Youngberg v. Romeo

Summary

Nicholas Romeo, a man with a profound intellectual disability who could not speak and needed help with the most basic tasks, lived with his parents in Philadelphia until his father died in May 1974. His mother, unable to care for him or to manage his outbursts, asked a county court to admit him to a state facility, and in June 1974 he was committed to the Pennsylvania institution known as Pennhurst State School and Hospital. There he was hurt on many occasions, by his own violence and by other residents, and for a period in the hospital ward his arms were restrained for part of each day. In November 1976 his mother sued three Pennhurst administrators for damages under the federal civil rights statute. After an eight-day trial in 1978, a jury instructed under Eighth Amendment standards found for the officials. The Third Circuit, sitting en banc, ordered a new trial, holding that the Fourteenth Amendment governed but dividing over the proper test. The question was what the Due Process Clause guarantees to a person whom a state has involuntarily committed and does not release: safe conditions, freedom from bodily restraint, and training, often called habilitation. Romeo's counsel argued that a man confined by the state retains fundamental liberties that may be curtailed only for compelling reasons, and that he was owed minimally adequate habilitation in its own right. Pennsylvania's officials answered that they had provided food, shelter, clothing and medical care, that restraint and training were matters of professional discretion in an underfunded institution, and that the Constitution imposed no duty to provide any particular program. On 18 June 1982 the Court vacated and remanded, with all nine justices agreeing in the judgment. Justice Powell held that Romeo retained liberty interests in reasonable safety and freedom from undue restraint, and that the state must provide such training as is reasonable to secure those interests. Courts were to balance these interests against the state's, deferring to the judgment of qualified professionals: a decision is presumptively valid unless it departs so far from accepted professional standards that no professional judgment was actually exercised. Justice Blackmun, joined by Justices Brennan and O'Connor, concurred to identify two questions the Court left open, including whether training needed to preserve self-care skills a resident brought into the institution is itself constitutionally required. Chief Justice Burger concurred only in the judgment, stating that he would hold that there is no constitutional right to habilitation as such. The library text contains Powell's opinion, Blackmun's concurrence and Burger's separate opinion; the notes of the official report are left out, though a few explanatory notes about the parties and the record appear at the end. The professional-judgment standard became the leading test for claims by residents of state institutions. Pennhurst itself had been the subject of separate class litigation, Pennhurst State School and Hospital v. Halderman, and the institution closed in 1987. The Court later addressed community placement under federal disability law in Olmstead v. L. C. (1999).

Top Lessons

• Liberty that survives commitment

  The Court held that a person lawfully committed by a state does not lose every liberty at the institution's door. Romeo kept interests in bodily safety and in not being restrained without reason, and Powell compared his position favorably with that of convicted prisoners, whose confinement is meant to punish.

• Deference to professionals

  Rather than letting juries second-guess daily decisions in crowded institutions, the Court gave the judgment of qualified staff a presumption of correctness. Supporters saw this as realistic about how institutions work; others worried that it might shield poor practice so long as a professional had signed off.

• Deciding only what the record requires

  Blackmun's concurrence shows the discipline of leaving hard questions for a case that squarely presents them. Because the record did not clearly show what training Romeo sought, the Court declined to announce a broader right to habilitation, while Burger would have rejected that right at once.

Verified Quotes

Medical Lens

A central case in the law of institutional care: it defines what a state owes residents it holds involuntarily and makes the judgment of qualified staff the measure of constitutional adequacy, so that the history of restraint, safety and habilitation in American institutions is read through a standard of professional practice rather than of punishment.

• Opinion of the Court, Part I, paragraph beginning At Pennhurst, Romeo was injured on numerous occasions

  Describes the injuries and the complaint that led a mother to sue the administrators of the institution where her son lived, and the arm restraints later used in its hospital ward.

• Opinion of the Court, Part IV, at the sentence beginning In determining whether the State has met its obligations

  Gives decisions of professional staff a presumption of correctness and acknowledges that such institutions were often overcrowded and understaffed.

• Concurrence of Justice Blackmun, paragraph beginning The second difficult question left open today

  Raises whether training to preserve a resident's existing self-care skills, such as dressing and hygiene, is part of the minimally adequate care the Constitution requires.