The Right to Humane Treatment in Institutional Settings

The courts have played an important role in establishing minimum standards of care for people with developmental disabilities in the United States living in institutional settings. During the 1970s, dozens of lawsuits were filed regarding the abusive conditions in the nation’s institutions, prompted in part by media exposés showing how existing institutions were failing to meet even the most basic needs of the people they were intended to serve.

These lawsuits eventually led to a recognition of the constitutional rights of people with developmental disabilities living in institutional settings to protection and to treatment. These cases also established standards for humane treatment in institutional settings, as well as mechanisms for ensuring that these standards are met.

The constitutional basis for these rulings was recognized by the U.S. Supreme Court in 1982, in Youngberg v. Romeo, 457 U.S. 307 (1982). Unfortunately, however, litigation and court monitoring for compliance with these constitutional standards is still ongoing.

Three significant series of such cases were:

A quick look at the Olmstead Decision, ADA, Willowbrook State Hospital, and the Welsch Case

Closure of Institutions

The reform of residential institutions for people with disabilities was accompanied by a growing demand for persons with disabilities to live outside of institutions, in more natural, community settings. The evolution in thinking about the rights of people with developmental disabilities from ensuring humane treatment within institutions, to supporting living outside of institutions, was accompanied by the enactment of state and federal laws supporting the integration of people with developmental disabilities into community settings. This evolution can be demonstrated by the progress of this litigation:

The following series of U.S. Supreme Court cases outlines this evolution in thinking about the rights of people with developmental disabilities from ensuring humane treatment within institutions, to supporting living outside of institutions.

In this video interview, United States Supreme Court Justice Harry Blackmun speaks about his impressions of state institutions and the line of cases that followed and cited Pennhurst. (Video Source: Library of Congress)