WEST V. ATKINS, 487 U. S. 42 (1988)

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U.S. Supreme Court

West v. Atkins, 487 U.S. 42 (1988)

West v. Atkins

No. 87-5096

Argued March 28, 1988

Decided June 20, 1988

487 U.S. 42


Respondent, a private physician under contract with North Carolina to provide orthopedic services at a state prison hospital on a part-time basis, treated petitioner for a leg injury sustained while petitioner was incarcerated in state prison. Petitioner was barred by state law from employing or electing to see a physician of his own choosing. Alleging that he was given inadequate medical treatment, petitioner sued respondent in Federal District Court under 42 U.S.C. § 1983 for violation of his Eighth Amendment right to be free from cruel and unusual punishment, relying on Estelle v. Gamble, 429 U. S. 97. The court entered summary judgment for respondent, holding that, as a "contract physician," respondent was not acting "under color of state law," a jurisdictional prerequisite for a § 1983 action. The Court of Appeals ultimately affirmed.

Held: A physician who is under contract with the State to provide medical services to inmates at a state prison hospital on a part-time basis acts "under color of state law," within the meaning of § 1983, when he treats an inmate. Pp. 487 U. S. 48-57.

(a) If a defendant's alleged infringement of the plaintiff's constitutional rights satisfies the state action requirement of the Fourteenth Amendment, the defendant's conduct also constitutes action "under color of state law" for § 1983's purposes, since it is "fairly attributable to the State." Lugar v. Edmondson Oil Co., 457 U. S. 922, 457 U. S. 935, 457 U. S. 937. Thus, a state employee generally acts under color of state law when, while performing in his official capacity or exercising his official responsibilities, he abuses the position given to him by the State. Polk County v. Dodson, 454 U. S. 312, distinguished. Pp. 487 U. S. 49-50.

(b) The Court of Appeals erred in concluding that defendants are removed from § 1983's purview if they are professionals acting in accordance with professional discretion and judgment, and that professionals may be liable under § 1983 only if exercising custodial or supervisory authority. The court's analogy between respondent and the public defender in Polk County, supra, is unpersuasive. Pp. 487 U. S. 50-54.

(c) Respondent's conduct in treating petitioner is fairly attributable to the State. The State has an obligation, under the Eighth Amendment

Page 487 U. S. 43

and state law, to provide adequate medical care to those whom it has incarcerated. Estelle, supra, at 429 U. S. 104; Spicer v. Williamson, 191 N.C. 487, 490, 132 S.E. 291, 293. The State has delegated that function to physicians such as respondent, and defers to their professional judgment. This analysis is not altered by the fact that respondent was paid by contract, and was not on the state payroll, nor by the fact that respondent was not required to work exclusively for the prison. It is the physician's function within the state system, not the precise terms of his employment, that is determinative. Pp. 487 U. S. 54-57.

815 F.2d 993, reversed and remanded.

BLACKMUN, J., delivered the opinion of the Court, in which REHNQUIST, C.J.,and BRENNAN, WHITE, MARSHALL, STEVENS, O'CONNOR, and KENNEDY, JJ., joined. SCALIA, J., filed an opinion concurring in part and concurring in the judgment, post, p. 487 U. S. 58.

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