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The U.S. Supreme Court first issued a decision on HIV and the Americans With Disabilities Act (ADA) on June 25, 1998, and for AIDS advocates it was a high point in their efforts to provide legal protection to HIV-infected people. However, there subsequently have been some disappointing ADA decisions by the nation’s highest court, and while it’s debatable whether these will affect HIV patients, it’s clear they won’t help. The ADA requires individuals claiming its protection to show that they have an impairment that substantially limits a major life activity or that they are regarded as having such an impairment by the person discriminating against them.
Here’s a look at the court’s rulings with regard to HIV and the ADA:
• Bragdon v. Abbott: This June 1998 decision was about a Maine dentist, Randon Bragdon, who refused to fill a cavity for Sidney Abbott because Abbott was HIV-positive, a fact that was listed on her intake form. A federal trial court ruled in Abbott’s favor, as did the First Circuit Court of Appeals. Bragdon petitioned the U.S. Supreme Court to review the case, and the court agreed to do so.
The court examined three issues, including whether asymptomatic HIV is a disability under ADA, whether reproduction is a major life activity under the ADA (Abbott claimed that her HIV infection impaired her ability to have children), and whether courts should defer to a health care professional’s judgment about the direct threat a particular patient might pose.
The Supreme Court ruled in a 5-to-4 vote that HIV is always an impairment under the ADA, and they held that medical professionals are not entitled to special treatment in discrimination cases. Although the court’s ruling pertained to a woman who claimed protection under the ADA because her impairment would limit her major life activity of having children, it did note that "reproduction and the sexual dynamics surrounding it are central to the life process itself." This suggests that any person who is experiencing impairment of sexual activity due to HIV infection might be covered under the ADA.
This case has resulted in consistent lower court decisions that conclude that HIV-infected individuals are protected under the ADA, says Ben Klein, an attorney with Gay and Lesbian Advocates and Defenders in Boston, which was involved in the case.
• Albertsons v. Kirkingburg; Sutton v. United Airlines; Murphy v. United Parcel Service: In June 1999, the Supreme Court issued some additional ADA rulings that would appear to limit the act’s scope. These decisions basically said that individuals who have mostly eliminated the impact of their impairments through mitigating measures are not disabled enough to be covered by the ADA. For example, in the Albertsons v. Kirkingburg decision, a Portland truck driver was fired due to of his monocular vision. He had an excellent driving record, but his employer argued that his vision impairment was too serious to permit him to work but not serious enough to be covered by the ADA.
In Murphy v. United Parcel Service, the case involved a mechanic named Vaughn L. Murphy who was required to drive commercial vehicles. He had high blood pressure and was granted certification and began to work, despite the Department of Transportation’s health certification requirement that commercial drivers have no current clinical diagnosis of high blood pressure that would likely interfere with the person’s ability to drive safely. Murphy’s blood pressure is controlled by medication. Later, UPS let him go, citing his inability to meet certification requirements, so he sued under the ADA.
The Supreme Court ruling said, "Again, assuming without deciding that these regulations are valid, petitioner has failed to demonstrate that there is a genuine issue of material fact as to whether he is regarded as disabled." The ruling further states that UPS fired Murphy because of a physical impairment that the company believed would prevent him from obtaining DOT health certification and not because the company regarded Murphy as disabled.
Klein says while these decisions may be bad news for certain disabled people, including those who have diabetes or other conditions that can be successfully mitigated, they shouldn’t affect court decisions about HIV patients.
These rulings were completely inconsistent with Congress’ intent and the language of the ADA, says Catherine Hanssens, a lawyer and director of the AIDS Project at Lambda Legal Defense and Education Fund in New York City. Lambda participated in friend-of-the-court briefs in all three cases.
"But I think they are likely to have far less negative impact on people with HIV than those with other disabilities," Hanssens explains. "In the Bragdon v. Abbott decision, the first ADA case and the first HIV case the Supreme Court reviewed, even the more conservative members of the court seemed to recognize there is a stigma around HIV," she says.
• University of Alabama v. Garrett: This case, which was still pending as of the end of 2000, involves two state employees, Patricia Garrett and Milton Ash, who lost their jobs at the University of Alabama. Garrett was a nurse who was encouraged to leave her job after the university found out she had cancer. She took an unpaid leave of absence, and when she returned she was demoted. Ash, a security guard who has severe asthma, asked the university to enforce a no-smoking rule in his security booth and to maintain a truck he drove so that he wouldn’t get sick from the smoke and fumes. Both plaintiffs won in the 11th Circuit, and the Supreme Court heard their arguments on Oct. 11.
"The question the Supreme Court has considered in this past term is whether Congress violated the Constitution when they imposed the requirements of the ADA on the states," Hanssens says. "How the court rules will be particularly important in southern states where alternative remedies against state government discriminators are not as generous as they are in some of the Northeastern states and other parts of the country."
Lambda Legal Defense and Education Fund filed an amicus curiae brief in this case on behalf of civil rights and AIDS organizations. But whether this decision will affect HIV-infected workers will depend on what the court says when it finally rules on the case, Hanssens says.