The opinion of the court was delivered by: Urbina, District Judge.
The above captioned case arises out of two cases now
consolidated into one. The
first case, Civil Action No. 95-601, was originally filed by the
United States of America against the District of Columbia and
William Bennett, a representative patient at Saint Elizabeths
Hospital in Washington, D.C. The second case, Civil Action No.
96-2551, was originally filed by a group of patients at Saint
Elizabeths Hospital, including Mr. Bennett, against Janet Reno in
her official capacity as Attorney General of the United States
and Zanni Guido in his official capacity as Commissioner on
Mental Health Services for the District of Columbia. In the
consolidated case, Civil Action No. 95-601, the plaintiff is the
United States of America and the defendants are the District of
Columbia and the group of patients at Saint Elizabeths Hospital.
The consolidated case is currently before the court on all
parties' motions for summary judgment. For the reasons stated
herein, the court will grant the plaintiff's motion for summary
judgment and deny the defendants' motions for summary judgment.
This action commenced on March 29, 1995, when the United States
of America (hereinafter "plaintiff") filed a complaint against
the District of Columbia and Mr. Bennett seeking release of the
psychiatric records of a group of patients who had been committed
to Saint Elizabeths Hospital (hereinafter "St. Elizabeths")
pursuant to D.C.Code Ann. § 24-301(d)(1) after having been found
not guilty of federal crimes by reason of insanity. In the
original complaint, the plaintiff alleged that it was entitled to
access the patients' psychiatric records pursuant to
24 U.S.C. § 225f, which provided for the transfer to the District of Columbia
of "all right, title, and interest of the United States in all
real property at Saint Elizabeths Hospital. . . ."
24 U.S.C. § 225f(a)(1). During the pendency of this litigation, however,
Congress amended 18 U.S.C. § 4243 to include a provision that
specifically grants the plaintiff access to the records sought.
See Title III of the Economic Espionage Act of 1996, Pub.L. No.
104-294, § 301, 110 Stat. 3488, 3494-95 (Oct. 11, 1996)
(hereinafter "Title III"). Consequently, the plaintiff now relies
primarily on Title III to support its allegation of entitlement
to the patients' psychiatric records.
Both the District of Columbia and the patients whose records
are being sought (hereinafter collectively referred to as
"defendants") contend that the plaintiff is not legally entitled
to the records. Consequently, on November 8, 1996, the patients
filed a complaint seeking a declaration that the provision of
Title III that grants the plaintiff access to their records
(hereinafter "access provision") is unconstitutional and seeking
an injunction barring St. Elizabeths from releasing their
records. The patients also seek a declaration that a separate
provision of Title III, which provides for the transfer of the
patients themselves into the custody of the Attorney General,
(hereinafter "transfer provision") is unconstitutional. In
addition, they seek an injunction barring the plaintiff from
attempting to obtain custody of the patients.
On November 20, 1996, the court granted the patients' motion
for a temporary restraining order, thus barring the plaintiff
from either accessing the records or attempting to obtain custody
of the patients. Subsequently, the court consolidated the
plaintiff's original complaint and the complaint later filed by
the patients into the action currently before the court.
II. LEGAL STANDARD FOR SUMMARY JUDGMENT
All parties to this action have filed motions for summary
judgment. Summary judgment is appropriate upon a finding that
"there is no genuine issue as to any material fact and that the
moving party is entitled to a judgment as a matter of law."
Fed.R.Civ.P. 56(c). The substantive law upon which a claim rests
determines which facts are "material." See Anderson v. Liberty
Lobby, Inc., 477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202
(1986). If a
fact bears upon an essential element of the legal claim, then it
is material; otherwise, it is not. See id.; Celotex Corp. v.
Catrett, 477 U.S. 317, 322, 106 S.Ct. 2548, 91 L.Ed.2d 265
(1986). Only disputes over facts that can establish an element of
the claim, and thus might affect its ultimate resolution, can
create a "genuine issue" sufficient to preclude summary judgment.
See Anderson, 477 U.S. at 248, 106 S.Ct. 2505; Celotex, 477
U.S. at 322, 106 S.Ct. 2548.
To prevail on a motion for summary judgment, the moving party
bears the burden of establishing that there are no genuine issues
of material fact and that the nonmoving party has failed to offer
sufficient evidence to support a valid legal claim. See
Anderson, 477 U.S. at 256, 106 S.Ct. 2505; Celotex, 477 U.S.
at 325, 106 S.Ct. 2548. In ruling on the motion, the court must
accept the evidence of the nonmoving party as true and must draw
all justifiable inferences in favor of the nonmoving party. See
Anderson, 477 U.S. at 255, 106 S.Ct. 2505. It is not sufficient,
however, for the nonmoving party to establish "the mere existence
of a scintilla of evidence in support of the [nonmoving party's]
position . . .; there must be evidence on which the jury could
reasonably find for the [nonmoving party]." Id. at 252, 106
S.Ct. 2505. If the evidence in favor of the nonmoving party "is
merely colorable, or is not significantly probative, summary
judgment may be granted." Id. at 249-50, 106 S.Ct. 2505
(internal citations omitted).
In this case, the court concludes that there are no genuine
issues of material fact and that the plaintiff is entitled to
judgment as a matter of law. Accordingly, the plaintiff's motion
for summary judgment will be granted and the defendants' motions
for summary judgment will be denied.
A. Legislative History
The Insanity Defense Reform Act, 18 U.S.C. § 4243, which
Congress enacted in 1984, provides for the mandatory
hospitalization of defendants found not guilty of federal crimes
by reason of insanity. Even prior to the enactment of
18 U.S.C. § 4243, however, defendants charged with federal crimes in the
District of Columbia who were found not guilty by reason of
insanity were automatically committed to a hospital for the
mentally ill. These defendants were committed to St. Elizabeths
pursuant to D.C.Code Ann. § 24-301(d)(1), which provides as
If any person tried upon an indictment or information
for an offense raises the defense of insanity and is
acquitted solely on the ground that he was insane at
the time of its commission, he shall be committed to
a hospital for the mentally ill until such time as he
is eligible for release. . . .
It was pursuant to D.C.Code Ann. § 24-301(d)(1) that all of the
patients who are parties to this action were committed to St.
From 1855 until 1987, St. Elizabeths was owned and operated by
the United States government. See 24 U.S.C. § 225, 225f. On
October 1, 1987, however, Congress transferred ownership and
control of St. Elizabeths to the District of Columbia. See
24 U.S.C. § 225f. Nevertheless, the United States remained
financially responsible for all patients committed to St.
Elizabeths as a result of having been found not guilty of federal
crimes by reason of insanity. See 24 U.S.C. § 225g(b)(1)(C)
(directing the United States to pay "the full costs for the
provision of mental health diagnostic and treatment services for
. . . any individual referred to the system as a result of a
criminal proceeding in a Federal court").
Nothing in 24 U.S.C. § 225-225h expressly entities the United
States to access to the psychiatric records of the patients for
whom it is financially responsible. Title III, however, does just
that. In relevant part, the access provision of Title III states:
[T]he District of Columbia and St. Elizabeths Hospital —
(1) not later than 30 days after the date of
enactment of this Act, shall provide to the Attorney
General copies of all records in the custody or
control of the District or the Hospital on such date
of enactment pertaining to persons described in
section 4243(i) of title 18, United States Code (as
added by subsection (a));
(2) not later than 30 days after the creation of
any records by employees, agents, or contractors of
the District of Columbia or of St. Elizabeth's
Hospital pertaining to persons described in section
4243(i) of title 18, United States Code, provide to
the Attorney General copies of all such records
created after the date of enactment of this Act. . ..
See Pub.L. No. 104-294, § 301, 110 Stat. at 3495. "Persons
described in section 4243(i) of title 18, United States Code (as
added by subsection (a))" includes "all persons who have been
committed to a hospital for the mentally ill pursuant to section
301(d)(1) of title 24 of the District of Columbia Code, and for
whom the United States has continuing financial responsibility."
See Pub.L. No. 104-294, § 301, 110 Stat. at 3494. Accordingly,
Title III expressly mandates the release of the defendant
patients' records to the plaintiff.
Title III does not stop there, however. In addition to
providing for access to the patients' records, Title III also
provides for the transfer of the patients themselves into the
custody of the Attorney General. In relevant part, the transfer
provision of Title III states:
[A]ll persons who have been committed to a hospital
for the mentally ill pursuant to section 301(d)(1) of
title 24 of the District of Columbia Code, and for
whom the United States has continuing financial
responsibility, may be transferred to the custody of
the Attorney General, who shall hospitalize the
person for treatment in a suitable facility.
See Pub.L. No. 104-294, § 301, 110 Stat. at 3494. This court
begins its analysis of the claims presently before it in the wake
of Title III and its clearly expressed intent to entitle the
United States to access the patients' records and to transfer the
patients into its custody.
With respect to the constitutionality of Title III's transfer
provision, the plaintiff argues that the issue is not ripe for
adjudication. Having reviewed the parties' submissions, the
relevant law and the record herein, the court agrees with the
plaintiff that the issue regarding the constitutionality of Title
III's transfer provision is not yet ripe for review and, thus, is
not properly before the court at this time.
To determine whether or not an issue is ripe for adjudication,
a court must "evaluate both the fitness of the issues for
judicial decision and the hardship to the parties of withholding
court consideration." Texas v. United States, 523 U.S. 296, 118
S.Ct. 1257, 1260, 140 L.Ed.2d 406 (1998) (quoting Abbott Lab. v.
Gardner, 387 U.S. 136, 149, 87 S.Ct. 1507, 18 L.Ed.2d 681
(1967)) (internal quotations omitted). With respect to the
"fitness for judicial decision" prong, the Supreme Court has said
that "[a] claim is not ripe for adjudication if it rests upon
`contingent future events that may not occur as anticipated, or
indeed may not occur at all.'" Texas, 118 S.Ct. at 1259
(quoting Thomas v. Union Carbide Agric. Products Co.,
473 U.S. 568, 581, 105 S.Ct. 3325, 87 L.Ed.2d 409 (1985)). Similarly, with
respect to the "hardship to the parties" prong, the Supreme Court
has said that an abstract harm is not sufficient; there must be
an immediate harm with a "direct effect on the day-to-day
business of the plaintiffs." Texas, 118 S.Ct. at 1260 (quoting
Abbott, 387 U.S. at 152, 87 S.Ct. 1507) (internal citations
Examining the allegations in the instant case through the lens
of Texas v. United States, the court concludes that the
future events contemplated by the defendants are too speculative
and the hardship is too abstract to warrant judicial
consideration of the defendants' constitutional challenge to
Title III's transfer provision. On its face, the transfer
provision of Title III does nothing more than authorize the
Attorney General to establish custody over the defendant
patients. It does not, however, mandate that the Attorney General
take such action. Moreover, even if the Attorney General were to
exercise her authority under Title III to establish custody over
the defendants, Title III does not mandate a physical transfer of
the patients from St. Elizabeths to some other facility. Title
III merely states that the Attorney General, upon taking custody
of any patient, "shall hospitalize the person for treatment in a
suitable facility." This could mean keeping the patient at St.
Elizabeths or moving the patient elsewhere, but nothing in Title
III suggests that any one outcome is more likely than another.
Under these circumstances, where the court has no idea whether
one or any of several possibilities will occur, the potential
harm from one anticipated possibility is not immediate and the
issue is not fit for adjudication. See Texas, 118 S.Ct. at 1260
("Under these circumstances, where we have no idea whether or
when such a sanction will be ordered, the issue is not fit for
adjudication." (quoting Toilet Goods Assn., Inc. v. Gardner,
387 U.S. 158, 163, 87 S.Ct. 1520, 18 L.Ed.2d 697 (1967))
(internal quotations omitted)). Accordingly, the court concludes
that the defendants' constitutional challenge to Title III's
transfer provision is not ripe for review and, therefore, not
justiciable at this time.
C. Unclean Hands
Having determined that the issue regarding the
constitutionality of Title III's transfer provision is not
properly before it, the court will limit the remainder of its
analysis to the issue of whether or not the United States is
entitled to access the defendant patients' psychiatric records.
At the outset of this analysis, the court will address the
defendants' argument that the United States may not seek
declaratory relief because it has "unclean hands."
"The doctrine of `unclean hands' is designed to preserve the
integrity of the Court by protecting it from exercising its
powers to aid those who are before the Court as a result of their
own fraudulent behavior." Rubin v. Warner, 881 F. Supp. 23, 25
(D.D.C. 1995). The defendants offer three arguments in support of
their assertion that the plaintiff has unclean hands. First, they
argue that the plaintiff has disregarded its duty under
24 U.S.C. § 225g(b)(1)(C) to pay for the care and treatment of the
defendant patients. (Mem. of Points and Auth. in Supp. of D.C.'s
Mot. for Summ.J. at 9.) Second, they argue that the plaintiff has
misrepresented facts to this court by incorrectly stating that it
pays "millions of dollars each year" for the care and treatment
of the defendant patients. (Mem. of Points and Auth. in Supp. of
D.C.'s Mot. for Summ.J. at 9.) Finally, they argue that the
plaintiff is "request[ing] confidential records under the
pretense of administrative need when in fact, the United States
wants to assert a punitive, prosecutorial role with regard to the
[defendant patients]." (Mem. of Points and Auth. in Supp. of
D.C.'s Mot. for Summ.J. at 10.)
With respect to the defendants' second and third arguments, the
court concludes that there is not sufficient evidence in the
record to support the defendants' allegations or to warrant
application of the unclean hands doctrine. With respect to the
defendants' first argument, the court also concludes that
application of the unclean hands doctrine would be inappropriate.
The unclean hands doctrine is appropriately applied when "the
alleged misconduct is connected with the transaction upon which
the plaintiff seeks relief." Rubin, 881 F. Supp. at 26 (quoting
Adams v. Manown, 328 Md. 463, 615 A.2d 611, 617 (1992))
(internal quotations omitted). In the instant case, the court
that the alleged uncleanliness proffered by the defendants is not
sufficiently connected with the transaction upon which the
plaintiff seeks relief. This is especially so given that the
alleged uncleanliness is itself the subject of separate
litigation filed by the defendants. (See Mem. of Points and
Auth. in Supp. of D.C.'s Mot. for Summ.J. at 8 (referencing
United States Court of Federal Claims No. 93-601C).) Accordingly,
the court will not invoke the unclean hands doctrine to preclude
the plaintiff from seeking declaratory relief in this case.
Turning now to the merits of the issue of whether the United
States is entitled to access the psychiatric records of the
defendant patients, the court will first address the question of
preemption. The defendants argue that Title III does not preempt
District of Columbia laws prohibiting access to the patients'
records because Title III is, in essence, a local law, not a
federal law. The defendants base this argument on the fact that
Title III applies exclusively to the District of Columbia and has
no effect on any other state. Despite the limited repercussions
of Title III, however, the court concludes that Title III is
indeed a federal law and that it preempts District of Columbia
1. Federal Versus State Law
In Brown v. United States, 742 F.2d 1498 (D.C.Cir. 1984), the
United States Court of Appeals for the District of Columbia
Circuit recognized that
[u]nder the Constitution, Congress has authority to
act as the local legislature for the District of
Columbia, and thus Congress frequently enacts
legislation applicable only to the District and
tailored to meet local needs. Absent evidence of
contrary congressional intent, such enactments should
be treated as local law, interacting with federal law
as would the laws of the several states.
Id. at 1502. The defendants cite this and other similar cases
in support of their proposition that Title III constitutes a
local, not federal, law. These cases, however, represent
instances in which Congress, by its authority to act as the local
legislature for the District of Columbia, enacted provisions of
law within the D.C.Code, not the United States Code. See, e.g.,
Brown, 742 F.2d at 1501 (discussing federal applicability of
D.C.Code Ann. § 12-309); Key v. Doyle, 434 U.S. 59, 61, 98
S.Ct. 280, 54 L.Ed.2d 238 (1977) (discussing whether D.C.Code
Ann. § 18-302 was a "statute of the United States"). The instant
case is distinguishable in that it represents an instance in
which Congress enacted an amendment to an already existing
federal statute within the United States Code, namely
18 U.S.C. § 4243.
There is no question but that 18 U.S.C. § 4243 is a federal law
applicable to all states in the Union. As an amendment to
18 U.S.C. § 4243, Title III merely supplements that law by
addressing an issue that was left unresolved by the original
statute. The fact that the issue is germane to the District of
Columbia and Title III is, therefore, limited in its application
to the District does not take the amendment out of the scope of
the overall statute. Accordingly, the court concludes that Title
III has the force and effect of a federal law.
2. Federal Preemption of State Law
Under the preemption doctrine "state law that conflicts with
federal law is `without effect.'" Cipollone v. Liggett Group,
Inc., 505 U.S. 504, 516, 112 S.Ct. 2608, 120 L.Ed.2d 407 (1992)
(quoting Maryland v. Louisiana, 451 U.S. 725, 746, 101 S.Ct.
2114, 68 L.Ed.2d 576 (1981)). In determining whether Congress
intended a federal law to preempt a state law, "the purpose of
Congress is the ultimate touchstone of [the] analysis."
Cipollone, 505 U.S. at 516, 112 S.Ct. 2608 (quoting Malone v.
White Motor Corp., 435 U.S. 497, 504, 98 S.Ct. 1185, 55 L.Ed.2d
443 (1978)) (internal quotations omitted). Congress
may explicitly state its intent in the language of a statute or
it may implicitly state its intent via a statute's structure and
purpose. See Cipollone, 505 U.S. at 516, 112 S.Ct. 2608. "In
the absence of an express congressional command, state law is
preempted if that law actually conflicts with federal law." Id.
The explicit language of Title III makes clear that Congress
intended to provide for the acquisition by the United States of
"all records in the custody or control of the District or [St.
Elizabeths] Hospital" pertaining to the defendant patients.
Pub.L. No. 104-294, § 301, 110 Stat. at 3495. There is no
reasonable way to reconcile this purpose with any congressional
intent but that Title III would preempt any D.C. law that
prohibited such acquisition by the United States. Accordingly,
the court concludes that Congress intended by the explicit
language of Title III to preempt any D.C. law in conflict with
Title III's stated purpose.
Having concluded that Title III is a federal law which preempts
District of Columbia law, the court will dispense with those
arguments of the defendants that are grounded in D.C. law and
will instead move to a discussion of the constitutionality of
Title III's access provision.
E. Right to Privacy
The defendants argue that the access provision of Title III
violates the defendant patients' rights to privacy and is,
therefore, unconstitutional. Consequently, the defendants argue
that the court should not enforce the mandates of the access
provision. The court, however, concludes that Title III's access
provision is constitutional and enforceable.
There is no express provision in the Constitution of the United
States that bestows upon individuals a right to privacy. The
Supreme Court, however, has recognized that such a right exists
by virtue of the Due Process Clause of the Fourteenth Amendment.
See Carey v. Population Services Int'l, 431 U.S. 678, 684, 97
S.Ct. 2010, 52 L.Ed.2d 675 (1977). The right to privacy protects
at least two separate interests. The first is an individual's
interest in "avoiding disclosure of personal matters." Whalen v.
Roe, 429 U.S. 589, 599-600, 97 S.Ct. 869, 51 L.Ed.2d 64 (1977).
The second is an individual's interest in "independence in making
certain kinds of important decisions." Id. The defendant
patients in the instant case argue that the court should
recognize a privacy right protecting their interest in avoiding
disclosure of their psychiatric records.
Several courts, including the Supreme Court, have recognized an
individual's right to privacy in avoiding disclosure of medical
records. See, e.g., Whalen, 429 U.S. at 603-604, 97 S.Ct. 869
(recognizing a limited privacy interest in the confidentiality of
medical records); Doe v. Southeastern Pennsylvania Transp.
Auth., 72 F.3d 1133, 1137 (3d Cir. 1995) (stating that medical
records fall within the scope of the right to privacy); F.E.R.
v. Valdez, 58 F.3d 1530, 1530 (10th Cir. 1995) (recognizing that
patients have a legitimate expectation of privacy in their
psychiatric records). This right to privacy is not absolute,
however, and "a limited impairment of the right may be allowed if
properly justified." Soto v. City of Concord, 162 F.R.D. 603,
618 (N.D.Cal. 1995).
Various courts have developed slightly different tests to
determine whether encroachment upon an individual's right to
privacy rises to the level of a constitutional violation. See,
e.g., Doe, 72 F.3d at 1140 (setting forth seven factors to be
weighed in determining whether disclosure of medical records
constitutes an invasion of privacy); F.E.R., 58 F.3d at 1535
(employing a three-part balancing test); Soto, 162 F.R.D. at
619 (setting forth five factors to be considered); Fraternal
Order of Police v. Philadelphia, 812 F.2d 105, 111 (3d Cir.
1987) (applying a "flexible balancing test"). In essence,
however, all courts agree that the constitutionality of a
government action that encroaches upon the
privacy rights of an individual is determined by balancing the
nature and extent of the intrusion against the government's
interest in obtaining the information it seeks.
The court begins its analysis, therefore, by examining the
nature and extent of the defendant patients' interest in avoiding
disclosure of their psychiatric records. In this respect, several
facts seem particularly relevant. First, the defendant patients
in the instant case have, to some extent, made their mental
conditions matters of public record by pleading not guilty to
federal crimes by reason of insanity. The United States Court of
Appeals for the Eighth Circuit has noted that "[w]hatever the
scope of the constitutional right of privacy . . ., it is clear
that `the interests in privacy fade when the information involved
already appears on the public record.'" McNally v. Pulitzer Pub.
Co., 532 F.2d 69, 77 (8th Cir. 1976) (quoting Cox Broad. Corp.
v. Cohn, 420 U.S. 469, 494-95, 95 S.Ct. 1029, 43 L.Ed.2d 328
(1975)). In McNally, the Eighth Circuit held that the
publication of an inmate's confidential psychiatric report did
"not support a claim for invasion of any constitutional right of
privacy" because "substantial information regarding [the
inmate's] mental competency was a matter of public record." Id.
at 77-78. Thus, although the court believes that the defendant
patients do have a privacy interest in avoiding disclosure of
their psychiatric records, this interest is somewhat lessened by
the fact that the patients have to some extent made their mental
conditions matters of public record.
Second, the plaintiff in the instant case does not seek to
obtain the patients' records for public disclosure. The United
States merely seeks to obtain the records for its own use. In a
similar case, the Supreme Court noted that non-public disclosures
of medical records constitute less of an intrusion upon an
individual's right to privacy than do public disclosures. See,
e.g., Whalen, 429 U.S. at 601, 97 S.Ct. 869 (taking into
consideration the fact that there was "no support in the record .
. . for an assumption that the security provisions of the statute
[would] be administered improperly"). Indeed, in Whalen the
Supreme Court went so far as to state that non-public disclosures
of private medical records to authorized government employees are
meaningfully distinguishable from a host of other
unpleasant invasions of privacy that are associated
with many facets of health care. . . . [D]isclosures
of private medical information to doctors, to
hospital personnel, to insurance companies, and to
public health agencies are often an essential part of
modern medical practice even when the disclosure may
reflect unfavorably on the character of the patient.
Requiring such disclosures to representatives of the
State having responsibility for the health of the
community, does not automatically amount to an
impermissible invasion of privacy.
Whalen, 429 U.S. at 602, 97 S.Ct. 869 (internal footnote
omitted). Similarly, the court concludes in the instant case that
requiring disclosure of the defendant patients' psychiatric
records to representatives of the United States having financial
responsibility for the care and treatment of the patients does
not automatically amount to an impermissible invasion of the
patients' privacy rights.
On one side of the scale, then, is a limited privacy interest
of the defendant patients in avoiding disclosure of their
psychiatric records to the plaintiff. On the other side of the
scale is the plaintiff's interest in obtaining the patients'
records. In considering the plaintiff's interest, the court notes
that the plaintiff is financially responsible as a matter of law
for the care and treatment of the patients. The plaintiff has a
compelling interest "in ensuring that services and supplies for
which it is being billed have been provided, and that [it] is not
being defrauded." Hawaii Psychiatric Soc'y v. Ariyoshi,
481 F. Supp. 1028, 1041 (D.Haw. 1979). Moreover, the plaintiff in the
instant case has an additional
responsibility to ensure that the defendant patients who have
been committed to St. Elizabeths after having been found not
guilty of federal crimes by reason of insanity are afforded the
highest quality care in a facility that is most suited to their
needs as well as the needs of the public. Cf. Jones v. United
States, 463 U.S. 354, 368, 103 S.Ct. 3043, 77 L.Ed.2d 694 (1983)
("The Due Process Clause requires that the nature and duration of
commitment bear some reasonable relation to the purpose for which
the individual is committed. The purpose of commitment following
an insanity acquittal . . . is to treat the individual's mental
illness and protect him and society from his potential
dangerousness." (internal quotations and citations omitted));
Youngberg v. Romeo, 457 U.S. 307, 317, 102 S.Ct. 2452, 73
L.Ed.2d 28 (1982) ("When a person is institutionalized — and
wholly dependent on the State — . . . a duty to provide certain
services and care does exist. . . ."); Reese v. United States,
614 A.2d 506, 506 (D.C. 1992) ("The dual purposes of [commitment
of individuals found not guilty by reason of insanity] are first,
the treatment and recovery of the patient, and second, the
protection of society and the patient." (internal quotations
Weighing the competing interests asserted by the parties, the
court concludes that the intrusion upon the defendant patients'
privacy rights caused by allowing the plaintiff access to their
records does not rise to the level of a constitutional violation
given the plaintiff's compelling interest in obtaining the
records. Accordingly, the court concludes that the access
provision of Title III is constitutionally valid. Moreover, the
court concludes that the plaintiff cannot properly fulfill its
responsibilities to the patients without the benefit of access to
all of their psychiatric records. Accordingly, the court will
grant the plaintiff's request for declaratory relief to secure
access to the patients' records pursuant to Title III.
For the reasons stated herein, the court rules that the issue
regarding the constitutionality of Title III's transfer provision
is not ripe for adjudication at this time. With respect to the
access provision of Title III, the court rules that the provision
is constitutionally valid. The court further rules that the
plaintiff, the United States of America, is entitled under Title
III to access the psychiatric records of the defendant patients.
Accordingly, the court will grant the plaintiff's motion for
summary judgment and deny the defendants' motions for summary
An appropriate Order directing the parties in a fashion
consistent with this Memorandum Opinion is separately and
contemporaneously executed and issued this 31st day of March,
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