Opinion ID: 545510
Heading Depth: 2
Heading Rank: 2

Heading: Equal Protection under the Fourteenth Amendment

Text: 45 Leckelt also contends that the defendants violated his right to equal protection under the Fourteenth Amendment. As the Supreme Court stated in City of Cleburne, Tex. v. Cleburne Living Center, 473 U.S. 432, 105 S.Ct. 3249, 87 L.Ed.2d 313 (1985): 46 The Equal Protection Clause of the Fourteenth Amendment commands that no State shall 'deny to any person within its jurisdiction the equal protection of the laws,' which is essentially a direction that all persons similarly situated should be treated alike.... The general rule is that legislation is presumed to be valid and will be sustained if the classification drawn by the statute is rationally related to the legitimate state interest. Id. 105 S.Ct. at 3254 (citations omitted). 47 A plurality of the Court in Cleburne went on to hold that handicapped persons--there, the mentally retarded--are not a quasi-suspect classification calling for a more exacting standard of judicial review than is normally accorded economic and social legislation. Id. at 3255; see id. at 3256 (Heightened scrutiny inevitably involves substantive judgments about legislative decisions, and we doubt that the predicate for such judicial oversight is present where the classification deals with mental retardation.). But see id., 105 S.Ct. at 3260 (Stevens, J., joined by Burger, C.J., concurring) (rejecting clearly defined standards of equal protection review based on the differing classifications of affected persons); id. at 3263 (Marshall, J., joined by Brennan, J., and Blackmun, J., concurring and dissenting) (endorsing heightened scrutiny of classifications involving the mentally retarded). 48 According to Leckelt, the plurality in Cleburne, notwithstanding its explicit language to the contrary, in effect applied some form of intermediate scrutiny. See id. at 3263-64 (Marshall, J., dissenting); L. Tribe, American Constitutional Law Sec. 16-31, at 1595 n. 20 (2d ed. 1988). Leckelt, therefore, contends that a classification involving handicapped persons must have a medically reasonable basis in order to be upheld under the equal protection clause. In support of this contention, Leckelt relies on this Court's opinion in Brennan, where we assume[d] without deciding that our 'rational basis' scrutiny of governmental decisions based on mental or physical handicaps is somewhat closer than usual. 834 F.2d at 1258. 49 Compelled by the clear expression of the Supreme Court in Cleburne, Leckelt, 714 F.Supp. at 1390 n. 8, the district court held that TGMC's infection control policies are rationally related to a legitimate state interest of protecting patients and health care workers from the spread of infectious or communicable diseases. Id. at 1390. The court also upheld the defendants' actions under the heightened scrutiny of the Louisiana Constitution. See La.Const. Art. 1, Sec. 3. The Court stated, The state had a substantial and compelling interest in preventing the spread of HIV infection or AIDS to hospital patients and co-workers, in preventing the spread of highly contagious diseases to HIV victims with impaired immune systems, and insuring that health care workers can safely and adequately perform their jobs. Leckelt, 714 F.Supp. at 1391. 50 Even if some form of heightened scrutiny were applicable to classifications involving handicapped persons, we conclude that no equal protection violation was established. As discussed above, TGMC required its employees to report exposure to any infectious or communicable disease and to undergo testing and working restrictions where necessary. For example, a health care worker who was exposed to HBV, a blood-borne disease like HIV, was required to be tested serologically and, if infected, to take at least three weeks' leave of absence. The November 1985 CDC guidelines provided that a health care worker who was relevantly exposed to HIV also should be tested periodically for seropositivity to HIV antibodies and, if infected, should be counseled and evaluated as to whether any work restrictions were appropriate. In light of its infection control policies and these guidelines, TGMC requested that Leckelt submit the results of the HIV antibody test that he had voluntarily taken on his own initiative. Likewise, at about the same time, TGMC requested that an RN, who had recently been exposed to HIV through a needle stick, undergo HIV antibody testing and submit those results to TGMC. 21 Under the circumstances, there was a reasonable medical basis for suspecting that Leckelt had been exposed to HIV and for requiring that he submit the results of his HIV antibody test. We therefore conclude that TGMC had a substantial and compelling interest in enforcing such infection control policies. 51