical officers of the United States
Public Health Service, who shall conduct all medical examinations
and shall certify, for the information of the immigration officers
and the boards of special inquiry hereinafter provided for, any and
all physical and mental defects or diseases observed by said
medical officers in any such alien. . . . Any alien certified for
insanity or mental defect may appeal to the board of medical
officers of the United States Public Health Service, which shall be
convened by the Surgeon General of the United States Public Health
Service, and said alien may introduce before such board one expert
medical witness at his own cost and expense. . . ."
42 C.F.R., 1947 Supp., § 34.13:
"
Reexamination; convening of boards; expert witnesses;
reports. (a) The Surgeon General, or when authorized, a
medical officer in charge, shall convene a board of medical
officers to reexamine an alien"
"
* * * *"
"(2) Upon an appeal by the alien from a certificate of insanity
or mental defect, issued at a port of entry."
"
* * * *"
"(c) Re-examination shall include:"
"(1) A medical examination by the board;"
"(2) A review of all records submitted;"
"(3) Use of any laboratory or diagnostic methods or tests deemed
advisable; and"
"(4) Consideration of statements regarding the alien's physical
or mental condition made by a reputable physician after his
examination of the alien."
"
* * * *"
"(g) The findings and conclusions of the board shall be based on
its medical examination of the alien and on the evidence presented
to it and made a part of the record of its proceedings."
"(h) The board shall report its findings and conclusions to the
Immigration Service, and shall also give prompt notice thereof to
the alien if the reexamination has been held upon his appeal. The
board's report to the Immigration Service shall specifically
affirm, modify, or reject the findings and conclusions of prior
examining medical officers."
It will be noted that the evidence presented to the board was
made a part of the report to the Board of Special Inquiry, as
required by the regulation.
[
Footnote 2/3]
"It hardly seems necessary to add that the statement of the
appellate board that it had 'considered the appeal,' cannot be
treated as a certification that petitioner had been given an
independent medical examination."
[
Footnote 2/4]
Lewis v. United States, 279 U. S.
63,
279 U. S. 73:
"It is the settled general rule that all necessary prerequisites
to the validity of official action are presumed to have been
complied with, and that, where the contrary is asserted, it must be
affirmatively shown."
Stearns Co. v. United States, 291 U. S.
54,
291 U. S. 63,
and authorities cited;
United States v. Chemical
Foundation, 272 U. S. 1,
272 U. S. 14.
[
Footnote 2/5]
We refused to review an issue not raised before an
administrative body in
Unemployment Commission v. Aragan,
329 U. S. 143,
329 U. S.
155:
"A reviewing court usurps the agency's function when it sets
aside the administrative determination upon a ground not
theretofore presented and deprives the Commission of an opportunity
to consider the matter, make its ruling, and state the reasons for
its action."
Tri-State Broadcasting Co. v. FCC, 71 App.D.C. 157, 107
F.2d 956, 958.
Cf. Myers v. Bethlehem Shipbuilding
Corporation, 303 U. S. 41,
303 U. S. 51,
note 9;
Blair v. Oesterlein Mach. Co., 275 U.
S. 220.
The Administrative Procedure Act contemplates presentation
before the administrative agency of every issue that may be made
the subject of judicial review by habeas corpus or appellate
process. 60 Stat. 237, § 7(c), 8(b)(2), 10(b), (c) and (e).
The rule against raising questions on judicial review that were not
raised in administrative proceedings has general application,
see Caldarone v. Zoning Board of Review, 60 A.2d 158, 159;
Reisberg v. Board of Standards and Appeals, 81 N.Y.S.2d
511, 513;
General Transp. Co. v. United
States, 65 F. Supp.
981, 984.
[
Footnote 2/6]
Cf. Hormel v. Helvering, 312 U.
S. 552,
312 U. S.
557.