Court Opinion

ID: 9471890
Source: CourtListenerOpinion
Date Created: 2023-08-05 03:43:32.07155+00
Date Added: 2024-06-11T17:39:05.230598
License: Public Domain

WINTER, Circuit Judge,
dissenting:
Since I believe that Section 504 applies to the provision of medical services to handicapped infants, I respectfully dissent. I would reverse and remand for further consideration of whether the kinds of federal financial assistance received by the defendant hospital subject the hospital to the commands of Section 504 in the case of the infant in question.
I
Section 504 provides that
[n]o otherwise qualified handicapped individual ... shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or. activity receiving federal financial assistance.
29 U.S.C. § 794. It thus states with as much clarity as is reasonably possible that in some circumstances recipients of federal financial assistance may not differentiate between individuals on grounds that one or more is handicapped. The only ambiguity relevant to the present case, I respectfully suggest, is whether the hospital is such a recipient with regard to its obligations to Baby Jane Doe and not whether Section 504 includes the provision of medical services to handicapped infants.
Although modern courts frequently rely upon legislative history to reach results at odds with the seemingly plain language of a statute, only the most compelling reasons should induce a court to override statutory language because the legislative history is silent on a particular point. Such compelling circumstances might exist in the present case if Congress had no reason to address the questions at hand when it enacted Section 504. It hardly needs stating that the underlying issues brim with political and moral controversy and portend to extend the hand of the federal government into matters traditionally governed by an interaction of parental judgment and state authority. Were I able to conclude that Congress had no reason to address these *162issues in its consideration of Section 504, I would concur with the majority on the grounds that specific consideration by the Congress of this political and moral minefield would be appropriate before applying the statute as written.
However, such a conclusion is untenable since Section 504 is no first step into a hitherto uncharted legal wilderness. As the Senate Report stated:
Section 504 was patterned after, and is almost identical to, the antidiscrimination language of section 601 of the Civil Rights Act of 1964, 42 U.S.C. 2000d-1 (relating to race, color, or national origin), and section 901 of the Education Amendments of 1972, 42 U.S.C. 1683 (relating to sex). The section therefore constitutes the establishment of a broad government policy that programs receiving Federal financial assistance shall be operated without discrimination on the basis of handicap.
S.Rep. No. 1297, 93d Cong., 2d Sess., reprinted in 1974 U.S.Code Cong. & Ad. News 6373, 6390. Section 504 was thus enacted against a background of well understood law which was explicitly designated as a guide to interpretation. Congress was persuaded that a handicapped condition is analogous to race and that, so far as the administration of federal financial assistance is concerned, discrimination on the basis of a handicap should be on statutory par with discrimination on the basis of race.
Once Section 504’s legislative heritage is acknowledged, the “void” in the legislative history is eliminated and the many issues raised by defendants with regard to medical decisions, parental judgments and state authority simply evaporate. The government has never taken the position that it is entitled to override a medical judgment. Its position rather is that it is entitled under Section 504 to inquire whether a judgment in question is a bona fide medical judgment. While the majority professes uncertainty as to what that means, application of the analogy to race eliminates all doubt. A judgment not to perform certain surgery because a person is black is not a bona fide medical judgment. So too, a decision not to correct a life threatening digestive problem because an infant has Down’s Syndrome is not a bona fide medical judgment. The issue of parental authority is also quickly disposed of. A denial of medical treatment to an infant because the infant is black is not legitimated by parental consent. Finally, once the legislative analogy to race is acknowledged, the intrusion on state authority becomes insignificant.
The logic of the government’s position on these aspects of the case is thus about as flawless as a legal argument can be. Any doubt must stem not from a deficiency in the argument based on the analogy to Title VI of the Civil Rights Act but from a disagreement as to whether a handicapped condition is fully analogous to race. See American Academy of Pediatrics v. Heckler, 561 F.Supp. 395, 402 (D.D.C.1983). Whether that doubt is justified or not, however, courts are not the proper fora in which the reasonableness of the analogy to race is to be judged.
Selective refusals to be guided by precedents under Title VI of the Civil Rights Act are likely to lead to an incoherent body of interpretative law under Section 504. Ambiguity pervades the majority opinion as to exactly which services and which handicapped persons are excluded from the statute. All one can know for certain is that some medical services may be denied to some handicapped persons, without running afoul of Section 504. The majority even implies, inter alia, that Section 504 may not apply at all to the provision of medical services, since such services are inseparable from treatment decisions. This is in the face of the explicit statement of the Senate Report that it “was enacted to prevent discrimination against all handicapped individuals ... in ... health services,” S.Rep. No. 1297, supra, reprinted in 1974 U.S.Code Cong. & Ad.News at 6388. If that interpretation stands, the handicapped will be deprived of a fairly won political victory and exposed to the possibil*163ity of future decisions excluding other services from coverage by Section 504. On the other hand, the majority opinion also implies that a narrower holding may be intended and that only certain kinds of handicapped persons are excluded. If that interpretation stands, then the federal courts may be forced to resolve individually each of these human tragedies and moral dilemmas. It was Judge Gesell’s prediction in American Academy of Pediatrics, the precedent drawn upon so heavily by the majority, that Section 504 will require line-drawing in individual cases between the extremes of a failure to provide services to a mildly handicapped child and a failure to use heroic measures to prolong for a period of time the life of an infant who has no hope of achieving even minimal consciousness. 561 F.Supp. at 402. Such a reading of Section 504, however, intrudes quite as profoundly upon medical decisions, parental judgments and state authority as the interpretation proffered by the government and thus undermines the reasoning of the majority.
Also, I would respectfully suggest that we act outside our legitimate area of authority in declining to follow the path staked out by Title VI of the Civil Rights Act. Congress did not adopt the analogy to race merely as a legislative means to a policy goal but was persuaded and politically energized by the view that the analogy was correct. A judicial failure to follow the analogy where it leads is an outright disagreement with Congress’ judgment and an unconstitutional act in itself.
Finally, we facilitate the democratic legislative process by applying the analogy to race as adopted by the Congress. A political temptation to avoid confrontations with issues of moral or prudential controversy is an inevitable aspect of legislative deliberations. If courts are perceived as ready to “correct” overbroad legislation, Congress will find it ever more tempting to avoid its responsibility to address and resolve the highly delicate issues which may lurk in seemingly unobjectionable legislative proposals. Rhetorical flourishes will be substituted for statutory precision and “voids” in legislative histories will be ever more frequent. This is particularly so in cases involving legislative analogies to race. The moral and legal successes of the civil rights movement have prompted many groups to seek legislation which puts a particular characteristic or condition on a legal par with race. So long as the courts are perceived to stand ready to consider tempering such legislation where it leads to controversial results, the path of least political resistance will always be for the Congress to avoid serious consideration of the actual consequences of legislating particular analogies to race. Only an apprehension that such legislative analogies will be enforced by courts as written can provide a counter incentive to induce Congress to address its legislative responsibilities.
II
I agree with that portion of the discussion in Part II A of Judge Pratt’s opinion which concludes that we cannot determine on the present record whether the defendant hospital is a recipient of “financial federal assistance” within the meaning of Section 504 and whether the “program or activity” to which that section applies is the entire hospital. I would, therefore, reverse and remand so that the record can be amplified. In light of the pendency of Grove City College v. Bell, 687 F.2d 684 (3rd Cir.1982) cert. granted — U.S. -, 103 S.Ct. 1181, 75 L.Ed.2d 429 (1983) argued Nov. 29, 1983, see — U.S.-, 104 S.Ct. 521, 78 L.Ed.2d 706 (1983) and in view of the majority's decision, further discussion of this issue by me would be superfluous.
For the reasons stated above, I dissent.