Opinion ID: 2279740
Heading Depth: 2
Heading Rank: 1

Heading: The District's Limited Constitutional Duty

Text: The Supreme Court has held that federal and state governments have a non-delegable duty, based on the Eighth Amendment to the Constitution, to provide adequate medical care to persons incarcerated within their prison systems. See West v. Atkins, 487 U.S. 42, 54, 108 S.Ct. 2250, 2258, 101 L.Ed.2d 40 (1988). Further, the Court has held that a private physician treating prison inmates under a contract with a state is a government agent, acting under color of authority sufficient to hold the state liable under federal civil rights statutes, such as 42 U.S.C. § 1983, for damages resulting from the physician's deliberate indifference to the medical needs of the inmates. Id. at 55-56, 108 S.Ct. at 2258-60. Such deliberate indifference to serious medical needs of prisoners constitutes the `unnecessary and wanton infliction of pain' ... proscribed by the Eighth Amendment. Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 291, 50 L.Ed.2d 251 (1976) (citation omitted). Proof of such indifference may be manifested by prison doctors in their response to the prisoner's needs or by prison guards in intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed. Id. at 104-05, 97 S.Ct. at 291 (citations omitted). With respect to medical treatment, however, an inadvertent failure to provide adequate medical care cannot be said to constitute [a violation of the Eighth Amendment]. Id. at 105, 97 S.Ct. at 292. Although a state has a constitutional duty to provide for the basic human needs of anyone whose liberty it has restrained, and although medical care is included among those basic human needs, De Shaney v. Winnebago County Dep't of Social Services, 489 U.S. 189, 200, 109 S.Ct. 998, 1005, 103 L.Ed.2d 249 (1989), the state also has considerable discretion in determining the nature and scope of its responsibilities. Youngberg v. Romeo, 457 U.S. 307, 317, 102 S.Ct. 2452, 2459, 73 L.Ed.2d 28 (1982). What these and similar cases say, in essence, is that an allegation of medical malpractice alone will not support a claim that a prisoner's Eighth Amendment rights have been violated. Thus, to prove a constitutional violation in providing medical services, a prisoner must show conduct so extreme that it surpasses simple negligence. See Ancata v. Prison Health Services, Inc., 769 F.2d 700, 705 (11th Cir.1985); Henderson v. Harris, 672 F.Supp. 1054, 1063 (N.D.Ill.1987) (Contracting with private health services agencies will not relieve the federal government from its constitutional obligation (citations omitted)). [5] Although appellant occasionally refers in her brief to a possible constitutional duty on the part of the District, she makes no substantial Eighth Amendment claim, nor did she do so in the trial court. Instead, she appears to contend that the District has only a general, non-delegable duty to prevent the commission of simple medical malpractice on prisoners in its custody. If such a duty exists, therefore, it must be found outside the confines of the Constitution.