Doe v. Delie , 257 F.3d 309 ( 2001 )


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  •                                                                                                                            Opinions of the United
    2001 Decisions                                                                                                             States Court of Appeals
    for the Third Circuit
    7-19-2001
    Doe v. Delie
    Precedential or Non-Precedential:
    Docket 99-3019
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    Recommended Citation
    "Doe v. Delie" (2001). 2001 Decisions. Paper 160.
    http://digitalcommons.law.villanova.edu/thirdcircuit_2001/160
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    Filed July 19, 2001
    UNITED STATES COURT OF APPEALS
    FOR THE THIRD CIRCUIT
    No. 99-3019
    JOHN DOE,
    Appellant
    v.
    JOAN DELIE, Health Care Administrator;
    PAUL NOEL, Medical Director; DIANE MANSON,
    Medical Nurse/Grievance Officer; SOPHIE SWIKA, Medical
    Nurse; KIM ZIMMERMAN, Medical Nurse, and all other
    parties et al., relevant to this instant civil action against
    them; JAMES PRICE, Superintendent (SCI Pittsbur gh)
    Appeal from the United States District Court
    for the Western District of Pennsylvania
    (D.C. Civil Action No. 97-cv-01264)
    District Judge: Honorable Donald E. Ziegler
    Argued September 11, 2000
    Before: NYGAARD, ROTH and GARTH, Cir cuit Judges
    (Opinion filed: July 19, 2001)
    Martha E. Johnston, Esquire
    (Argued)
    Wolf, Block, Schorr and
    Solis-Cohen LLP
    1650 Arch Street, 22nd Floor
    Philadelphia, PA 19103-2097
    Attorney for Appellant
    D. Michael Fisher, Attorney General
    Calvin R. Koons,
    Senior Deputy Attorney General
    John G. Knorr, III,
    Chief Deputy Attorney General
    Howard G. Hopkirk, Esq.
    J. Bart DeLone, Esquire (Argued)
    Office of Attorney General of
    Pennsylvania
    Strawberry Square, 15th Floor
    Harrisburg, PA 17120
    Attorneys for Appellees
    Charles W. Kenrick, Esquire
    Vincent C. Longo, Esquire (Argued)
    Grogan, Graffam & McGinley
    Three Gateway Center, 22nd Floor
    Pittsburgh, PA 15222
    Attorneys for Appellee,
    Paul Noel
    OPINION OF THE COURT
    ROTH, Circuit Judge:
    John Doe, a former inmate of the Pennsylvania
    Department of Corrections, is HIV-positive. He was
    informed by the medical staff at the State Correctional
    Institution at Pittsburgh (SCIP) that his medical condition
    would be kept confidential. However, because of certain
    practices permitted by prison officials, Doe's condition was
    not kept confidential. Doe sued under 42 U.S.C.S 1983,
    claiming that prison practices violated his right to medical
    privacy under the Fourteenth Amendment and under the
    Pennsylvania Confidentiality of HIV-Related Information
    Act, 35 P.S. S 7601 et seq. The District Court granted
    defendants' motions to dismiss the S 1983 claims on the
    basis of qualified immunity, declined jurisdiction over the
    state claims, and dismissed the case.
    Although we ultimately agree that defendants ar e entitled
    to qualified immunity, we do not agree with the District
    2
    Court's reasoning. We hold that the Fourteenth Amendment
    protects an inmate's right to medical privacy, subject to
    legitimate penological interests. However , because this right
    was not clearly established at the time of defendants'
    conduct, we will affirm the dismissal of Doe's complaint.
    I. FACTS
    John Doe arrived at SCIP on January 11, 1995. Shortly
    thereafter, Doe was informed by the medical staff that he
    was HIV-positive. After signing a written consent of
    disclosure form, he was told that his medical condition
    would be kept confidential and that medical r ecords
    relating to his illness would be maintained separately from
    his general prison file.
    Because of certain procedures permitted by defendants,
    Doe's condition was not kept confidential. Specifically,
    when Doe was taken for sick call appointments, staf f
    informed the escorting officers of Doe's medical condition.
    During physician visits, staff kept the door to the clinic
    room open, allowing officers, inmates, and guards in the
    area to see and hear Doe and the treating physician.
    Finally, while administering medication, nurses announced
    his medication loudly enough for others to hear , allowing
    inmates to infer Doe's condition. Doe filed administrative
    grievances concerning the sick call and medication
    distribution practices, but the grievances did not bring
    about any change in the practices.
    On July 11, 1997, Doe, proceeding pr o se, filed suit
    under 42 U.S.C. S 1983 and the Pennsylvania
    Confidentiality of HIV-Related Infor mation Act, 35 P.S.
    S 7601 et seq. in the United States District Court for the
    Western District of Pennsylvania. The complaint named as
    defendants Joan Delie, Health Care Administrator at SCIP;
    Dr. Paul Noel, Medical Director of SCIP; Diane Manson, a
    Nurse/Grievance Officer; and Sophie Swika and Kim
    Zimmerman, both nurses at SCIP. Doe claimed his
    constitutional right to privacy was violated by the"open-
    door" examination room policy, by the disclosure of his
    medical condition to corrections officer escorts, and by the
    loud announcement of the names of his medications. He
    3
    alleged that these practices made him reluctant to discuss
    embarrassing symptoms with doctors, subjected him to
    psychological harassment and humiliation, and caused him
    to discontinue treatment. Doe requested declaratory and
    injunctive relief, as well as nominal, compensatory, and
    punitive damages.
    On August 5, 1997, Doe filed motions for a temporary
    restraining order and a preliminary injunction ordering
    defendants to provide for nondisclosure of his medical
    information during sick call visits and medication
    distribution. The Magistrate Judge recommended that both
    motions be denied pending service of the complaint and
    motions on defendants. This Report and Recommendation
    was adopted by the District Court on September 16, 1997.
    After service of the complaint,1 defendants Delie, Manson,
    and Swika, and defendant Noel by separate motion, moved
    to dismiss for failure to state a claim pursuant to Federal
    Rule of Civil Procedure 12(b)(6). Doe was granted leave to
    file an amended complaint and did so on Mar ch 3, 1998.
    The amended complaint added James Price, the
    superintendent of SCIP, as a defendant and otherwise
    reasserted Doe's privacy claims. Defendants r easserted
    their motions to dismiss based, inter alia, on the defense of
    qualified immunity, which shields public officials from
    actions for damages unless their conduct was unr easonable
    in light of clearly established law.
    The Magistrate Judge issued a Report and
    Recommendation on September 21, 1998. The Magistrate
    found that no clear federal constitutional right to
    nondisclosure of an inmate's medical condition exists and
    recommended dismissal of defendants Delie, Manson,
    Swika, and Price on grounds of qualified immunity. The
    Magistrate found that the only involvement alleged as to
    defendant Noel was his inadequate response to Doe's
    grievances, which did not give rise to a S 1983 claim. In
    addition, the Magistrate Judge found, sua sponte , that
    _________________________________________________________________
    1. Nurse Zimmerman was never served with pr ocess in the district court.
    She is not a Commonwealth employee, and was appar ently referred to
    SCIP through a private nursing facility. Ef forts to locate her at that
    agency were unsuccessful.
    4
    defendant Zimmerman was entitled to qualified immunity
    for her alleged misconduct and recommended dismissal of
    the complaint against her pursuant to 28 U.S.C.
    S 1915(e)(2)(B)(ii). Finally, the Magistrate Judge
    recommended that the District Court decline to exercise
    supplemental jurisdiction over Doe's state law claims.
    Over Doe's objections, the District Court adopted the
    Magistrate Judge's Report and Recommendation and
    dismissed the case on December 17, 1998. On January 13,
    1999, Doe filed his notice of appeal of the District Court's
    decision. We appointed counsel for Doe and have benefitted
    as a result from counsel's willingness to undertake this
    representation.
    Shortly before oral argument, counsel informed us that
    Doe was awaiting a re-trial on his conviction. Counsel has
    now informed us that Doe was acquitted in his re-trial, and
    therefore is no longer an inmate at SCIP .
    II. JURISDICTION AND STANDARD OF REVIEW
    The District Court had subject matter jurisdiction over
    Doe's S 1983 claims pursuant to 28 U.S.C.S 1331 and over
    the state law claim under 28 U.S.C. S 1367. W e have
    appellate jurisdiction over the District Court'sfinal
    judgment pursuant to 28 U.S.C. S 1291. W e exercise
    plenary review over the District Court's dismissal of a
    complaint pursuant to Fed.R.Civ.P. 12(b)(6) for failure to
    state a claim. Piecknick v. Commonwealth of Pennsylvania,
    
    36 F.3d 1250
    , 1255 (3d Cir. 1994). W e must accept as true
    all of the factual allegations in the complaint as well as the
    reasonable inferences that can be drawn fr om them. Moore
    v. Tartler, 
    986 F.2d 682
    , 685 (3d Cir. 1993). We may
    dismiss the complaint only if it is clear that no r elief could
    be granted under any set of facts that could be pr oved
    consistent with the allegations. Hishon v. King & Spalding,
    
    467 U.S. 69
    , 73 (1984).
    III. DISCUSSION
    Because Doe is no longer an inmate at SCIP, we must
    first consider whether his claims are moot before reviewing
    the District Court's qualified immunity analysis.
    5
    A. MOOTNESS
    The Constitution limits the power of the federal judiciary
    to the resolution of "cases and contr oversies." See U.S.
    Const. art. III, S 2, cl.1. Federal courts ar e not empowered
    to decide moot questions. North Carolina v. Rice, 
    404 U.S. 244
    , 246 (1971) (per curiam). The mootness doctrine
    requires that an actual controversy exist at all stages of
    review, not merely at the time the complaint is filed. New
    Jersey Turnpike Auth. v. Jersey Cent. Power & Light, 
    772 F.2d 25
    , 31 (3d Cir. 1985).
    We have stated that "mootness has two aspects: (1) the
    issues presented are no longer `live' or (2) the parties lack
    a cognizable interest in the outcome." 
    Id.
     As a result of his
    acquittal, Doe is no longer an inmate at SCIP . It is clear
    that any declaratory or injunctive relief with respect to the
    staff at SCIP would have no impact on him, and therefore
    his equitable claims are moot.
    Doe argues that his case falls into the "capable of
    repetition, yet evading review" exception to the mootness
    doctrine. The exception is limited to cases which have two
    elements: "(1) the challenged action was in its duration too
    short to be fully litigated to its cessation or expiration and
    (2) there is a reasonable likelihood that the same
    complaining party would be subjected to the same action
    again." Abdul-Akbar v. Watson, 4 F .3d 195, 206 (3d Cir.
    1993) (emphasis omitted), quoting Weinstein v. Bradford,
    
    423 U.S. 147
    , 149 (1975)(per curiam). Given the length of
    time it took Doe, proceeding pro se and in forma pauperis,
    to reach this stage of the litigation, we will assume,
    arguendo, that the first element is satisfied.
    However, as a result of his acquittal, we simply cannot
    conclude that there is a reasonable likelihood that he would
    be subjected to the same conduct. See Weinstein, 
    423 U.S. at 149
     (former inmate's challenge to par ole decisions
    mooted upon his release from supervision); see also Abdul-
    Akbar, 4 F.3d at 206 (cautioning against"conjecture" that
    prisoner could again be incarcerated at maximum security
    unit and holding prisoner's release from maximum security
    unit mooted challenge to law library in maximum security
    unit).2 Doe is no longer incar cerated at SCIP. Because there
    _________________________________________________________________
    2. But see Doe v. Wigginton, 21 F .3d 733, 736 (6th Cir. 1994) (no
    discussion of mootness, although facts state plaintiff was released from
    6
    is no reasonable likelihood that Doe will be subjected to the
    same action, Doe's acquittal has clearly mooted his claims
    for declaratory and injunctive relief.
    Nonetheless, where a plaintiff has r equested several
    forms of relief and some of the r equests become moot, the
    court must still consider the viability of the r emaining
    requests. Jersey Cent. Power & Light Co. v. State of New
    Jersey, 
    772 F.2d 35
    , 40 (3d Cir. 1985). "[T]he availability of
    damages or other monetary relief almost always avoids
    mootness." 
    Id. at 41
    .3 Therefore, we must review the
    District Court's qualified immunity analysis with respect to
    Doe's nominal and punitive damages claims.
    B. A PRISONER'S RIGHT TO PRIVACY IN MEDICAL
    RECORDS
    Section 1983 imposes civil liability upon any person who,
    acting under the color of state law, deprives another
    individual of any rights, privileges or immunities secured by
    the Constitution or laws of the United States. 42 U.S.C.
    S 1983. This section does not create any new substantive
    rights, but it provides a remedy for the violation of a federal
    constitutional or statutory right conferred elsewhere. Baker
    v. McCollan, 
    443 U.S. 137
    , 144 n.3 (1979).
    _________________________________________________________________
    prison prior to appeal). The Sixth Circuit r eached the merits to dismiss
    the privacy claim of an HIV-positive prisoner , but, as discussed in
    footnote six, infra, the substantive law of privacy in the Sixth Circuit
    conflicts with that of the Third Circuit.
    3. While the District Court did not consider the effect of S 803(d)(e) of
    the
    Prison Litigation Reform Act, codified at 42 U.S.C. S 1997e(e), on Doe's
    claims, we have since recognized that S 1997e(e) prohibits compensatory
    damages for mental or emotional injury absent allegations of physical
    injury. Allah v. Al-Hafeez, 
    226 F.3d 247
    , 251 (3d Cir. 2000). However,
    S 1997e(e) does not bar claims seeking nominal damages to vindicate
    constitutional rights, nor claims seeking punitive damages to deter or
    punish egregious violations of constitutional rights. 
    Id.
     Therefore, while
    Doe's claims for compensatory damage are barr ed by S 1997e(e), his
    claims for nominal damages survive. Moreover , to the extent that Doe's
    punitive damages claims stem solely from the violations of his right to
    medical privacy, and not from any emotional or mental distress suffered,
    those claims are not barred by S 1997e(e). See 
    id. at 252
    .
    7
    When the defendant in a S 1983 action claims qualified
    immunity, a court must first determine if the plaintiff 's
    allegations are sufficient to establish the violation of a
    federal constitutional or statutory right. W ilson v. Layne,
    
    526 U.S. 603
    , 609 (1999), citing Conn v. Gabbert , 
    526 U.S. 286
    , 290 (1999).4 If the plaintif f 's allegations meet this
    threshold, a court must next determine whether the right
    that the defendant's conduct allegedly violated was a clearly
    established one, about which a reasonable person would
    have known. 
    Id.
     If the plaintiff 's allegations fail to satisfy
    either inquiry, then a defendant is entitled to qualified
    immunity and dismissal of the case. Deciding "this purely
    legal question permits courts expeditiously to weed out
    suits which fail the test without requiring a defendant who
    rightly claims qualified immunity to engage in expensive
    and time consuming preparation to defend the suit on its
    merits." Siegert v. Gilley, 
    500 U.S. 226
    , 232 (1991).
    With this framework in mind, we must deter mine
    whether an HIV-positive inmate has a right to privacy in his
    medical information. If so, we must deter mine whether that
    right was clearly established in 1995.
    _________________________________________________________________
    4. Notwithstanding the fact that the Supr eme Court has twice stated in
    mandatory, unqualified language that "[a] court evaluating a claim of
    qualified immunity must first deter mine whether the plaintiff has alleged
    the deprivation of an actual constitutional right at all . . ." Wilson,
    526
    U.S. at 609 quoting Conn v. Gabbert, 
    526 U.S. at 290
     (internal
    quotations omitted) (emphasis added), Judge Garth's dissent would
    prefer that we skip the first prong of qualified immunity analysis. See
    Dissent, infra at p. 40. This practice ignor es the Supreme Court's
    express language and creates an exception based on the procedural
    posture of the case. While there may be pragmatic considerations
    favoring Judge Garth's qualification of the Supr eme Court's unqualified
    language, the Court has not yet suggested any basis for departing from
    the rule articulated in Wilson. Our thr eshold task here, in qualified
    immunity analysis, is to determine whether Doe has alleged a violation
    of a constitutional right. We hold that he has, although the full extent
    of
    that right in the prison setting has yet to be delineated. Whether and
    how prison officials must accommodate, or may curtail and even
    extinguish that right, in light of the penological interests concerned, is
    not before the Court today.
    8
    1.
    An individual has a constitutional right to privacy which
    protects "the individual interest in avoiding disclosure of
    personal matters." Whalen v. Roe, 
    429 U.S. 589
    , 599
    (1977). We have long recognized the right to privacy in one's
    medical information: "There can be no question that . . .
    medical records, which may contain intimate facts of a
    personal nature, are well within the ambit of materials
    entitled to privacy protection." United States v.
    Westinghouse Elec. Corp. 
    638 F.2d 570
    , 577 (3d Cir. 1980).
    The right to privacy in one's medical information extends to
    prescription records. Doe v. Southeastern Pa. Transp. Auth.,
    
    72 F.3d 1133
    , 1138 (3d Cir. 1995), cert. denied 
    519 U.S. 808
     (1996) [hereinafter "Doe v. SEPT A"]. In Doe v. SEPTA,
    we acknowledged that the privacy interest in information
    regarding one's HIV status is particularly strong because of
    the stigma, potential for harassment, and "risk of much
    harm from non-consensual dissemination of the
    information." Id. at 1140.
    The District Court recognized Doe's right to privacy in his
    medical information, but concluded that such a right does
    not exist in prison. We disagree. As the Supreme Court has
    noted, prison inmates do not shed all fundamental
    protections of the Constitution at the prison gates. Wolff v.
    McDonnell, 
    418 U.S. 539
    , 555 (1974). Inmates r etain those
    rights that are not inconsistent with their status as
    prisoners or with the legitimate penological objectives of the
    corrections system. Pell v. Procunier, 
    417 U.S. 817
    , 822
    (1974).
    For example, prisoners retain rights af forded by the First
    Amendment. O'Lone v. Shabazz, 
    482 U.S. 342
    , 348 (1987).
    They retain the protection of due pr ocess, Wolff, 
    418 U.S. at 555
    , and the protection against racial discrimination. Lee v.
    Washington, 
    390 U.S. 333
    , 334 (1968) (per curiam). Of
    course, prisoners retain the Eighth Amendment's protection
    against cruel and unusual punishment. Wilson v. Seiter,
    
    501 U.S. 294
    , 297 (1991). While many rights survive
    incarceration, however, it is clear that some rights retained
    by free citizens are necessarily extinguished by
    imprisonment.
    9
    The defendants correctly assert that prisoners do not
    have a Fourth Amendment right to privacy in their cells.
    Hudson v. Palmer, 
    468 U.S. 517
    , 529 (1984). The Supreme
    Court has concluded that the Fourth Amendment right to
    privacy, to be free from unreasonable searches, is
    fundamentally inconsistent with incarceration. 
    Id. at 527
    .
    Mindful that internal security is a chief concern in prisons,
    the Court recognized that it would be impossible to prevent
    the introduction of weapons, drugs and other contraband
    into the premises if prisoners maintained a right of privacy
    in their cells. 
    Id.
     Therefore,"the Fourth Amendment has no
    applicability to a prison cell." 
    Id. at 536
    .
    However, Doe's asserted right to privacy in his medical
    information is completely differ ent than the right
    extinguished in Hudson. See, e.g., Powell v. Schriver, 
    175 F.3d 107
    , 112 n.3 (2d Cir. 1999) (noting right to
    confidentiality of medical information is distinct from right
    of privacy implicated in Hudson); Anderson v. Romero, 
    72 F.3d 518
    , 522 (7th Cir. 1995) (same). The Hudson court
    confirmed that a Fourth Amendment right to be free from
    unreasonable searches and seizures is inconsistent with
    incarceration. In the instant case, Doe is asserting his
    Fourteenth Amendment right to privacy in his medical
    information. The right to nondisclosur e of one's medical
    information emanates from a different source5 and protects
    _________________________________________________________________
    5. The Fourth Amendment prohibits the gover nment from conducting
    unreasonable searches and seizures. U.S. Const. amend. IV. While
    courts and commentators have emphasized the privacy interests
    protected by the Fourth Amendment, the Supr eme Court has clarified
    that the Fourth Amendment "protects individual privacy against certain
    kinds of governmental intrusion, but its pr otections go further, and
    often
    have nothing to do with privacy at all." Katz v. United States, 
    389 U.S. 347
    , 350 (1967).
    There are at least two types of privacy pr otected by the Fourteenth
    Amendment: the individual interest in avoiding disclosure of personal
    matters, and the right to autonomy and independence in personal
    decision-making. See Whalen, 
    429 U.S. at 599-600
    ; Westinghouse, 
    638 F.2d at 577
    . Cases in the latter category describe the liberty interests
    in
    matters relating to marriage, procr eation, contraception, family
    relationships, and child rearing and education. See e.g. Troxel v.
    Granville, 
    120 S.Ct. 2054
     (2000) (parents' rights to make decisions
    10
    different interests than the right to be free from
    unreasonable searches and seizures. Compare Whalen, 
    429 U.S. at
    598-99 with Hudson, 
    468 U.S. at 525
    .
    It is beyond question that information about one's HIV-
    positive status is information of the most personal kind and
    that an individual has an interest in pr otecting against the
    dissemination of such information. See Doe v. SEPTA, 72
    F.3d at 1140; Westinghouse, 
    638 F.2d at 577
    . Moreover, a
    prisoner's right to privacy in this medical infor mation is not
    fundamentally inconsistent with incarceration. Therefore,
    we join the Second Circuit in recognizing that the
    constitutional right to privacy in one's medical information
    exists in prison. See Powell, 
    175 F.3d at 112
    .
    We acknowledge, however, that a prisoner does not enjoy
    a right of privacy in his medical information to the same
    extent as a free citizen. We do not suggest that Doe has a
    right to conceal this diagnosed medical condition fr om
    everyone in the corrections system. Doe's constitutional
    right is subject to substantial restrictions and limitations in
    order for correctional officials to achieve legitimate
    correctional goals and maintain institutional security.
    Specifically, an inmate's constitutional right may be
    curtailed by a policy or regulation that is shown to be
    "reasonably related to legitimate penological interests."
    Turner v. Safley, 
    482 U.S. 78
    , 89 (1987). Courts must
    respect the administrative concerns underlying a prison
    regulation, without requiring proof that the regulation is
    the least restrictive means of addressing those concerns.
    We have summarized the analysis as follows:
    _________________________________________________________________
    concerning care and custody of childr en); Roe v. Wade, 
    410 U.S. 113
    (1973) (right to abortion); Loving v. Vir ginia, 
    388 U.S. 1
     (1967)
    (freedom
    to marry); Griswold v. Connecticut, 
    381 U.S. 479
     (1965) (right to marital
    privacy in use of contraceptives); Pierce v. Society of Sisters, 
    268 U.S. 510
     (1925) (parents' right to teach own childr en); Meyer v. Nebraska,
    
    262 U.S. 390
     (1923) (right to teach foreign language). As described
    above, Doe's privacy interest clearly falls into the first category. Some
    courts have referred to the first category as a "right to
    confidentiality," to
    distinguish it from the right to autonomy and independence in personal
    decision making. E.g. Powell v. Schriver , 
    175 F.3d 107
    , 113-14 (2d. Cir.
    1999).
    11
    [Turner] directs courts to assess the overall
    reasonableness of such regulations by weighing four
    factors. First, there must be a valid, rational
    connection between the prison regulation and the
    legitimate governmental interest put forward to justify
    it, and this connection must not be so remote as to
    render the policy arbitrary or irrational. Second, a
    court must consider whether inmates retain alternative
    means of exercising the circumscribed right. Third, a
    court must take into account the costs that
    accommodating the right would impose on other
    inmates, guards, and prison resour ces generally. And
    fourth, a court must consider whether there ar e
    alternatives to the regulation that fully accommodate
    the prisoner's rights at de minimis cost to valid
    penological interests.
    Dehart v. Horn, 
    227 F.3d 47
    , 51 (3d Cir. 2000) (en banc)
    (internal quotations omitted).
    Appellant alleges that his constitutional right to privacy
    in his medical information was violated by thr ee practices:
    the "open-door" examination room policy, the disclosure of
    his medical condition to corrections officer escorts, and the
    loud announcement of the names of his medications. Doe
    concedes that the "open door" examination r oom policy
    could conceivably be justified by a legitimate security
    interest but contends that no such inter est has been
    advanced here. In addition, Doe maintains that the other
    disclosures are unrelated to any legitimate penological
    interests, and thus violated his right to privacy.
    Given the disposition of the case by the District Court,
    defendants did not have the opportunity to come forward
    with any evidence of legitimate penological inter ests, costs
    of accommodating Doe's privacy interest, or availability of
    alternatives to the disclosures made her e. Based on this
    undeveloped record, we are unable to assess any of the
    Turner factors. Rather than speculating about these factors,
    we ordinarily would remand for consideration by the trial
    court on those issues. However, we need not decide those
    issues in this case because of our disposition of the second
    prong of the qualified immunity analysis.
    12
    2.
    As stated earlier, the qualified immunity doctrine shields
    public officials from actions for damages unless their
    conduct was unreasonable in light of clearly established
    law. Harlow v. Fitzgerald, 
    457 U.S. 800
    , 818 (1982). We
    have recognized that qualified immunity applies if
    "reasonable officials in the defendants' position at the
    relevant time could have believed, in light of what was in
    the decided case law, that their conduct would be lawful."
    Good v. Dauphin County Social Servs. for Childr en & Youth,
    
    891 F.2d 1087
    , 1092 (3d Cir. 1989).
    Thus, having determined that Doe has alleged a violation
    of a constitutional right, we must determine whether Doe's
    right to privacy was "clearly established" in a
    "particularized" sense. Anderson v. Cr eighton, 
    483 U.S. 635
    ,
    640 (1987). "The contours of the right must be sufficiently
    clear that a reasonable official would understand that what
    he is doing violates that right." 
    Id.
     W e do not require precise
    factual correspondence between the right asserted and
    prior case law. Good, 
    891 F.2d at 1092
    . Whether an official
    may be protected by qualified immunity tur ns on the
    "objective legal reasonableness of the action, assessed in
    light of the legal rules that were clearly established at the
    time it was taken." Wilson v. Layne, 
    526 U.S. 603
    , 614
    (1999) (internal quotes omitted). The issue is whether, given
    the established law and the information available to
    Defendants, reasonable prison officials in Defendants'
    positions could have believed that their conduct was lawful.
    See Paff v. Kaltenback, 
    204 F.3d 425
    , 431 (3d Cir. 2000).
    Appellant makes three arguments in support of his
    contention that his right to privacy in his medical
    information was clearly established in 1995. First, Doe
    argues that a Pennsylvania statute both cr eates a right and
    serves to inform defendants of the existence of that right.
    Second, Doe argues that, by 1995, a "gr owing consensus"
    of other courts had held that inmates possess a right to
    privacy in their medical records. Finally, Doe argues that
    the class action settlement in Austin v. Pennsylvania Dept.
    of Corrections, 
    876 F. Supp. 1437
     (E.D.Pa. 1995), put
    defendants on specific notice of the existence of a prisoner's
    13
    constitutional right to privacy in his medical infor mation.
    We address each argument in tur n.
    The Pennsylvania Confidentiality of HIV-Related
    Information Act, 35 P.S. S 7603, became effective March 1,
    1991. Under the Act, any person who obtains confidential
    HIV-related information in the course of providing health or
    social services, or pursuant to consent, may not disclose
    the information, except by consent, or to certain designated
    persons. 35 P.S. S 7607. The state right is enforceable in a
    private cause of action for damages. 35 P.S.S 7610. Doe
    contends that he consented to the HIV test but did not
    consent to the various disclosures made by defendants.
    While Doe concedes that the state statute cannot be the
    basis for his federal action, he argues that prison officials
    could not have been acting "reasonably" when they were in
    direct violation of a clear state statute; they thus lost the
    protections of qualified immunity.
    This argument misinterprets the ef fect of a state law on
    a federal constitutional claim. The Supreme Court has held
    that officials do not forfeit qualified immunity from suit for
    violation of a federal constitutional right because they failed
    to comply with a clear state statute. Davis v. Scherer, 
    468 U.S. 183
    , 195 (1984); see also D.R. by L.R. v. Middle Bucks
    Area Vocat'l Tech. School, 
    972 F.2d 1364
    , 1375-76 (3d Cir.
    1992) (en banc) ("[I]llegality under the state statute can
    neither add to nor subtract from the constitutional validity
    of a state's actions.") (internal quotes and citation omitted).
    To overcome qualified immunity, Doe's clearly established
    right must be the federal right on which the claim for relief
    is based.6 Claims for violations of the Pennsylvania
    Confidentiality of HIV-Related Infor mation Act can be
    vindicated in state courts, or, as Doe did here, as a
    _________________________________________________________________
    6. For example, state law may bear upon a claim under the Due Process
    clause when the property interest pr otected by the Fourteenth
    Amendment is created by state law. See Boar d of Regents v. Roth, 
    408 U.S. 564
    , 577 (1972); Acierno v. Cloutier , 
    40 F.3d 597
     (3d. Cir. 1994). A
    federal statute can provide the clearly established right when it is the
    basis for the action. See, e.g. Maine v. Thiboutot, 
    448 U.S. 1
     (1980)
    (vindicating rights under Social Security Act). This case involves neither
    situation.
    14
    supplemental claim. But the state statute cannot"clearly
    establish" the federal right for qualified immunity purposes.
    Second, a review of decisions which had addr essed the
    issue by 1995 reveals that no court of appeals had held
    that prisoners retained a constitutional right to the privacy
    of their medical information. In fact, only a handful of
    district court opinions had done so.
    The earliest circuit opinion addressing the issue analyzed
    a prison policy of segregating HIV-positive inmates from the
    general prison population. Harris v. Thigpen, 
    941 F.2d 1495
    , 1515-1521 (11th Cir. 1991). In Harris, the Eleventh
    Circuit stated that the "precise natur e and scope of the
    privacy right at issue in this case is rather ill-defined." 
    Id. at 1513
    . Nevertheless, the court assumed, ar guendo, that
    HIV-positive inmates had a "constitutionally-protected
    privacy interest" in nondisclosure of their medical
    information. The court acknowledged that "the scope of
    such a right, however, is far from settled, and we need not
    divine its precise parameters here," 
    Id.
     at 1513 n. 26,
    because it found that the Department of Corr ections'
    decision to segregate such inmates from the general prison
    population served a legitimate penological inter est in
    reducing the transmission of HIV and reducing the threat
    of violence. 
    Id. at 1521
    .
    Prior to 1995, other courts of appeals likewise upheld the
    segregation of HIV-positive inmates fr om the general
    population. See, e.g. Camarillo v. McCarthy, 
    998 F.2d 638
    ,
    640 n.2 (9th Cir. 1993) (reserving question of whether HIV
    segregation policy is constitutional but holding officers
    entitled to qualified immunity); Moore v. Mabus, 
    976 F.2d 268
    , 271 (5th Cir. 1992) (finding HIV segr egation policy
    reasonably related to legitimate penological interests).7 Of
    _________________________________________________________________
    7. By 1995, the Sixth Circuit had explicitly held that the right of
    privacy
    is not implicated at all by prison official's disclosure of an inmate's
    HIV
    status. See Doe v. Wigginton, 
    21 F.3d 733
    , 740 (6th Cir. 1994). However,
    Sixth Circuit law conflicts with our cir cuit on this issue because the
    Sixth Circuit does not recognize the right to privacy in one's medical
    information in any setting. Compare J.P. v. DeSanti, 
    653 F.2d 1080
     (6th
    Cir. 1981) (no right to privacy in "social histories" and medical records)
    with United States v. Westinghouse Elec. Corp., 
    638 F.2d 570
     (3d Cir.
    1980) (right to privacy in medical recor ds).
    15
    course, the nature of the disclosures in HIV housing
    segregation cases is different than the disclosures Doe
    challenges here.
    In 1995, the Seventh Circuit considered disclosures that
    are closer to the ones that occurred in the present case.
    Anderson v. Romero, 
    72 F.3d 518
     (7th Cir. 1995). In
    Anderson, the prison superintendent told a guar d, in the
    presence of another guard, to make sur e inmate Anderson
    was in a cell by himself because he was HIV-positive. The
    information was repeated to at least one other guard. The
    Anderson court recognized a "qualified constitutional right
    to confidentiality of medical records and medical
    communications" outside of prison, but concluded that it
    was an open question as to whether the right applied in the
    prison setting. 
    Id. at 522
    . The court r ejected two district
    court opinions which had found that nonsystematic
    disclosures of HIV status had violated HIV -positive inmates'
    right to privacy and instead relied on the fact no appellate
    court had yet recognized the right. 
    Id. at 523-25
     (discussing
    Woods v. White, 
    689 F. Supp. 874
     (W.D.Wis. 1988) aff 'd
    
    899 F.2d 17
     (7th Cir. 1990) (table) and Rodriguez v.
    Coughlin, 
    1989 WL 59607
     (W.D.N.Y. 1989). The Anderson
    court concluded that the officials were entitled to qualified
    immunity because, if such a right existed, it was not clearly
    established in 1992 nor in 1995.8Id. at 524.
    _________________________________________________________________
    8. The appellate cases illustrate the problem identified by the Supreme
    Court in qualified immunity cases: "[T]he generally sound rule of
    avoiding determination of constitutional issues does not readily fit the
    situation presented here [because] when liability is claimed on the basis
    of a constitutional violation, even a finding of qualified immunity
    requires some determination about the state of constitutional law at the
    time the officer acted. What is more significant is that if the policy of
    avoidance [of constitutional issues] wer e always followed in favor of
    ruling on qualified immunity whenever ther e was no clearly settled
    constitutional rule of primary conduct, standar ds of official conduct
    would tend to remain uncertain, to the detriment both of officials and
    individuals. An immunity determination, with nothing more, provides no
    clear standard, constitutional or non-constitutional . . . . therefore the
    better approach is to determine the right before determining whether it
    was previously established with clarity." County of Sacramento v. Lewis,
    
    523 U.S. 833
    , 841 n.5 (1998). See also W ilson v. Layne, 
    526 U.S. 603
    ,
    609 (1999).
    16
    We note that Doe has cited several district court cases
    which concluded, by 1995, that inmates have a right to
    privacy in their medical information. See Austin v.
    Pennsylvania Dept. of Corrections, 876 F . Supp. 1437
    (E.D.Pa. 1995) (approving class action settlement including
    policies regarding treatment of HIV positive inmates);
    Clarkson v. Coughlin, 
    898 F. Supp. 1019
     (S.D.N.Y. 1995)
    (failure to provide qualified interpr eters violated deaf
    inmates' right to privacy); Faison v. Parker, 
    823 F. Supp. 1198
     (E.D. Pa. 1993) (disclosure of inmate's medical
    conditions in presentence report did not violate right to
    privacy); Nolley v. County of Erie, 776 F . Supp. 715
    (W.D.N.Y. 1991) (HIV-positive inmate's right to privacy
    violated by involuntary segregation and placing red stickers
    on his documents); Doe v. Coughlin, 697 F . Supp. 1234,
    1238 (N.D.N.Y. 1988) (granting preliminary injunction to
    halt involuntary segregation of HIV-positive inmates);
    Woods v. White, 
    689 F. Supp. 874
    , 876 (W.D. Wis. 1988),
    aff 'd 
    899 F.2d 17
     (7th Cir . 1990) (table) (gratuitous
    disclosure of HIV-positive status to guar ds and inmates
    violated constitutional right to privacy).
    Of course, all of these opinions are factually and legally
    distinguishable from the present case. Both Nolley and Doe
    v. Coughlin are HIV-positive inmate segregation cases.
    These cases conflict with the subsequent appellate HIV
    segregation cases, which upheld the practice. 9 See
    Camarillo, 
    998 F.2d at 640
    ; Moor e, 
    976 F.2d at 271
    ; Harris,
    
    941 F.2d at 1515-21
    . Likewise, the district court decision in
    White v. Woods was specifically considered and rejected by
    the Seventh Circuit's opinion in Anderson v. Romero. 
    72 F.3d at 525
     (holding prisoners had no clearly established
    right to privacy in medical records in 1995). In Faison, the
    district court found that disclosure of an inmate's medical
    conditions in a court-ordered presentence report did not
    violate the inmate's right to privacy. 823 F . Supp. at 1205.
    And Clarkson v. Coughlin addressed deaf inmates, not HIV-
    positive ones. 
    898 F. Supp. at 1024
    .
    _________________________________________________________________
    9. These opinions also conflict with other New York district court cases
    which upheld the segregation of HIV-positive inmates. See Baez v.
    Rapping, 
    680 F. Supp. 112
     (S.D.N.Y. 1988); Cordero v. Coughlin, 
    607 F. Supp. 9
     (S.D.N.Y. 1984).
    17
    In short, none of these decisions, individually or
    collectively, makes it sufficiently clear to r easonable officials
    that their conduct violated a prisoner's federal
    constitutional right. District court opinions may be relevant
    to the determination of when a right was clearly established
    for qualified immunity analysis.10 However, in this case, the
    absence of binding precedent in this cir cuit,11 the doubts
    _________________________________________________________________
    10. See Hayes v. Long, 
    72 F.3d 70
    , 73-74 (8th Cir. 1995) (looking to all
    decisional law, including Supreme Court, cir cuit courts, district courts,
    and state court opinions for clearly established rights); Tribble v.
    Gardner, 
    860 F.2d 321
    , 324 (9th Cir . 1988)(same). We note that the
    Fourth, Tenth and Eleventh Circuits do not look to district court
    decisions to determine if rights are clearly established. See, e.g., Anaya
    v. Crossroads Managed Care Sys., Inc., 
    195 F.3d 584
    , 594 (10th Cir.
    1999) (considering only Supreme Court, forum circuit, highest state
    court, or clearly established weight of authority fr om other circuit
    courts); Edwards v. City of Goldsboro 
    178 F.3d 231
    , 251 (4th Cir.
    1999)(considering only Supreme Court, forum cir cuit and highest state
    court); Jenkins by Hall v. Talladega City Bd. of Educ., 
    115 F.3d 821
    , 826
    n.4 (11th Cir.) cert. denied, Jenkins ex rel. Hall v. Herring, 
    522 U.S. 966
    (1997)(same). The Second and Seventh Circuits consider district court
    opinions as evidence of the law but hold that they cannot clearly
    establish the law of the circuit. Anderson , 72 F.3d at 525; Jermosen v.
    Smith, 
    945 F.2d 547
    , 551 (2d Cir. 1991). The Sixth Circuit has held that
    a district court must find binding precedent from the Supreme Court,
    the Sixth Circuit, or from itself. Ohio Civil Serv. Employees Ass'n v.
    Seiter, 
    858 F.2d 1171
    , 1177 (6th Cir . 1988).
    We have held that district court decisions do not establish the law of
    the circuit, and are not even binding on other district courts within the
    district. Threadgill v. Armstrong World Indus., Inc., 
    928 F.2d 1366
    , 1371
    (3d Cir. 1991). Yet, as our prior decisions have illustrated, district
    court
    opinions do play a role in the qualified immunity analysis. See e.g. Pro
    v. Donatucci, 
    81 F.3d 1283
     (3d Cir . 1996) (affirming district court's
    reliance on Fifth Circuit opinion and two district court opinions to find
    clearly established right in qualified immunity analysis); cf. Brown v.
    Grabowski, 
    922 F.2d 1097
     n.13 (3d Cir . 1990) (accepting the use of out
    of circuit and district court opinions in qualified immunity analysis but
    reversing because opinions had been render ed after conduct in
    question).
    11. The absence of circuit precedent does not mean an official will always
    retain the immunity defense. "The easiest cases don't even arise." United
    States v. Lanier, 
    520 U.S. 259
    , 271 (1997) (citations and internal
    quotation marks omitted).
    18
    expressed by the most analogous appellate holding,
    together with the conflict among a handful of district court
    opinions, undermines any claim that the right was clearly
    established in 1995.
    Finally, we address Doe's argument r egarding the
    settlement in Austin v. Pennsylvania Dept. of Corrections,
    
    876 F. Supp. 1437
     (E.D.Pa. 1995). In Austin, the district
    court accepted a negotiated settlement between a class of
    inmates and the Pennsylvania Department of Corr ections
    over numerous prison conditions, including medical care.
    As part of the settlement, the DOC agreed to keep inmates'
    medical information regarding their HIV status confidential
    and to advocate a universal precautions policy instead of a
    notification policy in future union negotiations. 
    Id. at 1453
    .
    Doe argues that, in light of the Austin settlement, prison
    officials could not reasonably believe that non-consensual
    disclosures of an inmate's HIV status wer e lawful.
    We agree that, in some ways, the Austin settlement is
    more persuasive than the scattered district court opinions
    previously discussed. Austin has significant factual
    correspondence to Doe's case. In addition, the opinion
    documents the participation of the DOC in lengthy
    negotiations regarding treatment of HIV-positive inmates to
    settle the class action. Cf. Buckley v. Rogerson , 
    133 F.3d 1125
    , 1130-31 (8th Cir. 1998) (district court class action
    judgment against Missouri state prison system clearly
    established right for Iowa state prisoner to over come
    qualified immunity defense).
    Nevertheless, Austin is also less persuasive than other
    district court opinions. Rather than providing a decision on
    the legal merits of the claims, the Austin court merely
    approved a settlement. As the Austin court itself noted, it
    "only evaluate[ed] the probable outcome of the litigation
    and [was] not required to weigh and decide each
    contention." Austin, 
    876 F. Supp. at
    1464 n.16. The Austin
    court's statement about the constitutionality of disclosing
    an inmate's medical information was in r esponse to
    proposed, and rejected, courses of conduct.12 The legal
    _________________________________________________________________
    12. The Austin court stated: "One gr oup of inmates objects to the
    Settlement Agreement because they believe the provisions which ensure
    19
    conclusion regarding the constitutional right to privacy was
    dictum. It was not binding on the parties and it certainly
    did not clearly establish a constitutional right.
    Nor can the fact that the DOC agreed to settle a case
    clearly establish a federal constitutional right. The law
    favors settlement, particularly in class actions and other
    complex cases, to conserve judicial resour ces and reduce
    parties' costs. See In Re General Motors Corp. Pick-Up Truck
    Fuel Tank Litig., 
    55 F.3d 768
    , 784 (3d Cir.) cert. denied,
    General Motors v. French, 
    516 U.S. 824
     (1995). Where, as in
    Austin, the factual and legal issues wer e numerous, broad
    and complex, the decision to settle a case cannot be
    elevated to the recognition of a constitutional right.
    Based on the foregoing, we cannot conclude that the
    cited authorities, individually or in combination, clearly
    established an inmate's constitutional right to privacy in
    his medical information. Government officials must stay
    abreast of constitutional developments, but they are not
    "expected to predict the future course of constitutional
    law." Wilson v. Layne, 
    526 U.S. at 617
    . We conclude that
    the contours of defendants' legal obligations under the
    Constitution were not sufficiently clear in 1995 that a
    reasonable prison official would understand that the non-
    consensual disclosure of a prisoner's HIV status violates
    the Constitution. Accordingly, we will affir m the District
    Court order granting Defendants qualified immunity from
    Plaintiff 's claims.13
    _________________________________________________________________
    the anonymity of HIV-infected inmates ar e too stringent. These inmates
    want the DOC to test all inmates and notify the general population of
    those inmates who are HIV-positive. Such a notification procedure is
    unrelated to any penological interest and would most likely violate state
    law . . . and the Constitution of the United States." Austin, 
    876 F. Supp. at 1466
    . With respect to the Turner factors, however, the Austin court
    stated that "there was no assurance that this Court would order an
    elimination of the notification provision. Although individuals have an
    interest in preventing disclosure of their HIV status which is protected
    by state law and the Constitution, inmates' rights must necessarily yield
    to a certain extent to legitimate penological inter ests." 
    Id. at 1467
    .
    13. We will likewise affirm the District Court's order dismissing Nurse
    Zimmerman pursuant to 28 U.S.C. S 1915(e)(2)(B)(ii) for qualified
    immunity and declining supplemental jurisdiction over the state claims.
    20
    3.
    Although the exact boundaries of such a right have yet to
    be established, we hold today that prison inmates r etain a
    Fourteenth Amendment substantive due process right to
    privacy in their medical information. The exact parameters
    of a prisoner's right to privacy in that infor mation will have
    to be determined in a later case on a mor e complete record,
    where the Turner factors can be fully considered in the
    context of the penological interests concer ned. Moreover,
    because we are granting qualified immunity to the
    defendants, we also do not go on to the issue of the
    standard that is utilized to determine whether a prisoner's
    right to privacy in his medical information has been
    violated. That determination too will have to wait for
    another day.
    IV. CONCLUSION
    We hold that the Fourteenth Amendment pr otects an
    inmate's right to medical privacy, subject to legitimate
    penological interests. However, because this right was not
    clearly established at the time of defendants' conduct, we
    will affirm the District Court's dismissal of Doe's complaint
    on the basis of qualified immunity.
    21
    NYGAARD, concurring and dissenting:
    I agree with Judge Roth's conclusion that prisoners have
    a right to privacy in their medical information, and that
    this right may be compromised only if it conflicts with a
    legitimate penological objective that satisfies the criteria
    outlined in Turner v. Safley, 
    482 U.S. 78
    , 
    107 S.Ct. 2254
    (1987). I would conclude, however, that Doe's right to
    privacy in medical matters was clearly established at the
    time of the alleged violations such that Appellees, as
    reasonable employees of the Pennsylvania Department of
    Corrections, should have known that the right existed and
    therefore cannot be dismissed from defending these
    allegations on the basis of qualified immunity. Hence, I
    dissent from the conclusions contained in Section III, B. 2
    of Judge Roth's opinion.
    It is now axiomatic that the doctrine of qualified
    immunity bars government officials fr om liability for
    damages unless they disobeyed "clearly establish[ed]
    statutory or constitutional rights of which a r easonable
    person would have known." Harlow v. Fitzgerald, 
    457 U.S. 800
    , 818, 
    102 S.Ct. 2727
    , 2738 (1982). Debates over
    defendants' qualified immunity typically tur n on this
    "clearly established right" clause. The Supr eme Court has
    unpacked the meaning of Harlow by pr oviding the following
    analytic parameters: For a right to be clearly established,
    the "contours of the right must be sufficiently clear that a
    reasonable official would understand that what he is doing
    violates that right," Anderson v. Creighton, 
    483 U.S. 635
    ,
    640, 
    107 S.Ct. 3034
    , 3039 (1987). Nonetheless, at the same
    time, a court need not have ruled on a case bearing a
    "precise factual correspondence" with the one under
    consideration. Assaf v. Fields, 178 F .3d. 170 (3d Cir. 1999),
    cert. denied, 
    120 S.Ct. 374
     (1999). Thus, gover nment
    officials are not barred from the protection of qualified
    immunity if they fail to predict fluctuations in legal debates.
    They will not, however, be granted immunity if they fail to
    make obvious inferences from a generally established right,
    to its application in particular situations.
    The question is whether these members of the
    Pennsylvania Department of Corrections should have
    known from 1995 through 1997 that prisoners possessed a
    22
    right to the privacy of their medical recor ds. I proceed to
    my conclusion as follows:
    First, we have recognized the right to confidentiality in
    medical records since 1980. United States v. Westinghouse
    Elec. Corp., 
    638 F.2d 570
    , 577 (3d Cir . 1980). We stated in
    Westinghouse that medical recor ds, which "may contain
    intimate facts of a personal nature, ar e well within the
    ambit of materials entitled to privacy protection.
    Information about one's body and state of health is a
    matter which the individual is ordinarily entitled to retain
    within the private enclave where he may lead a private life."
    
    Id. at 577
     (citations omitted). Those infected with HIV are
    often subjected to discrimination, ridicule, and violence,
    and therefore by 1995 we recognized the heightened
    importance of respecting the medical privacy of HIV
    carriers. See Doe v. Southeastern Pennsylvania Transp.
    Auth., 
    72 F.3d 1133
    , 1140 (3d Cir . 1995) (noting not only
    the importance of maintaining the privacy of medical
    records but also the corollary r esponsibility of maintaining
    the confidentiality of prescriptions for medications used to
    treat AIDS.); see also Doe v. City of New Y ork, 
    15 F.3d 264
    (2d Cir. 1994); Doe v. Borough of Barrington, 
    729 F. Supp. 376
     (D.N.J. 1990). Thus the constitutional right to privacy
    of medical information in the non-prison context was well
    established at the time the defendants here"leaked" the
    information about Doe.
    Likewise, the standard for determining the legitimacy of
    an infringement on a prisoner's constitutional right, such
    as the right to confidentiality in medical r ecords, was well
    established by 1995. In Turner, 482 U.S. at 89, 107 S.Ct.
    at 2257, the Supreme Court determined that any alleged
    violation of a prisoner's right will be unwarranted unless it
    is determined to be "reasonably r elated to legitimate
    penological interests." See also W ashington v. Harper, 
    494 U.S. 210
    , 
    110 S.Ct. 1028
     (1990); O'Lone v. Estate of
    Shabazz, 
    482 U.S. 342
    , 
    107 S.Ct. 2400
     (1987); Monmouth
    County Corr. Inst. v. Lanzara, 834 F .2d 326, 343 (3d Cir.
    1987). Turner provided four questions to guide our analysis.
    First, is there a valid and rational connection between the
    regulation or activity and the legitimate gover nmental
    interest? Second, is there an alter native means for the
    23
    prisoner to exercise the right? Third, will accommodating
    the right cause an unreasonable burden on the staff, other
    inmates, or prison resources? Fourth, is there another
    obvious means to accomplish the prison's objective? The
    Court's intention in fashioning this test was "to formulate
    a standard of review for prisoners' constitutional claims
    that is responsive both to the policy of judicial restraint
    regarding prisoner complaints and [to] the need to protect
    constitutional rights." Turner, 482 U.S. at 89, 107 S.Ct. at
    2257 (citations omitted).
    Although we have given "[p]rison officials . . . broad
    discretion in fashioning appropriate r esponses to legitimate
    penological objectives consistent with the constitutional
    rights of inmates," Monmouth County, 834 F.2d at 343,
    Turner demands that the responses at issue reasonably
    serve a valid penological interest. The courts must not,
    therefore, allow our analysis to be obscur ed by bald
    assertions from prison officials who claim that the policy in
    question serves a legitimate end. Expressing some
    frustration that the Turner standar d was being misapplied,
    the Supreme Court restated its purpose and application in
    Washington v. Harper, 
    494 U.S. 210
    , 
    110 S.Ct. 1028
     (1990).
    "We made quite clear," Justice Kennedy admonished, "that
    the standard of review we adopted in Turner applies to all
    circumstances in which the needs of prison administration
    implicate constitutional rights." 
    Id. at 223
    , 
    110 S.Ct. at 1038
    .
    Well before 1995, therefore, officials for the Pennsylvania
    Department of Corrections should have known 1) that a
    constitutional right to privacy in medical r ecords exists,
    particularly for HIV-related infor mation, and 2) that under
    Turner, prisoners do not forfeit constitutional rights except
    when those rights cannot reasonably be r econciled with
    legitimate penological objectives. With these two premises
    well known, I would expect reasonable prison officials to
    infer that they cannot arbitrarily violate a prisoner's right to
    privacy in medical information. In this situation, the
    "contours of the right [were] sufficiently clear" for Appellees
    to understand that they were violating Doe's
    constitutionally protected right. Anderson , 
    483 U.S. at 640
    ,
    107 S.Ct. at 3039.
    24
    Next, I believe that a "consensus of cases of persuasive
    authority" had been established by 1995. W ilson v. Lane,
    
    526 U.S. 603
    , 616, 
    119 S.Ct. 1692
    , 1700 (1999). The
    Eleventh Circuit Court of Appeals had pr esumed the
    existence of the right to privacy in HIV-r elated medical
    information for prisoners by 1991. See Harris v. Thigpen,
    
    941 F.2d 1495
     (11th Cir. 1991). Likewise, in 1992 the
    Court of Appeals for the Fifth Circuit r eviewed segregation
    of HIV-positive inmates under the Tur ner test, finding that
    the identification and segregation of HIV -positive prisoners
    "obviously serves a legitimate penological inter est," and
    thereby acknowledging the existence of a prisoner's right to
    privacy in medical information that can only be abrogated
    by a legitimate penological objective. Moor e v. Mabus, 
    976 F.2d 268
    , 271 (5th Cir. 1992).
    In 1993, the Eastern District of Pennsylvania held that
    inmates have a constitutionally protected privacy interest in
    nondisclosure of confidential medical infor mation
    concerning their HIV status. Faison v. Parker, 
    823 F. Supp. 1198
     (E.D. Pa. 1993). Although the court recognized this
    right, it ultimately held that the disclosur e of such
    information in a presentencing report served the state's
    compelling and countervailing interest of utilizing this
    knowledge to provide an appropriate sentence and care
    regimen. The balance of interests favor ed disclosure
    because the medical information was not included in the
    public record, was treated as confidential, and was
    provided only to the appropriate officials. Thus, by 1993 the
    Eastern District of Pennsylvania recognized the right to
    privacy in inmates' HIV-related medical information and
    further understood that this right could be compr omised
    only by the need to meet a compelling and incompatible
    government interest. The Eastern District of Pennsylvania
    reinforced this ruling in Austin v. Pennsylvania Dept. of
    Corr., 
    876 F. Supp. 1437
     (E.D. Pa. 1995), which I will
    discuss in more detail below.
    A series of other District Courts reached the same
    conclusion by 1995. Clarkson v. Coughlin, 
    898 F. Supp. 1019
    , 1041 (S.D.N.Y. 1995) ("Prison inmates retain a
    constitutional right to privacy concerning medical
    information about them."); Nolley v. County of Erie, 
    802 F. 25
    Supp. 898 (W.D.N.Y. 1992); Inmates of N.Y. State with
    Human Immune Deficiency Virus v. Cuomo, No. 90-CV-252,
    
    1991 WL 16032
    , *3 (N.D.N.Y. Feb. 7, 1991)("[T]he federal
    Constitution protects against the unwarranted and
    indiscriminate disclosure of the identity of HIV-infected
    individuals and of their medical records; that is to say, the
    court accepts . . . the proposition that the constitutional
    right of privacy extends to such matters, and that prisoners
    enjoy such a privacy right. . . ."); Bor ough of Barrington,
    
    729 F.Supp. at 384
     ("The government's interest in
    disclosure here does not outweigh the substantial privacy
    interest involved. The government has not shown a
    compelling state interest in breaching the Does' privacy.");
    Woods v. White, 
    689 F. Supp. 874
     (W.D. Wis. 1988), aff 'd
    without opinion, 
    899 F.2d 17
     (7th Cir . 1990);1 Rodriguez v.
    Coughlin, No. 87 Civ. 1577E, 
    1989 WL 59607
     (W .D.N.Y.
    June 2, 1989); Doe v. Coughlin, 697 F . Supp. 1234, 1238
    (N.D.N.Y. 1988) ("[I]n recognition of the particularly
    personal nature of the information potentially subject to
    disclosure under the state's program, the court determines
    that the prisoners subject to this program must be afforded
    at least some protection against the non-consensual
    disclosure of their diagnosis.")
    Appellees argue, and Judge Roth agrees, that these cases
    do not constitute a proper consensus. T o the contrary, I
    agree with the Court of Appeals for the Eighth Circuit,
    which explained that "[i]n the absence of binding precedent,
    a court should look to all available decisional law, including
    decisions of state courts, other circuits and district courts."
    Norfleet v. Arkansas Dep't of Human Services , 
    989 F.2d 289
    , 291 (8th Cir. 1993); see also Buckley v. Rogerson, 
    133 F.3d 1125
    , 1129-30 (8th Cir. 1998) (finding a right clearly
    established on the basis of decisions from out of circuit
    district courts). We should remember that the Supreme
    Court has recently made clear that all that is required to
    defeat claims of qualified immunity is a "consensus of cases
    of persuasive authority," and not a consensus of binding
    authority. Wilson, 526 U.S. at 616. Thus although a lone
    _________________________________________________________________
    1. Judge Roth states that the Seventh Circuit "rejected" Woodsin
    Anderson v. Romero, 72, F.3d 518 (7th Cir. 1995). This is not entirely
    accurate. The court in Anderson merely declined to reach the question.
    26
    District Court opinion may not secure a right, when that
    opinion is combined with opinions from the Supr eme Court,
    Courts of Appeals, and a variety of District Courts, then I
    would conclude that the right was established to an extent
    sufficient to notify the officials.
    Two other factors render the officials' failure to recognize
    Doe's right to privacy in his medical recor ds still more
    unreasonable. First, The Pennsylvania Confidentiality of
    HIV-Related Information Act, 35 P .S. S 7603, which became
    effective on March 1, 1991, provides a statutory right to
    nondisclosure. Section 7607 states:
    (a) Limitations on disclosure.--No person or employee,
    or agent of such person, who obtains confidential HIV-
    related information in the course of pr oviding any
    health or social service or pursuant to a release of
    confidential HIV-related information under subsection
    (c) may disclose or be compelled to disclose the
    information.
    The statute makes no exception for inmates, as it states
    that HIV-related information can be disclosed to
    [e]mployees of county mental health/mental
    retardation agencies, county childr en and youth
    agencies, county juvenile probation departments,
    county or State facilities for delinquent youth, and
    contracted residential providers of the above-named
    entities receiving or contemplating residential
    placement of the subject, who:
    (i) generally are authorized to receive medical
    information; and
    (ii) are responsible for ensuring that the subject
    receives appropriate health care; and
    (iii) have a need to know the HIV-r elated information
    in order to ensure such care is pr ovided.
    Id. Because no exception is made for adult prisoners, and
    all other exceptions are clearly stated, the Department of
    Corrections should have known by March 1991 that
    prisoners possess a right to the privacy of their HIV-related
    information. Considering the specificity of the statute, and
    27
    its precise applicability to the facts of this case, the right
    under review was clearly established in 1991.
    Appellees, and Judge Roth, claim that a state statute is
    irrelevant to the issue of qualified immunity on a federal
    claim. See Davis v. Scherer, 
    468 U.S. 183
    , 194-97, 
    104 S.Ct. 3012
    , 3019-21 (1984). I disagree. As the Supreme
    court explained in Elder v. Halloway, Davis held that
    an official's clear violation of a state administrative
    regulation does not allow a S 1983 plaintiff to overcome
    the official's qualified immunity. Only in this context is
    the Court's statement comprehensible: `A plaintiff who
    seeks damages for violation of constitutional or
    statutory rights may overcome the appellee official's
    qualified immunity only by showing that those rights
    were clearly established . . .' Davis, in short, concerned
    not the authorities a court may consider in
    determining qualified immunity, but this entirely
    discrete question: Is qualified immunity defeated where
    an appellee violates any clearly established duty,
    including one under state law, or must the clearly
    established right be the federal right on which the
    claim for relief is based? The Court held the latter.
    
    510 U.S. 510
    , 515, 
    114 S.Ct. 1019
    , 1023 (1994) (citations
    omitted).
    The reason why I disagree with Judge Roth is that
    although a state statute will not, by itself, place an official
    on notice of a federal right, to me such a statutory right
    should raise the official's awareness that a parallel federal
    right may exist. Such a warning should facilitate a
    reasonable official's ability to make the inference discussed
    above. This position is congruent with the objectives of the
    doctrine of qualified immunity. If a state statute clearly
    articulates a right, and places those within its jurisdiction
    on notice of that right, and if that right per fectly coincides
    with a federally protected right, then why would we not
    consider the statute's existence when determining whether
    the offender should have known of the federal right? I think
    we should. Indeed it seems to me that a state statute,
    locally promulgated, and free from many of the
    uncertainties of case law, most effectively notifies the
    community of a protected right, and reinforces federal law.
    28
    Regardless of how a person learned of the right, and
    regardless of whether she thought she was violating state
    or federal law, she knew that a right existed and that she
    was violating it. The purpose of qualified immunity is to
    protect government officials fr om having to defend
    themselves in litigation over rights and duties that they did
    not know they were violating. Here, the Appellees were
    clearly notified by the 1991 statute that Doe was entitled to
    the privacy of his medical records under state law. The
    inference that prisoners were entitled to the same right
    under federal law was implicit by 1995. If we allow the state
    statute to play no role in assessing whether or not the
    officials should have known of the federal right, then we
    allow officials to turn a blind eye to the general state of the
    law and discourage them from making a good faith effort to
    recognize such implicit principles. I consider this good faith
    effort to be within the responsibilities of a "reasonable
    official."
    In addition, as powerful evidence that these officials
    knew they were violating Doe's right to privacy, in an
    opinion establishing a right to privacy for inmates' HIV-
    related medical records, Austin v. Pennsylvanian Dep't of
    Corr., the very agency and officials before us now were also
    appellees in that case. In that opinion in January 1995, the
    Court stated that the "DOC has agreed to keep inmates'
    medical information regarding HIV status confidential and
    to advocate a universal precautions policy in place of the
    current Contagious Disease Notification Policy in its
    forthcoming negotiations with the union repr esentative of
    its custody staff." Austin, 876 F . Supp. at 1453. This
    decision alone directly notified Appellees of their obligation
    to protect Doe's privacy right. As Judge Roth correctly
    states, court approval of a settlement does not provide a
    legal decision regarding the constitutionality of the
    elements of the settlement. But that is not the test. The
    court clearly warned the very institution before us in this
    matter that it risked constitutional violations by disclosure.
    Indeed the language the Court used was that disclosure of
    a prisoner's HIV-related medical infor mation, if "unrelated
    to any penological interest . . . would most likely violate
    state law, and the Constitution of the United States." Id. at
    1437. Austin explained that "[a]lthough individuals have an
    29
    interest in preventing disclosure of their HIV status which
    is protected by state law and the Constitution, inmates'
    rights must necessarily yield to a certain extent to
    legitimate penological interests," and then clearly stated the
    criterion of the Turner test. Id. In light of this notification,
    it seems disingenuous to claim that the officials here
    deserve protection from Doe's claims because they did not
    know that they could not arbitrarily disclose a prisoner's
    medical information.2
    In summary, the combination of the preponderance of
    case law, the state statute, and the Pennsylvania
    Department of Corrections' previous agr eement to respect
    privacy in prisoners' HIV-related materials, clearly
    established the right in question. I would find that, taken
    together, these factors defeat Appellees' claim to qualified
    immunity. I therefore respectfully dissent from this aspect
    of the Majority's decision.
    _________________________________________________________________
    2. Finally, I note that the manner in which this delicate information was
    disseminated indicates to me that the officials knew they were
    misbehaving, but persisted in doing so regar dless of the fact that they
    were mistreating Doe.
    30
    GARTH, Circuit Judge, dissenting and concurring.
    I agree with Judge Roth that the District Court's decision
    dismissing Doe's complaint should be affir med because the
    defendants have qualified immunity from Doe's claims.
    However, I cannot agree that, on this r ecord brought before
    us on a Rule 12(b)(6) motion,1 we can or should declare
    that "a constitutional right to privacy in one's medical
    information exists in prison." (Roth Op. at 11.) This case is
    one of first impression, and Judge Roth's holding, with
    which Judge Nygaard concurs as to the constitutional right,2
    may have a multitude of ramifications in this Cir cuit where
    major prisons abound. It is for that reason that I write
    separately contesting the creation of a constitutional right
    of privacy and confidentiality for prisoners. 3
    It is true that, in so holding, Judge Roth qualifies this
    statement, observing that "Doe's constitutional right is
    subject to substantial restrictions and limitations in order
    _________________________________________________________________
    1. A motion brought pursuant to Federal Rule of Civil Procedure 12(b)(6)
    is granted only if: "taking the allegations of the complaint as true, . .
    .
    and viewing them liberally giving plaintiffs the benefit of all inferences
    which fairly may be drawn therefrom, . . .`it appears beyond doubt that
    the plaintiff[s] can prove no set of facts in support of [their] claim
    which
    would entitle [them] to relief.' "Bogosian v. Gulf Oil Corp., 
    561 F.2d 434
    ,
    444 (3d Cir. 1977) (internal citations omitted).
    2. For ease of reference, I will r efer to Judge Roth's holding throughout
    this dissent and concurrence, although Judge Nygaard constitutes her
    majority with respect to the establishment of a constitutional right to
    privacy in prison.
    3. In her footnote 3, relevant to her discussion of mootness, (see Roth
    Op., Part III.A), Judge Roth asserts that S 1997e(e) of the Prison
    Litigation Reform Act ("PLRA") does not bar claims for punitive damages,
    relying on Allah v. Al-Hafeez, 226 F .3d 247, 251 (3d Cir. 2000). I
    disagree with her analysis, because I believe that this case is far more
    similar to Davis v. District of Columbia, 
    158 F.3d 1342
     (D.C.Cir. 1998),
    where the D.C. Circuit held that an inmate's punitive damages claims
    were barred by the PLRA. We distinguished Davis in Allah "because
    those claims [in Davis] stemmed fr om the allegations of emotional and
    mental injury [suffered as a r esult of the violation of Davis'
    constitutional
    right to privacy]." 
    226 F.3d at 252
    . As a consequence, contrary to Judge
    Roth, I would hold that Doe's punitive damages claim is barred by the
    PLRA, although I agree that the claim for nominal damages prevents our
    dismissing Doe's action as moot.
    31
    for correctional officers to achieve legitimate correctional
    goals and maintain institutional security." (Roth Op. at 11.)
    Nevertheless, because she and I agree that such a
    constitutional right of privacy in prison has not been and is
    not clearly established, the prudential and wiser course of
    action in this case is to decline to determine that such a
    constitutional right has been established at all .
    I.
    The record before us in this case is naked of anything
    other than Doe's allegations in his complaint--allegations
    which complain of a lack of privacy and confidentiality as
    well as a violation of his grievance/appeal rights. 4 However,
    _________________________________________________________________
    4. That statement of Doe's claim alleges:
    - Doe is a death row prisoner;
    - After submitting to a blood test, Doe was informed by the prison
    medical staff that he was HIV-positive and that this medical
    condition would be kept confidential;
    - He has undergone medical examinations and tests in the open
    presence of correctional officers and other inmates;
    - The clinic door is kept open when Doe is seen by doctors and
    specialists from the Centers for Disease Contr ol (CDC), so that
    correctional officers can see Doe;
    - When Doe has an appointment with a CDC specialist, the
    correctional officers who escort him to the appointment are
    informed of the nature of the appointment;
    - On one occasion, a nurse announced aloud the names of the
    medications being delivered to Doe in the pr esence of other
    inmates and that nurse told a corrections officer about Doe's
    condition;
    - In connection with Doe's internal grievance about the sick call
    procedure, he was interviewed by a medical grievance officer
    whom Doe told that another inmate twice over heard a nurse
    stating the name of Doe's medication when delivering it to him;
    - Doe's internal grievance, which contained information about his
    HIV-positive status, was forwarded to the superintendent of the
    prison;
    32
    we have not been informed and do not know whether Doe,
    who was a death penalty prisoner, was r equired to be
    closely guarded at all times by prison guar ds, thereby
    virtually ensuring that the guards would be privy even to
    private conversations. We do not know the construction and
    dimensions of the medical area or medication dispensary at
    SCI-Pittsburgh--whether there ar e communal examination
    rooms or private examination cubicles. W e do not know the
    location of Doe's death penalty cell in the Restricted
    Housing Unit ("RHU"), or the route, access, and distance
    from his cell to the medical area. W e do not know the
    circumstances under which medication is dispensed at sick
    call--the structure and configuration of the dispensary, the
    location in the dispensary of physicians, nurses, guards,
    and other prisoners, or the manner in which prisoners
    receive medication (are they separately scheduled or are
    they scheduled in a group or in an open line?). Nor do we
    know the administrative complexities encounter ed by
    prison authorities in ensuring the manner in which each
    prisoner receives the correct medication. We do not know
    the state of the security precautions in the dispensary area
    as compared to the security in the RHU, nor do we know
    the required provisions for security in the passageways
    between the two areas.
    All that we do know from Doe's complaint is 1) that the
    clinic door is kept open when Doe is seen by doctors and
    CDC specialists so that Doe may be viewed by corr ections
    officers,5 and 2) that, when Doe receives his medication, the
    medication is sometimes referred to by name. Moreover,
    _________________________________________________________________
    - Prison officials responded to Doe's internal grievance by
    informing him that the nurses denied his allegations and that the
    door had to be left open when Doe was being examined by
    specialists and doctors due to a "security issue"; and
    - His appeal rights had been affected by being obliged to go
    through the superintendent prior to appeal tofinal review.
    (App. 15a-19a.)
    5. Judge Roth acknowledges that Doe has conceded that this practice
    may be justified by the prison's legitimate security concerns. (Roth Op.
    at 12.)
    33
    because, on a Rule 12(b)(6) motion, no response or
    information is available from, in this case, the prison
    authorities, we have no knowledge of the physical,
    structural, or security conditions in prison that contribute
    to and may generate a diminished expectation of privacy or
    confidentiality.6
    Prisons are communal environments in which a large
    number of inmates and prison employees coexist in a
    confined living space. For this reason, inmates have little
    physical privacy, and the circumstances of medical
    treatment may not conform to private, non-prison norms.
    Prisoners must do everything in close proximity to other
    inmates and prison personnel, including sleeping, eating,
    dressing, bathing, and, to a certain extent, r eceiving
    medical attention.
    II.
    Another reality of prison life is the fact that prison
    _________________________________________________________________
    6. Because, as noted, this is an appeal fr om a Rule 12(b)(6) dismissal,
    the defendants have not been able to inform us of their actions,
    procedures, regulations, explanations, or justifications in response to
    Doe's complaint. (See text infra, discussing the inadvisability of
    creating
    constitutional rights based on a naked recor d consisting only of the
    prisoner-plaintiff 's allegations.) It is not only impossible to analyze
    the
    factors identified in Turner (connection between regulation and
    justification; alternative means of exer cising right; costs of
    accommodating right; and alternatives to the r egulation), as even Judge
    Roth acknowledges (see Roth Op. at 12 ("defendants did not have the
    opportunity to [produce] any evidence of legitimate penological interests,
    costs. . . , or availability of alternatives. . .")), but it is similarly
    hopeless
    to draw upon instruction from the "privacy?" cases cited by both Judge
    Roth and Judge Nygaard. This is so because, her e, there are no factual
    circumstances that can be likened or compar ed to the circumstances
    described in the cases my colleagues have cited, almost all of which are
    non-prison cases or are inapposite for some other reason and, therefore,
    are not relevant in any event. See, e.g., Doe v. Southeastern Pennsylvania
    Transp. Auth., 72 F3d 1133 (3d Cir . 1995) (non-prison case); United
    States v. Westinghouse Elec. Corp., 638 F .2d 570 (3d Cir. 1980) (non-
    prison case); Moore v. Mabus, 976 F .2d 268 (5th Cir. 1992) (does not
    establish privacy right); Harris v. Thigpen, 
    941 F.2d 1495
     (11th Cir.
    1991) (does not establish privacy right).
    34
    resources are limited. Prison systems are generally in this
    day and age overcrowded and understaf fed. Therefore,
    accommodation of prisoners' privacy and confidentiality
    demands, their needs, and even their rights cannot be
    assumed or declared in a vacuum. Considering the
    communal nature of prison existence, similar in many
    privacy (or lack of privacy) aspects to life in the military,
    together with the limited and often insufficientfinancial
    resources of prisons, I believe it to be rash and imprudent
    to hold at this time, without much more infor mation about
    prison security concerns, that Doe has a constitutional
    right to privacy in his HIV-positive status, any more than
    he has a constitutional right of privacy in his cell. See
    Hudson v. Palmer, 
    468 U.S. 517
    , 525-26 (1984).
    I recognize, of course, that the rationale of Hudson,
    analyzed under the Fourth Amendment, dealt with the lack
    of privacy an inmate has in his cell accommodation,
    whereas here our attention is drawn to rights under the
    Fourteenth Amendment and the "penumbras" of rights
    encompassing privacy. See Griswold v. Connecticut, 
    381 U.S. 479
    , 484 (1965) (holding that "specific guarantees in
    the Bill of Rights have penumbras," one of which is the
    right of privacy). However, certainly Doe's expectation of
    privacy and confidentiality of medical infor mation in a
    communal dispensary setting cannot be deemed to be
    greater than his expectation of privacy in his cell,
    depending, of course, on all of the circumstances which I
    have noted above and as to which we have no infor mation.
    Indeed, I take issue with Judge Roth's assertion that
    "Doe's asserted right to privacy in his medical information
    is completely different than the right extinguished in
    Hudson." (Roth Op. at 10.) After all, in Hudson, the
    Supreme Court declined to declare a constitutional right
    because "[t]he recognition of privacy rights for prisoners in
    their individual cells simply cannot be reconciled with the
    concept of incarceration and the needs and objectives of
    penal institutions," 468 U.S. at 526, wher eas, here, Judge
    Roth has declared a constitutional right, but has held that
    "Doe's constitutional right is subject to substantial
    restrictions and limitations in order for correctional officials
    to achieve legitimate correctional goals and maintain
    35
    institutional security." (Roth Op. at 11.) If there are
    concerns, as evidently Judge Roth has her e, that
    "legitimate correctional goals" and "institutional security"
    may be jeopardized by the exercise of Doe's purported
    constitutional right, it would seem to me only prudent that
    we should withhold declaring a constitutional right of
    privacy until we have obtained the information we lack.
    That is the course of action that the Supreme Court took
    in Hudson, where the Court decided the very limited
    question of a prisoner's Fourth Amendment privacy right in
    his cell on an appeal from a grant of summary judgment,
    not a Federal Rule of Civil Procedure 12(b)(6) motion, and
    even Powell v. Schriver, 
    175 F.3d 107
     (2d Cir. 1999), which
    Judge Roth cites in support of her declared constitutional
    right, went to full trial before the Second Cir cuit announced
    that a constitutional right had been established.
    I believe that we can analogize Doe's situation to the
    Supreme Court's rationale in Hudson, where the Court, as
    noted, held that prisoners do not have a Fourth
    Amendment right to privacy in their cells. Doe's complaint
    includes claims of violation of his privacy, violation of
    confidentiality, and violation of his rights under the
    grievances and appeal procedures. My r eading of Doe's
    complaint reveals that it is the privacy aspect on which Doe
    has focused and which has caused his distress. But, the
    question that then arises is whether Doe had a legitimate
    expectation of privacy concerning his HIV -positive status.
    In this respect, I believe we can look to Hudson, where the
    Court stated:
    Determining whether an expectation of privacy is
    "legitimate" or "reasonable" necessarily entails a
    balancing of interests. The two inter ests here are the
    interest of society in the security of its penal
    institutions and the interest of the prisoner in privacy
    within his cell. The latter interest, of course, is already
    limited by the exigencies of the circumstances: A prison
    "shares none of the attributes of privacy of a home, an
    automobile, an office, or a hotel room." We strike the
    balance in favor of institutional security, which we
    have noted is "central to all other corrections goals." A
    right of privacy in traditional Fourth Amendment terms
    36
    is fundamentally incompatible with the close and
    continual surveillance of inmates and their cells r equired
    to ensure institutional security and inter nal order. We
    are satisfied that society would insist that the
    prisoner's expectation of privacy always yield to what
    must be considered the paramount interest in
    institutional security. We believe that it is accepted by
    our society that "[l]oss of freedom of choice and privacy
    are inherent incidents of confinement."
    Hudson, 
    468 U.S. at 527-28
     (internal citations omitted)
    (emphasis added). So too is the privacy inter est implicated
    in this case "limited by the exigencies of the
    circumstances," namely the communal natur e of prison life,
    the logistical problems with prisoner confidentiality in
    prison medical facilities, and the need for prisoners,
    especially death row prisoners such as Doe, to be watched
    closely by prison guards. Therefor e, I believe that,
    depending upon the prison information as to which we are
    still ignorant, Doe's right to privacy in the communication
    of his medical information may be "fundamentally
    incompatible with the close and continual surveillance of
    inmates" as was the Fourth Amendment right in Hudson.7
    _________________________________________________________________
    7. I should note that the connection between the prison's security
    interest and the deprivation of Doe's right to privacy is less direct here
    than in the Fourth Amendment context. In Hudson , the Supreme Court
    observed that prison officials must be able to maintain prison safety by
    entering inmate's cells to search for weapons and contraband. Here,
    Doe's right to privacy is overshadowed and diminished by the general
    need to monitor and guard prisoners and by the very nature of a forced
    communal living environment, both of which make it difficult to preserve
    a prisoner's privacy.
    Moreover, I believe that the balancing of interests prescribed by the
    Supreme Court in Hudson whereby expectations of privacy must be
    balanced against legitimate penological and security interests cannot be
    undertaken unless and until those interests ar e known and spread upon
    the record. Until that time, I cannot subscribe to or hold that prisoners
    have the same privacy interests as the general non-prison population
    enjoys. I also believe that, when the balancing equation is completed, it
    will weigh in favor of institutional security and against prisoners'
    unrealistic expectations of privacy as it does in the Fourth Amendment
    context.
    37
    See Pell v. Procunier, 
    417 U.S. 817
    , 822 (1974) ("challenges
    to prison restrictions that are asserted to inhibit First
    Amendment interests must be analyzed in ter ms of the
    legitimate policies and goals of the corrections system, to
    whose custody and care the prisoner has been committed
    in accordance with due process of law").
    Thus, the realities of prison life compel a holding that
    Doe has not established a constitutional right to privacy on
    the record here--and certainly not in the current posture of
    this case. Though the Supreme Court has held that
    prisoners retain "those [constitutional] rights not
    fundamentally inconsistent with imprisonment itself or
    incompatible with the objectives of incarceration," Hudson
    v. Palmer, 
    468 U.S. 517
    , 523 (1984), the Court has also
    observed repeatedly that "[l]awful incar ceration brings
    about the necessary withdrawal or limitation of many
    privileges and rights, a retraction justified by the
    considerations underlying our penal system." 8 Price v.
    Johnston, 
    334 U.S. 266
    , 285 (1948). These "considerations"
    include "deterrence of crime, rehabilitation of prisoners,
    and institutional security," DeHart v. Hor n, 
    227 F.3d 47
    , 50
    (3d Cir. 2000), as well as, I believe, allocation of limited
    prison resources. Indeed, the Supr eme Court has stated:
    "because the `problems of prisons in America are complex
    and intractable,' and because courts are particularly `ill
    equipped' to deal with these problems, we generally have
    _________________________________________________________________
    Hence, I am neither influenced nor persuaded by Judge Roth's reliance
    on Powell v. Schriver, 
    175 F.3d 107
     (2d Cir. 1999), a Second Circuit case
    not binding in this Circuit and completely distinguishable because: 1)
    Powell was decided only after a full jury trial, whereas here we have a
    Rule 12(b)(6) motion which takes the allegations of the complaint as
    true, see note 1, supra; 2) Powell extrapolated its privacy holding from
    Doe v. City of New York, 
    15 F.3d 264
     (2d Cir. 1994), which is a non-
    prison case of privacy; and 3) Powell's emphasis was wholly on
    transsexualism--a condition with its unique pr oblems not relevant in
    Doe's case.
    8. The Supreme Court reaffirmed this principle most recently in Shaw v.
    Murphy, stating that "constitutional rights that prisoners possess are
    more limited in scope than the constitutional rights held by individuals
    in society at large." 
    121 S.Ct. 1475
    , 1479 (2001).
    38
    deferred to the judgments of prison officials in upholding
    these regulations against constitutional challenge." Shaw v.
    Murphy, 
    121 S.Ct. 1475
    , 1480 (2001) (inter nal citations
    omitted) (holding that a prisoner has no First Amendment
    right to provide legal assistance to other inmates and that,
    therefore, prison officials did not violate the prisoner's
    constitutional rights when they intercepted a letter
    containing legal advice that he sent to another prisoner).
    III.
    I also note that a decision in this case that 1) the record
    is not sufficient to establish a constitutional right but that
    2) the right was not clearly established in any event is
    consistent with the Supreme Court's dir ective in Wilson v.
    Layne, 
    526 U.S. 603
     (1999). In Wilson , the Court stated
    that "[a] court evaluating a claim of qualified immunity
    `must first determine whether the plaintiff has alleged the
    deprivation of an actual constitutional right at all, and if so,
    proceed to determine whether that right was clearly
    established at the time of the alleged violation.' " 
    526 U.S. 603
    , 609 (1999) (quoting Conn v. Gabbert, 
    526 U.S. 286
    ,
    290 (1999)). The Court explained that "[d]eciding the
    constitutional question before addressing the qualified
    immunity question . . . promotes clarity in the legal
    standards for official conduct, to the benefit of both the
    officers and the general public." 526 U.S. at 609.
    However, Wilson arose in the context of a district court's
    ruling on a summary judgment motion, not on a Rule
    12(b)(6) motion to dismiss, as did the other cases cited by
    the Court in Wilson. See Conn v. Gabbert, 
    526 U.S. 286
    (1999); County of Sacramento v. Lewis, 
    523 U.S. 833
    (1998); see also Siegert v. Gilley, 
    500 U.S. 226
     (1991).9 This
    doctrine makes sense in the context of a summary
    _________________________________________________________________
    9. Powell v. Schriver, see note 5, supra, in which the Second Circuit held
    that a transsexual prisoner had a constitutional right to privacy in that
    medical information but that the constitutional right to privacy in prison
    was not clearly established, arose in the context of a district court's
    grant of judgment notwithstanding the verdict to the defendant. In that
    case, unlike this one, the Second Circuit had the benefit of a full
    factual
    record after a full jury trial.
    39
    judgment motion, which occurs at the close of discovery
    when a court may make a decision on the existence of a
    constitutional right with the benefit of the r elevant facts.
    Hence, it seems to me that the Wilson rule is not
    appropriately extended to rulings on Rule 12(b)(6) motions
    to dismiss, where the factual recor d is as scant as it is
    here. In my opinion, to construct a constitutional right out
    of the whole cloth without analysis and without any
    knowledge of the institutional factors or security concerns
    attendant to a prison population or to a penal envir onment
    appears to me to be not only improvident but, as I have
    stated, rash. Indeed, I find it highly unusual that a court
    should decide the existence of a constitutional right when
    it has essentially no record befor e it and no basis on which
    it may balance the claims made by the prisoner of privacy
    expectations against legitimate security inter ests of the
    prison. Such a decision does not "promote[ ] clarity in the
    legal standards for official conduct, to the benefit of both
    the officers and the general public," W ilson, 
    526 U.S. at 609
    , but instead causes uncertainty and confusion by
    establishing an hitherto undeclared constitutional right
    with no discernable standards.
    Judge Roth in her majority opinion has responded to this
    critique and my thesis by citing two Supreme Court cases
    and declaring that the Supreme Court unequivocally
    demands that, in qualified immunity cases, the
    constitutional right first be declared befor e we address
    whether that right has been clearly established. (Roth Op.
    at 8 n.4.) I quite agree with her that the doctrine she
    invokes requires the declaration of a constitutional right as
    the first order of business. However, and this is a major
    "however," those cases to which she r efers were not cases
    decided by a district court on a Rule 12(b)(6) motion. See
    Wilson v. Layne, 
    526 U.S. 603
    , 608 (1999) ("The District
    Court denied respondents' motion for summary judgment
    on the basis of qualified immunity."); Conn v. Gabbert, 
    526 U.S. 286
    , 289 (1999) ("[Defendants] moved for summary
    judgment on the basis of qualified immunity, and the
    District Court granted the motion."). The very nature of a
    Rule 12(b)(6) motion, as contrasted with a summary
    judgment motion, with its concomitant standar d of review
    40
    (accepting all of the plaintiff 's allegations as true), is alien
    to certain types of judicial declarations (namely,
    declarations of constitutional rights).
    The Seventh Circuit, albeit in a differ ent context, has
    recently held that district court judges should not apply the
    Rule 12(b)(6) standard of accepting a plaintif f 's allegations
    as true when they determine whether to certify a class. The
    Seventh Circuit instructed that, "[b]efore deciding whether
    to allow a case to proceed as a class action, .. . a judge
    should make whatever factual and legal inquiries ar e
    necessary under Rule 23." Szabo v. Bridgeport Machines,
    Inc., 
    249 F.3d 672
     (7th Cir. 2001). Similarly, I suggest that
    the Rule 12(b)(6) standard cannot be applied by district
    courts in first determining the existence of a constitutional
    right, because the facts and circumstances of the case, as
    they bear upon penological interests and concer ns, must be
    explored before a court can unequivocally announce a
    constitutional right.
    Moreover, I have great difficulty, as I envisage the bench
    and bar will also have, in identifying the contours and
    parameters of an asserted constitutional right of prison
    privacy that is still subject to the restrictions and
    limitations of penal security interests. Even Judge Roth
    admits that these restrictions, limitations, and
    accommodations have yet to be delineated. In particular,
    since the relevant penological interests are presently not
    known and may, by their very nature, cause the
    constitutional right at issue here to disappear into thin air
    or be diminished to a point of nothingness, it seems to me
    far better that we know precisely the right with which we
    are dealing before creating such a right liable to be
    dismissed on its first documented challenge.
    Certainly the Supreme Court could never have intended
    that a fundamental constitutional right be cr eated with no
    regard for the framework or circumstances relevant to its
    application. It is for that reason, I suggest and strongly
    urge, that it is far more prudent and r esponsible to await
    the development of an appropriate recor d before plunging
    ahead to create a fundamental right which may not ever be
    sustainable in a communal prison context.
    41
    Judge Roth acknowledges that the record in this case is
    undeveloped just as Doe himself "concedes that the `open
    door' examination room policy [see note 3, supra] could
    conceivably be justified by a legitimate security interest but
    contends that no such interest has been advanced here."
    (Roth Op. at 12.) Judge Roth, recognizing that we would
    ordinarily remand for consideration by the trial court of
    issues concerning legitimate penological inter ests, security
    concerns, costs of accommodating Doe's privacy interest,
    availability of alternatives, etc., did not take that course
    because the right which she has declared was not clearly
    established.
    I would hold that, if a record is undeveloped, as this one
    is, it cannot suffice to form the basis for the declaration of
    a constitutional right. The announcement of a
    constitutional right--an announcement which is never
    lightly reached and which inevitably has far -reaching and
    unpredictable consequences--should be gr ounded on
    unassailable legal principles and formulated based on a full
    factual record. Had Judge Roth just assumed arguendo
    that a constitutional right existed in prison, as the Eleventh
    Circuit did in Harris v. Thigpen, 941 F .2d 1495, 1513 (11th
    Cir. 1991), (which was admittedly decided before the
    Supreme Court's holding in Wilson v. Layne, 
    526 U.S. 603
    (1999)), while I would have been uncomfortable, I would not
    have resisted her announcement as I have. But, to
    announce without reservation a full-fledged constitutional
    right of privacy in prison, as a matter of first impression,
    without a factual record, and without any substantial or
    persuasive case support, I believe transcends our r ole as
    reviewing judges. I think the declaration made in this case
    is wrong and is a grave mistake to publish as this Circuit's
    precedent. I think that we will ultimatelyfind it necessary
    to retreat from the constitutional position this panel has
    taken.
    IV.
    Accordingly, in my opinion, we are corr ect in disposing of
    this case on qualified immunity grounds, not only because
    the constitutional right was not clearly established but
    because, at this time and in the posture of the present
    42
    case, we should not announce a constitutional right which
    cannot be defined at this stage of the proceedings.
    I therefore respectfully dissent fr om Judge Roth's
    constitutional holding but concur in the final judgment,
    because I agree with Judge Roth that such a right has not
    been, and is not, clearly established and that, ther efore, the
    District Court's dismissal of Doe's action should be
    affirmed.
    A True Copy:
    Teste:
    Clerk of the United States Court of Appeals
    for the Third Circuit
    43
    

Document Info

Docket Number: 99-3019

Citation Numbers: 257 F.3d 309

Filed Date: 7/19/2001

Precedential Status: Precedential

Modified Date: 1/12/2023

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