457 U.S. 307 (1982)
Nicholas Romeo is a profoundly retarded individual with the mental capacity of an 18-month-old child and an I.Q. between 8 and 10.1 Until he was 26, Romeo lived with his parents in Philadelphia.2 After his father's death in May 1974, his mother petitioned the Philadelphia County Court of Common Pleas for his permanent admission to a state facility, stating she was unable to care for him or control his violence.3 Following examinations by a physician and psychologist who certified that Romeo was severely retarded and unable to care for himself, the Court of Common Pleas committed him on June 11, 1974, to the Pennhurst State School and Hospital under the Pennsylvania Mental Health and Mental Retardation Act.4
At Pennhurst, Romeo was injured on at least sixty-three occasions between July 1974 and November 1976, both by his own violence and by reactions from other residents.5 His mother filed this complaint on November 4, 1976, in the United States District Court for the Eastern District of Pennsylvania as his next friend against three administrators of the institution under 42 U.S.C. § 1983.6 The complaint alleged that the officials knew or should have known Romeo was suffering injuries and failed to institute appropriate preventive procedures.7
Romeo was transferred to the hospital for treatment of a broken arm.8 While in the infirmary, he was physically restrained during portions of each day by order of a doctor.9 A second amended complaint filed in December 1977 alleged that the defendants were restraining him for prolonged periods on a routine basis.10 The second amended complaint also added a claim for damages to compensate Romeo for the defendants' failure to provide him with appropriate treatment or programs for his mental retardation.11 All claims for injunctive relief were dropped prior to trial because Romeo was a member of a class seeking such relief in another action.12
An eight-day jury trial was held in April 1978.13 Petitioners introduced evidence that Romeo participated in several programs teaching basic self-care skills.14 A comprehensive behavior-modification program designed to reduce his aggressive behavior was never implemented because of his mother's objections.15 Respondent introduced evidence of his injuries and of conditions in his unit.16 The district court instructed the jury using a deliberate indifference standard drawn from Eighth Amendment cases, and the jury returned a verdict for the defendants.17
The Court of Appeals for the Third Circuit, sitting en banc, reversed and remanded for a new trial in 1980.18 The Supreme Court granted certiorari in 1981 because of the importance of the questions presented to the administration of state institutions for the mentally retarded.19
Whether an involuntarily committed mentally retarded person has substantive rights under the Due Process Clause of the Fourteenth Amendment to safe conditions of confinement?20
Yes. Nicholas Romeo was involuntarily committed to Pennhurst State School and Hospital on June 11, 1974, after examinations certified he was severely retarded and unable to care for himself.23 Between July 1974 and November 1976 Romeo suffered injuries on at least sixty-three occasions both by his own violence and by reactions from other residents.24 His mother filed the section 1983 complaint alleging that the three administrators knew or should have known of these injuries yet failed to institute appropriate preventive procedures.25
These facts establish an infringement of the protected liberty interest in safety that survives involuntary commitment.26
Romeo possesses a substantive right under the Due Process Clause to safe conditions of confinement.27
Whether an involuntarily committed mentally retarded person has a substantive right under the Due Process Clause of the Fourteenth Amendment to freedom from bodily restraints?28
Yes. After Romeo was transferred to the hospital for treatment of a broken arm he was physically restrained during portions of each day by order of a doctor.31 The second amended complaint filed in December 1977 alleged that the defendants were restraining Romeo for prolonged periods on a routine basis.32 These restraints implicate the fundamental liberty interest in freedom from bodily restraint that the Due Process Clause protects even after lawful commitment to a state institution for the mentally retarded.33
Romeo possesses a substantive right under the Due Process Clause to freedom from bodily restraints.34
Whether an involuntarily committed mentally retarded person has a substantive right under the Due Process Clause of the Fourteenth Amendment to training or habilitation?35
When an involuntarily committed resident's liberty interests in safety and freedom from undue restraint are at stake, the state must provide minimally adequate training.36 A qualified professional determines what training is reasonable to ensure those interests.37 Decisions by professionals are entitled to a presumption of correctness.38 Liability is imposed only for substantial departures from accepted professional judgment.39
Yes. Romeo's primary needs at Pennhurst were bodily safety and a minimum of physical restraint.40 The record shows he participated in some self-care programs while a behavior-modification program designed to reduce his aggressive behavior was never implemented because of his mother's objections.41 The district court erroneously instructed the jury under an Eighth Amendment deliberate-indifference standard rather than the professional-judgment standard required by due process.42
Because training related to safety and restraint may be necessary to avoid unconstitutional infringement of those established liberty interests, Romeo is entitled to such minimally adequate training as professionals reasonably deem appropriate.43
Romeo possesses a substantive right under the Due Process Clause to such training or habilitation as may be required to ensure his safety and freedom from undue restraint.44
Related opinions on this issue
Joined by Justices Brennan And O'connor
Justice Blackmun joined the Court's opinion but wrote separately to note that the record leaves uncertain whether Romeo seeks habilitation unrelated to safety and restraint.45 He would recognize a distinct liberty interest in training reasonably necessary to prevent deterioration of pre-existing self-care skills that the committed individual possessed upon commitment.46 Loss of such skills through state refusal to train constitutes an additional deprivation of liberty distinct from unsafe conditions or restraints.47
On the present record Blackmun agreed it was premature to resolve that claim and therefore concurred in the judgment.48
Chief Justice Burger concurred in the judgment but would hold flatly that respondent has no constitutional right to training or habilitation per se.49 He emphasized that because Romeo cannot function outside the institution and neither he nor his family seeks discharge, the state's provision of food, shelter, medical care, and reasonably safe living conditions justifies custody without any affirmative constitutional duty to supply particular training programs.50 Burger viewed any self-care instruction as relevant only insofar as it prevents unreasonable infringement of safety and restraint interests, not as an independent right.51