697 F. Supp. 1234

John DOE, on behalf of himself and all others similarly situated, Plaintiff, v. Thomas A. COUGHLIN, III, Commissioner, and Raymond Broaddus, Ph.D., Assistant Commissioner for Health Services, Defendants.

No. 88-CV-964.

United States District Court, N.D. New York.

Oct. 14, 1988.

Prisoners’ Legal Services of New York, Poughkeepsie, N.Y., for plaintiff; John Gresham, Geri Pomerantz, Ken Stephens, Law Graduate, of counsel.

Robert Abrams, Atty. Gen. of State of N.Y., Albany, N.Y., for defendants; Alan S. Kaufman, Bruce D. Feldman, Asst. At-tys. Gen., of counsel.

MEMORANDUM — DECISION & ORDER

MUNSON, District Judge.

This court is today presented with the difficult task of first determining the nature and extent of the privacy rights of inmates who have tested positive for exposure to the Human Immunodeficiency Virus (HIV)1 and then balancing that privacy *1235interest against the asserted interest of the New York State Department of Correctional Services (“DOCS”) in establishing a dormitory to house such inmates, all of whom will be transferred there involuntarily. That dormitory is known as “D-2” and is located in the Greene Correctional Facility in Coxsackie, New York. Inmates are purportedly placed in D-2 in order to facilitate and improve the medical care provided them, and to effectuate cost reductions related to the transportation of these prisoners for treatment at the Albany Medical Center. Presently there are 21 HIV positive inmates housed in D-2; all arrived on September 15, 1988, shortly before the cutoff hour set by this court in an order temporarily restraining any further transfers of HIV positive inmates to that dormitory.2

Plaintiff John Doe is an inmate currently confined in the general population of one of New York State’s medium security correctional institutions who has tested positive for exposure to the HIV virus.3 Doe seeks to pursue this action on behalf of a class of inmates confined in the correctional facilities of New York State who have been or will be selected by DOCS to be housed in any separate dormitory set aside at Greene Correctional Facility for inmates who have tested positive for HIV or who have acquired immune deficiency syndrome (“AIDS”) or AIDS related complex (“ARC”). Although a motion for certification has not been made, the court will exercise the power given it by Fed.R.Civ.P. 23(c)(1) to certify class actions “as soon as practicable after the commencement of an action brought as a class action.” See Gore v. Turner, 563 F.2d 159, 166 (5th Cir.1977); 7b C. Wright, A. Miller & M. Kane, Federal Practice and Procedure: Civil 2d, § 1785 at 90-91 (1986). In exercising that power, the court has weighed carefully the factors identified as central to a certification decision.4

*1236In making its ultimate decision on the requested injunctive relief this court treads on relatively unexplored territory. In prior cases, prisoners have typically rested their attacks on such segregated housing on either the due process or equal protection clauses of the fourteenth amendment to the United States Constitution. See, e.g., Cordero v. Coughlin, 607 F.Supp. 9, 10-11 (S.D.N.Y.1984) (rejecting first, eighth and fourteenth amendment challenges to plan segregating AIDS patients from other inmates). Perhaps chastened by the uniform failure of these attacks, plaintiff has chosen the less travelled path marked by the uncertain borders of the constitutionally protected right to privacy. Plaintiff faces an uphill battle. Not only must he demonstrate the existence of the right to privacy, but he must also show that the program as it now exists is not reasonably related to a legitimate penological objective. See Turner v. Safley, — U.S. —, 107 S.Ct. 2254, 2261, 96 L.Ed.2d 64 (1987).

In this Memorandum — Decision and Order the court is not making a dispositive ruling on the merits of the action. Plaintiff merely seeks preliminary injunctive relief. In the Second Circuit it is well established that a party is entitled to such relief upon making either of two showings. Under either alternative, the party must first demonstrate that the injunctive relief is necessary to prevent irreparable injury. Upon meeting this initial burden, the mov-ant must establish either that he is likely to prevail on the merits of the underlying controversy or that there exist sufficiently serious questions going to the merits as to make them a fair ground for litigation, together with a balance of hardships tipping decidedly toward the movant. Abdul Wali v. Coughlin, 754 F.2d 1015, 1025 (2d Cir.1985); Jackson Dairy, Inc. v. HP. Hood & Sons, Inc., 596 F.2d 70, 72 (2d Cir.1979).

An essential component of plaintiff’s argument for injunctive relief is his belief that placement in a dormitory such as D-2 should be voluntary, based on an informed decision made by the inmate. Implicitly, plaintiff recognizes that a properly designed program which segregates patients with AIDS is a worthy objective. It is the involuntariness of the program challenged here that plaintiff believes causes the infringement of his right to privacy.

In determining whether to grant the relief plaintiff seeks, the court first must identify the privacy right implicated by the involuntary transfer of HIV positive inmates to the segregated dormitory. Defendants choose to characterize that asserted right as “the right to keep confidential the possible incidental communication of an inmate's medical diagnosis as a result of a decision by [DOCS] to house the inmates in a particular dormitory.” This characterization is only partly correct. Certainly any communication of the inmate’s medical diagnosis can be said to be incidental in *1237that it would most likely be occasioned by a visual identification of the inmate with those housed in D-2 or by one of several avenues of communication, none of which would be instigated by prison officials.5 Nonetheless, the right asserted here is not properly described by the narrow language chosen by defendants. The means by which the communication is revealed, the “incidental communication,” does not define the right; it merely summarizes the circumstances surrounding the disclosure. Quite simply, plaintiff asserts a right to privacy in preventing the non-consensual disclosure of his medical diagnosis and that of the other class members.6

So defined, that right must be analyzed in light of existing interpretations of the right to privacy. The cases setting forth the general parameters of that right are legion. See, e.g., Carey v. Population Services International, 431 U.S. 678, 684-85, 97 S.Ct. 2010, 2015-16, 52 L.Ed.2d 675 (1977); Whalen v. Roe, 429 U.S. 589, 598-600, 97 S.Ct. 869, 875-76, 51 L.Ed.2d 64 (1977). In Whalen, Justice Stevens spoke for a unanimous court when he identified two interests encompassed by the right to privacy. “One is the m. ‘ddual interest in avoiding disclosure of personal matters,7 and another is the interest in independence in making certain kinds of important decisions.” 8 Whalen v. Roe, 429 U.S. at 599-

600, 97 S.Ct. at 876-77. Both of these interests are directly implicated by the state’s program.

Those who are currently at D-2 and those who would be placed in D-2 all share a common characteristic. Each is fully aware that he is infected with a disease which at the present time has inevitably proven fatal. In the court’s view there are few matters of a more personal nature, and there are few decisions over which a person could have a greater desire to exercise control, than the manner in which he reveals that diagnosis to others. An individual’s decision to tell family members as well as the general community that he is suffering from an incurable disease, particularly one such as AIDS, is clearly an emotional and sensitive one fraught with serious implications for that individual. Certain family members may abandon the AIDS victim while others may be emotionally unprepared to handle such news. Within the confines of the prison the infected prisoner is likely to suffer from harassment and psychological pressures. Beyond the prison’s walls the person suffering from AIDS is often subject to discrimination.9

As Justice Stevens has observed, “the concept of privacy embodies the ‘moral fact that a person belongs to himself and not others nor to society as a whole.’ ” Thom-*1238burgh v. American College of Obstetricians & Gynecologists, 476 U.S. 747, 777 n. 6, 106 S.Ct. 2169, 2175 n. 5, 90 L.Ed.2d 779 (1986) (Stevens, J., concurring) (quoting Fried, Correspondence, 6 Phil. & Pub.Affairs 288-89 (1977)). Implicitly, the Court recognizes the value of making independent decisions concerning one’s self. It may be even more essential for a prisoner than a person who enjoys the freedoms associated with life outside of prison, and the personal strength derived from those freedoms, that the prisoner be accorded the ability to protect and shape his identity to as great a degree as possible.10 There is little question but that the prisoner identified as having AIDS will be severely compromised in his ability to maintain whatever dignity and individuality a prison environment allows.

The court also believes that once the prisoner leaves the prison, he should be burdened with only those residual scars imprisonment must inflict.11 The threat to family life and the “emotional enrichment [gained] from close ties with others,” Roberts v. United States Jaycees, 468 U.S. 609, 619, 104 S.Ct. 3244, 3250, 82 L.Ed.2d 462 (1983), is quite real when an AIDS victim’s diagnosis is revealed. Ignorance and prejudice concerning the disease are widespread; the decision of whether, or how, or when to risk familial and communal opprobrium and even ostracism is one of fundamental importance. Within the jurisprudence concerning the right to privacy, and in recognition of the particularly personal nature of the information potentially subject to disclosure under the state’s program, the court determines that the prisoners subject to this program must be afforded at least some protection against the non-consensual disclosure of their diagnosis. Accord, Woods v. White, 689 F.Supp. 874 (W.D.Wis.1988). The extent of that protection must now be considered.

In the context of prison administration, it is a “familiar proposition that ‘incarceration brings about the necessary withdrawal or limitation of many privileges and rights, a retraction justified by the considerations underlying our penal system.’ ” Pell v. Procunier, 417 U.S. 817, 822, 94 S.Ct. 2800, 2804, 41 L.Ed.2d 495 (1974) (citing Price v. Johnston, 334 U.S. 266, 285, 68 S.Ct. 1049, 1060, 92 L.Ed. 1356 (1948)). Certainly, one *1239of the principal considerations is the maintenance of security within the prison. So explained, courts have upheld numerous limitations upon prisoners’ rights. See, e.g., Pell v. Procunier, 417 U.S. at 827-28, 94 S.Ct. at 2806-07 (first amendment rights permissibly limited by regulation designed to reduce visits for security purposes); Jones v. North Carolina Prisoners’ Union, 433 U.S. 119, 132-33, 97 S.Ct. 2532, 2541-42, 53 L.Ed.2d 629 (1977) (security concerns regarding prisoners’ efforts to form unions justified limitations on various first amendment rights); Bell v. Wolfish, 441 U.S. 520, 556-57, 99 S.Ct. 1861, 1883-84, 60 L.Ed.2d 447 (1979) (pre-trial detainee’s reasonable expectation of privacy within cell based in the fourth amendment lessened in deference to security measures); Block v. Rutherford, 468 U.S. 576, 586, 104 S.Ct. 3227, 3232, 82 L.Ed.2d 438 (1984) (limitations on contact visits upheld in deference to security concerns).

In summarizing the rationale of these cases, and in the interest of stating definitively what standard should govern review of prison regulations in such cases, the Supreme Court has recently stated that “when a prison regulation impinges on inmates’ constitutional rights, the regulation is valid if it is reasonably related to legitimate penological interests.” Turner v. Safley, 107 S.Ct. at 2261. In Turner, the Court set out a four part test designed to guide a court’s application of this reasonableness standard. First, there should be a “ ‘valid rational connection’ between the prison regulation and the legitimate governmental interest put forward to justify it.” Turner, 107 S.Ct. at 2262 (quoting Block v. Rutherford, 468 U.S. at 586, 104 S.Ct. at 3232). Second, the court must determine “whether there are alternative means of exercising the right that remain open to prison inmates.” Id. Third, there should be “consideration [of] the impact accommodation of the asserted constitutional right will have on the guards and other inmates, and on the allocation of prison resources generally.” Id. Finally, the court should determine the availability of other, ready alternatives. Id. Concerning this final factor, the Turner Court emphasized that it was not setting up a “least restrictive alternative” test. The reviewing court may consider the availability of an “alternative that fully accommodates the prisoner’s rights at de minimis cost to valid penological interests [as evidence] that the program does not satisfy the reasonable relationship standard.” Id.

Before considering the reasonableness of the program DOCS seeks to impose, the court notes that the defendants have asserted only one relatively incidental security rationale for this program.12 Moreover, it is clear that what DOCS seeks to institute at Greene is not a regulation directed at limiting any specific conduct on the part of inmates, the typical subject of regulations infringing constitutional rights. See, e.g., Id. at 2262-67 (upholding limitations on inmate-to-inmate correspondence; striking regulation burdening inmate’s right to marry). The privacy right at issue in this case is passive in nature, and does not involve an inmate’s affirmative conduct. Thus, this case is somewhat distinguishable from those which led to Turner, and from Turner itself. Nonetheless, Turner does provide a good starting point for the court’s analysis of the program.

The general parameters of the program were revealed to the court during two days of hearings. DOCS has cleared D-2, an open dormitory housing unit, of all its inmates for the purpose of providing bed space for 50 inmates who are HIV positive. Each of the affected inmates is ambulatory, and in correctional parlance, is said to be “fully programmable”. Each will be eligible to participate in and intermingle *1240with other prisoners during all activities conducted outside the dormitory. Thus there is no suggestion that these prisoners are being segregated in order to protect others from infection with the virus.

It is the state’s intention to provide a trained counselor who apparently will be available to the D-2 inmates for at least one shift during the day. Nursing care will be available for 16 hours per day from a person stationed within the dormitory. The state also indicates that a correctional officer will be stationed within D-2 during the day so that any inmate who tires during programming can be escorted back to his bed and guarded while he rests. All other dormitories remain closed during programming.

Perhaps of greatest significance to the well-being of the prisoners, DOCS indicates that a clinic will be established at the prison for the treatment of the inmates in D-2 and others within the state system. The clinic will be established in conjunction with the Albany Medical Center, a leading facility in the treatment of AIDS. Currently, state prisoners needing treatment for the virus are transported to the medical center from numerous prisons to the north and west of Albany. Many of these prisoners face long hours of possibly debilitating transport. Meanwhile, DOCS incurs transportation expenses which could be greatly reduced if the AIDS patients were centrally located at Greene given that facility’s proximity to the Albany Medical Center.13

Turning to the first prong of the Turner framework,14 it is readily apparent that DOCS seeks to further legitimate interests through the program. Improving and expediting medical care for inmates with AIDS is not only a desirable objective, it is a highly commendable one. Similarly, the effectuation of budget reductions through the elimination of certain transportation costs can only benefit the prison system by making funds available for other programs, or for the state’s other budget needs.

Unfortunately, these objectives are served in a constitutionally impermissible manner. Without question, those assigned to D-2 will be known by guards and the general prison population to be infected by the HIV virus.15 And as noted earlier, these inmates also face a substantial risk of having their diagnosis revealed to family *1241members and friends.16 To justify these invasions, the state argues that its program is the most appropriate means of accomplishing its interests. As noted, inmates within D-2 who need treatment do realize one significant benefit; even without the establishment of a clinic within Greene, these prisoners can be treated at Albany Medical Center without the rigors of many hours of travel. Concomitantly, DOCS saves on transportation costs and eliminates some of the logistical concerns associated with the bringing of prisoners to the medical center. Nonetheless, these benefits are insufficient standing alone to warrant permitting infringement of the prisoner’s right to privacy.

Before stating the reasons for this determination, the court emphasizes that it undertakes its analysis, and considers the alternatives available to DOCS not for the purpose of instructing DOCS how to run its prisons. The court is fully aware of the oft-stated admonition concerning the limited role courts should take when the administration of prisons is at issue. See, e.g., Turner v. Safley, 107 S.Ct. at 2259. Notwithstanding that admonition, the court is also cognizant of “an alternative that fully accommodates the prisoner’s rights at de minimis cost to [the department’s interests].” Id. at 2262.

As observed earlier, plaintiff does not disagree with the concept of establishing a dormitory for the housing of prisoners in need of treatment for AIDS. His objection centers on the involuntary placement of inmates in D-2; his solution hinges on granting to the inmates the right to choose whether they wish to be housed in D-2. In effect, plaintiff argues that inmates ought to retain the power to make an informed decision as to a waiver of their constitutional right to privacy. Testimony from two of the defendant’s witnesses makes clear that the inmate’s objective can be achieved at only a de minimis cost. Commissioner Coughlin testified that D-2 is primarily a diagnostic dormitory. At some point, presumably within a short period after arrival at Greene, the inmate is examined by medical personnel for a determination of whether he is in need of what the commissioner characterized as “treatment.” It is apparent that the commissioner did not mean treatment generally, but rather that he was considering the treatment which he believes will ultimately be available in D-2 since at least some of those in D-2 were already receiving some type of treatment for their condition before they arrived at Greene. The commissioner testified that after diagnosis, the medical staff might determine that the inmate should not be placed in D-2, or that even if his condition warranted placement there, DOCS would honor an inmate’s informed decision17 to refuse such treatment.18 In either case, *1242the inmate would no longer be housed in D-2, yet his privacy rights would have been violated.

*1241Q: Well, I take it it’s also your position that inmates do not have a right to refuse the benefits which you’re offering them in dormitory D-2?
A: Oh, I think if the inmate after evaluation says I don’t want this treatment, then I’ll move him from D-2;
Q: We got 21 people in there right now, Mr. Coughlin, are you willing to move them out?
A: After evaluation. Remember, Mr. Gresham, this is a diagnostic unit. If they are seen, our physicians in their medical judgment feel that these people should be seen, if after they’ve seen, they are seen by Albany Medical Center and Albany Medical Center says that these people are not appropriate for treatment, then they’ll be moved out. If ...
Q: Let’s suppose ...
A: Can I finish my answer? If after they’re seen and Albany Medical Center says they are appropriate for treatment, and the inmate says I don’t want the treatment, then I’ll move him out.
Q: You certainly aren’t according the inmate a right to refuse being transferred there in the first place?
A: He doesn’t have the right, Mr. Gresham.

*1242As a solution to this predicament, the plaintiff proposes that the informed decision be made before the prisoner is brought to Greene. Testimony of defendants’ medical expert, Thomas Fordham Brewer, M.D., indicates that the principal difficulty with such a proposal is the systematic unavailability of personnel trained to diagnose and then counsel the prisoner. Thus, argues Brewer, a central facility must be developed at which qualified personnel can inform the inmates of their alternatives. This court does not question Brewer’s conclusion. Nonetheless, implicit in his testimony, and quite evident from the testimony of Commissioner Coughlin, is the fact that the inmate will be granted the option of deciding whether to remain in D-2. Undeniably then, what DOCS is truly seeking is the right to place an inmate in D-2 involuntarily during the period when his diagnosis is undertaken and prior to the time when an informed decision can be made.

Returning briefly to consideration of the benefits currently realized by the program at Greene, it appears abundantly clear that those benefits can be realized equally well through placement of inmates in general population at Greene prior to the time when he can make his informed decision. Without any of the stigma arising from placement in D-2, DOCS will still have the well recognized right to involuntarily transfer to Greene those prisoners it believes may benefit from the program in D-2. See, e.g., Hewitt v. Helms, 459 U.S. 460, 468, 103 S.Ct. 864, 869, 74 L.Ed.2d 675 (1983) (transfer of an inmate to less amenable quarters for non punitive reasons within power of prison authorities). Moreover, DOCS will be fully able to conduct its diagnosis and counsel the prisoner regardless of where the inmate is housed within Greene. The prisoner, in turn, will not be stigmatized unless he chooses to be housed in D-2.

The court is unaware of what the expected turnover rate will be in D-2; nonetheless, with a total of only 50 beds, that turnover will evidently not be great. There is simply no reason why DOCS can not, once the program is fully operational, place a sufficient number of prospective D-2 inmates within the general population, undertake the necessary diagnostic procedures, and thereby retain a pool of inmates ready to accept a bed in D-2 when one becomes available. All of the identifiable benefits will be realized; and there will, at worst, only be a de minimis impact on the program. Moreover, DOCS will eliminate what strikes the court as the very real and disturbing prospect of permanently stigmatizing an individual solely for the purpose of determining if he might benefit from placement in D-2.

Finally, before returning to a discussion of injunctive relief, the court will briefly discuss other facets of the program it finds disturbing. Commissioner Coughlin testified that guidelines have not yet been formulated for the selection of inmates for placement in D-2. One inmate testified that he expected to be released in November of this year. Coupled with the testimony of Doctor Sharpe that some inmates with AIDS are treated only once every several months, it is readily apparent that this inmate or some other inmate might very well be placed in D-2 and have his diagnosis revealed, yet never receive treatment. Another inmate testified that he voluntarily took a blood test in February of this year, was informed that the results would be kept confidential, yet he found himself transferred to D-2. He testified that he is not receiving any treatment. It baffles this court as to why such an individual should be placed in D-2. It certainly does not baffle the court as to how it occurred when the Commissioner has testified that formal written guidelines have not yet been formulated for the selection of inmates.19

*1243As currently funded and equipped, prisoners’ constitutional rights are being violated by a program which offers very few of the benefits it is capable of providing. As commissioner Coughlin testified, the counselor for D-2 has not been selected or trained, nor have nurses been hired. Defendant Broaddus testified that the New York State Legislature has not yet appropriated funds for these positions. Similarly, the proposed clinic has not been established; at this point it is unclear what space, if any, will be provided for the treatment personnel at the prison, and it is equally uncertain as to how frequently the clinic’s services will be made available.

Most important of all, however, is the fact that those benefits which are offered could be provided equally well, with no more than de minimis costs to the program’s objectives, in a program designed to allow the prisoner to choose whether he wishes to be housed in D-2. The commissioner of corrections has indicated that inmates with AIDS effectively have this power. There is no acceptable reason why a prisoner must have his constitutional rights violated, particularly in an incomplete program, during the short period necessary to diagnose and counsel him.

In conclusion, the court finds that the plaintiff has established that he and others in the class are likely to suffer irreparable harm. Plaintiff has also established to the court’s satisfaction that he is likely to prevail on the merits of this action, assuming no major changes in the program take place prior to a full hearing. Moreover, the court also believes that, given the various areas of concern identified by the court, there are serious questions going to the merits as to make them a fair ground for litigation. Again barring any major changes prior to a full hearing on the merits, the balance of hardships tips decidedly toward the movant.

Therefore, the court will grant the plaintiff’s request for preliminary relief. The defendants are enjoined from making any further involuntary transfers of inmates who have tested positive for HIV to any separate dormitory set aside at the Greene Correctional Facility for such inmates.20 This relief will remain in effect until such time as a full hearing can be held on the merits and a further decision is rendered by the court.

It is So Ordered.

Doe v. Coughlin
697 F. Supp. 1234

Case Details

Name
Doe v. Coughlin
Decision Date
Oct 14, 1988
Citations

697 F. Supp. 1234

Jurisdiction
United States

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