George Mitchell v. State of Washington
818 F.3d 436
9th Cir.2016Background
- George Mitchell, a 59-year-old African-American, is civilly committed at SCC for sexually violent predator status since 2003.
- Mitchell was diagnosed with Hepatitis C in 2000; discussions about interferon and ribavirin occurred from 2003–2005, with initial postponement due to weight loss.
- In 2009, Mitchell requested interferon and ribavirin; Dr. Bell declined citing racial disparities in treatment efficacy and lack of disease progression to justify side effects.
- Mitchell was placed on interferon and ribavirin in 2012, which proved unsuccessful; Mitchell filed suit in 2012 against Dr. Bell, Cunningham, and the State of Washington for unconstitutional medical care and equal protection violations.
- The district court granted summary judgment; on appeal, the Ninth Circuit affirmed in part, addressing Eleventh Amendment immunity, mootness, and qualified immunity.
- Concurrently, a concurrence by Judge Clifton discussed the propriety of strict scrutiny in race-based medical decisions.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Eleventh Amendment damages immunity | Mitchell seeks damages personally from officials. | States officials are immune in official-capacity suits for damages. | Damages claims against individuals in personal capacities not barred; Eleventh Amendment does not bar. |
| Mootness of injunctive/declaratory claims | Injunctive relief still needed to ensure future treatment. | Treatment occurred; no ongoing need; claims moot. | Injunctive/declaratory claims deemed moot. |
| Constitutional violation—medical care standard | Dr. Bell's refusal violated Fourteenth Amendment right to reasonable medical care under Youngberg. | Decision was within professional judgment; not a constitutional violation. | District court summary judgment reversed; strict scrutiny applied due to race factor; violation found. |
| Equal protection—race-based medical decision | Race used as a factor in denying treatment violates equal protection. | Race consideration informed clinical judgment; not unconstitutional under strict scrutiny if narrowly tailored. | Strict scrutiny applied; race-based decision insufficiently narrowly tailored; violation found. |
| Qualified immunity | Dr. Bell violated clearly established rights; officials not entitled to immunity. | Right was not clearly established for the exact race-based treatment context. | Dr. Bell not clearly established; qualified immunity afforded; no damages liability. |
Key Cases Cited
- Ammons v. Wash. Dep’t of Soc. & Health Servs., 648 F.3d 1020 (9th Cir. 2011) (Youngberg professional judgment standard governs protected medical care in civil commitment)
- Youngberg v. Romeo, 457 U.S. 307 (Supreme Ct. 1982) (professional judgment standard for involuntarily committed persons)
- Fisher v. University of Texas, 133 S. Ct. 2411 (Supreme Ct. 2013) (strict scrutiny applies to race-based decision-making)
- Johnson v. California, 543 U.S. 499 (Supreme Ct. 2005) (race-based classifications subjected to strict scrutiny)
- Adarand Constructors, Inc. v. Pena, 515 U.S. 200 (Supreme Ct. 1995) (strict scrutiny for racial classifications)
- Grutter v. Bollinger, 539 U.S. 306 (Supreme Ct. 2003) (context matters in race-based governmental action; narrow tailoring required)
- Pearson v. Callahan, 555 U.S. 223 (Supreme Ct. 2009) (controlling oncerned to whether to address clearly established rights first)