543 F.2d 178 (D.C. Cir. 1976), 75-1074, United States v. Ecker

Docket Nº:75-1074.
Citation:543 F.2d 178
Party Name:UNITED STATES of America v. Lewis C. ECKER, II, Appellant.
Case Date:April 02, 1976
Court:United States Courts of Appeals, Court of Appeals for the District of Columbia Circuit
 
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Page 178

543 F.2d 178 (D.C. Cir. 1976)

UNITED STATES of America

v.

Lewis C. ECKER, II, Appellant.

No. 75-1074.

United States Court of Appeals, District of Columbia Circuit

April 2, 1976

Rehearing En Banc Denied 16 July 1976.

Certiorari Denied Jan. 17, 1977.

See 97 S.Ct. 788.

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W. Anthony Fitch, Washington, D. C., with whom Frederick H. Weisberg, Washington, D. C. (both appointed by this Court) was on the brief for appellant.

Mary-Elizabeth Medaglia, Asst. U. S. Atty., Washington, D. C., with whom Earl J. Silbert, U. S. Atty., John A. Terry and Roger M. Adelman, Asst. U. S. Attys., Washington, D. C., were on the brief for appellee.

Before LUMBARD, [*] Senior Circuit Judge for the Second Circuit, WRIGHT and WILKEY, Circuit Judges.

Opinion for the Court [**] filed by Circuit Judge WILKEY.

Concurring opinion filed by Circuit Judge LUMBARD.

Dissenting opinion filed by Circuit Judge J. SKELLY WRIGHT.

WILKEY, Circuit Judge:

This appeal is from an order entered 27 December 1974 by the district court denying a request by the superintendent of Saint Elizabeths Hospital for the conditional release of one of the hospital's mental patients, Lewis C. Ecker, II. 1 Appellant Ecker urges this court to reverse the decision of the district court and direct that court to order his conditional release in accordance with the conditions outlined in the superintendent's recommendation.

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He bases his attack on the district court's findings of facts and conclusions of law on four separate grounds. Appellant argues (1) that the district court applied an improper standard of review and, regardless of the proper standard, made findings of fact and conclusions of law not based on evidence in the record; (2) that the trial court erred in placing the burden of proof on the patient in this conditional release proceeding; (3) that rejection of the hospital's prescription of conditional release unlawfully deprived appellant of his statutory right to treatment; and (4) that the requirement of district court approval for hospital-initiated, conditional release proposals deprived appellant of equal protection of the laws. We find that the district court was correct in its actions, tested against all four issues raised, and therefore affirm its judgment.

I. FACTUAL BACKGROUND

On 22 May 1967 a twenty-four year old senatorial aide was brutally raped and murdered in her apartment in Southwest Washington, D. C. Six days later Lewis C. Ecker, II, was arrested and charged with commission of these offenses. Upon Ecker's motion for a mental examination to determine his competency to stand trial and his mental condition at the time of the alleged offenses, an order issued transferring appellant from the District of Columbia Jail to Saint Elizabeths Hospital. After almost three months of examination the hospital staff members involved with the case unanimously agreed that appellant was mentally ill, but competent to stand trial, and that the alleged offenses, if committed by him, were caused by his mental illness. Appellant's condition was tentatively diagnosed as sociopathic personality disturbance, sexual deviation (sadism) (with organic features). In addition, the chairman of the hospital staff conference on Ecker's competency concluded that appellant was "one of the sickest people we've ever had in this hospital." 2

Having been found competent to stand trial, appellant elected to waive a jury and submit his case to the court on stipulated facts. Judge John L. Smith of the United States District Court for the District of Columbia found Ecker not guilty by reason of insanity on separate counts of felony murder and rape. At the hearing held immediately thereafter to determine appellant's present mental state, Judge Smith concluded that Ecker was suffering from a mental illness and if released, he would be likely to injure himself or others. 3 Accordingly, Ecker was committed to Saint Elizabeths Hospital pursuant to 24 D.C.Code § 301(d)(1). 4

On 4 January 1973 a letter from the superintendent of Saint Elizabeths Hospital recommending appellant's conditional release was filed in the district court. The superintendent asked the court to approve a conditional release program whereby appellant could attend vocational classes in Arlington, Virginia, and visit his parents' home without hospital supervision. At a hearing on 30 January 1973 the government opposed that portion of the hospital's proposal recommending unsupervised home visitation and took no position on the proposed educational program other than seeking to insure that it was narrowly circumscribed and carefully supervised. Dr. George Saiger, a staff psychiatrist at the hospital and the author of the conditional release proposal, was the only witness at the hearing. At the close of the hearing Judge Smith denied the hospital's conditional release proposal in toto.

Appellant noted an appeal to this court and moved for summary reversal on the

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ground that the district court had abused its discretion in denying the hospital's proposal. On 29 May 1973 this court denied appellant's motion and sua sponte summarily affirmed the decision of the district court. 5

Only three months after this court's decision in Ecker I the superintendent of Saint Elizabeths again certified that appellant was ready for conditional release. The second conditional release proposal differed from the first proposal only in that it outlined several stages whereby appellant's access to the community could be gradually increased at the hospital's discretion. Throughout all stages appellant would be required to live at the hospital and participate in therapy there, but from the first day of his conditional release there would be unsupervised contact with the community.

The government objected to this second proposal, and pursuant to section 24 D.C.Code § 301(e) 6 a hearing was held in the district court. Four expert witnesses testified at this hearing, and all four recommended court approval for the hospital's conditional release request. Three of these witnesses were psychiatrists called by the defense; the fourth was a psychologist called by the government. Judge Smith took the matter under advisement, and on 27 December 1974 entered findings of fact and conclusions of law and an order denying the hospital's proposal.

II. STANDARD OF REVIEW

Ecker complains that the district court applied an overly broad standard of review when it decided to reject the conditional release program proffered by Saint Elizabeths Hospital. In support of his position appellant primarily relies on Tribby v. Cameron. 7 Like Ecker, the patient in Tribby was committed pursuant to 24 D.C.Code § 301(d)(1), which provides that a person tried on a criminal charge and acquitted solely on the ground that he was insane at the time of the offense shall be confined in a hospital for the mentally ill. When the patient in Tribby filed a writ of habeas corpus complaining that he was not receiving adequate treatment, this court held that he was entitled to a hearing and findings on the issue of treatment and remanded the case for further proceedings. In determining the adequacy of the patient's treatment, Senior Judge Edgerton suggested that on remand the district court should apply the following standard of limited judicial review:

We do not suggest that the court should or can decide what particular treatment this patient requires. The court's function here resembles ours when we review agency action. We do not decide whether the agency has made the best decision, but only make sure that it has made a permissible and reasonable decision in view of the relevant information and within a broad range of discretion. 8

We find no basis for concluding that this narrow standard of review on the issue of adequate treatment also applies to hospital certifications for conditional release. Tribby was a "decision relat(ing) essentially to the internal administration of the hospital" 9 and did not involve the public safety considerations inherent in a conditional or unconditional release proposal. When a district court is asked to review the medical judgment of a hospital staff on a question of internal administration its function does "resemble( ) ours when we review agency action," and in deference to medical expertise the hospital should be allowed to operate "within a broad range of discretion." On the other hand, when a district court is asked to review a conditional release certification the basic policy underlying section

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301(e) comes into play, and the court must decide whether the hospital's proposal "provide(s) treatment and cure for the individual in manner which affords reasonable assurance for the public safety." 10

The narrow standard of review described in Tribby only applies when public safety is not a factor; it has no applicability in release proceedings (conditional or unconditional) under section 301(e). 11 To anticipate a bit what may be distilled from our decisions in this field, which we discuss below, the agency analogy is only pertinent within the hospital grounds. In that area we and the district court may give a degree of deference to the hospital's judgment equivalent to the deference we accord agency action; when, and if, the patient is to cross the hospital boundary, then other factors affecting the public come into play, and both the statute and our decisions impose a different role and far heavier responsibilities on the courts.

We turn now to an analysis of section 301(e) and the case law dealing with this statute. The language of the statute itself describes an active, rather than passive, role for the district court:

(I)f, after a...

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