Bragdon v. Abbott

Decision Date25 June 1998
Docket Number97156
Citation118 S.Ct. 2196,524 U.S. 624,141 L.Ed.2d 540
PartiesRandon BRAGDON, Petitioner, v. Sidney ABBOTT et al
CourtU.S. Supreme Court
Syllabus*

Respondent is infected with the human immunodeficiency virus (HIV), but had not manifested its most serious symptoms when the incidents in question occurred. At that time, she went to petitioner's office for a dental examination and disclosed her HIV infection. Petitioner discovered a cavity and informed respondent of his policy against filling cavities of HIV-infected patients in his office. He offered to perform the work at a hospital at no extra charge, though respondent would have to pay for use of the hospital's facilities. She declined and filed suit under, inter alia, the Americans with Disabilities Act of 1990(ADA), which prohibits discrimination against any individual "on the basis of disability in the . . . enjoyment of the . . . services . . . of any place of public accommodation by any person who . . . operates [such] a place,'' 42 U.S.C. §12182(a), but qualifies the prohibition by providing: "Nothing [herein] shall require an entity to permit an individual to participate in or benefit from the . . . accommodations of such entity where such individual poses a direct threat to the health or safety of others,'' §12182(b)(3). The District Court granted respondent summary judgment. The First Circuit affirmed, agreeing with the lower court that respondent's HIV was a disability under the ADA even though her infection had not yet progressed to the symptomatic stage, and that treating her in petitioner's office would not have posed a direct threat to the health and safety of others. In making the latter ruling, the court relied on the 1993 Dentistry Guidelines of the Centers for Disease Control and Prevention (CDC) and on the 1991 American Dental Association Policy on HIV.

Held:

1.Even though respondent's HIV infection had not progressed to the so-called symptomatic phase, it was a "disability'' under §12102(2)(A), that is, "a physical . . . impairment that substantially limits one or more of [an individual's] major life activities.'' Pp. ____-____.

(a) The ADA definition is drawn almost verbatim from definitions applicable to §504 of the Rehabilitation Act of 1973 and another federal statute. Because the ADA expressly provides that "nothing [herein] shall be construed to apply a lesser standard than . . . under . . . the Rehabilitation Act . . . or the regulations issued . . . pursuant to [it],'' §12201(a), this Court must construe the ADA to grant at least as much protection as the regulations implementing the Rehabilitation Act. Pp. ____-____.

(b) From the moment of infection and throughout every stage of the disease, HIV infection satisfies the statutory and regulatory definition of a "physical impairment.'' Applicable Rehabilitation Act regulations define "physical or mental impairment'' to mean "any physiological disorder or condition . . . affecting . . . the . . . body['s] . . . hemic and lymphatic [systems].'' HIV infection falls well within that definition. The medical literature reveals that the disease follows a predictable and unalterable course from infection to inevitable death. It causes immediate abnormalities in a person's blood, and the infected person's white cell count continues to drop throughout the course of the disease, even during the intermediate stage when its attack is concentrated in the lymph nodes. Thus, HIV infection must be regarded as a physiological disorder with an immediate, constant, and detrimental effect on the hemic and lymphatic systems. Pp. ____-____.

(c) The life activity upon which respondent relies, her ability to reproduce and to bear children, constitutes a "major life activity'' under the ADA. The plain meaning of the word "major'' denotes comparative importance and suggests that the touchstone is an activity's significance. Reproduction and the sexual dynamics surrounding it are central to the life process itself. Petitioner's claim that Congress intended the ADA only to cover those aspects of a person's life that have a public, economic, or daily character founders on the statutory language. Nothing in the definition suggests that activities without such a dimension may somehow be regarded as so unimportant or insignificant as not to be "major.'' This interpretation is confirmed by the Rehabilitation Act regulations, which provide an illustrative, nonexhaustive list of major life activities. Inclusion on that list of activities such as caring for one's self, performing manual tasks, working, and learning belies the suggestion that a task must have a public or economic character. On the contrary, the regulations support the inclusion of reproduction, which could not be regarded as any less important than working and learning. Pp. ____-____.

(d) Respondent's HIV infection "substantially limits'' her major life activity within the ADA's meaning. Although the Rehabilitation Act regulations provide little guidance in this regard, the Court's evaluation of the medical evidence demonstrates that an HIV-infected woman's ability to reproduce is substantially limited in two independent ways: If she tries to conceive a child, (1) she imposes on her male partner a statistically significant risk of becoming infected; and (2) she risks infecting her child during gestation and childbirth, i.e., perinatal transmission. Evidence suggesting that antiretroviral therapy can lower the risk of perinatal transmission to about 8%, even if relevant, does not avail petitioner because it cannot be said as a matter of law that an 8% risk of transmitting a dread and fatal disease to one's child does not represent a substantial limitation on reproduction. The decision to reproduce carries economic and legal consequences as well. There are added costs for antiretroviral therapy, supplemental insurance, and long-term health care for the child who must be examined and treated. Some state laws, moreover, forbid HIV-infected persons from having sex with others, regardless of consent. In the context of reviewing summary judgment, the Court must take as true respondent's unchallenged testimony that her HIV infection controlled her decision not to have a child. Pp. ____-____.

(e) The uniform body of administrative and judicial precedent interpreting similar language in the Rehabilitation Act confirms the Court's holding. Every agency and court to consider the issue under the Rehabilitation Act has found statutory coverage for persons with asymptomatic HIV. The uniformity of that precedent is significant. When administrative and judicial interpretations have settled the meaning of an existing statutory provision, repetition of the same language in a new statute indicates, as a general matter, Congress' intent to incorporate such interpretations as well. See, e.g., Lorillard v. Pons, 434 U.S. 575, 580-581, 98 S.Ct. 866, 869-870, 55 L.Ed.2d 40. Pp. ____-____.

(f) The Court's holding is further reinforced by the guidance issued by the Justice Department and other agencies authorized to administer the ADA, which supports the conclusion that persons with asymptomatic HIV fall within the ADA's definition of disability. The views of agencies charged with implementing a statute are entitled to deference. See Chevron U.S.A. Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837, 844, 104 S.Ct. 2778, 2782-2783, 81 L.Ed.2d 694. Pp. ____-____.

2.In affirming the summary judgment, the First Circuit did not cite sufficient material in the record to determine, as a matter of law, that respondent's HIV infection posed no direct threat to the health and safety of others. The ADA's direct threat provision, §12182(b)(3), stems from School Bd. of Nassau Cty. v. Arline, 480 U.S. 273, 287, 107 S.Ct. 1123, 1130-1131, 94 L.Ed.2d 307, in which this Court reconciled competing interests in prohibiting discrimination and preventing the spread of disease by construing the Rehabilitation Act not to require the hiring of a person who posed "a significant risk of communicating an infectious disease to others,'' id., at 287, and n. 16, 107 S.Ct., at 1130-1131, and n. 16. The existence of a significant risk is determined from the standpoint of the health care professional who refuses treatment or accommodation, and the risk assessment is based on the medical or other objective, scientific evidence available to him and his profession, not simply on his good-faith belief that a significant risk existed. See id., at 288, 107 S.Ct., at 1131; id., at 288, n. 18, 107 S.Ct., at 1131 n. 18, distinguished. For the most part, the First Circuit followed the proper standard and conducted a thorough review of the evidence. However, it might have mistakenly relied on the 1993 CDC Dentistry Guidelines, which recommend certain universal precautions to combat the risk of HIV transmission in the dental environment, but do not actually assess the level of such risk, and on the 1991 American Dental Association Policy on HIV, which is the work of a professional organization, not a public health authority, and which does not reveal the extent to which it was based on the Association's assessment of dentists' ethical and professional duties, rather than scientific assessments. Other evidence in the record might support affirmance of the trial court's ruling, and there are reasons to doubt whether petitioner advanced evidence sufficient to raise a triable issue of fact on the significance of the risk, but this Court's evaluation is constrained by the fact that it has not had briefs and arguments directed to the entire record. A remand will permit a full exploration of the issues through the adversary process. Pp. ____-____.

107 F.3d 934, vacated and remanded.

KENNEDY, J., delivered the opinion of the Court, in which STEVENS, SOUTER, GINSBURG, and BREYER, JJ., joined. STEVENS, J., filed a concurring opinion, in which BREYER, J., joined. GINS...

To continue reading

Request your trial
1391 cases
  • Scarborough v. Natsios
    • United States
    • U.S. District Court — District of Columbia
    • 20 Marzo 2002
    ...(8th Cir.1998). 11. The words "disability" and "handicap" are used interchangeably in this Opinion. See Randon v. Abbott, 524 U.S. 624, 631, 118 S.Ct. 2196, 141 L.Ed.2d 540 (1998) ("The ADA's definition of disability is drawn almost verbatim from the definition of `handicapped individual' i......
  • Schobert v. CSX Transp. Inc.
    • United States
    • U.S. District Court — Southern District of Ohio
    • 30 Noviembre 2020
    ...identified major life activity." Hentze v. CSX Transp., 477 F.Supp.3d 644, 659–60(S.D. Ohio 2020) (citing Bragdon v. Abbott , 524 U.S. 624, 631, 118 S.Ct. 2196, 141 L.Ed.2d 540 (1998) ).Start with the first element. The definition of "physical impairment" is broad and includes "any physiolo......
  • Messier v. Southbury Training School
    • United States
    • U.S. District Court — District of Connecticut
    • 5 Junio 2008
    ...to which courts and litigants may properly resort for guidance." Id. at 598, 119 S.Ct. 2176 (quoting Bragdon v. Abbott, 524 U.S. 624, 642, 118 S.Ct. 2196, 141 L.Ed.2d 540 (1998) (quoting Skidmore v. Swift & Co., 323 U.S. 134, 139-140, 65 S.Ct. 161, 89 L.Ed. 124 (1944))); See also Helen L. v......
  • Paris v. Arc/Davidson County, Inc., No. 1:02CV01012.
    • United States
    • U.S. District Court — Middle District of North Carolina
    • 25 Febrero 2004
    ...person has a disability under the ADA on a case-by-case basis. Id. at 483, 119 S.Ct. 2139 (1999) (citing Bragdon v. Abbott, 524 U.S. 624, 641-42, 118 S.Ct. 2196, 141 L.Ed.2d 540 (1998) and 29 C.F.R. pt. 1630, App. § 1630.2(j)). "[T]he ADA requires those claiming the Act's protection to prov......
  • Request a trial to view additional results
2 firm's commentaries
  • The Alice in Wonderland world of HUD’s definition of “handicap.”
    • United States
    • LexBlog United States
    • 5 Abril 2024
    ...the terms “handicap,” whereas this document uses the term “disability.” Both terms have the same legal meaning. See Bragdon v. Abbott, 524 U.S. 624, 631 (1988). Bragdon v. Abbott concerned whether HIV infection was a disability as that term is defined in the ADA. As part of its analysis the......
  • Disability Wrongs, Disability Rights
    • United States
    • Mondaq United States
    • 13 Febrero 2013
    ...influences outcomes in litigation and in social policy. The first ADA case to be decided by the U.S. Supreme Court, Bragdon v. Abbott (524 U.S. 624 (1998)), concerned an HIV-positive woman seeking dental assistance. Bragdon refused to treat Abbott. His gut told him that both he and his staf......
90 books & journal articles
  • Genetic Privacy: New Intrusion a New Tort?
    • United States
    • Creighton University Creighton Law Review No. 34, 2000
    • Invalid date
    ...that current statutory protection does not exist. Fentonmiller & Semmel, 10 GEO. MASON U. CIV. RTS. L.J. at 252. In Bragdon v. Abbott, 524 U.S. 624 (1998), asymptomatic HIV infection was held to be a statutory disability. Chief Justice William H. Rehnquist, joined by Justices Antonin Scalia......
  • Is HIV a disability under the Americans with Disabilities Act: unanswered questions after Bragdon v. Abbott.
    • United States
    • Journal of Law and Health Vol. 14 No. 2, June 1999
    • 22 Junio 1999
    ...than 25 occasions since 1987, the Supreme Court has refused to grant writs of certiorari in HIV-AIDS cases. (122) Bragdon v. Abbott, 118 S. Ct. 2196, 2200 (123) See Petitioner's Brief, 1998 WL 4678 at 19. (124) As the petitioner, Dr. Bragdon argued in his brief, it was Congress' intent to a......
  • Disability discrimination
    • United States
    • James Publishing Practical Law Books Texas Employment Law. Volume 1 Part V. Discrimination in employment
    • 5 Mayo 2018
    ...that its standards are not lesser than those applicable under the Rehabilitation Act. 42 U.S.C. §12201(a); see Bragdon v. Abbott , 118 S. Ct. 2196, 2202 (1998). Accordingly, courts and the Equal Employment Opportunity Commission (“EEOC”) have recognized that Rehabilitation Act cases general......
  • Disability Discrimination
    • United States
    • James Publishing Practical Law Books Archive Texas Employment Law. Volume 1 - 2014 Part V. Discrimination in employment
    • 16 Agosto 2014
    ...that its standards are not lesser than those applicable under the Rehabilitation Act. 42 U.S.C. §12201(a); see Bragdon v. Abbott , 118 S. Ct. 2196, 2202 (1998). Accordingly, courts and the Equal Employment Opportunity Commission (“EEOC”) have recognized that Rehabilitation Act cases general......
  • Request a trial to view additional results
1 provisions
  • 29 C.F.R. 1630 app to Part 1630 Interpretive Guidance On Title I of the Americans With Disabilities Act
    • United States
    • Code of Federal Regulations 2023 Edition Title 29. Labor Subtitle B. Regulations Relating to Labor Chapter XIV. Equal Employment Opportunity Commission Part 1630. Regulations to Implement the Equal Employment Provisions of the Americans With Disabilities Act
    • 1 Enero 2023
    ...importance to most people's daily lives"). Indeed, this holding was at odds with the earlier Supreme Court decision of Bragdon v. Abbott, 524 U.S. 624 (1998), which held that a major life activity (in that case, reproduction) does not have to have a "public, economic or daily aspect." Id. a......

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT