While an inmate at Stateville penitentiary, Dennis Anderson was discovered to be infected with the AIDS virus, HIV (human immunodeficiency virus). The virus gradually destroys an essential component of the immune system, exposing the host to opportunistic infections that eventually kill him. In 1992, after being transferred to Joliet, another Illinois prison, Anderson brought suit for damages and an injunction under 42 U.S.C. § 1983. The complaint alleges that defendant Romero, the superintendent of the cell house at Joliet in which Anderson was placed, told defendant Douglas, a guard, in the presence of another guard, to make sure that Anderson was put in a cell by himself because he was HIV-positive. Douglas told at least one other guard that Anderson was HIV-positive. Later Douglas noticed an inmate named Curry sleeping on the floor of Anderson’s cell. (Curry was not Anderson’s cellmate. How he got into the cell is not explained.) He told Curry that Anderson was a homosexual and a faggot and that Curry could catch AIDS from him and so had better stay away from him. On another occasion, while Anderson and Curry were standing next to an ice machine, Douglas said to Anderson, “Get away from the ice machine. Pretty soon you will have the whole institution infected.” Douglas told an inmate barber not to cut Anderson’s hair because Anderson had AIDS. Romero denied Anderson yard privileges for several months, and Anderson believed that this was because he was HIV-positive. All these are just allegations in a complaint; they may be false; but they have not (yet) been denied, and they are not so incredible as to be unworthy of belief on their face. We must therefore take them as true.
The complaint charged that the defendants had violated both Anderson’s constitutional right of privacy and the Illinois AIDS Confidentiality Act, 410 ILCS 305/1
et seq.,
by revealing that he was infected with the AIDS virus, and also that they had deprived him of the equal protection of the laws and of liberty without due process of law by preventing him from having his hair cut and from exercising. All these acts are also charged as cruel and unusual punishments. The defendants moved to dismiss the complaint, citing the qualified immunity of public officers from suits for damages. The judge denied the motion on the ground that there were not enough facts in the record to determine whether the defense of immunity was valid. The defendants appealed. Anderson died of AIDS while the appeal was pending, and after determining that the suit survived his death we appointed his lawyers to carry on the suit as the representatives of his estate.
If a defendant’s immunity from suit depends on a resolution of conflicting factual assertions, or even on determining whether there
is
a contestable factual question material to the defense of immunity, the court of appeals has no jurisdiction to review the denial of the immunity.
Johnson v. Jones,
— U.S. -,
From the district judge’s cryptic discussion we cannot be sure what facts bearing on the defense of immunity he thought in doubt. The only factual uncertainty to which he alluded was whether the defendants had acted pursuant to some duly deliberated prison policy concerning the disclosure of an inmate’s HIV status or had disclosed Anderson’s status “casually,” that is, without reference to any policy. This would be material only if there might be immunity for following a policy but not for acting without reference to a policy. It is not clear how the existence of a policy would affect the issue of immunity, although it could affect the underlying merits of the suit. The parties have not attempted to enlighten us on this score. It occurs to us that by the reference to acting “casually” the judge may have meant acting out of personal spite rather than genuine concern with the danger posed by AIDS, a motivation that could conceivably be inferred from Douglas’s use of the word “faggot.” Proof of spite does not nullify a defense of immunity.
Schertz v. Waupaca County,
So Douglas’s spitefulness, if that is what it was, is irrelevant to the question whether he acted with justification in disclosing Anderson’s HIV status, or more precisely whether it was clear in 1992, when this suit was brought, that in disclosing Anderson’s HIV status Douglas was infringing a constitutional right of a prison inmate to hide his being HIV positive.
Harlow v. Fitzgerald,
A brief sketch of the history of the legal concept of privacy will help frame the issue. The concept originated in a famous article by Warren and Brandéis that found latent in a number of areas of the common law, ranging from copyright to trespass, a policy of protecting people against the invasion of their “private space” (not Warren and Brandeis’s term) and the involuntary revelation of personal, private facts about them. Samuel D. Warren
&
Louis D. Brandeis, “The Right to Privacy,” 4
Harv.L.Rev.
193 (1890). After a lag, the concept proposed by Warren and Brandéis fructified in a distinct, many-branched tort of invasion of the right of privacy, a tort that could be committed by wiretapping and other electronic eavesdropping, by publicity that cast a person in a false light, by publicizing intimate details of a person’s life or person, by intrusive surveillance (as by searching through a person’s private papers), and even by using a celebrity’s name or likeness in advertising without the celebrity’s consent.
Haynes v. Alfred A. Knopf, Inc.,
A right to conceal one’s medical history is readily derivable from the branch of the tort of invasion of privacy that protects people against the indiscriminate publicizing of intimate details of their personal lives. But that branch has evolved mainly as a part of the common law, rather than of the constitutional law, of privacy. Nothing in the Fourth Amendment or in the eases recognizing a right of sexual and reproductive autonomy bears directly on the interest in the privacy of one’s medical records. Although there are cases in which a demand for medical records might be met by a defense based on the Fourth Amendment or even the right of sexual privacy, this case is not one of them.
The strongest precedent in the Supreme Court for recognizing a constitutional right to conceal one’s medical history is
Whalen v. Roe,
None of the cases that have recognized the right involve inmates. Obviously they do not have all the rights of free persons. The Supreme Court has actually held that prison inmates have no right of privacy,
Hudson v. Palmer,
We
cannot find any appellate holding that prisoners have a constitutional right to the confidentiality of their medical records. The closest is
Harris v. Thigpen,
Now, even if there is no such right, we can assume that certain disclosures of medical information or records would be actionable. But they would be actionable under the cruel and unusual punishments clause of the Eighth Amendment rather than under the due process clause of the Fourteenth. If prison officials disseminated humiliating but penologically irrelevant details of a prisoner’s medical history, their action might conceivably constitute the infliction of cruel and unusual punishment; the fact that the punishment was purely psychological would not excuse it. E.g.,
Thomas v. Farley,
But the only question presented by this appeal, so far. as the disclosure of Anderson’s medical situation is concerned, is whether in 1992 the constitutional right of a prisoner in Anderson’s position—that is, a carrier of the AIDS virus—to be free from the specific acts that the defendants are alleged to have committed was clearly established, for if not the defendants cannot be made to pay damages under 42 U.S.C. § 1983. We can recast the issue slightly more concretely as follows: Would a prison employee who was conversant with constitutional ease law have known that he could not do the things that Romero and Douglas did?
Anderson v. Creighton,
We go further: even if a right of prisoners to the confidentiality of their medical records in general had been clearly established in 1992, it would not follow that a prisoner had a right to corieeal his HIV status. There is a great difference, so far as the balance between privacy and public health is concerned, between a communicable and a noncommuni-eable disease. A person with a noncommunicable disease is a danger only to himself, and the compelled disclosure of his condition to others is unlikely to further a legitimate interest of the state. But a person with a communicable disease is a danger to others— a grave danger when as in the case of HIV-AIDS the disease is invariably fatal and has already reached epidemic proportions. The fact that some methods of protecting the public from a communicable disease are barbarous, such as branding, does not entail that all are.
Neither in 1992 nor today was (is) the law clearly established that a prison cannot without violating the constitutional rights of its HIV-positive inmates reveal their condition to other inmates and to guards in order to enable those other inmates and those guards to protect themselves from infection. Cf.
Camarillo v. McCarthy,
Lambda’s amicus brief argues that the best way to reconcile the interests of HIV-positive inmates with the interests of potential targets of infection is by the adoption of what are called “universal precautions,” whereby everyone who may be infected is treated as if he were infected. OSHA requires dentists to protect their staff against the possibility of infection with the AIDS or hepatitis virus by every patient, however unlikely it is that the particular patient is infected.
American Dental Association v. Martin,
Among the alternatives to universal precautions as methods of limiting the spread of AIDS in prison are the segregation of HIV-positive prisoners from the rest of the prison population and the ad hoe warning of endangered inmates or staff. The first alternative has been held to be constitutional against the argument that it results in disclosing the identity of the HIV-positive inmates to the rest of the prison community.
Harris v. Thigpen, supra,
It is true that one of the district court decisions that we have cited, Woods v. White, was affirmed — and by this court. But it was affirmed without a published opinion. The unpublished decisions of this court have no weight as precedent. 7th Cir.R. 53(b)(2)(iv). And, although we cannot find any cases on the point, we are confident that an unpublished decision cannot elevate the decision that it affirms to the status of circuit precedent. Since almost all unpublished decisions are affirmances, the effect would be to create an immense body of precedents consisting of all district court decisions that had ever been appealed and affirmed without a published opinion. Such a result would thwart the purpose of having rules such as 7th Cir.R. 53(b)(2)(iv) that limit the number of opinions citable as precedent. The fact that the district court’s decision had been published would not be a rational basis for relaxing the rule, for the decision to publish or not is made by the district judge rather than by this court. The district court would be shaping the law of the circuit.
The aptness of these reflections is shown by the fact that our unpublished decision- in
Woods
did not in fact affirm the holding of the district judge that prisoners have a right to the secrecy of their HIV status. We expressly declined to reach the question.
Woods v. White,
No. 88-2853, slip op. at 5 n. 7,
A barber, especially if he uses a razor, may cut the skin of the person whose hair he is cutting and if he gets the person’s blood on a part of his skin where he has a cut or abrasion may become infected. The danger, as we said, is slight, though given the violence endemic to American prisons and the prevalence of HIV and AIDS in those prisons cannot be considered entirely fanciful. It is possible that Douglas labored under a profound misconception about how HIV is transmitted (the ice-machine episode suggests that he did), or that his motivation was vindictive rather than protective, or that it would be far more sensible to tell the barber to wear gloves when cutting any inmate’s hair (“universal precautions”) than to warn him about a specific HIV-positive inmate. But these points are wide of the issue whether a prisoner has a constitutionally protected right to the concealment of his HIV-positive status from prison staff. :We doubt that he has such a right; we are sure the right was not clearly established in "1992.
Douglas and Romero are alleged to have done more than warn Curry and the barber. They are alleged to have spread the word generally about Anderson’s status, to have prevented Anderson from getting his hair cut (which is different from warning the barber), and to have denied him yard privileges extended to prisoners not known to be infected with HIV. If, as the cases we have cited hold — we believe correctly, in view of the prevalence of HIV in prisons and the amount of violence and- homosexual intercourse in prisons — HIV-positive inmates can be segregated from the rest of the prison population, it would seem to follow that they can be identified, since segregation automatically identifies them. Identification might be considered a less restrictive means of protecting the rest of the population than quarantining the infective inmates. Lambda’s brief emphasizes the adverse consequences of discrimination against persons known to be infected with the AIDS virus. But the consequences it discusses, such as reduced opportunities for good housing and employment, have no significance in a prison; and the dangers of infection that warrant quarantining the infected population or warning the not yet infected are far greater inside prison than outside. The rape of males is extremely rare outside of prisons; homosexual intercourse is probably less common outside of prisons; and the prevalence of HIV-AIDS is much lower outside of prison. Although an inmate identified as HIV positive may be at greater risk, not of being raped, but of being subjected to other violence, by his fellow inmates, any prisoner who believes that he is at risk from other prisoners can demand to be placed in protective custody. Ill.Admin.Rules, Title 20, §§ 501.300 et seq. If the belief is reasonable, refusal to honor the demand would present a grave constitutional issue under our decision in Billman.
It is one thing to warn other prisoners that an inmate is an HIV carrier; it is another to “punish” him for being a carrier by refusing to allow him to get a haircut or to exercise in the prison yard. Although this is the first appellate case in which these specific modalities of punishing HIV carriers have been alleged, it has long been clear that the Eighth Amendment forbids the state to punish people for a physical condition, as distinct from acts,
Robinson v. California,
The complaint also charges that Anderson had an entitlement to a haircut that the defendants could not deprive him of without giving him due process of law. This has nothing to do with AIDS, but the defendants contend that the right Anderson claims is not clearly established and so they are entitled to immunity from this part of the complaint as well. An Illinois statute provides that “all” facilities of the state’s department of corrections (thus including the Joliet prison) “shall provide every committed person with access to ... barber facilities.” 730 ILCS 5/3—7—2(a). This is mandatory language, and while an element of vagueness is injected by the absence of any indication of how often the inmate is entitled to a haircut (in contrast, the statute says that he is entitled to access to “bathing facilities at least once a week”), the defendants make nothing of this in their appeal and we shall assume therefore that the right to a haircut conferred by the statute is sufficiently definite to count as an entitlement. Nor do the defendants argue that there is an implicit exception for inmates who, being HIV-positive, could pose a danger, however minuscule if proper precautions are taken, of infecting the barber.
Entitlements confer property or liberty rights within the meaning of the due process clauses, rights that a state cannot take away without due process in the sense of notice and a hearing of some sort not here provided to the inmate.
Hewitt v. Helms,
But while this appeal was pending the Supreme Court decided
Sandin v. Conner,
— U.S. --,
To summarize the decision thus far, we hold that Anderson’s claim for damages based on the assertion that his constitutional rights were violated by the disclosure of his HIV status to other inmates or to prison staff, or by other actions taken against him on the basis of his HIV status (except insofar as those actions are alleged to have been taken purely to punish him for that status), is barred by the doctrine of official immunity. His claim to damages based on the denial of barber services in violation of the due process clause is also not barred, at least on the record compiled thus far.
The complaint also alleges that Anderson was denied yard privileges for “several months” and that this denial, regardless of its motivation, constituted cruel and unusual punishment in violation of the Eighth Amendment. The defendants have not appealed from the denial of immunity from this claim, and so we do not decide whether they are entitled to immunity. We offer a few uncontroversial observations for what limited guidance they may provide the district court. To deny a prisoner
all
opportunity for exercise outside his cell would, the cases suggest, violate the Eighth Amendment unless the prisoner posed an acute security risk if allowed out of his cell for even a short time.
Davenport v. DeRobertis,
But these are matters for the district judge to consider in the first instance.
Affirmed in Part, Reversed in Part.
