Press Release - June 25, 1998
U.S. Supreme Court Rules That The Americans with Disabilities Act Covers People with HIV

(Boston, MA) The United States Supreme Court ruled today, in its first HIV discrimination case, that the federal Americans with Disabilities Act (ADA) covers people who are infected with the Human Immunodeficiency Virus (HIV), even if the person does not have an AIDS diagnosis or outwardly visible signs of illness.

The case, Bragdon v. Abbott (No. 97-156), was brought by New England's Gay & Lesbian Advocates & Defenders (GLAD), a public interest law firm, against Bangor, Maine dentist Randon Bragdon who had a written policy of refusing to treat any patient who is HIV-positive.

"Sixteen years into this epidemic, people with HIV still experience widespread discrimination. Today, the United States Supreme Court sent a clear message that Americans living with HIV cannot be denied jobs, housing or health care based on unwarranted prejudice," said GLAD staff attorney Bennett H. Klein, who is one of the lawyers representing the plaintiff Sidney Abbott. Northeastern University Law School Professor Wendy E. Parmet, another of Ms. Abbott's attorneys, states that, "The Supreme Court today made crystal clear that science, not fear and stereotypes, must be the basis for our national health policy.”

Today's Supreme Court decision is an enormous victory for the legal rights of people living with HIV and for the public health efforts to fight this epidemic. According to Klein, "Unless people can be assured that a positive HIV test will not result in discrimination, people will not be tested for HIV, will not disclose their HIV status to doctors, and will not get counseling about how to prevent HIV transmission to others."

While the Supreme Court has sent the case back to the lower court for a re-assessment of the “direct threat” defense, the Supreme Court made clear that there is no special standard for health care workers and that every defendant needs objective scientific evidence to justify reliance on the defense. Subjective good faith belief that a substantial risk exists “would not relieve [the defendant] from liability,” according to the Court.

In this case, Bangor, Maine resident Sidney Abbott went to Dr. Bragdon with tooth pain caused by a cavity. Dr. Bragdon refused to fill her cavity in his office solely because Ms. Abbott disclosed on a medical questionnaire that she has HIV. Although Dr. Bragdon offered to fill Ms. Abbott's cavity in a hospital surgical operatory if she paid the extra hospital charges, Dr. Bragdon has never had hospital privileges. Two months after Ms. Abbott filed a complaint against him, Dr. Bragdon for the first time applied for privileges at a hospital two hours away from his office. His application was not granted. In addition, according to the United States Center for Disease Control and Prevention, and every expert on both sides of the case, a hospital setting would not provide any safety feature to prevent HIV transmission other than the standard universal precautions which are routinely used in private dental offices.

GLAD sued Dr. Bragdon on Ms. Abbott's behalf for refusing to treat her, claiming disability discrimination under the federal ADA. The Civil Rights Division of the Justice Department intervened in the case in support of GLAD. GLAD argued that public health authorities, such as the United States Centers for Disease Control and the American Dental Association, have determined that people with HIV may be treated safely in a private dental office with the use of standard infection control procedures known as "universal precautions," which are utilized by all patients. Indeed, there has never been a single documented case of HIV transmission from patient to dentist, and it is much more likely that Dr. Bragdon would be struck by lightning than that he would contract HIV from a patient.

In December, 1995, a federal trial judge in Bangor, Maine agreed with GLAD and ruled that Dr. Bragdon's fears about HIV transmission were based on mere "speculation," and "conjecture." The trial judge ordered Dr. Bragdon to comply with the ADA. In March, 1997, the United States Court of Appeals for the First Circuit in Boston, Ma upheld the trial court's decision.