On June 13, 2014, United States District Court Judge Carol E. Jackson issued a Memorandum and Order decision holding that a former psychiatric inmate was allowed to bring federal civil rights claims under 42 U.S.C. §1983 against hospital personnel when the hospital continued to hold her against her will after authorization had expired. The court also held that at that preliminary stage the former patient could maintain her action for battery for forced drugging. The procedural setting is called “summary judgment,” which is whether, based on facts that are not in dispute, either side is entitled to win as a matter of law. To the extent facts are in dispute summary judgment cannot be granted.
Ruth Pierce, then an 84 year old widow, was court-ordered into the hospital on what is called an ex parté petition upon the allegation that “she had displayed mental instability and threatened bodily harm to others.” Ex parté means without her being informed or given a chance to present her side. Under Missouri law, the hospital had to file a petition for a further period of detention to hold her more than 96 hours. The hospital never filed such a petition and then later tricked Ms. Pierce into signing a voluntary admission form. It came out that it is standard procedure in Missouri to ignore the 96 hour rule.
The defendants, Dr. Pang, and Ms. Moore moved to throw the case out of court on various grounds, such as Ms. Pierce did not file a health care affidavit required in medical malpractice cases and that they were immune.
42 U.S.C. §1983 allows people to sue for violations of federal civil rights, including constitutional rights, against people acting “under color of state law,” meaning implementing state law or acting under the authority of state law. Money damages are allowed as well as injunctions and to obtain rulings on what the law is.
In her Memorandum and Order decision, Judge Jackson took Ms. Pierce’s rights seriously and, reading through it, one gets a sense that the court was offended by the cavalier attitude of hospital personnel towards their patients’ rights. More specifically, the court held that Ms. Pierce was allowed to go forward with her claims against Dr. Pang and Ms. Moore for unlawful psychiatric confinement under the United States Constitution as well as state law claims for false imprisonment, and battery for forced drugging.
More specifically, with respect to being detained without due process of law, the court noted:
To establish a procedural due process violation, plaintiff must demonstrate that she has a protected liberty interest at stake and that she was deprived of that interest without due process of law. “For more than a century the central meaning of procedural due process has been clear: Parties whose rights are to be affected are entitled to be heard; and in order that they may enjoy that right they must first be notified. It is equally fundamental that the right to notice and an opportunity to be heard must be granted at a meaningful time and in a meaningful manner.” “These essential constitutional promises may not be eroded.”
“[F]or the ordinary citizen, commitment to a mental hospital produces a massive curtailment of liberty, and in consequence requires due process protection.” (“It is undisputed that ‘civil commitment for any purpose constitutes a significant deprivation of liberty that requires due process protection.’”). Even where a patient’s initial confinement is founded on a constitutionally sound basis, it cannot constitutionally continue after that basis no longer exists.
With respect to the battery claim, the Court held:
To establish battery based on lack of consent, “a plaintiff is only required to prove the occurrence of unconsented touching.” Therefore, plaintiff must plead and prove that she did not give consent or that she withdrew consent.
Many people have argued that forced drugging that was not properly authorized is a battery and this court agreed.
Ms. Pierce also filed what is known as a substantive due process claim. The Court held:
[T]he state violates substantive due process when it infringes “fundamental” liberty interests, without narrowly tailoring that interference to serve a compelling state interest
In sum, the Court basically held that Ms. Pierce was allowed to go forward with these claims and later set November 17, 2014 as the date for jury trial. However, since then the defendants have moved to file what is known as an interlocutory appeal, meaning to appeal before the case is over and to put the trial on hold until such an appeal is filed. As of this date the court hasn’t ruled on these motions.
The Importance of Taking Such Cases
In my first blog on MadInAmerica.Com, A Three Pronged Approach to Mental Health System Change, I wrote about how taking strategic cases can force changes in the mental health system. It is clear that if the Court’s ruling is upheld, it can result in dramatic improvement in the way people are treated in Missouri psychiatric hospitals.
In my 2008 law review article, Involuntary Commitment and Forced Psychiatric Drugging in the Trial Courts: Rights Violations as a Matter of Course, I point out that while the article specifically addresses Alaska’s involuntary commitment and forced drugging regimes, the same thing happens throughout the country with just the details being different. Ms. Pierce’s case illustrates that this is so.
The Court’s ruling is on all fours with what PsychRights has been asserting since its founding in 2002. I talked about these principles in Role of Litigation in a Strategic Approach to Mental Health System Change (YouTube video of whole talk) at NARPA-the National Association of Rights Protection and Advocacy in 2013. I start talking about these legal principles at 32:36.
Kudos to Jim Bruce for taking this case. We need more like him.
Thanks to Susan Stefan for bringing this decision to my attention.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.