Justice PARRISH, opinion of the Court:

INTRODUCTION

¶ 1 For millennia, physicians have sworn, "With regard to healing the sick, ... I will take care that they suffer no hurt or damage."1 And for perhaps just as long, the sick have sought redress when hurt or damage inevitably occur.2 Caught in the middle, lawmakers have tried to strike a balance that provides redress for the injured while accounting for the concerns of the medical profession.3

¶ 2 In 1986, the Utah Legislature amended the Utah Health Care Malpractice Act, sections 78B-3-401 to -425 of the Utah Code, (the "Malpractice Act") and imposed a cap on noneconomic damages in medical malpractice cases.4 But the Legislature did not explicitly account for the Utah Constitution's prohibition of such damage caps in wrongful-death cases.5 Almost thirty years later, we find ourselves at the confluence of these provisions and have been asked by the United States District Court to resolve the conflict. That court has certified to us this question: Is the noneconomic damages cap in section 78B-3-410 of the Malpractice Act permissible as applied to wrongful-death cases under article XVI, section 5 of the Utah Constitution? We hold that it is not.

BACKGROUND

¶ 3 Gregory Lynn Smith's son, Gregory Lee Smith, died on October 22, 2010, of an acute drug intoxication involving the medications prescribed to him by medical staff at the VA medical center in Salt Lake City. The VA staff had prescribed the pain medications upon his discharge from the medical center after a back surgery.

¶ 4 Mr. Smith filed suit against the United States of America in the United States District Court for the District of Utah, alleging that VA medical staff negligently caused his son's death.6 That court certified two questions to us:

We have jurisdiction to answer these questions pursuant to Utah Code section 78A-3-102(1).

STANDARD OF REVIEW

¶ 5 On certification from a federal court, there is no prior decision and thus no standard of review.8 We answer the legal questions presented and do not resolve the underlying dispute.9

ANALYSIS

¶ 6 The United States District Court has asked us if the damages cap in section 78B-3-410 of the Malpractice Act is permissible under article XVI, section 5 of the Utah Constitution in cases of medical malpractice that result in death. Article XVI, section 5 provides,

But the damages cap in section 78B-3-410 provides,

Our analysis proceeds in two parts. We hold that article XVI, section 5 protects both economic and certain noneconomic damages in wrongful-death cases and that its exception is not implicated except in the context of a scheme akin to workers' compensation. As a result, we conclude that the damages cap in section 78B-3-410 of the Malpractice Act is not constitutionally permissible as applied to wrongful-death cases.

I. ARTICLE XVI, SECTION 5 OF THE UTAH CONSTITUTION

¶ 7 The interpretation of article XVI, section 5 turns on two distinct questions. First, what species of damages are protected? Second, when does the compensation exception apply?12 We address each question in turn.

A. Article XVI, Section 5 Protects Economic and Certain Noneconomic Damages

¶ 8 The parties agree that article XVI, section 5 protects those damages that were available at the time of its adoption. Indeed, our case law has so held for almost one hundred years.13 But the parties disagree as to the nature of those protected damages. Both parties cite opinions by our predecessors on the territorial court discussing the damages then available in wrongful-death actions, including the seminal case of Webb v. Denver & R.G.W. Railway.14 However, they disagree about how to read them.

¶ 9 A particular point of disagreement is the pronouncement in Webb that "only the pecuniary loss sustained can be compensated" in a suit for wrongful death.15 Mr. Smith argues that "pecuniary" as used in that case includes economic and noneconomic damages. The United States argues that pecuniary damages are limited to economic damages. We agree with Mr. Smith and conclude that the damages allowed under Webb and its progeny are not so limited.

¶ 10 To understand Webb and the scope of protection afforded by section 5 of article XVI, we begin with the legal landscape in which the constitutional protection was enacted. At common law, a cause of action for personal injury — including fatal injury — died with the injured party, leaving survivors with no recourse.16 But Lord Campbell's Act, adopted in 1846 by the British parliament, abrogated this harsh rule and vested a cause of action for wrongful death in the heirs of the deceased.17 This new cause of action rippled through the common law world resulting in the enactment of a materially identical statute in the Territory of Utah in 1874.18 That statute provided,

Ten years later, the territorial legislature enacted a new wrongful-death statute. The new statute provided,

Unlike its predecessor, the new statute contained no limit on the amount of damages. It was against the backdrop of this statute that the constitutional provision prohibiting damage caps in wrongful-death cases went into affect in 1896 when Utah became a state.21

¶ 11 The first case to address the issue of allowable damages under the revised Utah statute was the 1890 case of Webb v. Denver & R.G.W. Railway, which both parties recognize as the seminal case on this question. In that case, our predecessors recognized

The court's inclusion of the word pecuniary is the basis for the substantial differences in the parties' understanding of the holding in Webb. The word pecuniary has the same meaning today as it did in the late nineteenth century — "consisting of or measured in money" or "of or relating to money."23 But the court in Webb stated that "the word `pecuniary' in this [context] is not construed in any very strict sense."24 Indeed, the court held that there is "great[ ] liberality" in allowable damages under the statute and they "include every element of injury that may be deemed to have a pecuniary value, although this value may not be susceptible of positive proof, and can only be vaguely estimated."25 It further stated that even though "the pecuniary injury... cannot be proved with even an approach to accuracy, ... [it is] to be estimated and awarded, for ... the jury is to give such damages as may be just under all the circumstances."26 The court then listed various species of allowable damages, including the loss of nurture, intellectual and moral training, and society.27 These damages are not pecuniary as that term is commonly understood. We are therefore persuaded that the badge pecuniary, as that word is commonly understood, is not helpful in identifying the damages that were available in wrongful-death cases at the time the Utah Constitution was adopted. Instead, we must look to the species of damages allowed by the court under the statute.

¶ 12 In the years leading to the adoption of the Utah Constitution, the court upheld a broad range of damages for wrongful death, including both economic and noneconomic damages. In the arena of economic damages, the court held that the jury should consider the financial contribution the deceased reasonably would have provided to his survivors based on "his ability to earn wages and provide for his family," "the number in the family dependent upon him for support and previously provided for," "the number and ages of the children," "the age and health of his wife, and age and health of the deceased."28 In short, the court allowed recovery for loss of the reasonably-expected net financial productivity of the deceased and the financial cost occasioned by his death.29

¶ 13 Significantly for our purposes, the court also allowed damages for certain noneconomic losses. For example, the court allowed recovery for "the loss of nurture, [that is] the intellectual, moral, and physical training" of a parent and "the loss of the society of a near relative," including "the loss of [a] father by children who are of full age living away from the home of the deceased and supporting themselves."30 The court also upheld instructions for the jury to "take into account the loss of society, and the comfort" that surviving parents would have gained by raising the deceased child;31 to "include any loss which the widow of [the] deceased and his daughter have sustained or may hereafter sustain by being deprived of the support, care, nurture, companionship, assistance, and protection which ... they would have received from the deceased if he had not been killed";32 and to award damages for the loss of "the benefits from the associations, comforts, and pleasures that ... [the decedent's survivors] would have received from him had his life been spared."33 This court continued a broad conception of allowable damages by upholding similar awards after statehood.34

¶ 14 While the court clearly allowed damages for noneconomic losses, such damages were not unlimited. In Webb, the court held that "no compensation can be given for the mental anguish or suffering of the heirs or next of kin of the deceased."35 The opinion in Webb notes the same concerns expressed in the seminal English case on this issue,36 namely that "if the mental suffering of the heirs is to be taken into the account, and compensated for in money, the difficulty [of proving or estimating the pecuniary loss] is infinitely increased."37 In short, the court held that this kind of loss is "too remote and sentimental to be a proper element of damage under the statute."38

¶ 15 It is against this legal backdrop that the framers adopted the constitutional provision protecting the recovery of damages for wrongful death. Accordingly, article XVI, section 5 protects recovery of economic damages — compensation for the loss of the reasonably-anticipated net financial productivity of the deceased and the costs occasioned by the death. It also protects recovery of certain noneconomic damages designed to compensate for the loss of the assistance, association, care, comfort, companionship, nurture, pleasure, protection, society, and support of the deceased. Because such damages were available at the time our constitution was adopted, they "shall not be subject to any statutory limitation." But those damages for the mental anguish and suffering of survivors, which were not available at the time of statehood, may be limited by the Legislature.

B. The Compensation Exception to Article XVI, Section 5 Applies Only to Schemes Akin to Workers' Compensation

¶ 16 Having defined the types of wrongful-death damages protected by article XVI, section 5, we proceed to consider whether the damages at issue fall within the exception to the constitutional protection. Article XVI, section 5 excepts from constitutional protection "cases where compensation for injuries resulting in death is provided for by law."39 The parties disagree with respect to the scope of this exception. Their disagreement turns on the meaning of "compensation." Mr. Smith argues that "compensation" means something akin to a workers' compensation scheme, while the United States argues that "compensation" has a broader meaning and includes any form of recovery allowed by law.40 We agree with Mr. Smith.

¶ 17 The compensation exception to article XVI, section 5 does not immunize the damages cap of the Malpractice Act from constitutional challenge. The constitutional provision differentiates between "damages" and "compensation." The word damage defines the constitutional protection; the word compensation defines the scope of the exception. Accordingly, the two terms must mean something different otherwise the exception would swallow the rule. We gain insight into the meaning of the compensation exception by its context. The compensation exception was not part of the original constitution, but was added through an amendment made in 1921.41 The exception remedied the inconsistency between the unamended constitutional provision and the Workmen's Compensation Act of 1917.42 Thus, as we have previously held, the term compensation, as used in amended section 5, carries the same meaning that it had in the Workmen's Compensation Act, namely "any payment required by the act to be made to a workman or to his dependents, or for their benefit, or into the state treasury for the special purposes of the compensation act."43

¶ 18 The United States argues that the exception applies because the Smiths are still entitled to recover damages (compensation) up to the amount of the cap. In other words, it suggests that the exception empowers the Legislature to cap damages as long as the cap is some number greater than zero. But the practical impact of this proposed construction is completely at odds with the constitutional language. Article XVI, section 5 enshrines two separate protections on the right to recover for wrongful death. The first is that the right to recover damages "shall never be abrogated." The second is that the amount of the damages "shall not be subject to any statutory limitation." The United States' suggestion that the right to recover damages up to the level of the cap constitutes compensation ignores the two separate protections and would, in fact, render the second constitutional guarantee a nullity.

¶ 19 The United States' proposed construction is also flawed because it conflates the concept of damages with that of compensation. The fact that the Smiths may be entitled to recover some damages under the cap does not transform those recoverable damages into compensation. In fact, the terms damages and compensation have distinct meanings. The word compensation means "making amends" or "that which is necessary to restore an injured party to his former position."44 In contrast, the word damages means "[a] pecuniary compensation ..., which may be recovered in the courts by any person who has suffered loss, detriment, or injury ... through the unlawful act or omission or negligence of another."45 As Black's Law Dictionary stated in 1891 and repeated in 1910, "[d]amages [are] amends exacted from a wrong-doer for a tort" but "[c]ompensation is amends for something which was taken without the owner's choice, yet without commission of a tort."46 Thus, compensation is distinguished from damages because damages require fault.47 Because any damages awardable within the cap are based upon a medical provider's fault, the fact of their awardability does not make the constitutional exception available. Accordingly, we hold that the compensation exception to article XVI, section 5 of the constitution does not apply in cases implicating the damages cap of the Malpractice Act.

II. SECTION 78B-3-410 OF THE UTAH CODE IS UNCONSTITUTIONAL AS APPLIED TO WRONGFUL-DEATH CASES

¶ 20 The Malpractice Act limits noneconomic damages in a "malpractice action," including damages in those cases of malpractice that result in death.48 Section 78B-3-410(1) of the Utah Code provides,

The parties agree that this statute cannot constitutionally limit damages that article XVI, section 5 of the Utah Constitution protects. But they disagree on how to resolve the clear tension between the constitution and the statute. Mr. Smith has proposed three alternatives for our consideration. First, he suggests that we construe the cap as inapplicable in all wrongful-death cases. Second, he proposes that we construe the cap to limit only those damage awards that are not protected by the constitution. Finally, if we reject his first two alternatives, he argues that we must declare the cap unconstitutional as applied to wrongful-death cases. The United States soundly rebuts the first two of Mr. Smith's proposed alternatives by pointing out that they are foreclosed by the plain language of the Malpractice Act. But the United States proposes no other option to avoid declaring the cap unconstitutional as applied to wrongful-death cases. Accordingly, we hold that the damages cap in section 78B-3-410 of the Malpractice Act is unconstitutional as applied to cases of wrongful death.

¶ 21 When construing a statute, we seek primarily to give effect to the intent of the Legislature.49 To begin, we look to the plain language of the specific provision within its context.50 And because we presume that the Legislature intends a statute to complement, not contradict, constitutional protections, we attempt to construe it accordingly.51 We address Mr. Smith's three alternatives in turn.

¶ 22 First, Mr. Smith reasons that the Legislature never intended for the Malpractice Act to apply to wrongful-death cases because it did not explicitly reference the cap in the wrongful-death statute itself. Mr. Smith points to the consortium statute as an example. In that statute, the Legislature provided that "[d]amages awarded for loss of consortium ... may not exceed any applicable statutory limit on noneconomic damages, including [the damages cap in] Section 78B-3-410" of the Malpractice Act.52 No such explicit reference to the cap appears in the wrongful-death statute.53

¶ 23 The United States soundly rebuts this reasoning on the basis of the express scope of the cap. The first sentence denotes the cap's scope: "[i]n a malpractice action against a health care provider."54 And the definition section defines "[m]alpractice action against a health care provider" as "any action against a health care provider, whether in contract, tort, breach of warranty, wrongful death, or otherwise."55 Further, there is nothing in the language of the cap indicating that it applies only if it is expressly referenced in the statute giving rise to the underlying cause of action. In short, the plain language of the Malpractice Act forecloses any reading under which it is inapplicable as a whole to wrongful-death cases.

¶ 24 Mr. Smith's second proposed construction would narrow the application of the cap to apply only to those damages that are not protected by the constitution. The Malpractice Act provides that

Mr. Smith proposes that we narrowly construe the phrase "noneconomic losses to compensate for pain, suffering, and inconvenience" to refer only to damages for "mental anguish and suffering" because the latter are not protected by the constitution.

¶ 25 As the United States points out, this construction results in a reading of the Malpractice Act that is contrary to our precedent. We previously have noted that damages for "pain, suffering, and inconvenience" provided by this statute "amount to the same measure" as noneconomic loss or general damages.57 Thus, Mr. Smith's proposed reading of "pain, suffering, and inconvenience" as a subset of noneconomic damages is inconsistent with our precedent. And we will not depart from our common-sense precedent to adopt an unnatural reading of the statutory text.

¶ 26 Moreover, Mr. Smith's second proposed construction would vitiate the policy addressed by the Legislature in the Malpractice Act as a whole. The damages cap applies to all medical malpractice cases, only a small subset of which involve wrongful death. Were we to narrowly construe the damages cap on the basis of the constitutional protection for wrongful-death damages, that narrow construction would impact the scope of the cap in all medical malpractice cases, not just those involving wrongful death. This approach would unduly narrow the damages cap imposed by the Legislature. We are unwilling to sacrifice the cap's broader operation in order to avoid its application in the limited number of wrongful-death cases with impermissible constitutional implications. Accordingly, we reject Mr. Smith's second proposed construction.

¶ 27 Finally, Mr. Smith reasons that if the statute cannot be saved through either of the first two alternatives, it must be declared unconstitutional as applied to the class of cases involving damages for wrongful death. The United States has proposed no construction to stave off this alternative. Accordingly, we hold that the damages cap in section 78B-3-410 of the Malpractice Act is unconstitutional as applied to wrongful-death cases.

¶ 28 We are generally reluctant to strike down statutory enactments. But declaring the damages cap unconstitutional in this narrow subset of cases is the only viable approach given the conflicting constitutional and statutory language. The Malpractice Act provides broad procedural safeguards for the medical profession that are applicable in all malpractice cases.58 The Legislature clearly intended for these protections to apply in wrongful-death cases. But when it inserted the damages cap in 1986, it did not account for the constitutionally significant differences between the operation of the cap inside and outside of the wrongful-death context. Had the Legislature intended to abrogate the constitutional protection for wrongful-death damages in the context of medical malpractice, it could have sought an exception to article XVI, section 5 as it did to accommodate the workers' compensation scheme some sixty years earlier. But it did not. Thus, limiting the application of the cap to cases outside the wrongful-death context allows the broadest operation of the legislative scheme.

¶ 29 We note that our holding is limited to those damages that are protected by article XVI, section 5. It has no application in those cases where the alleged medical malpractice does not result in death. And the remaining sections of the Malpractice Act, which have not been challenged in this case, remain in full force in wrongful-death cases.

CONCLUSION

¶ 30 The United States District Court has asked us to resolve the conflict between the prohibition of damage caps in article XVI, section 5 of the Utah Constitution with the cap on noneconomic damages in section 78B-3-410 of the Malpractice Act. The conflict between these two provisions comes to a head in this case, where the alleged medical malpractice resulted in death. We hold that the damages cap in section 78B-3-410 of the Malpractice Act is unconstitutional as applied to cases of wrongful death under article XVI, section 5 of the Utah Constitution.