Youngberg v. Romeo

PETITIONER: Duane Youngberg
RESPONDENT: Nicholas Romeo
LOCATION: Pennhurst State School and Hospital

DOCKET NO.: 80-1429
DECIDED BY: Burger Court (1981-1986)
LOWER COURT: United States Court of Appeals for the Third Circuit

CITATION: 457 US 307 (1982)
ARGUED: Jan 11, 1982
DECIDED: Jun 18, 1982

ADVOCATES:
David H. Allshouse - on behalf of the Petitioners
Edmond A. Tiryak - on behalf of the Respondent

Facts of the case

Nicholas Romeo was a 33-year-old man with the mental capacity of an 18-month-old child. Following the death of his father, Romeo’s mother was unable to adequately care for Romeo and had him involuntarily committed to Pennhurst State School and Hospital (“Pennhurst”) on a permanent basis. During his time in the state facility, Romeo suffered injuries on numerous occasions and was physically restrained at times. Romeo’s mother became concerned, and after objecting to Romeo’s treatment several times, sued the facility on behalf of Romeo. Romeo’s mother claimed that his treatment violated the protections of the Due Process Clause of the Fourteenth Amendment and the prohibition against cruel and unusual punishment in the Eighth Amendment. Specifically, Romeo’s mother claimed Romeo had the right to safe conditions of confinement, freedom from bodily restraints, and access to habilitation (training or treatment with the goal of eventual release).

At trial, the court instructed the jury that they could only find that Pennhurst violated Romeo’s constitutional rights if the officials had been “deliberately indifferent” to Romeo’s medical and psychological needs, and the jury found in favor of Pennhurst. On appeal, the U.S. Court of Appeals for the Third Circuit reversed and remanded for a new trial. The Court of Appeals held the Eighth Amendment’s prohibition of cruel and unusual punishment was inapplicable, because it applies to individuals convicted of crimes, not the involuntarily committed. However, under the Due Process Clause of the Fourteenth Amendment, Romeo had liberty interests in freedom from restraint, safe conditions, and minimally adequate habilitation, which could only be violated if three distinct standards were met. An infringement of the right to safe conditions can only be justified by “substantial necessity,” the right to freedom from bodily restraints can only be infringed for “compelling necessity,” and the access to habilitation must be “acceptable in the light of present medical or other scientific knowledge.

Question

(1) Does the Due Process Clause of the Fourteenth Amendment grant an involuntarily committed patient the right to safe confinement?

(2) Does the Due Process Clause of the Fourteenth Amendment grant an involuntarily committed patient the right to freedom from bodily restraints?

(3) Does the Due Process Clause of the Fourteenth Amendment grant an involuntarily committed patient the right to adequate habilitation?

Media for Youngberg v. Romeo

Audio Transcription for Oral Argument - January 11, 1982 in Youngberg v. Romeo

Warren E. Burger:

We will hear arguments next in Youngberg against Romeo and others.

Mr. Allshouse, you may proceed whenever you're ready.

David H. Allshouse:

Mr. Chief Justice and may it please the Court:

This case involves an action brought under 42 USC Section 1983 by a mentally retarded resident of Pennhurst State School and Hospital.

The plaintiff seeks damages in this action based on his treatment while there from three supervisory officials at Pennhurst.

In the District Court the case was tried before a jury which found in favor of each of the defendants.

On appeal the Third Circuit vacated and remanded the case, holding that the institutionalized mentally retarded had a number of substantive due process rights, including first a right to treatment which must be acceptable in light of present scientific or medical knowledge, and also must be the least intrusive available under certain circumstances.

Secondly, a right to be free of restraint absent a showing of substantial or compelling necessity by the state and also a showing that the least restrictive alternative was used.

And finally, it held that there was a right, a constitutional right to be protected from harm absent a showing by the state of substantial necessity.

It's our--

Do you think there is a body of medical opinion defining what is the appropriate or proper medical treatment for each of the conditions that you're dealing with?

David H. Allshouse:

--No, Your Honor.

As a matter of fact, that's one of the critical flaws in the Third Circuit decision.

This is an area where experts continue to disagree as to the types and benefits of various levels of treatment.

And an example of the way the Third Circuit has ignored this Court's warning as to the fact that courts are poorly equipped to make medical judgments are what it has done with the treatment standards and the particular standards that would apply to the various rights which it found.

For example, it would use such phrases as "least intrusive", "compelling necessity", "least restrictive" to those concepts.

What Judge Aldus referred to as constitutional buzz words?

David H. Allshouse:

Absolutely, Your Honor.

These buzz words are difficult for the health care professionals who are responsible for implementing those standards to understand and apply, and the danger of applying such concepts in this area is to force health care professionals to make decisions not necessarily based on their professional opinion as to what is best for the mentally retarded, but rather on what the Third Circuit would require based on its decision in this case.

A good example of the way in which the Third Circuit has made medical psychological judgments is what it has done with the concept of restraints.

The Third Circuit held that the use of restraints is presumptively punitive, and to quote the court below,

"has been relegated to the closets of an earlier age. "

Nevertheless, federal regulations, the various amici organizations in this Court, and even plaintiffs recognize the use of restraints under certain circumstances.

In addition, in the very limited circumstances where the court below would recognize use of restraints on the mentally retarded, it did so only for protection of the resident himself or for treatment.

Once again, however, the various amici organizations and federal regulations recognize use of restraints in some circumstances either for protection of the resident or for protection of others.

Do we know all these things as a matter of record facts?

David H. Allshouse:

Well, in this case as to the use of restraints, we don't have specific findings by the jury, but the record does reflect that the use of restraints being challenged here is use of restraints which occurred while Mr. Romeo was in the medical ward, the hospital ward at Pennhurst.

Wouldn't you have been better off from the point of view of your position had you let the case go back and be tried to get a full record instead of coming up here in the condition in which it is?

David H. Allshouse:

Your Honor, under the proper standard, which we would urge this Court to adopt, no purpose would be served by a remand.

Under the proper standard the defendants are entitled to judgment as a matter of law.