Nicholas Romeo was a man with significant developmental disabilities. He had lived with his parents until he was 26, but after the death of his father his mother was unable to care for him. Upon petition of his mother, pursuant to the procedures for involuntary commitment, he was committed to the Pennhurst State School and Hospital in 1974. Romeo’s mother became concerned by the numerous injuries that he incurred while living at Pennhurst. On November 4, 1976, she filed a suit in the U.S. District Court for the Easter District of Pennsylvania on his behalf, alleging violation of his rights under the Eighth and Fourteenth Amendments, for failing to institute appropriate measures to avoid injuries, restraining him for prolonged periods on a routine basis, and failing to provide appropriate treatment.
After an eight-day trial, the jury returned a verdict for Romeo. The jury instructions guiding this verdict provided that a violation of Romeo’s constitutional rights under the Eighth Amendment (prohibiting cruel and unusual punishment) and the Fourteenth Amendment could be based on: a failure to take reasonable steps to prevent known physical attacks on his person; shackling or denial of treatment as punishment; or deliberate indifference to his serious medical and psychological needs.
The jury verdict was appealed to the U.S. Court of Appeals for the Third Circuit, which reversed and remanded the case for a new trial. The Court held that the Eighth Amendment did not apply to the rights of the involuntarily committed, but that the Fourteenth Amendment did. However, the Court of Appeals could not agree on the standards by which to judge whether Romeo’s Fourteenth Amendment rights had been violated. The Supreme Court granted the petition for certiorari in this case, to consider, “for the first time the substantive rights of involuntarily committed mentally retarded persons under the Fourteenth Amendment to the Constitution.”
The Supreme Court began by asserting that “The mere fact that Romeo has been committed under proper procedures does not deprive him of all substantive liberty interests under the Fourteenth Amendment.” The Court recognized that persons subject to involuntary commitment proceedings have a liberty interest, protected under the Due Process Clause, to safety and to freedom from bodily restraint, thus affirming decisions in N.Y. State Ass’n v. Carey (Willowbrook), Wyatt, Welsch, and earlier Pennhurst litigation. Both of these liberty interests had been recognized by the Court in the past as surviving criminal conviction and incarceration. In Romeo, the Court expressly extended them to persons involuntarily committed.
The Court recognized that neither of these liberty rights are absolute, and that they are to some extent in conflict. Some restrictions of liberty or restraints might be necessary or appropriate, and “an institution cannot protect its residents from all danger of violence if it is to permit them to have any freedom of movement.” “Accordingly, whether [Romeo’s] constitutional rights have been violated must be determined by balancing his liberty interests against the relevant state interests.” In doing this balancing, the Court should “make certain that professional judgment in fact was exercised”, but should not attempt to choose among professionally acceptable choices.
The Supreme Court also affirmed Romeo’s “constitutional right to minimally adequate habilitation”. The Court cited Chief Judge for the Third Circuit Court of Appeals Collins J. Seitz, in his concurrence to the Court of Appeals decision, saying, “I believe that the plaintiff has a constitutional right to minimally adequate care and treatment. The existence of a constitutional right to care and treatment is no longer a novel legal proposition.”
However, under the particular circumstances of this case, the Court concluded that it did not have to go further than to conclude that “respondent’s liberty interests require the State to provide minimally adequate or reasonable training to ensure safety and freedom from undue restraint.” In determining what is “minimally adequate training”, the court stressed that the “courts must show deference to the judgment exercised by a qualified professional.”
Youngberg Resources and References
Articles and Other Secondary Sources
Phyllis Podolsky Dietz, The Constitutional Right to Treatment in Light of Youngberg v. Romeo. 72 Geo. L.J. 1785 (1984)
Rosalie Berger Levinson, Wherefore Art Thou Romeo: Revitalizing Youngberg’s Protection of Liberty for the Civilly Committed, 54 Boston College Law Review 535 (2013).
Michael Ashley Stein and William P Alford., “Youngberg v. Romeo” (2009). Faculty Publications. Paper 1553