Doe v. Delie

The Appellant, Doe, an HIV-positive former inmate of the State Correctional Institution at Pittsburgh (SCIP), brought this claim against SCIP officials, alleging that prison practices violated his constitutional right to privacy under the Fourteenth Amendment to the Constitution.

SCIP medical staff informed Doe that his HIV status would be kept confidential. However, because of practices permitted by prison officials, Doe’s condition was disclosed to prison officials and other prisoners.  When Doe was taken for sick call appointments, staff informed the escorting officers of Doe’s HIV status. During physician visits, staff kept the door to the clinic room open, allowing officers, inmates and guards in the area to see and hear Doe and the attending physician. While administering medication, nurses announced his medication loudly enough for others to hear, allowing inmates to infer Doe’s condition. Doe alleged that these practices made him reluctant to discuss embarrassing symptoms with doctors, subjected him to psychological harassment and humiliation, and caused him to discontinue treatment.

The trial court dismissed Doe’s claims and this appeal followed.

The court held that SCIP staff members (as government officials) were immune from Doe’s claim that prison practices violated his constitutional right to privacy. The court held that the "open-door" examination room policy, the disclosure of Doe’s HIV status to corrections officer escorts, and the loud announcement of the names of Doe’s medications, in this case, were protected by qualified immunity because an inmate’s constitutional right to privacy in their medical information was not clearly established at the time of the conduct.

The court applied a two-step inquiry in arriving at this conclusion: it considered whether an HIV-positive inmate had a right to privacy in his medical information, and if so, whether that right was clearly established in 1995, at the time of the alleged practices.

1. Did an HIV-positive inmate have a right to privacy in his medical information?

Yes. The court held that a right to medical privacy clearly existed and that, subject to legitimate penological interests, this right extended to those in prison. It stated that while inmates did not have a Fourth Amendment right to privacy in their cells, the Fourteenth Amendment right to non-disclosure of one’s medical information protected different interests. It explained that while Fourth Amendment privacy rights were “fundamentally inconsistent with incarceration,” a prisoner’s right to privacy in medical information was not inconsistent incarceration and could therefore be recognised.

The court qualified its holding by adding that Doe did not enjoy a right to conceal his diagnosed medical condition from everyone in the corrections system. It explained that an inmate’s constitutional right to privacy in their HIV related medical information may be curtailed by a policy or regulation that is shown to be reasonably related to legitimate penological interests and the maintenance of institutional security.

2. Was a prisoner’s right to privacy in his medical information clearly established at the time the conduct occurred?

No. The court surveyed a number of earlier cases and concluded that “the contours of [prison officials’] legal obligations under the Constitution were not sufficiently clear” at the time the conduct occurred. The Court held that a “reasonable prison official” might not have been aware that “the non-consensual disclosure of a prisoner’s HIV status [would] violate the Constitution.”

“The District Court recognized Doe's right to privacy in his medical information, but concluded that such a right does not exist in prison. We disagree. As the Supreme Court has noted, prison inmates do not shed all fundamental protections of the Constitution at the prison gates . . . Inmates retain those rights that are not inconsistent with their status as prisoners or with the legitimate penological objectives of the corrections system.” 257 F.3d, p. 315.

“It is beyond question that information about one's HIV-positive status is information of the most personal kind and that an individual has an interest in protecting against the dissemination of such information . . . Moreover, a prisoner's right to privacy in this medical information is not fundamentally inconsistent with incarceration. Therefore, we join the Second Circuit in recognizing that the constitutional right to privacy in one's medical information exists in prison.”  257 F.3d, p. 317.

“We acknowledge, however, that a prisoner does not enjoy a right of privacy in his medical information to the same extent as a free citizen. We do not suggest that Doe has a right to conceal this diagnosed medical condition from everyone in the corrections system. Doe's constitutional right is subject to substantial restrictions and limitations in order for correctional officials to achieve legitimate correctional goals and maintain institutional security.” 257 F.3d, p. 317.