In a 4-3 decision, the Missouri Supreme Court ruled the non-economic damage cap in medical malpractice cases violates the Missouri Constitutional right to trial by jury. In reaching its decision, the Court declared unconstitutional a non-economic damage cap originally enacted by the Missouri legislature in 1986, and amended in 2005. With this ruling, the Court also overruled a 1992 Missouri Supreme Court case that had declared the cap to be constitutional.