James Covington v. David W. Harris

COVINGTON, Appellant, James HARRIS, Appellee.

David W.

No. 21935. Appeals States

United Circuit. District of Columbia

Argued Dec. March

Decided hospital, pend-

committed to the and the ing charge murder dismissed. Ever original since his confinement he has lodged continuously been in the John (maximum security) Pavilion. Green, Asst. U. S. Mr. Thomas C. Though Q. 52, the risen to I. has Bress, Atty., G. Messrs. David with whom says suffering he from is still Q. Nebeker, Atty., U. and Frank S. syndrome. the same motion, Atty., the on Asst. U. S. were Generally, during years , ten in John his appellee. Howard, appellant by all accounts has Halpern, whom with Mr. Charles R. patient, cooperating been a model with Rosenberg Stephen on the Mr. was B. staying the staff and Un- out trouble. motion, opposition appellant. der the influence medication he has Judge, Fahy, Before Chief Bazelon, signs shown no In overt of violence. Judge, McGowan, Senior Circuit December, 1966, experi- while under an Judge.* Circuit mentally dosage medication, reduced having he confessed “murderous BAZELON, Judge: Chief thoughts” towards some his fellow dis- District Court heard The patients, thoughts but these were stilled corpus peti- appellant’s missed habeas by dosage. restoring his full Consider- seeking the maxi- from tion transfer ing improvement record and the he this security pavilion of Saint Eliza- mum during confinement, had shown Hospital restrictive beths to some less supervising Weickhardt, physician, Dr. only appellant appeal ward. On this September, recommended in that he order, that also contests this but asserts be transferred out of maximum se- from he is entitled to released Saint curity The division. recommendation altogether of numer- Elizabeths because disapproved Acting Superintend- was alleged proceedings in the ous defects Harris, brought whereupon appellant ent Appel- leading to commitment. his civil corpus this habeas in District action summary af- promptly moved for lee pro se, explaining he “would that grounds the record that firmance on get grounds like to on I out where denying adequately supports the order ground privileges and catch a little is- transfer and that none fresh- air.” presented appellant sues now raises was hearing Judge Sirica, In a before Dr. Thereupon, appellant requested below. Weickhardt stood his recommenda- summary transfer issue reversal tion, stating appellant that while argument Be- further others. intelligence, never achieve normal record, in the we cause deficiencies long as he such as takes medicine remand, final think rather than getting tranquilizer— he now —a disposition, serve inter- would best long and as. as he refrains from the justice. ests alcohol, get use think he can I that along supervision. well under I unable, however, The doctor had been Appellant de- was convicted second Superintendent ap- gree convince a 14- murder in 1942 and served pellant, freedom, might permitted year more prison In soon aft- sentence. begin alcohol, “unpre- again charged to use release, with er his he was consequences.” dictable found with time he was murder. This thought prudent it a full more to wait incompetent to stand trial because year thoughts” Q.] psy- after deficiency "murderous “mental I. [38 episode risking reaction,” before a less restrictive confined chotic and was régime. Judge complained civilly Sirica he he was Elizabeths. Saint participate Judge in the case. decision remand this McGowan did Circuit uncommon, money “why Superintendent while not itself couldn’t see formally in John Howard accept of the doctor contraband advice doesn’t time,” Appellant found he had but Pavilion. said man all the that sees money courtyard where others until the case decided to continue gambling, in- had advertently had transfer been he reconsidered had neglected in, turn it sched- in December as recommendation uled, though year “mur- he done so. he knew should have end of the at the Despite that, thoughts.” had the fact will- derous fully rules, violated course he was hospital did not reconsider only incriminating by reporting himself decision; indeed, not have even theft, Dr. concluded Weickhardt request.1 formally reconsidered Covington reg- rdingly, if Mr. back cannot follow the Acco Judge February, 1968, ulations about contraband in Maxi- before court * * Building *, Security mum he now reversed But Hart. Dr. Weickhardt a would be less inclined to to recommend even follow his and field refused all, supervision. the them where there is less unkindest cut the transfer. change of doctor the reason said Finally, the noted that doctor appel in which heart was an incident had in committed murder after 1942 patient had reported lant that another money. altercation over small sum money from The authorities stolen him. appellant’s He conceded behavior in that found patient and accused searched the money calmly reporting in- the instant drugs, dollars contraband five and some was, contrast, cident to his “much including liquid. pills pink This and a credit,” Super- he the but surmised that discovery of infer set in a train motion might pos- intendent “felt be a there which, according Weick ences to Dr. things sibility hap- that like would this hardt, cumulatively appel fatal were pen again pa- another between him and hopes. Appellant’s was lant’s medication ” * * * tient. though pink liquid. medici other And evidence, liquids pavilion On this the court dismissed the nal administered in petition, relying analysis Superintend- pink, though the on was the also no were performed transfer, drug deny ent’s initial decision to the confiscated by any appel unopposed decision medical if it could now determine have been authority. lant’s, though appellant that testified given pills that he and was never II obliged pink always to swallow his summary liquid presence of On its motion for af an attendant— the firmance, deny appellee concluded not that does nonetheless Dr. Weickhardt appellant may discovery pills pink out of John from and seek transfer corpus. liquid It thief was rea Pavilion via habeas that “there corpus is well lenges some deal settled chal son to think there had been habeas that * * * ings [appellant] place and the fact of well as between confinement,2 challenged money patient about even that, drugs.” Moreover, place particular ward,3 appears hospital it is a lodged records, Bonner, 242, Appellant’s 2. In re 151 U.S. 14 S.Ct. appeal presented (but 323, (1894) ; this court on 38 L.Ed. 149 Lake v. Court) Cameron, U.S.App.D.C. 264, the District make no mention 364 F. request (1966) (en banc), denied, transfer after 2d 657 cert. September 863, 126, wait decision to until 382 U.S. 86 S.Ct. 15 L.Ed.2d may be, however, Overholser, 100; U.S.App. December. Miller v. complete since, (1953). not a set records F.2d 415 D.C. though not filed until December were entry Overholser, is December the last dated Miller v. 31, 1967. Fahy specifically particular Judge page ward is delineated John Howard 630.8 Pavilion.4 Rather, says appellee under Ill governing judicial review

the standard ** concerning internal decisions “permissible A deci- Tribby v. administration articulated Tribby one sion” v. Cameron9 Cameron,5 question not whether demonstrably of “the account takes decision, made the best has principal relevant information.” only whether judicial purpose of of ad- limited review action is to insure ministrative permissible made and reason- has (1) a rea- decision-makers have reached of the relevant able decision in view decision, (2) range soned and not unreasonable information a broad and within criteria, by employing proper of discretion.6 (3) overlooking anything of sub- without Appellee the District that since submits stantial More this the hospital’s relevance. than implicitly de- found do, pretend probably reasonable,” courts do “permissible cision competent “clearly are not do. To do less finding er- since roneous,” abandon interests affected no issue there is substantial power Appellant, absolute administrative appellate determination. officials. hand, the hos- on the other asserts carry

pital manifestly its bur- failed to only judicial principle Not proof therefore en- den and that is of review, Amer whole scheme of summary titled to reversal. government, ican reflects institution agree alized of mistrust such unchecked appellee that Trib with We power by and applicable of unbalanced over essential standard states depend liberties. judicial predicate for That mistrust does not But review. venality range assumption on an of hospital’s inveterate of discretion” “wide incompetence gives part Tribby of men under a record which is power, Presidents, legislators, they made decision has been assurance administrators, judges, or doctors. It “in of the relevant information.” view nature, nature, is not present doctors’ but human record We cannot tell from the prospect which from the consider such information was benefits whether Indeed, supervision. Accordingly, the fact ed or neither not. since judicial scope objects limited of hos parties review of the clarification necessarily record,7 decisions assumes we District remand good professional expertise expand faith and proceedings Court for further findings of fact. staff. Judicial review the record and make only against fallibility safety a scope proceedings catch on remand The men; accurately opinion best of not the least of required supra 4; Cameron, U.S.App.D.C. Cameron, 8. v. note Cf. Stultz 127 4. Stultz v. Cameron, U.S.App.D.C. (1967) (en 519, 324, Rouse 125 F.2d 520-521 383 ; 366, 451, (1966) 374, 458 F.2d banc). 373 Overbolser, In Miller v. note 2. F.2d 104 5. 126 Miller, we remanded a similar assertion (1967). right of a within Saint to transfer Elizabeths F.2d at 105. 6. Id. at find- with instructions it make a urges alternative, us 7. ing to the conditions supplemental record on for a to remand necessary, confinement, receiving, ad- during question, oral the transfer pleadings in that ditional and evidence argument stated the Government * * regard F.2d *. Id. at objection the court have no “would at in order to a remand would felt Supra issue.” on this more evidence take unique spur to double- that John Howard is a service them is to its services provide Elizabeths. performance and Saint their check own they a checklist them with appears that John Howard houses readily may do so. “criminally principally the so-called in- hearing ex- almost dealt below The have, in sane.” facilities Such appel- single clusively issue past, notoriously se- rivalled maximum dangerousness to others. potential lant’s curity prisons pervasiveness of however, question, wheth- libérty upon their total- restraint and the enough dangerous appellant was er dignity. ity impositions upon of their confinement, but require continued predecessor Pavil- to John Howard properly confined he could whether ion at Saint Elizabeths was described of maximum conditions this court as in- appears to question That detention. place a lent, criminal, for the confinement the vio- besides other considerations volve insane, hopeless instead dangerousness. potential abstract * * * designed place op- a erated for the of the mental- Consequences A. Confinement * * *11 ly ill. in John Howard Pavilion. Howard, appellant Of the John change request for a A mere says in his brief: dormitories or for transfer between sub sup physically prison. John Howard a stantially wards could not similar in; they Its inmates are locked corpus. port petition A a for habeas ground privileges, no their outdoor ac- seeking placement patient of his review tivities a are conducted in walled-in at least within the must show yard yard; prison identical to their that there are differences substantial only visitors for a be received of confinement between conditions' minutes, prison- few and then in to be. where he is and where he wants visiting room; like are denied such need not decide when We whether many access to the recreational showing request for could made educational to other facilities available John transfer from than a service other patients hospital. at the alleges Appellant’s petition in Howard. right only Thus, to a substance that he has there to con- is reason believe that Howard, kept anywhere normally in John in John is not finement contemplated Howard necessary petition premise civilly pa- of such for committed persons designation they refers who This to there were “difficult were because civilly Id., committed but are not been assaultive.” description criminal confined a result of rather of How- A more recent John they proceedings, ard, are in- either because im- recommendations competent pending report provement, to stand trial is contained in the of charges found or because have been In- ad hoc committee of the National an guilty by insanity (“The of a reason of Evalua- of Mental Health stitute Security Programs In How- criminal offense. John and Facili- tion of population comprised Hospital,” “es- ard’s was No- ties at Saint Elizabeths sentially prisoner patients.” 1968), portions all Hear- of which are at- vember Opera- ings Appendix opinion. on the an Administration tached as this Hospital tion Saint Elizabeths before Overholser, 11. Miller v. of the House Committee Subcommittee Labor, [hereinafter on 206 F.2d at 419. 107, Education Herold, Hearings”] Cong., “1964 In Baxstrom v. 383 U.S. 88th 1st Sess. 760, 15 (1964), (1964) (testimony 113, 86 Dr. S.Ct. L.Ed.2d 620 Dale C. Supreme Cameron, Superintendent took note of Eliza- of Saint Hospital). patients “striking” between Dan beths Of the 380 dissimilarities Howard, thirty only were New "York for the then in John nemora —-the “criminally patients (of York’s insane” —and “civil” New which hospitals. 6000), then “civil” housed some and those few extraordinary depriva- and, vass less tients and entails restrictive alternatives none, finding liberty dignity make which tions of consider the effect of it, effect, penitentiary deprivations than such more extreme on in his treat- provides hospital, if it also ment. even some treatment. Availability B. The Less Restrictive Alternatives. entertaining peti appellant’s In evidently pro tion, the District Court Cameron,13 we Lake assumption ceeded on reasonable reviewing corpus held in on habeas designation that, se “maximum civilly patient’s committed confinement in curity implies, confinement service” hospital, in a mental the court should impose in fact sub John Howard does satisfy disposi itself that no less onerous stantially greater con deprivations than tion purpose of the com serve hospital. anywhere else finement thought principle mitment. We this (cid:127) However, appellant made no record implicit provisions the Dis that he was except to note matter Hospitalization trict of Columbia ground privileges. We do denied Mentally authorizing III Act14 the com assumption dispute the District Court’s mitting court consider alternatives concerning Howard. of John the nature hospitalization15 evincing pro Indeed, con our further observations congressional found concern for the lib cerning inadequacy of the record rest leg mentally erties of the ill. The new However, assumption. on the same however, apart, islation principle only Congress are since and the courts the least restrictive consist alternative operations of beginning to examine legitimate ent purposes with the of a Elizabeths,12 is desirable Saint very commitment inheres nature par fully informed the courts commitment, of civil entails ex equipped to re ties. court A better traordinary deprivation liberty justifi exceptional view a decision only respondent able when is “mental justified liberty if it restrictions ly likely ill to the extent that he is precision what reasonable knows with injure persons himself or other al are. those restrictions liberty.”16 lowed to remain at A stat sanctioning ute a drastic such curtail about nature facts rights ment of the of citizens must-fee-' peculiarly John Pavilion are narrowly, grudgingly, even construed in knowledge hospital, within the liberty deprivations order avoid properly part of and were process without due of law.17 remand, de now case On below. principle \ re- If the least velop the record. those facts equally applicable says, strictive alternative is they then before are as now dispositions to within a mental denying appellant’s request for alternate trans hospital. guard obliged It to makes little sense hospital to can- fer both the Aptheker Secretary State, e.g., Hearings 17. v. See, of 378 before the Subcom 12. Cf. 500, 514, 1659, Rights 84 12 U.S. S.Ct. L.Ed.2d the of mittee on Constitutional (1964). proc- Judiciary It is of due 992 an axiom on the Committee Senate that ess the Constitutional Bill to Protect a though purpose Cong., governmental Mentally Ill, the Rights even 88th legitimate substantial, pur-' Hearings, (1963) ; that be 1964 12 Sess. 1st pursued by pose means that cannot 10. broadly personal stifle fundamental lib- 13. 364 F.2d 657 the be more erties when end can nar- (1966). rowly legis- of achieved. The breadth abridgment must be viewed in lative (1967). 21-591 14. to D.C.Code 21-501 §§ light for the less drastic means achieving purpose. same basic the (1967). (b) § 21-545 D.C.Code Tucker, Shelton v. 364 U.S. (1960). 247, 252, (1967). 5 L.Ed.2d 21-544 S.Ct. § D.C.Code personal physician or patient’s against possibility un- to zealously the the hospi- request.21 provided attorney upon prior It deprivations to warranted periodic hos- only the the watch talization, to abandon reconsideration — hospi- pital, by physicians, disappears the patient behind outside the once disposi- range hospitalization possible need courts —of the tal The doors. prescribed mentally person in detail It ill within itself.22 even of a tions might security hospital out- con- to the hospital, maximum when how from incoming patient status, as as that trol mail and other communica- almost wide compelled patient,23 commit- dispositions to and it felt tions without. hospital expressly unneces- more to no authorizes affirm the ment statute range right sary former “reason- still retains the to make restrictions within regarding latter. rules visitation hours than it does within the able telegraph telephone facil- the use of only feature distinctive pervasive These limitations ities.” suggesting dispositions intra-hospital hospital’s own run its discretion to might subject a different to shop negate any repeal in the intent con they involve rule is fact ordinary statutory pre- same breath the hospital administration siderations sumption liberty in- or to in favor of entrusted, in in the first which are accountability hospital from all sulate the stance, hospital Efficient authorities. right. protection of for its require the does administration Thus, much courts to accord the administrators before court can deter determining ap hospital’s in mine that to con broader discretion decision intra-hospital dis propriateness patient of an in a fine maximum assaying is, discretion, position “per need in than ward within broad * * rec hospitalization ab But initio. missible and reasonable ognition hospital’s primary information,”25 re view of the relevant scope sponsibility, narrow reflected hos- must able to conclude that judicial Tribby Cam- review inade- has considered and found prin-] eron,18 quate dispositions not detract from does all relevant alternative beyond ciple Moreover, hospital. that additional restrictions we within the necessarily by hospitaliza-' Cameron, entailed has those noted Lake v. the state justification obligation need of Lion as much in are liberty; deprivations any exploration of to bear the burden of judicial preclude review nor all does it indigent possible can- alternatives an of internal decisions. * * Appellant not bear *. Act,19 Congress required carry scotched In the 1964 burden not public showing availability notion that a of alter- Proceedings involving are temple mortals is a into which mere natives. rudely mentally It marched ill allowed and treatment of the care gaze./^ sanctorum, very strictly adversary proceedings. where into sanctum are made, and purely Moreover, appellant plainly are medical decisions does right cognizable judicially established a to ascer- know and lacks the means alternatives, any, instructed tain treatment.20 what keep available, government records all detailed knows administered, knowing available and to make them means of has the Supra 21-547, 21-546, note 5. 21-548 22. D.C.Code §§ (1967). Supra 19. note 14. (1967): (a) (b) 21-561 23. D.C.Code § (1967) ; v. 20. 21-562 Rouse § D.C.Code Cameron, supra (1967). (c) note 8. 24. 21-561 § D.C.Code 21. Id. Cameron, Tribby supra 25. 6. note

625 public hospitalized hos- person A a the court therefore assist shall, dur- for a mental illness acquiring information.26 such ing hospitalization, to entitled be intra-hospital duty explore al- to psychiatric treat- medical and care and security to maximum confine- ternatives ment.29 hardly as an in- ment can be assailed may hospital provision, the Under that on the administrators. tolerable burden making required be that it is Professionally, show a vol- doctor even owes improve or “a bona fide effort” to cure patient of al- untary canvass careful pro- patient, and that the treatment He treatment. owes ternatives drastic particular vided “is to his suited patient confined at least as much to a 30 needs.” against for his will. The instant record is devoid evi- Appellant that does not contend alternatives dence that an evaluation of right statutory he has been denied his that was made. At it shows most is an treatment. But since treatment thought hospital appellant should be justifying purpose of civil essential * * closely supervised protection of for the commitment, “permissible years, In ten never others. has been patient decision” to under maxi- confine a unruly.27 medica- violent or Under full mal restrictions cannot made with- tion, expressed “mur- he has not even therapeutic out con- consideration may thoughts,” medication derous sequences. That of con- .conditions maxi- course administered outside a may significantly finement enhance Appellant security mum asserts ward. given patient’s recovery retard security hospital has other open to doubt. wards, depriva- imposing the extreme prop- hospital, milieu Pavilion, tions John * * * erly structured, a con- supervision provided. can be well; getting for structive force may not for These wards be suitable improperly is a force constructed appellant, dis- the record does not remaining sick.31 hospital close a reasoned conclusion that remand, hospital On not. may confine- It “be assumed opportunity will show in its maximum in a [or ment security it has considered alternative is beneficial ward] ‘environ^ 32 to ex- accommodations for therapy’ if in for all.” Even plain why inadequate. it finds them security 'confine- some cases maximum positively therapeutic, cases ment is such C. Relation of Confinement exceptional. meth- .Whatever Treatment. applied, 'the ultimate od of treatment law, present prin involuntarily Under goal therapy persons justification cipal involuntary hos up their hospitalized to shore must be treatment, pitalization prospect satisfactorily capacity in the to function provide and a failure to treatment would outside unrestricted environment of ques goal “serious constitutional is un- appears world. 28 Congress Accordingly, tions.” has patient has likely if the achieved provided that opportunity for controlled little no Supra, 13, U.S.App.D.C. (1967). 26. 124 note at 21-562 D.C.Code § 267-268, F.2d at 660-661. Cameron, supra 28, 125 Rouse v. note Indeed, U.S.App.D.C. 371, records at 456. 373 F.2d at regularly permit- show that he has been supra 10, Hearings, 23-24 31. 1964 note large work with knives and other ted to (Testimony Superintendent Dale Dr. sharp broom instruments Cameron). C. shop. Cameron, Cameron, U.S.App.D.C. 32. Rouse v. 28. Rouse v. (1967). 366, 370, at 456. 373 F.2d F.2d According- 21-562, experiments Congress expressly pro- with freedom. C.Code § ly, rarely civilly patients are vided committed that all,33 sent at John Howard Pavilion to public The administrator of each hos- typical program at treatment the detailing pital keep shall records all are Saint for few who Elizabeths those psychiatric medical and care and treat- envisages transfer into housed there hospitalized person ment received regime.34 progressively less restrictive for a mental the records illness and may appellant that benefits be available, per- upon shall be made that security therapeutically from maximum authorization, son’s written his to at- confinement, such or that in his case torney personal physician. or The rec- neutral, therapeutically confinement preserved by shall ords the ad- that, though most to the an obstacle person ministrator until been the has rapid progress, effects its detrimental discharged hospital. from the outweighed the on are treatment his Plainly, appellant’s attorney could have pre- patients protect or to need other to introduced these into evidence. records possi- Any escape. vent of these his might do His failure to so not be cause adequately explain hos- the bilities could remand if the were other- record pital’s decision, the record contains but adequate, wise but that the the fact Dis- one, any, explains no hint to if as which trict Court had its to conduct review appears, it the For all fact. that without benefit of an additional them is only hospital appel- may considered requiring reason for further considera- ignored dangerousness his lant’s tion. treatment one-sided bal- needs. Such a inevitably ance all doubts resolve appellant Even had deliber Moreover, against greater freedom. ately records, to chosen not his introduce proper since a often involves balance however, hospital the used could have comparative unquantifiable evaluation explain may to them That it decision. variables, intelligent judicial re- review parties not them to disclose with outside analy- quires hospital at a reasoned least patient’s imply the not out consent does among sis them. Because conflict it is forbidden to introduce them in analysis, it the no record such contains pa court where are relevant provides no assurance corpus. contentions tient’s on habeas relevant information.” considered “the statutory plain purpose of rec One For the reasons he cannot same requirement judicial ords is to facilitate availability required to establish care review accord alternatives, less restrictive may patient.35 petitioner ed A reasonably obliged cannot to bear confidentiality records use of his attacking hospital deci- burden of deprive a sword to court en grounds sion on medical vacuo. On lightenment requirement records explain remand, ei- should designed give submit it. records why ther confinement maximum appeal notably on this in ted are impair prospects does not formative, may there well be rehabilitation, promptest records, and limited material even the dangerous im- require is so such light on available now throws some pairment. thinking. hospital’s Appellant’s Hospital D. Records. prerogative of its intro- view Appellant sought records, obliga- hospital’s to file has leave duce such challenged records In D. with this court. tion show that decision 10, supra. Cameron, supra 33. See note 35. See Rouse v. note 370-371, F.2d Hearings, 34. 1964 . at 455-456. Superintendent (Testimony Dr. Dale Cameron). O. is, record, present er that decision consideration a reasoned reflects ** ordi- “reasonable within a broad information relevant However, range narily hos- discretion.” be burdensome either parties the court the records useful or the courts. Even case, flag inadequate full remand several troublesome issues by by spirit appellant’s kept stat- of the raised the record and records dossier, usually hospital utory requirement suf- not introduc- would be which was hos- ed to the ficient in themselves below. fulfill obligation. By pital’s evidentiary articu- by First, passed considerations the lating by plan ex- a and pos- hearing are below all silence the plaining important the for deci- basis counterweights consideration to the sible affecting they patient, would sions the dangerousness. appellant’s potential glance. fully In- the inform court at a danger not one case is feared cidentally, they the also enhance would dismissed, lightly do not to and we thoroughness integrity, reliability, and outweigh suggest all it never could decision-making hospital’s own recently But as we other considerations. procedures. incidental The bothersome “dan- in Millard Harris38 made clear v. paperwork price pay for is small to so a thing. gerousness” many splendored ais blessings. many Besides, paper- such analy- discriminating Unless muzzled precisely often be- work is bothersome nominally weigh sis, likely against is to process of formal articulation cause way competing a wolf considerations busy forces administrators to confront weighs against sheep in the same problems intui- and .considerations their sheep heavier is scales: even might reactions have overlooked. tive weighed separately, somehow when always prevails the two wolf when suggested in Camer- As we Rouse v. dangerous- weighed together. Keeping on,36 hospital internal established especially diffi- is on a taut leash ness procedures reviewing own deci- its murder, danger of there is where cult redressing grievances it could sions and grave admittedly danger and since ju- largely eliminate occasion improbability, theoreti- its which since litiga- challenges, any residual dicial and exceeding- gravity, cally discounts its readily disposed of on tion could be ly quantify. difficult to summary judgment. Expert adminis- agencies govern- federal trative him- Moreover, shown man has once a prop- primarily with ment which deal impos- dangerous, all but it is self liberties, erty, follow and with lives negative that prove the for him to sible course, procedures such as a matter longer specters he is no menace. policies in order to maintain consistent 35 appellant committed murder Large- correct their own errors. long jail years ago sen- (expiated ly rarely so, courts because do may com- tence) and the murder disturb their for other than decisions obviously ago years than mitted more 10 procedural infirmities. thought very hospital at haunt granting measure him the least IV He Elizabeths. freedom within Saint ground privileges ten docile then, respects, after asks these record consisting, regime ac- years inadequate the hos- show whether files, maxi- cording “permissible decision” to made a confinement, pink liquids, keep Pavilion mum Howard John interviews; psychiatric and a dozen brief information.” “in view of the relevant those about worries Accordingly, and the wheth- we do consider 151-153, 146, pp. n. 38. 132 Id. at n. 373 F.2d at (1968). 964, 969, 971 F.2d Tribby Cameron, supra note 6. “unpredictable merely conse- mieux, murders de serious faute quences” questions ensue if hospital priorities he should arise as statutory rights.40 ever have access to alcohol. con- Their and constitutional may Moreover, cern is understandable well have seized fully justified. appears, upon change But for all that Dr. Weickhardt’s of heart unpredictable the murders conse- aas sufficient reason not to recon- even quences twenty still be there after postponed so, will sider If decision.41 years fifty. Appellant after analysis episode Dr. Weickhardt’s murder, involving convicted of the second money appellant’s theft of hospitalization tacitly con- disturbing is not importance. assumes His ex- verted planation into a How- convincingly lay sentence to John life does not ard. possibility rest either that request for transfer was denied a dis- In to these ask circumstances it is fair ciplinary to measure minor enforce hos- hospital appellant can dem- how ever rules, money epi- or else that per- onstrate his for a less readiness pretext sode served as oth- under which of vasive confinement: What evidence er undisclosed interests could be served. improvement looking they for? public, court, hospital, The prospect What is the ever will appellant, profit least If, would be, may hospital find it? greatly thorough from a of ventilation likely administrators think he never will these matters and a careful attention to sufficiently purged dangerous- be of his legitimacy ness, considerations reviewing then the court at should prove which to have been crucial. opportunity least have an to scrutinize despair. the basis for such a counsel Y very unlikely For the reason that he is soon, ever, hos- to be released from the Quite issue, apart from the transfer pital, provide it is crucial to check some appellant first now contends for the time against becoming non-person, his de- that his civil commitment in 1964 was prived any rights minimally ration- fatally respects. defective numerous al hospital treatment within the because says statutory right He he was denied his he may murdered mur- once and independent judicial an evaluation again. dered mental condition and need for com his mitment, committing since the court had Second, there is some indication that it before no on which to information denied transfer rea- predicate He also such an evaluation. simple dangerousness. sons other than says this defect a denial of amounts to suggest appel- The records process. Furthermore, allege due he request may initially lant’s have been s right deprivations statutory to a deferred, inherently not because he was trial, jury alleged right to a tran risk, a bad space but no because was script hearing pre-commitment of his be available other where could wards Commission, fore the Mental Health adequately supervised.39 right rep cannot, course, the constitutional to effective space create does have, appellant but is in John resentation of counsel. deferring original action on the rec- this No mention consideration hearings, ommendation made at the court either transferred, Acting Superintendent Har- however. ris wrote: agree supervision Cameron, All initial that his 40. See Rouse note v. very U.S.App.D.C. 372-373, [outside Howard] John F.2d must be at 373 dependable 457-458; Maryland, for the first 334 F.2d few months of v. at Sas security (4 1964). his At this mo- reduction. Cir. ment there is no service available placement provide 1, supra. can See needed close attention. process face, applicable due of law contentions stat- these On their utory provisions; and ordered appear nor when neither remote insubstan deprivation subject may to examination as some them tial. But least validity by proceedings cannot questions of which than fact turn by initially deprivation appellate court. More those in an be resolved normally Usually by appeal over, judicial from orderly procedure this is occurred. judgment dep- raising requiring the precludes appeal issues or order many judicial inquiry ques rivation; reasonably scope within the cor- presented petition for instances is available also habeas tion habeas pus proceedings. corpus. there no to consider so where There is reason This previous exception has been a civil commitment rule in the instant Elizabeths, validity St. as here. case. committed confinement of the continued simply procedure The usual person in ward the maximum appeal, aspect to dismiss this there, restrictive rather than in a less bring leaving appellant a new free facility, questioned and decided. corpus petition if he wishes. habeas Overholser, U.S.App.D.C. Miller However, indigent petitioner is an 110, 115, 415, 419; and 206 F.2d see Q. place upon him the an I. of 52. To Cameron, Lake v. petition preparing burden a new banc). When, (en how- 364 F.2d 657 attorney obtaining appointment of a new ever, liberty deprivation the of is based by seems an unwar the District Court dangerousness person’s himself the to hardship no ranted which would serve condition, the due to his mental or others judicial of admini ascertainable interest degree ju- deprivation for the of is not argument in this stration.42 At oral diciary pass upon except under a to court, clearly appeared the attor deep in- restraint consistent the with neys appeal appointed him on this discipline, that of the medical volvement willing repre continue to would to is, charged discipline under the of those Accordingly, any sent remand. him of the the law with the administration there in since to be a remand is institution. While the individual event, I would direct the District Court bring a case the matter to court as to on an consider these issues amended Constitution, controversy the the petition, quest the as well as transfer court, validity passing upon in the Judge Fahy’s position as ion.43 But see liberty, judicial deprivation func- concurring spe opinion to in his tion, recognizes responsibility the cially. charge upon places in law also those Remanded. Thus, Tribby Cam- the institution. in v. eron, F.2d (con- Judge FAHY, Senior Circuit Bazelon, Judge by pointed out as curring specially): question to stated be whether was agree Judge I with Bazelon administrator, case should be remanded for a fuller permissible reason- has made hearing, set but I wish as now to state in- able decision in of the relevant view my approach problem, forth to the albeit range formation and within a broad background on the of the more detail- of discretion. Judge opinion ed in discussion Bazelon. therefore, appropriate, on the It was by govern- having

Deprivation liberty pleadings case, appellant in this with ment is consonant authorized when in the maximum been confined U.S.App. Caplan Cameron, Cf. appellant pursue If decides to these (1966) ; below, D.C. 369 F.2d 195 Dobson I District think the Court matters may permit Cameron, petition. v. Cameron and Stultz v. him to amend his U.S.App.D.C. 324, (1967). so, 383 F.2d 519 If it to do he will of course declines by petition. to raise them a new be free have, years, appellant ten District the confinement ward therefor, inquire appellant with in whether the reasons reached liberty. recognition being excessively greater deprived deprivation that no this, liberty reasonably government as not contest should be had than is The does understand, taking required safety safety position that the I for his and the others, determining supports appellant’s de- record continued which considera- or, given desirability tion should be tention in John Howard Pavilion seeking not, hearing improvement so con- fuller dis- that a then, question, dition. is whether close. Our hearing did ex- in the District Court foregoing The should not be considered enough plore problem fully enable limiting hearing scope decide, appel- the court whether parties or the court advance valid, lant’s detention Elizabeths at St. data which the court of a exercise questioned in the District which was not sound discretion deems admissible.2 Court, but whether it should continue present in the John Pavilion. proof, my toAs the burden of view is agree for a As this I a remand appropriateness par- that when the of a hearing, respect particularly fuller deprivation liberty ticular has been possible less alternative facilities with question by supporting drawn evi- liberty. deprivation of restrictive dence, validity depends upon its continued hearing on the remand I think should showing, appel- in the circumstances of bring following into record: confinement,3 lant’s that within a broad range of discretion of the au- reports regarding appellant re- thorities, kept by quired upon hos- to be law exercised basis of the pital ; information, deprivation relevant supported history of his 2. The substantial evidence and condition, illness, including reasonable. receiving the hos- he is treatment origi- validity As to the treatment; efficacy pital, of the and the commitment, questioned nal for the first comparison Ho- the John 3. A court, appeal time on the in this there the treatment ward Pavilion and possible that on further consideration possible facili- with alternative available neither nor de- counsel would ties at and the St. Elizabeths pursue sire to I think our court this. available,1 exploration of there with an seeming should refrain from supervision re- to encour- differences comparative age pursuit. thera- strictions and the It is I a matter which peutic ensue; likely results parties think should be left for light the District such or conclusions 4. The conclusion might develop. as to the nature authorities circumstances as hope Though appellant 1. no issue as to 2. I makes itself will find itself treatment, procedures eval intertwined able to establish internal such suggested Cameron, supra is the of his confinement uation Rouse v. right appellant’s general Judge 1, repeated pres- consideration of Bazelon’s Cameron, opinion. Rouse v. to treatment. See ent 451; F.2d 373 U.S.App.D. Ragsdale Overholser, Compare Ragsdale Overholser, v. (concur 308, 315, (concurring opinion). F.2d C. note 1 ring opinion). Security Deci- Decentralization RECOMMENDATIONS AND the deci- The Committee views sions. FINDINGS Security section, sion-making par- A. issues, Recommendations ticularly it relates to Security (degree too practical to be centralized. aspects treat- integral part restrictions) security patients ment the so-called in Therefore, process. rec- it is separate need it. facilities for * * * made ommended that these decisions be professionals Few count these (wards) closely possible as to the area as people among problems in their their place, process takes where the treatment concerns. Efforts should be made by personnel responsible care for the bring patients requiring security all patient. services under an officer administrative responsi- who shall have four assistants Inpatient Ex- Pretrial 6. Reduction of training, for ble recruitment re- bed aminations. Much time and staff search, legal treatment services and mat- unnecessarily space utilized seems ters. psychiatric performance of exam- in the John Howard Pavil- Modification of greatly To re- for courts. inations study ion. The Committee indi- patients duce the number of admitted approximately cate that one-half of the Security psychiatric ex- for section patients in confined the JHP could be recommends amination Committee adequately cared for in the secure less that: Security within units section or in developed parts Hospital. con- other Elizabeths a. A Saint service ^[******] duct screening examinations on an out- vision, building comprehensive patient a maximum basis beds; community centers. with 395 West Division health Side (in Building), beds; the Center with 422 Security serv- b. Admission and the Cruvant Division with 123 beds. Hospital Saint Elizabeths ice only occupied patients requiring a. John more Howard Division those psychiatric proceedings patients comprehensive evaluations criminal competent to stand trial. ble the same should be true of committed because modalities within Saint Elizabeths Hos- through clinics and mental health serv- fective aftercare service be upon acquittal reason of general hospital and treatment ices, and social complished to the end that all treatment gration of clinical quiring security services. ommends 10. Use All atric service pital ever (optional for civil commitment when- Hospital Improved B. -*-*** d. e. Place those admitted Committee Program will be available housing. who are possible). transition of Develop Findings that the insanity itself. Aftercare Goal. The Committee rec- actually psychotic. appropriate as to screen Hospital of criminal workers wards. recommends long range goal of the Committee services should to the same status jail-located psychi- patients Service. So patients Services. on the staff of misdemeanants custody far mentally ^[*] patients charges by that an ef- to the Hos- committed developed persons * * be ac- possi- ^[*] Inte- level in- re- * include area because of problems Side Division tions of Saint Elizabeths “psychopaths.” pied there are some sexual tients. One ward is well as ing so. ment of Corrections and the aminations, ings patients commitments transferred from other sec- sanity, prisoners dangerous amination, of four inal aAs proceedings patients group mitted under the sexual reau competent sion. There are number of ity, incompetent to stand are b. Of the 422 c. The Cruvant Division is are misdemeanant criminal remaining treated proceedings patients. general practice almost of male those wards, potentially dangerous Prisons, and the need for more civil exclusively by committed approximately committed for guilty by three of patients patients guilty by * * * from the those found to be in- peculiar management patients patients stand trial and those John Howard occupied by involved those male psychopath reason of insan- which are treated here psychopaths who Hospital trial C.D. reason female in this build- of the West Federal pretrial pretrial potentially in felonies and sexual * * composed civil security. proceed- criminal are Depart- a small to this crim- occu- Divi- laws. been com- civil Bu- ex- pa- ex- in- al- transferred from John Howard Division The National Institute of Mental Health phases into the in- terminal of treatment responsible implementation volving security prior minimal to release program the treatment Eliza- at Saint community. into the 7,000 Hospital. beths fed- is bed This * * * Major eral mental of which beds 2. Issues for Staff. currently designated Security are system court-prison as a The values of the study section. Hospital The of this Committee and of the conflict in an those programming uneasy concerns evaluation and balance. is a confused defi- There “prison- these relate patients to this section of the nition of the as either Hospital. “patients.” contingencies ers” or The ignated 1. Security ^[*****] for Facilities. The section Security currently consists des- tasks of each does not of the seem to have value others. system The optimal trammel Hospital communi- up staff the of three the John Di- cation or a divisions: with the courts it serves suf- pital program patients knowledgeable un- in which ficiently critical all and can freely regardless participate legal principles derstanding type of the of the * * of deviant helps behavior have manifest- to administer. ed. major of staff is concern the A second words, imple- separation the space and facilities to of lack of so- “criminally insane,” involving concept called special of in a ment treatment separate apart therapeutic unit and therapeutic from the milieu of rest patient population satisfactory community The at level. Saint Eliza- at a Hospital, beths should validated saw evidence which considered as a Committee temporary opinion; space in example, the transitional measure this eventually largely will occu- lead is towards com- Division John Howard. integration plete leaving inadequate groups pa- of both pied patients, of tients therapy. therapeutic within a uniform space adjunctive hospital program. major of the staff third concern A Organization. 4. hospital per- A more inte- insufficient of number Staff grated categories. example, continuum care and record For sonnel all keeping necessary security personnel, professional as related to treatment beths mentation of those matters for the training The courts. culiar should other’s resources er and sharing * curity Hospital sections. Security autonomy, * * have law Semiautonomy ^[******] Hospital Hospital. services security patients. markedly those enforcement Integration psychiatric A section finds program of accomplished rotated modalities within semiautonomous facilities seem section, from hardly will likewise would facilitate and seem They shielded through residents of clinical linked to each e. agencies hardly Security Hospital Saint it most difficult g., the end that deprived from from relationships to be islands status be available Saint Eliza- largely pe- share Elizabeths from Security Section. services imple- large. of se- each oth- rest all three treatment services. responsibility units. professional assistants, one devoted to administrative recruitment tionships search, have rights assistant tion for the trative and clinical cer should their curity section. He should to whether served; making Legal Rights ^[******] units, legal rights are, services be one an function of patients, with is recommended that all complaints. these and one concerned with to act professional officer attorney the courts and chief legal coordinating training, rights informing placed functions Patients. as their administrative protecting officer charged devoted to rela- To at staff of the checking one to re- who would them within the spokesman least four carry being A consulta- with the adminis- special chief what legal offi- Se- out ob- mental illness. velopment another inal range Hospital program best be treated deviant behavior characteristic Committee As certain forms behavior ^[******] direction Committee form of a recommends (out modern of the Saint believes should mentally many psychiatric hos- be that towards ill setting illness can Elizabeths forms) the crim- of severe simply long de- ter than Hospital program in the tract nity. legal law these such institutions. dedication of a limited number These Treatment. departments officer functions services staff private treatment should not be could Security without law firms This is be obtained provided many academic commu- constraint, sections autonomous. due part with the in profes- to the is bet- con- plications, many persons highly laboring is a task for disad- staff sional legal in vantageous trained both the medical The John and circumstances. treatment peals peutic considerations. junctive panded sic, committed for on the wards at ligious number perience these resources should supplying them with merely finement, etc., be adequate vironment tity Too does not worsen social clear like. There is cational ence zation out operations. sional seem to focus Security Recent related to in etc. ^[******] often, deprivations of all the context controls, instruction, including no substitute time training and Pavilion therapy treatment which unit now suffer opinions from the All treatment. more “livable” explicitly escapes, the law and individuals therapeutic fillers. While Extensive adjunctive too much to the exclusion treatment sufficient will the condition academic discharged. needs should be of their is that recreation, their concern stated modify personality socializing experi- rehabilitation, re- quality in “sitting around” only be carried goals development treatment and interpreted ex- the maximum length which from massive education, sorts, that a must explicit utili- make its legal profes- it is greatly ex- less time. and and and Medically arts, of thera- receive prison- of con- person merely on the which amply quan- must least mu- Ap- Ad- vo- en- be n mal number there are available tally to be probably going to have to be reassessed treatment. We would modalities used in the nel which would precautions issues involved. techniques that in more will treat low. the institution will in the mental quantity is a more the number of dangerous to Hospital. of those data which would establish the mini- cial work and attendant should Security division, particularly in the so- Suffice it to Medically adequate treatment security settings. * ill in criminally likely Committee comparison required proceed with civilly committed; mentally * We would stress important general which have and facilities at to be say respect others personnel clinical and other hospital. Programming on the procedures committed * qualify is not ill to similar dangerous psychiatric hospitals, special persons. be consideration than patients or in * observe, however, care of There categories, assumption proved cognizant Saint attached to the addition to the to themselves. will continue methods patients that adequate adequacy institutions and than most Elizabeths should It who are (cid:127) effective itself is person- quality special * ranks men- true and and at quality of the disease combined the extension best features of a either limits patho- ideally, approach process, or, eliminates “corrections” hos- pital program. out with logicial It is carried situation. with competency commensurate skill Individual Treatment Plan. While community, the standards gener- presumed we have not to establish explicit implied or concurrence positions might alized clinical par- agreement between contractual might appropriate particular not be for a ties. patient, we would affirm that: the law the ments which have both ness and cal criteria. is a not be met * * * q>he dynamic type ^[******] regarding treatability To make balance District medical absolute these question between now demanded Columbia. of two balanced dangerous- questions legal im- categori- judg- b. There a. There should c. plemented ment limits of ment of the of the individual. plan. should available pathology good be a plan a recorded resources. faith recorded treat- and assets within assess- im- periodic d. should be a record- There West Side Division. The clinical di- prog- rectors, however, ed assessment of treatment of these two divisions may, do, exchange or patients, ress the lack it. if after period a of observation these are deter- Significant e. modifications to the greater mined to be in need of either or plan and their rationale security. lesser should be recorded. time it is makes the decision that a actual go without from the criminal mitted, son is in fact there is no reason for the that, merely facto guished ment into the where to house them as are mitted are as pital’s mitted son to read a person court that such determining mum trial, es in fact reason of committing person of those found tients practice it seems to be observed in f. Where available resources fall be- to maximum (pretrial examination, hospitalization greater Degrees security. and of those found not municate the realistic situation to individual low the committed persons. Hospital dangerousness. “ * * * * administrative say from the concerning placed patients primarily insanity) other mental * * restraint hospital designated by this. whether Hospital diagnosis because the assumed standards fully subject order. special security require- ” The court order does not dangerous by way security. Security. As clinician, incompetent committed to proper nor civil, with the maximum for criminal the criminal courts, merely necessarily than kept has Patients so discretion acceptable At the hospitals, of commitment housing Registrar individual there authorities. he must patient person The determi- prognosis and in need As has been needs others, civilly civilly should assumption court order as distin- orders the guilty by to stand security, any rea- duty present * purpos- courts, means comes in maxi- com- com- Hos- com- who com- * * ipso per- pa- to make it probably current character. ate plant. less sents curity therapeutic tal treatment on the staff a form of treatment that is maining should this institution and its current must on the inside should ceptions, whatever termediate and tion. inside treated open setting. security load” in the Howard unit would a sizable number of these * * * curity elsewhere—an all or none situa- end of the curity. District from Cruvant Division and the West is estimated that one half at JHP do not used and underused at the Side Division are (President’s Commissionon Crime in the .Any Reevaluation of the current It most physical future. ^[*] than desirable. appears there is excessive such a pay which could not It would seem clear that medium rational prisons, automatically in facilities On the other cognizance optimally spectrum measures large Columbia). JHP, structure will be Extensive less secure program. periphery. to be used approach to the be transferred ^[*] graduated step system. require number of are security built security controls effective within astonishingly and little or no se- However, inherent in the to- ^[*] to called for—an in- hand, modification security incorporated It seems clear surpassed With few maximum se- is both over- people Hospital. ^[*] of those re- provide beds even are needed history forces from the required the men immedi- physical “patient problem escapes permit at one it will repre- ^[*] to be even high up- ex- se- It At nation is in fact a Decentralized. mechanical new 10. Decisions one: decision-making, par- from the admissions U.S. District Court time the assigned ticularly to the John as it relates issues Howard Divi- sion; (transfers, releases, ground privileges, misdemeanants from etc.), General In mental are committed to the is too centralized. Sessions greatly community’s influ- tolerance (degree restric- hospital, pro- treatment ences formulation integral part tions) the treat- is an through public Hospital, grams, Therefore, process. decisions ment to im- program, must endeavor by education made should be restrictions about degree acceptance prove (wards) its regulate personnel the area who many as community. Development of as (milieu ther- processes where will hospital-community contacts possible therapy place. should apy) Milieu take programs only training help the intramural opportunity of provide the ex- much more open to a through doors planned also but emotionally disturbed pos.thospitalization proc- effective management tensive of the structure discharged patients. they program for live. esses situation Conditionally A Released. Care 11. criminally commit- number of certain conditionally patients released. ted follow-up very effective There is no conditionally re- aftercare, either discharged. finally or of those leased * * * Tlig bring way effective WASHINGTON, Jr., H. Thomas neighbor- into the the aftercare service Appellant, through mental the clinics hood through services, work- social health America, STATES UNITED Hospital itself staff ers Appellee. go patient’s home and who can No. 21451. neighborhood. means an This into the enlargement development and extensive Appeals States Court United of social services. Circuit. of Columbia District As legal ^[******] Hospital-Court personnel begin Relationships. learn about ** Decided June Argued Jan. 1969. they concepts, can build mental health cope legal procedures more effective obedience, prevent preventable,

with carry out their activities least ways. people

with in more effective “legal

Similarly, education” of Hos- developed personnel so should be exactly they social values know what legal concepts with which are built into roles as “ex- deal. relevant Such pert clearly under- witness” should be persons. health

standable

Psychiatrists staff behavioral go into court under- be able standing completely function what their they may carry it out be so that inappropriate and with anxieties

without participation. appropriate

a sense of

****** Community Every men- Tolerance. hospital, particularly

tal one security unit, aware of and must be community

sensitive level toler- programs patients.

ance As

Case Details

Case Name: James Covington v. David W. Harris

Court Name: Court of Appeals for the D.C. Circuit

Date Published: Mar 14, 1969

Citation: 419 F.2d 617

Docket Number: 21935

Court Abbreviation: D.C. Cir.