Bragdon v. Abbott

LOCATION: Randon Bragdon's Dental Office

DOCKET NO.: 97-156
DECIDED BY: Rehnquist Court (1986-2005)
LOWER COURT: United States Court of Appeals for the First Circuit

CITATION: 524 US 624 (1998)
ARGUED: Mar 30, 1998
DECIDED: Jun 25, 1998

Bennett H. Klein - Argued the cause for the respondents
John W. McCarthy - Argued the cause for the petitioner
Lawrence G. Wallace - Department of Justice, on behalf of the United States, as amicus curiae, supporting the respondents

Facts of the case

During a visit to her dentist's office, in order to fill a cavity, Sidney Abbott disclosed that although she did not manifest any obvious symptoms she carried the human immunodeficiency virus (HIV). When her dentist, Randon Bragdon, refused to treat her in his office, offering to conduct any necessary work at a hospital for no extra charge other than use of the facilities, Abbott challenged his policy as discriminatory. After both a federal trial and an appeals court ruled in Abbott's favor, Bragdon appealed and the Supreme Court granted certiorari.


Can a physician refuse or alter care of an HIV-positive patient without violating the equal treatment stipulations of the Americans with Disabilities Act of 1990 (ADA)?

Media for Bragdon v. Abbott

Audio Transcription for Oral Argument - March 30, 1998 in Bragdon v. Abbott

William H. Rehnquist:

We'll hear argument first this morning in Number 97-156, Randon Bragdon v. Sidney Abbott.

Mr. McCarthy.

John W. McCarthy:

Mr. Chief Justice, and may it please the Court--

Some risks are acceptable.

We know when we build a major bridge or a tunnel that there are risks of death during the course of construction, despite reasonable precautions, but these risks are acceptable because there are benefits to society and because the workers are not compelled to participate.

Ms. Abbott and her supporters believe the risk to the lives of dentists is outweighed by providing inoffice treatment to HIV positive patients without additional precautions.

Dr. Bragdon believes that when he provides service in the face of the risk of death, he should be allowed to take additional precautions.

This raises one of the fundamental questions in this case.

What is the proper legal standard for determining when to impose liability on a dentist facing a claim of discrimination under the Americans With Disabilities Act when the direct threat provisions are implemented?

Ruth Bader Ginsburg:

Mr. McCarthy, may I ask you to clarify at the outset whether you recognize that once the symptoms are visible, what is now described as AIDS, once a person has that disease, that that would constitute a disability?

John W. McCarthy:

I think that's very likely, Your Honor, but our position is that the definition applies for disability, and the definition is when there's a physical or mental impairment and here we're talking about HIV, that substantial limits a major life activity, if that comes into play, then the person's disabled, then it seems very likely it would come into play if a person had visible symptoms of HIV disease.

Anthony M. Kennedy:

You concede there is a physical impairment, or don't you?

John W. McCarthy:

I don't... we don't concede that, although we see the force of the respondents' argument on that issue.

We note that the Fourth Circuit in Runnebaum found that there was no physical impairment and we're unwilling to concede that issue when a circuit court of appeals has made that finding.

Sandra Day O'Connor:

I thought it was curious that the American Medical Association took the position that it is a physical impairment under the act from the beginning, and the dental association, on the other hand, takes the opposite view.

John W. McCarthy:

Well, I'm not sure what position the dental association takes with regard to physical impairment.

We don't think that it's really essential to the arguments that we are making in this matter.

Our arguments are directed to disability and... rather than a physical impairment.

There was, it appears to us, a great deal of confusion about those terms in Congress, where Congressmen and women sometimes didn't seem to understand the difference between impairment and disability.

Sandra Day O'Connor:

Well, the act seems to go further, and say if someone is regarded as having the impairment it's covered.

John W. McCarthy:

I think that the language of the act says, if someone is regarded as having such impairment, and when they say such impairment they're referring to an impairment that substantially limits a major life activity, so the regarded as only comes into play if you have an impairment that substantially limits a major life activity.

William H. Rehnquist:

Was that issue argued in the First Circuit, the regarded as?

Was that point argued in the First Circuit, or--

John W. McCarthy:

In our view it wasn't really argued aggressively, but the issue has appeared.

The Solicitor General, or the Department of Justice raised it in the First Circuit.

William H. Rehnquist:

--Had it been raised in the district court?

John W. McCarthy:

I believe the respondent believes that it has, and the record is somewhat ambiguous on that.

Anthony M. Kennedy:

Really a pretty skimpy record on that point.

John W. McCarthy:

There's a very skimpy record on that issue.

Ruth Bader Ginsburg:

But you are contending that a rational Congress would draw the line and exclude from this protection a person whose symptoms are not yet visible, yet include someone who would pose perhaps at least equal danger whose symptoms are visible?