So, when does a patient become involuntary? This isn’t an idle question; there’s an awful lot of government-run health care facilities, and the question of voluntary vs. involuntary patients is pretty important.
I just finished a brief to the 8th Circuit on this question. First, in DeShaney v. Winnebago County Department of Social Services, 489 U.S. 189 (1989), the Court held that the state does not have an affirmative duty to prevent people from private harm. However, in Youngberg v. Romeo, 457 U.S. 307 (1982), the Court also held that those who are involuntarily held have substantive due process rights, including rights not available to those in a DeShaney situation. So, in DeShaney, a child in an abusive home was never placed in foster care, even though everyone knew he needed to be removed from his father’s care. We all remember that, right? And in Youngberg, we all remember the mentally handicapped patient who was owed protection from private violence in the state hospital because he had been committed against his will. The way this has been interpreted is as saying that involuntary patients certainly have those substantive due process rights; but voluntary patients might, but in any event officials have qualified immunity. Kennedy v. Schafer, 71 F.3d 292 (8th Cir. 1995). So, if you are seeking to raise a claim against hospital officials for a private harm, you had better prove that the patient was involuntary. […]