Bragdon v. Abbott, 524 U.S. 624 (1998) (majority opinion)

Court and Agency Decisions and Orders (including case law)

Sidney Abbott, who is HIV-positive, sought dental care (filling a cavity) from Randon Bragdon, a dentist in Maine. After Abbott disclosed her HIV status on a registration form, Bragdon refused to treat her in his office, instead offering to treat her at a local hospital where, he asserted, they would be better equipped to minimize the risk of HIV exposure. Abbott declined the alternative arrangements and brought suit against Bragdon, alleging violation of Title III of the Americans with Disabilities Act (ADA), which prohibits discrimination on the basis of disability in places of public accommodation. Abbott asserted that her HIV infection substantially limited her ability to bear children, which qualified her as a person with a disability for purposes of ADA coverage. The District Court found in favor of Abbott, ruling that her HIV infection satisfied the statutory definition of disability, and that her HIV status did not pose a direct threat to Bragdon. On appeal, the First Circuit affirmed, holding that Abbott’s HIV infection qualified as a disability under the ADA, even though she was asymptomatic at the time, and that treating Abbott in a dental office would not have posed a direct threat to the health and safety of others. The Supreme Court affirmed. Writing for the court, Justice Kennedy, relying on the first prong of the ADA definition of disability, found that (1) HIV infection, whether symptomatic or asymptomatic, qualifies as an impairment, (2) reproduction is a major life activity, and (3) the impairment of HIV infection substantially limits the major life activity of reproduction. According to the court, “the [ADA] addresses substantial limitations on major life activities, not utter inabilities.” The court explicitly did not address the question of whether or not HIV infection is a per se disability under the ADA. The court also found that Bragdon did not present any “objective, medical evidence” indicating that it would be safer to treat Abbott in a hospital as opposed to his office. However, concerned that the First Circuit’s reliance on certain agency guidelines to support their position was misplaced, the court remanded the case on this issue.