Document: 422 U.S. 563 95 S.Ct. 2486 45 L.Ed.2d 396 J. B. O'CONNOR, Petitioner,v.Kenneth DONALDSON. No. 74—8. Argued Jan. 15, 1975. Decided June 26, Syllabus Respondent, who was confined almost 15 years 'for care, maintenance, and treatment' as a mental patient in Florida state hospital, brought this action for damages under 42 U.S.C. § 1983 against petitioner, the hospital's superintendent, other staff members, alleging that they had intentionally maliciously deprived him of his constitutional right to liberty. The evidence showed respondent, whose frequent requests release been rejected by petitioner notwithstanding undertakings responsible persons care if necessary, dangerous neither himself nor others, and, mentally ill, not received treatment. Petitioner's principal defense he acted good faith, since law, which believed valid, authorized indefinite custodial confinement 'sick,' even were treated their would be harmful, therefore immune from any liability monetary damages. jury found respondent awarded compensatory punitive codefendant. Court Appeals, on broad Fourteenth Amendment grounds, affirmed District Court's ensuing judgment entered verdict. Held: 1. A State cannot constitutionally confine, without more, nondangerous individual is capable surviving safely freedom or with help willing family members friends, found, upon ample evidence, did so confine it properly concluded violated respondent's Pp. 573-576. 2. Since Appeals consider whether trial judge erred refusing give an instruction requested concerning claimed reliance law authorization continued confinement, court below benefit decision Wood v. Strickland, 420 308, 992, 43 214, scope official's qualified immunity 1983, case vacated remanded consideration petitioner's vel non violating right. 576-577. 493 F.2d 507, remanded. Raymond W. Gearey, Jr., Tallahassee, Fla., pro hac vice, special leave Court. Bruce Ennis, New York City, respondent. Mr. Justice STEWART delivered opinion 1 Kenneth Donaldson, civilly committed Hospital at Chattachoochee January 1957. He kept custody there will nearly years. Dr. O'Connor, superintendent during most period. Throughout Donaldson repeatedly, but unsuccessfully, demanded release, claiming no one, that, rate, hospital providing treatment supposed illness. Finally, February 1971, lawsuit United States Northern Florida, named defendants, liberty.1 After fourday trial, returned verdict assessing both O'Connor Fifth Circuit judgment, 507. We granted O'Connor's petition certiorari, 419 894, 171, L.Ed.,2d 138 because important questions seemingly presented. 2 * Donaldson's commitment initiated father, thought son suffering 'delusions.' hearings before county Pinellas County, 'paranoid schizophrenia' 'care, pursuant statutory provisions have repealed.2 less than clear specifying grounds necessary commitment, record scanty condition time judicial hearing. These matters are, however, irrelevant, involves challenge initial focused, instead, followed. 3 power patient, remained ill lawfully committed.3 Despite many requests, refused allow exercised case. At indicated unable make 'successful adjustment outside institution,' could recall basis conclusion. retired shortly suit filed. few months thereafter, secured restoration competency, support staff. 4 testimony demonstrated, contradiction, posed danger others long indeed point life. conceded personal secondhand knowledge ever act. There suicidal likely inflict injury himself. One codefendants acknowledged earned own living hospital. done some 14 immediately job hotel administration. 5 Furthermore, supported provide might need release. In 1963, example, representative Helping Hands, Inc., halfway house patients, wrote asking its care. request accompanied supporting letter Minneapolis Clinic Psychiatry Neurology, codefendant 'good clinic.' offer, replying released only parents. That rule apparently making. time, 55 old, knew, parents too elderly infirm take responsibility him. Moreover, continuing correspondence parents, never informed them Hands offer. addition, four separate occasions between 1964 1968, John Lembcke, college classmate longtime friend, asked On each occasion refused. shows Lembcke serious person, able assume welfare. 6 simple regime enforced program designed alleviate cure Numerous witnesses, including one codefendants, testified nothing while described 'milieu therapy.' But witnesses context case, therapy' euphemism 'milieu' hospital.4 For substantial periods, simply large room housed 60 whom criminal commitment. ground privileges, occupational training, opportunity discuss repeatedly denied. 7 faith His position, short, given harm one.5 8 instructed should find liberty 9 'confined (Donaldson) will, knowing receiving alleged 10 'Now, purpose involuntary hospitalization mere punishment others. Without such justification stand-point unless you also either others.'6 11 further 12 'reasonably detention proper length . .. 13 'However, intentions do rise reasonable belief required justify (Donaldson's) Hospital.' codefendant, $38,500, $10,000 damages.7 dealing 'the farreaching question guarantees involuntarily hospitals.' F.2d, 509. appellate held when, rationale treatment, Constitution requires minimally adequate fact provided. Id., 521. expressed view regardless civil person institution has 'a receive cured improve condition.' 520. Conversely, court's implied permissible order treat illness, illness renders See id., 522—527. II 16 difficult issues dealt are presented present posture. Specifically, reason now decide themselves compulsory State, may compulsorily non-dangerous, As we it, raises single, relatively simple, nonetheless every man's 17 treatment.8 verdict, based abundant makes issue narrow one. whether, what procedures, which, contemporary statutes, generally advanced person—to prevent public, ensure survival safety,9 Jackson Indiana, 406 715, 736—737, 92 1845, 1857 1858, 32 435; Humphrey Cady, 405 504, 509, 1048, 1052, 31 394. none above case.10 18 Given jury's findings, left keeping confinement? harmless does itself establish confinement. supra, U.S., 720 723, S.Ct., 1849—1851; McNeil Director, Patuxent Institution, 407 245, 248—250, 2083, 2086—2087, 37 719. Nor enough original founded basis, was, initially permissible, continue after longer existed. 738, 1858; supra. 19 finding 'mental illness' alone State's locking up indefinitely Assuming term can reasonably precise content 'mentally ill' identified accuracy, still confining live freedom. 20 May merely standard superior enjoy private community? interest assistance unfortunate goes saying. presence disqualify preferring home comforts institution. arguably save harm, incarceration rarely raising standards those freedom, friends. Shelton Tucker, 364 479, 488—490, 81 247, 252 253, 231. 21 fence solely citizens exposure ways different? well ask avoid public unease, incarcerate all physically unattractive socially eccentric. Mere intolerance animosity deprivation person's physical See, e.g., Cohen California, 403 24—26, 91 1780, 1787—1789, 29 284; Coates City Cincinnati, 402 611, 615, 1686, 1689, 214; Street York, 394 576, 592, 89 1354, 1365 1366, 22 572; cf. Dept. Agriculture Moreno, 413 528, 534, 93 2821, 2825—2826, 782. more agent knowingly III 23 contends event personally liable decisions made faith.' argues acting believed, when compromise safety constitute expected know understood invalid. proposed effect Court.11 24 instruct jury, objection, assessed 'proper,' 'maliciously wantonly oppressively.' approved instructions. error refuse additional Further, recent possessed officials 1983. 214. 25 Under decision, relevant 'knew known took within sphere official violate rights (Donaldson), malicious intention cause (Donaldson).' 322, 1001. Scheuer Rhodes, 416 232, 247—248, 94 1683, 1692, 40 90; 330, 1005 (opinion Powell, J.). purposes question, has, course, duty anticipate unforeseeable developments. 1004. 26 Accordingly, vacate remand enable consider, light Judge's failure regard rendered inadequate instructions damages.12 27 It ordered. 28 Vacated Chief BURGER, concurring. 30 Although I join seems me several factors merit emphasis gives them. add following remarks. With respect damages,1 entirely irrelevant consistently offered him, needed treatment.2 appropriately takes notice uncertainties psychiatric diagnosis therapy, reported cases replete divergence medical vexing area. E.g., Greenwood States, 350 366, 375, 76 410, 415, 100 L.Ed. 412 (1956). Drope Missouri, 162, 896, 103 (1975). Nonetheless, areas agreement among behavioral specialists uncooperative therapy first step effective acknowledgment abnormal condition. Katz, Right Treatment—An Enchanting Legal Fiction? 36 U.Chi.L.Rev. 755, 768—769 (1969). adamant refusal taken into account considering good-faith defense. Perhaps factor referred obliquely opinion. numerous period unsuccessfully sought courts; indeed, last these proceedings terminated prior bringing action. 234 So.2d 114 (1969), cert. denied, 400 869, 104, 109 (1970). Whatever reasons courts' repeated denials relief, correctly resolved tendered them, surely justified approval independent intervening custody. Thus, inescapably related must considered new ordered, Court.3 33 points out, ante, 570 n. 6,-the part realistic cured,' (emphasis added), unequivocally phrase, standing alone, correct statement law. 520 (CA5 1974). plainly holding binds parties courts Circuit. 577-578, 12. importance future litigation area, emphasized Appeals' analysis A. 34 doubt like reason, accomplish due process Specht Patterson, 386 605, 608, 87 1209, 1211, 326 (1967). Cf. re Gault, 387 1, 12—13, 1428, 1435—1436, 527 Commitment legitimate interest, committing particular established appropriate proceeding. Equally important, cease exist. 249—250, 719 (1972); 435 (1972). 35 purported applying principles developing theories perceived traditional bases dangerousness oneself treatment—and stated: '(W)here, 'parens patriae' clause 'To deprive citizen her altruistic theory humane therapeutic then fail violates very fundamentals process." explain conclusion statutes require adjudicated incompetent ordered provided released, Rouse Cameron, 125 U.S.App.D.C. 373 451 More read establishing absolute findings regarding specific focus premise least dangerous, except 38 proposition descriptive traditionally Historically, considerable subsidized foster homes boarding houses benign form assumed responsibility. Until 19th century vast majority restrained poorhouses, almshouses, jails. Deutsch, Mentally Ill America 38—54, 114—131 (2d ed. 1949). institutions early concerned primarily place secondarily 'curing' sent there. 98—113. 39 trend toward expanded, eventually leading schemes protecting persons, dual functions institutionalization recognized. While goals movement range 'cure' places so-called 'dependent insane' again emerged major goal States' programs area century. 228—271; D. Rothman, Discovery Asylum 264—295 (1971). idea origin,4 historical imposing limitation power. Analysis sources likewise lends notion. little exercise police individuals protect society dangers significant antisocial acts communicable disease. Minnesota ex rel. Pearson Probate Ramsey 309 270, 523, 84 744 (1940); Jacobson Massachusetts, 197 11, 25—29, 358, 360—362, 49 643 (1905). Additionally, vested historic parens patriae power, 'persons legal disabilities act themselves.' Hawaii Standard Oil Co., 251, 257, 885, 888, 184 Mormon Church 136 56—58, 792, 807—808, 481 (1890). classic example role undertakes "the general guardian infants, idiots, lunatics." quoting Blackstone, Commentaries *47. 41 Of inevitable consequence exercising ward's substantially restrained, appointed control property, placed third party, however implemented, invoked indiscriminately. minimum, scheme protection rest legislative determination compatible best interests affected class themselves. use alternative forms motivated different considerations, justifications rationalize another. 737 1857—1858. American Bar Foundation, Disabled Law 254—255 (S. Brakel & R. Rock 1971). However, existence limitations advances knowledge, remains stubborn understood, untreatable sense yet discovered rates low. Schwitzgebel, Effective Mental Treatment, 62 Calif.L.Rev. 936, 941—948 (1974). debate uncertainty field tentativeness professional judgment.' 415. Ennis Litwack, Presumption Expertise: Flipping Coins Courtroom, 693, 697—719 (1974).5 Similarly, previously observed, universally recognized fundamental acknowledge cooperate attempting treatment; proportion common phenomenon. U.Chi.L.Rev., 768—769. categories,6 function suffer real sheltered environment. Lake 124 264, 270—271, 657, 663—664 (1966) (dissenting opinion). least, am say legislature powerless kind judgment. B Alternatively, argued patients derives safeguards follows: 44 '(A) principle three central government's detain—that retribution offense; limited fixed term; permitted proceeding where procedural observed—are absent, quid quo extended government And commonly provision rehabilitative treatment.' 522. To extent permit subject's ability society, gravest problems, agree score. suffers equally defects. ground. Developments Law—Civil discussion inflexible concept. Rather, requirements determined instances identifying accommodating society. Morrissey Brewer, 408 471, 480—484, 2593, 2599—2602, 484 2086—2087; McKeiver Pennsylvania, 545—555, 1976, 1986—1991, 647 (1971) (plurality Where claims said reduced substantive safeguards, 'candidly appraised.' 21, 27—29, 1440, 1443—1445. doing judges free notions policy health Constitution. Olsen Nebraska Western Reference Bond Ass'n, 313 236, 246—247, 61 862, 865—866, 85 1305 (1941). 46 sharp departure from, coexist with, principles. matter, presupposes essentially same involved situation seeks individual; assumption, incorrect. elementary unique impose commission offense prohibited enactment. Powell Texas, 392 514, 541—544, 88 2145, 2158—2160, 1254 (1968) Black, J.).7 incongruous, apply quarantine imposed highly 29—30, 362 363. 47 troublesome feature elevate concern right.8 Rather inquiring strict proof periodic redetermination patient's accepts absence insists benefits court, 'compensation' wide abnormalities, prospect especially troubling squared 'courts substitute judgments legislators understanding welfare, instead validity methods selected.' 71, 1466 (Harlan, J., concurring dissenting). adequacy procedure confinements ultimately courts, aided expert helpful. persuaded abandon review. C 48 sum, accept reasoning discern equating unquestioned treatment.9 human behavior things fraught peril irrevocably 'such (them) cured.' Our concepts tolerate 'trade-off.' Because authorizing results, complaint filed behalf fellow entire department Chattahoochee. addition claim, habeas corpus relief ordering class. declaratory injunctive requiring dismissed suit, amended complaint, repeating claim retained prayer eliminated trial. 512—513. 394.22(11) Public Health Code, provided: 'Whenever adjudged restraint self-injury violence shall direct forthwith admission regulations board commissioners institutions, sections 394.09, 394.24, 394.25, 394.26 394.27, disposition ..' Fla.Laws 1955—1956 Extra. Sess., c. 31403, p. 62. 'incompetent' days earlier 394.22(1), 'incompetent sickness, drunkenness, excessive drugs, insanity, condition, incapable caring managing dissipate lose property become victim designing Fla.Gen.Laws 1955, 29909, 3, 831. appear 394.22(11)(a) contemplated 'require(d) others.' certain, 394.22(11)(c) adjudicate 'harmless incompetent' 'not unnecessary 835 added). regard, noteworthy 'Order Delivery Incompetent' Floida 'confinement insure (Emphasis added.) statute whereby secure Whether 'right open dispute. 394.22(11)(a), 'to others' Recently totally revamped provides Fla.Stat.Ann. 394.459 (1973). sole reinstatement competency.' Code §§ 394.22(15) (16), pp. 838—841. Indeed, staff's initiative finally restored liberty, superintendency. always releasing patients—for 'trial visits,' 'home 'furloughs,' 'out discharges'—even though judicially competency. Those conditional releases often became permanent, closed books patient. deny patients; 'duty' determine having once reached hospital.' Christian Scientist, medication. award declined close chief, moved directed This motion 'if defendants declared unconstitutional accountable action.' instruction. defined 'You suggests paragraph out context, bracketed paragraphs making judge's rather self If ambiguous point, objected clarification. so. accordingly here pertinent part, 'The Plaintiff brief throughout Defendants withheld brief, Plaintiff's proper, result mistake, intent. 'In prove Civil Rights Act, burden preponderance facts: 'That '(T)hat Defendants' conduct Federal Constitutional denied phrase explained justifica- tion omission Defendant proximately caused oppressively done.' instructions, see possible went far knew all. nature 'treatment' construe fashion, remain case: wholly sane innocent pose seriously doubted. used 'dangerous himself.' foreseeable risk suicide, literally himself' helpless hazards through efforts aid detailed raised objection presumably clearly broadly defined. despite sufficient 'nonjusticiable' discretion profession. argument unpersuasive. asserted depriving unacceptable suggest present. 435. Neither party defining is, accordingly, or, can, how much suffice purpose. posture 5, During petitioned federal number occasions. None merits, evidentiary held. contended relied unsuccessful actions score requested. Upon remand, 8, needs consideration. holds necessity our vacating deprives precedential effect, leaving Munsingwear, 340 36, 71 36. difficulty hence required; hope sensitive presentation articulation petitioner. reference therapy,' 569, construed disparaging True, being cloak indifference, reality abnormalities respond Also, respond, variety physiological ailments, loosely called treatment,' i.e., comfortable, nourished, protected us baffling psychiatry pretense. counsel failed raise why preserved Editorial, Right, A.B.A.J. 516 (1960). threshold constitutes disease' 'treatment.' Szasz, Health, 57 Geo.L.J. 734 shared characteristics. paranoid schizophrenia, notoriously unsusceptible Livermore, Malmquist, Meehl, Justifications Commitment, 117 U.Pa.L.Rev. 75, 93, 52 (1968), reports introduced unwilling uncooperative. imply conclusions detain commit crimes. notion term' square widespread practice indeterminate sentencing, upper limit life sentence. Even advocates criticized E.G., Ill, Harv.L.Rev. 1190, 1325 pointed touched contexts here. plain, seeking 'without obtaining warranted.' 249, 2086, (972). 1956 hearing County procedurally defective ignored various relating allegations applied served Respondent review latter rulings, involve competency (1967); (1940). singled discriminatory privileges available Florida. differences conditions litigation. supra 723—730, 1850—1854; Baxstrom Herold, 383 107, 86 760, 620 (1966). 'Finally, whatever abused mistreated aggravated quality 'punishment' ill. concluding, therefore, Eighth Amendments. Robinson 370 660, 82 1417, 758 (1962).

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