In this case, the Court determined that a person who is infected with the human immuno-deficiency virus (HIV) is covered by the American with Disabilities Act of 1990 (ADA), even though she had not manifested its most serious symptoms at the time of the incident at issue. The respondent-plaintiff had disclosed her HIV status to her dentist who then refused to fill her cavity at his office, though he said he would do so at a hospital. Respondent refused and sued under the ADA, which prohibits discrimination "on the basis of disability in the . . . enjoyment of the . . . services . . . of any place of public accommodation by any person who . . . operates [such] a place." The Act also provides, however, that entities are not required to allow an individual to "participate in or benefit from the . . . accommodations of such entity where such individual poses a direct threat to the health or safety of others." The dentist argued that respondent was not covered by the ADA because her HIV status was not a covered disability, and that even if it was such a disability, he was justified in taking his action by Act’s "direct threat" exception. The trial court granted summary judgment for the patient, and the First Circuit affirmed.
The Supreme Court agreed that the HIV infection, though only in its early stages, was a "disability" which the Act defines as "a physical . . . impairment that substantially limits one or more of [an individual’s] major life activities." First, the Court found that the HIV infection, from its inception, fell within the disability regulations under the Rehabilitation Act of 1973. In the Court’s view, the scope of the Rehabilitation Act is significant because the ADA’s definition of disability was drawn from the Rehabilitation Act and Congress expressly mandated that the ADA provide at least as much protection as the Rehabilitation Act. Next, the Court found that from the moment of infection HIV limits an individual’s ability to reproduce and bear children, which is the "major life activity" under the ADA’s definition of "disability." In so doing, the Court rejected the suggestion that only activities that have a public, economic or daily character are "major" under the ADA. Finally, the Court noted that its holding is in accord with the uniform body of administrative and judicial precedent interpreting the Rehabilitation Act, and with guidance issued by the Justice Department and other agencies who administer the ADA.
With respect to the "direct threat" defense, the Court found that the First Circuit had cited insufficient record material in order to determine, as a matter of law, that the HIV infection posed no direct threat to the health and safety of others. As a result, the Court vacated the First Circuit’s ruling and remanded for further consideration of the "direct threat" defense.