Court Opinion

ID: 9457706
Source: CourtListenerOpinion
Date Created: 2023-08-04 20:30:27.765021+00
Date Added: 2024-06-11T17:35:28.391040
License: Public Domain

MOORE, Circuit Judge
(dissenting):
The opening sentence of the majority opinion presents, in my opinion, a quite inaccurate statement of the issue before us. To the many non-judicial issues as to which the federal courts increasingly include under their supervisory jurisdiction, I would not add to our decisions our fiat with respect to “the right of a woman "to decide how many children she shall bear.” This right (better termed “privilege”) exists without the aid of any Women’s Liberation Movement or constitutional protection and will not become State-controlled even in the all-too-rapidly-approaching year, 1984.1 In actuality, this case does not involve this affirmative privilege but, to the contrary, a negative pregnant. In short the plaintiff does not wish to have any more children — at least if she has to become pregnant for this purpose.
The real issue for adjudication can only be formulated after the facts are examined because it would be unwise for a court to disclose its lack of expertise in a field highly controversial amongst medical and psychiatric experts, without a factual background.
Specifically, this appeal is from an order dismissing the complaint — hence, we must turn to the complaint itself to test its sufficiency. In substance, plaintiff sought (a) a declaratory judgment that “the rules and regulations of defendant, Medical Center, regarding sterilization and the action of the defendants in refusing to perform a tubal ligation upon her violate her rights under the First, Fifth, Ninth and Fourteenth Amendments to the Constitution”; (b) an injunction, mandatory in effect, that defendants perform such an operation; (c) that defendants make available the necessary doctors and facilities for this purpose; and (d) damages of $250,000 for the injury caused by defendants’ wrongful actions.
In conclusory generalities, plaintiff alleges :
(a) invasion of her constitutional right to “privacy and liberty in matters relating to marriage, family and sex” *706and “to control of her own person” as guaranteed by the above-specified constitutional amendment;
(b) that she was placed in a precarious situation because “she might have become pregnant against the wishes of herself and her husband”;
(c) that she was deprived of medical care because of the religious beliefs of others (First Amendment violation);
(d) deprivation of equal protection because of financial means;
(e) cruel and unusual punishment (Eighth Amendment) because of “the daily fear of an unwanted pregnancy”;
(f) the right to choose to bear or not to bear children (First, Eighth, Ninth and Fourteenth Amendments); and
(g) invasion of the right of plaintiff and her physicians to receive and give treatment “determined by them to be desired, safe, indicated and proper” (same Amendments as in “(f)”).
Plaintiff further alleges that defendants, “under the color of defendant Medical Center’s rule [“by laws, rules, and regulations of defendant Medical Center did not allow the operation unless the applicant has five children”], refused to permit performance of the sterilization operation as a result of which plaintiff incurred damages.2
Affirmatively plaintiff asked the court to direct the defendants to make available “the doctors, the Medical Center premises and all equipment and support usually attendant thereto so that plaintiff may be sterilized forthwith.”
Here, indeed, is an extraordinary request which asks a federal court to direct a hospital and such surgeons as may be connected with it in the obstetrical and gynecological field to declare as unconstitutional the rules of the Medical Center and, in effect, to substitute its judicial judgment with respect to the medical judgment of the defendants.
Plaintiff asserts that her suit is “ . . authorized by Title 42 U.S.C. § 1983 and is to prevent her from deprivation under color of state law, statute, ordinance, regulation, custom or usage of rights, priveleges [sic], and immunities secured by the First, Fifth, Eight [sic], and Ninth Amendments. . . .” Damages also are claimed.
No “state law, statute, ordinance, regulation, custom or usage” is pleaded or even mentioned in the complaint. In fact, the only reference to the State of New York and the United States is found in the allegation that
“. . . the Medical Center . has been funded, regulated and controlled fully or in part by the State of New York (see Public Health Law) and the United States of America with respect to matters including but not limited to the construction and acquisition of facilities and equipment, licensing, inspection, payments for supplies and services to patients, Medicare and Medicaid, granting of special tax benefits, the setting of standards governing the promulgation of rules and regulations of the Medical Center, and the approval thereof and defendant Medical Center has had delegated to it by the State of New York public functions, including the power to determine with or without a hearing and irrespective of the medical judgment of a patient’s physician, whether or not the patient may receive specific medical care.”
The judgment in effect demanded is that the rules of the Medical Center be declared to be unconstitutional, that a mandatory injunction issue, that doctors and the Medical Center be made available for the performance of a sterilization operation and that because defendants’ alleged refusal was “an exercise in malpractice” damages be awarded.
Upon motion for a preliminary injunction and cross motion by defendants to *707dismiss the complaint, the trial court, upon a stipulation of the parties that plaintiff’s motion “ . . . for a preliminary injunction and other relief be and the same hereby is withdrawn, the defendants having permitted to be performed on the plaintiff the surgical procedure sought by her,” ruled that “ . . the substantive issues before this Court were moot and academic, and that all that possibly remained was a simple cause of action for damages, if any, over which this Court lacks jurisdiction and which could be brought in a state court where all issues could be resolved at a trial in such court.” Accordingly, the Court dismissed the complaint. From this order, plaintiff appeals.
Plaintiff asserts that her suit is authorized by 42 U.S.C. § 1983. Under that section, liability only falls upon a person who acts “ . . . under color of any statute, ordinance, regulation, custom, or usage, of any State or Territory” and thereby subjects another person “ . . .to the deprivation of any rights, privileges, or immunities secured by the Constitution and laws.”
Of plaintiff’s four requests for relief, (2) and (3) are academic because plaintiff no longer needs an order compelling the Hospital to afford her its facilities for a sterilization operation. As to (1), a declaratory judgment that the Hospital’s rules deprived her of her constitutional rights to sterilization, a resolution of this question would seem to be equally academic. This leaves only (4), damages. Query whether such a claim is embraced with § 1983.
The mere fact that New York State has a Public Health Law, gives financial benefits to hospitals, and sets standards for the operation of hospitals in the State does not bestow upon them the character of State agencies. The subject of “state action” was carefully and extensively considered in Powe v. Miles, 407 F.2d 73 (1968) wherein this Court said (per Friendly, C. J., now Chief Judge):
“. . . the state must be involved not simply with some activity of the institution alleged to have inflicted injury upon a plaintiff but with the activity that caused the injury. Putting the point another way, the state action, not the private action, must be the subject of complaint.” Powe at 81.
The Court had no difficulty in finding the liberal arts Alfred University not an arm of the State. As to the New York State College of Ceramics, a quite different situation existed. The State furnished land, buildings, equipment, and met the entire budget “and in the last analysis it can tell Alfred not simply what to do but how to do it.” (p. 83). As the Court said, “The very name of the college identifies it as a state institution.” (p. 82).
In distinct contrast are the defendants in this case. Neither the Medical Center, its Administrator, the Chief of Obstetrics, nor the President of its Board of Managers function under State control or supervision except as general Public Health laws apply to all hospitals. The mere fact that the hospital is available to members of the public is not determinative or even relevant to the issue here. Furthermore, there is no statute wherein the State prescribes standards for sterilization or even delegates to hospitals on its behalf such authority. The Legislature has not presumed to tell doctors, how, when, or why they should operate on a patient.
Plaintiff’s arguments and citation of cases would carry greater weight were they addressed to a statute forbidding sterilization (compare abortion cases) but New York allows sterilization.3 That certain doctors may in a specific case perform, or in specific situations *708are unwilling to perform, a sterilization operation is not due to the compulsion of any State statute or regulation.
The State has an interest in supervising banks, insurance companies and corporations generally, but this does not mean that these institutions are State agencies or arms of the State or that any act on the part of a State-supervised company is done under color of state law. Fortunately for our society, the State has wisely not undertaken to establish medical guidelines and procedures for doctors and surgeons in public hospitals. Of all professions in which the exercise of judgment should be as uncontrolled as possible, it is the medical profession. A legislative determination that sterilization of a young woman would not result in possible psychiatric consequences and that a surgeon must so operate on the request of any member of the public or lose his license would be an enactment scarcely imaginable in the most totalitarian state.
§ 1983 does not bring every conceivable action into the federal courts but is specifically limited to any action taken “. . . under color of any statute, ordinance, regulation, * * * of any State or Territory * * There is no such statute, ordinance or regulation pleaded here. At most it is asserted that this particular hospital had adopted a rule or regulation which “. . .is completely without a medical rationale in that it is not intended to and does not in any way base its limitations on the performance of such surgical procedures on any possible danger or risk to a particular patient from the performance of the operation.” There is no allegation or showing that such a regulation stems from any State statute, ordinance, or regulation. Presumably plaintiff would have us hold that any such rule must be State-oriented because of State funds being received. However, Powe distinctly points to the contrary conclusion.
Consideration must be given to the words up to now omitted in the discussion “custom, or usage.” In other words, is there any custom or usage in the State which forbids sterilization under the circumstances here presented? A negative answer could be found in plaintiff’s complaint and brief. Thus, she alleges (par. NINETEENTH) that “. . . there existed hospitals in other communities in this state and in the United States which would have permitted a sterilization in circumstances such as plaintiff’s.” And in her brief, it is asserted that, “. . . different hospitals in New York State have different rules on sterilization.” (p. 26). Such a situation would belie a custom or usage in the State forbidding sterilization to persons similarly situated.
The subjects of “Custom or Usage” and “State Action” have recently received thorough analysis and discussion by the Supreme Court in Adickes v. S. H. Kress & Co., 398 U.S. 144, 90 S.Ct. 1598, 26 L.Ed.2d 142 (1970). The court there traced § 1983 to its origin in the Ku Klux Klan Act of April 20, 1871, 17 Stat. 13, and concluded that “. the lineal ancestor of § 1983, also indicates that the provision in question here was intended to encompass only conduct supported by state action.” (p. 163, 90 S.Ct. p. 1611) and required “state involvement” (p. 166, 90 S.Ct. 1598) which, if it depended upon custom or usage, '“. . . must have the force of law by virtue of the persistent practices of state officials.” (p. 167, 90 S.Ct. p. 1613).
Whether any of plaintiff’s alleged constitutional claims have any merit is not before us. We are even spared from rendering a declaratory judgment on the wisdom of the rules of the Obstetrical Department or a judicial pronouncement as to how to avoid conception. Plaintiff is now free from the “daily fear” imposed upon her by the doctors’ rules which she regards as irrelevant to her life and thoughts. Her daily “frantic and fearful condition” should now be alleviated since she has become sterilized and she should no longer be in a position to cause “irreparable and psychological injury” to her husband and children.
*709Plaintiff, however, would keep alive the damage portion of her complaint wherein she claims that defendants’ refusal to permit the sterilization operation was “an exercise in malpractice.” To do this plaintiff must still comply with the requirements of § 1983. The conelusory allegation that the State of New York delegated to the Medical Center the power to determine “. whether or not the patient may receive specific medical care” (par. THIRD) is unsupported by any law or statute to this effect and would seem so unlikely of existence that it is insufficient to bring this case within § 1983. As to the public funds allegation, insufficiency is clearly established by Powe.
Plaintiff’s claim does not gain strength merely because all elements except damages have been removed. To recover any damages under § 1983 the same “state action” and “under color of law” prerequisites must be alleged in a non-conclusory manner. This failure is the weakness of plaintiff’s case under § 1983. Since by plaintiff’s concession defendants’ allegedly wrongful conduct was but an “exercise in malpractice,” the trial court was undoubtedly mindful that, if there were any malpractice capable of proof, plaintiff could proceed in a state court without being burdened with the prerequisites of § 1983.
I believe that the majority opinion in its reliance upon § 1983 fails to limit it to its underlying purpose and, by assumptions of non-existent facts with respect to state action, has the potential of injecting the judiciary into the illegal practice of medicine and surgery. Viewed realistically, the doctors, the Medical Center, and the other defendants did not pretend that a State statute, ordinance, rule, regulation, custom, or usage prevented them from operating; it was merely their judgment that the operation was not warranted in this plaintiff’s case. Query whether such a refusal would fit into the category of malpractice; it definitely, in my opinion, did not constitute State action under color of State law.
I, therefore, dissent.

. George Orwell, 1984.

. Pleadings should “allege” not “suggest”, as the majority states, that the Medical Center is a State institution. Such an allegation would then impose on plaintiff the burden of proving the allegation of action taken under color of State law.

. Monroe v. Pape, 365 U.S. 167, 81 S.Ct. 473, 5 L.Ed.2d 492 (1961) does not apply here. The action of the police officers there clearly fell within the category of State action. No allegation is made in plaintiff’s complaint that the defendant doctors are State employees.