Opinion of the Court
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SUPREME COURT OF THE UNITED STATES
No. 97—156
RANDON BRAGDON, PETITIONER v. SIDNEY
ABBOTT et al.
ON WRIT OF CERTIORARI TO THE UNITED STATES
COURT OF APPEALS FOR THE FIRST CIRCUIT
[June 25, 1998]
Justice Kennedy delivered the opinion of the Court.
We address in this case the
application of the Americans with Disabilities
Act of 1990 (ADA), 104 Stat. 327, 42 U.S.C. § 12101 et seq., to persons infected
with the human immunodeficiency virus (HIV). We granted certiorari to review,
first, whether HIV infection is a disability under the ADA when the infection
has not yet progressed to the so-called symptomatic phase; and, second, whether
the Court of Appeals, in affirming a grant of summary judgment, cited sufficient
material in the record to determine, as a matter of law, that respondent’s
infection with HIV posed no direct threat to the health and safety of her
treating dentist.
I
Respondent Sidney Abbott
has been infected with HIV since 1986.
When the incidents
we recite occurred, her infection had
not manifested its most serious
symptoms.
On September 16, 1994, she went to the office of petitioner Randon Bragdon
in Bangor, Maine, for a dental appointment. She disclosed her HIV infection
on the
patient registration form. Petitioner completed a dental examination, discovered
a cavity, and informed respondent of his policy against filling cavities
of HIV-infected patients. He offered to perform the work at a hospital
with no
added fee for
his services, though respondent would be responsible for the cost of using
the hospital’s facilities. Respondent declined.
Respondent sued petitioner
under state law and §302 of the ADA, 104 Stat.
355, 42 U.S.C. § 12182 alleging discrimination on the basis of her
disability. The state law claims are not before us. Section 302 of the
ADA provides:
“
No individual shall be discriminated against on the basis of disability in the
full and equal enjoyment of the goods, services, facilities, privileges, advantages,
or accommodations of any place of public accommodation by any person who … operates
a place of public accommodation.” §12182(a).
The term “public accommodation” is defined to include the “professional
office of a health care provider.” §12181(7)(F).
A later subsection qualifies the mandate not to discriminate. It provides:
“
Nothing in this subchapter shall require an entity to permit an individual to
participate in or benefit from the goods, services, facilities, privileges, advantages
and accommodations of such entity where such individual poses a direct threat
to the health or safety of others.” §12182(b)(3).
The United States and the
Maine Human Rights Commission intervened
as plaintiffs. After discovery, the parties filed cross-motions for
summary
judgment.
The District Court ruled in favor of the plaintiffs, holding that
respondent’s HIV infection
satisfied the ADA’s definition of disability. 912 F. Supp. 580, 585—587
(Me. 1995). The court held further that petitioner raised no genuine issue of
material fact as to whether respondent’s HIV infection would have posed
a direct threat to the health or safety of others during the course of a dental
treatment. Id., at 587—591. The court relied on affidavits
submitted by Dr. Donald Wayne Marianos, Director of the Division
of Oral Health
of the Centers
for Disease Control and Prevention (CDC). The Marianos affidavits
asserted it is safe for dentists to treat patients infected with
HIV in dental
offices if
the dentist follows the so-called universal precautions described
in the Recommended Infection-Control Practices for Dentistry issued
by
CDC in
1993 (1993 CDC Dentistry
Guidelines). 912 F. Supp., at 589.
The Court of Appeals affirmed.
It held respondent’s HIV infection was a
disability under the ADA, even though her infection had not yet progressed to
the symptomatic stage. 107 F.3d 934, 939—943 (CA1 1997). The Court of Appeals
also agreed that treating the respondent in petitioner’s office would not
have posed a direct threat to the health and safety of others. Id., at 943—948.
Unlike the District Court, however, the Court of Appeals declined to rely on
the Marianos affidavits. Id., at 946, n. 7. Instead the court relied on the 1993
CDC Dentistry Guidelines, as well as the Policy on AIDS, HIV Infection and the
Practice of Dentistry, promulgated by the American Dental Association in 1991
(1991 American Dental Association Policy on HIV). 107 F.3d, at 945—946.
II
We first review the ruling
that respondent’s
HIV infection constituted a disability
under the ADA. The statute defines
disability as:
“(A) a physical or
mental impairment that substantially limits
one or more of the major life activities
of such individual;
“(B) a record of such
an impairment; or
“(C) being regarded as having such impairment.” §12102(2).
We hold respondent’s
HIV infection was a disability under subsection
(A)
of the definitional section of the
statute. In light
of this conclusion, we need
not consider the applicability of subsections (B) or
(C).
Our consideration of subsection
(A) of the definition proceeds in three
steps. First, we consider whether respondent’s
HIV infection was a physical impairment. Second, we
identify the life
activity
upon which
respondent relies
(reproduction
and child bearing) and determine whether it constitutes
a major life activity under the ADA. Third, tying the
two statutory
phrases together,
we ask
whether the impairment substantially limited the major
life activity. In construing
the statute, we are informed by interpretations of
parallel definitions in previous
statutes and the views of various administrative agencies
which
have faced this interpretive question.
A
The ADA’s definition of disability is drawn almost verbatim from the definition
of “handicapped individual” included in the Rehabilitation Act of
1973, 29 U.S.C. § 706(8)(B) (1988 ed.), and the definition of “handicap” contained
in the Fair Housing Amendments Act of 1988, 42 U.S.C. § 3602(h)(1) (1988
ed.). Congress’ repetition of a well-established term carries the implication
that Congress intended the term to be construed in accordance with pre-existing
regulatory interpretations. See FDIC v. Philadelphia Gear Corp., 476 U.S. 426,
437—438 (1986); Commissioner v. Estate of Noel, 380 U.S. 678, 681—682
(1965); ICC v. Parker, 326 U.S. 60, 65 (1945).
In this case, Congress did more than suggest this
construction;
it adopted
a specific
statutory provision
in
the ADA directing as follows:
“
Except as otherwise provided in this chapter, nothing in this chapter shall be
construed to apply a lesser standard than the standards applied under title V
of the Rehabilitation Act of 1973 (29 U.S.C. 790 et seq.) or the regulations
issued by Federal agencies pursuant to such title.” 42 U.S.C. § 12201(a).
The directive requires us to construe the ADA to grant at least as much protection
as provided by the regulations implementing the Rehabilitation Act.
1 The first step in the inquiry
under subsection (A) requires us to determine
whether respondent’s condition constituted a physical impairment. The Department
of Health, Education and Welfare (HEW) issued the first regulations interpreting
the Rehabilitation Act in 1977. The regulations are of particular significance
because, at the time, HEW was the agency responsible for coordinating the implementation
and enforcement of §504. Consolidated Rail Corporation v. Darrone, 465 U.S.
624, 634, (1984) (citing Exec. Order No. 11914, 3 CFR 117 (1976—1980 Comp.)).
The HEW regulations, which appear without change in the current regulations issued
by the Department of Health and Human Services, define “physical or mental
impairment” to mean:
“(A) any physiological
disorder or condition, cosmetic disfigurement,
or anatomical loss affecting one or more
of the
following body systems: neurological; musculoskeletal; special sense organs;
respiratory,
including speech organs;
cardiovascular; reproductive, digestive,
genito-urinary; hemic and lymphatic; skin;
and endocrine; or
“(B) any mental or psychological disorder, such as mental retardation,
organic brain syndrome, emotional or mental illness, and specific learning disabilities.” 45
CFR § 84.3(j)(2)(i) (1997).
In issuing these regulations,
HEW decided against including a list of
disorders constituting
physical or mental
impairments, out of
concern that any specific
enumeration might not be comprehensive.
42 Fed. Reg. 22685 (1977),
reprinted
in 45 CFR pt. 84, App. A, p. 334 (1997).
The
commentary accompanying the regulations,
however, contains
a representative list
of disorders and conditions
constituting
physical impairments, including “such diseases and conditions as orthopedic,
visual, speech, and hearing impairments, cerebral palsy, epilepsy, muscular dystrophy,
multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional
illness, and … drug addiction and alcoholism.” Ibid.
In 1980, the President transferred responsibility
for the implementation and enforcement
of §504 to the Attorney General. See, e.g., Exec. Order No.
12250, 3 CFR 298 (1981). The regulations issued by the Justice Department, which
remain in force to this day, adopted verbatim the HEW definition of physical
impairment quoted above. 28 CFR § 41.31(a)(1)
(1997). In addition, the representative
list of diseases and
conditions originally relegated
to the
commentary accompanying
the HEW regulations were incorporated into
the text of the regulations.
Ibid.
HIV infection is not included
in the list of specific disorders constituting
physical
impairments,
in
part because HIV
was not identified as the
cause of AIDS until 1983. See Barré-Sinoussi et al., Isolation of a T-Lymphotropic
Retrovirus from a Patient at Risk for Acquired Immune Deficiency Syndrome (AIDS),
220 Science 868 (1983); Gallo et al., Frequent Detection and Isolation of Cytopathic
Retroviruses (HTLV—III) from Patients
with AIDS and at Risk for AIDS, 224 Science
500 (1984);
Levy
et al.,
Isolation of Lymphocytopathic
Retroviruses
from
San Francisco Patients with AIDS, 225
Science 840 (1984). HIV
infection does fall well within the general
definition set forth by the regulations,
however.
The disease follows a predictable
and, as of today, an unalterable course.
Once
a person
is infected
with HIV,
the virus invades
different cells
in the blood
and in body tissues. Certain white
blood cells,
known as helper T-lymphocytes or CD4+
cells, are particularly
vulnerable
to
HIV. The virus attaches
to the CD4 receptor site of the target
cell and fuses its membrane to the
cell’s
membrane. HIV is a retrovirus, which means it uses an enzyme to convert its own
genetic material into a form indistinguishable from the genetic material of the
target cell. The virus’ genetic material migrates to the cell’s nucleus
and becomes integrated with the cell’s chromosomes. Once integrated, the
virus can use the cell’s own genetic machinery to replicate itself. Additional
copies of the virus are released into the body and infect other cells in turn.
Young, The Replication Cycle of HIV—1, in The AIDS Knowledge Base, pp.
3.1—2 to 3.1—7 (P. Cohen, M. Sande, & P. Volberding eds., 2d
ed. 1994) (hereinafter AIDS Knowledge Base); Folks & Hart, The Life Cycle
of Human Immunodeficiency Virus Type 1, in AIDS: Etiology, Diagnosis, Treatment
and Prevention 29—39 (V. DeVita et al. eds., 4th ed. 1997) (hereinafter
AIDS: Etiology); Greene, Molecular Insights into HIV—1 Infection, in The
Medical Management of AIDS 18—24 (M. Sande & P. Volberding eds., 5th
ed. 1997) (hereinafter Medical Management of AIDS). Although the body does produce
antibodies to combat HIV infection, the antibodies are not effective in eliminating
the virus. Pantaleo et al., Immunopathogenesis of Human Immunodeficiency Virus
Infection, in AIDS: Etiology 79; Garner, HIV Vaccine Development, in AIDS Knowledge
Base 3.6—5; Haynes, Immune Responses
to Human Immunodeficiency Virus Infection,
in AIDS:
Etiology
91.
The virus eventually kills
the infected host cell. CD4+ cells play
a critical
role in
coordinating the body’s immune response system, and the decline
in their number causes corresponding deterioration of the body’s ability
to fight infections from many sources. Tracking the infected individual’s
CD4+ cell count is one of the most accurate measures of the course of the disease.
Greene, Medical Management of AIDS 19, 24. Osmond, Classification and Staging
of HIV Disease, in AIDS Knowledge Base 1.1—8;
Saag, Clinical Spectrum of Human Immunodeficiency
Virus Diseases,
in AIDS:
Etiology 204.
The initial stage of HIV
infection is known as acute or primary
HIV infection.
In a
typical case, this
stage lasts
three
months. The
virus concentrates
in the blood. The assault on the immune
system is immediate. The victim suffers
from
a sudden and serious decline in the
number
of
white blood cells. There is no
latency period. Mononucleosis-like
symptoms often emerge between six days
and six
weeks after infection,
at
times accompanied
by fever, headache, enlargement of
the lymph nodes (lymphadenopathy),
muscle
pain (myalgia),
rash, lethargy,
gastrointestinal disorders, and neurological
disorders. Usually these symptoms
abate within 14 to 21 days. HIV antibodies
appear in the bloodstream within 3
weeks; circulating HIV can
be detected
within 10 weeks.
Carr& Cooper, Primary HIV Infection, in Medical
Management of AIDS 89—91; Cohen & Volberding,
Clinical Spectrum of HIV Disease, in AIDS Knowledge Base 4.1—7; Crowe & McGrath,
Acute HIV Infection, in AIDS Knowledge Base 4.2—1 to 4.2—4; Saag,
AIDS: Etiology 204—205.
After the symptoms associated
with the initial stage subside, the disease
enters
what is
referred to sometimes
as its
asymptomatic phase. The
term is a misnomer,
in some respects, for clinical features
persist throughout, including lymphadenopathy,
dermatological
disorders,
oral lesions, and
bacterial
infections. Although
it varies with each individual, in
most instances this stage lasts from
7 to
11 years. The virus now tends to concentrate
in the lymph nodes, though low levels
of
the virus
continue
to appear
in the
blood. Cohen & Volberding, AIDS Knowledge
4.1—4, 4.1—8; Saag, AIDS: Etiology 205—206; Strapans & Feinberg,
Natural History and Immunopathogenesis of HIV—1 Disease, in Medical Management
of AIDS 38. It was once thought the virus became inactive during this period,
but it is now known that the relative lack of symptoms is attributable to the
virus’ migration from the circulatory system into the lymph nodes. Cohen & Volberding,
AIDS Knowledge Base 4.1—4. The migration reduces the viral presence in
other parts of the body, with a corresponding diminution in physical manifestations
of the disease. The virus, however, thrives in the lymph nodes, which, as a vital
point of the body’s immune response system, represents an ideal environment
for the infection of other CD4+ cells. Strapans & Feinberg, Medical Management
of AIDS 33—34. Studies have shown that viral production continues at a
high rate. Cohen & Volberding, AIDS Knowledge Base 4.1—4; Strapans & Feinberg,
Medical Management of AIDS 38. CD4+
cells continue to decline an average
of 5%
to 10% (40 to 80
cells/mm3) per year throughout
this
phase. Saag,
AIDS: Etiology
207.
A person is regarded as having
AIDS when his or her CD4+ count drops below
200
cells/mm3 of blood
or
when CD4+
cells comprise
less than
14% of his
or her total
lymphocytes. U.S. Dept. of Health and
Human Services, Public Health Service,
CDC, 1993
Revised Classification
System
for HIV Infection
and Expanded
Surveillance Case Definition for AIDS
Among Adolescents and Adults, 41 Morbidity & Mortality
Weekly Rep., No. RR—17 (Dec. 18, 1992); Osmond, AIDS Knowledge Base 1.1—2;
Saag, AIDS: Etiology 207; Ward, Petersen, & Jaffe, Current Trends in the
Epidemiology of HIV/AIDS, in Medical Management of AIDS 3. During this stage,
the clinical conditions most often associated with HIV, such as pneumocystis
carninii pneumonia, Kaposi’s sarcoma, and non-Hodgkins lymphoma, tend to
appear. In addition, the general systemic disorders present during all stages
of the disease, such as fever, weight loss, fatigue, lesions, nausea, and diarrhea,
tend to worsen. In most cases, once the patient’s CD4+ count drops below
10 cells/mm3, death soon follows. Cohen & Volberding, AIDS Knowledge Base
4.1—9; Saag, AIDS: Etiology 207—209.
In light of the immediacy
with which the virus begins to damage the
infected
person’s white blood cells and the severity of the disease, we hold it
is an impairment from the moment of infection. As noted earlier, infection with
HIV causes immediate abnormalities in a person’s blood, and the infected
person’s white cell count continues to drop throughout the course of the
disease, even when the attack is concentrated in the lymph nodes. In light of
these facts, HIV infection must be regarded as a physiological disorder with
a constant and detrimental effect on the infected person’s
hemic and lymphatic systems from the
moment of infection. HIV infection
satisfies the
statutory and
regulatory definition of a physical
impairment during every stage of the
disease.
2
The statute is not operative,
and the definition not satisfied, unless
the
impairment affects
a major life
activity. Respondent’s claim throughout
this case has been that the HIV infection placed a substantial limitation on
her ability to reproduce and to bear children. App. 14; 912 F. Supp., at 586;
107 F.3d, at 939. Given the pervasive, and invariably fatal, course of the disease,
its effect on major life activities of many sorts might have been relevant to
our inquiry. Respondent and a number of amici make arguments about HIV’s
profound impact on almost every phase of the infected person’s life. See
Brief for Respondent Sidney Abbott 24—27; Brief for American Medical Association
as Amicus Curiae 20; Brief for Infectious Diseases Society of America et al.
as Amici Curiae 7—11. In light
of these submissions, it may seem legalistic
to circumscribe
our discussion
to the activity
of reproduction.
We have little
doubt that had different parties brought
the suit they would have
maintained that an HIV infection imposes
substantial limitations on other major
life activities.
From the outset, however,
the case has been treated as one in which
reproduction was
the major life
activity limited by the
impairment.
It is our practice
to decide cases on the grounds
raised
and considered in the
Court of Appeals and
included in the question on which
we granted certiorari. See, e.g.,
Blessing
v. Freestone,
520 U.S. 329,
340, n. 3 (1997)
(citing this
Court’s
Rule 14.1(a)); Capitol Square Review
and Advisory Bd. v. Pinette, 515
U.S. 753,
760 (1995). We ask, then, whether
reproduction is a major life activity.
We have little difficulty
concluding that it is. As the Court of
Appeals
held, “[t]he
plain meaning of the word ‘major’ denotes comparative importance” and “suggest[s]
that the touchstone for determining an activity’s inclusion under the statutory
rubric is its significance.” 107 F.3d, at 939, 940. Reproduction falls
well within the phrase “major life activity.” Reproduction
and the sexual dynamics surrounding
it are central to the life process
itself.
While petitioner concedes
the importance of reproduction, he claims
that Congress
intended
the ADA only
to cover those aspects
of a
person’s life which have
a public, economic, or daily character. Brief for Petitioner 14, 28, 30, 31;
see also id., at 36—37 (citing Krauel v. Iowa Methodist Medical Center,
95 F.3d 674, 677 (CA8 1996)). The argument founders on the statutory language.
Nothing in the definition suggests that activities without a public, economic,
or daily dimension may somehow be regarded as so unimportant or insignificant
as to fall outside the meaning of the word “major.” The
breadth of the term confounds the
attempt to limit its construction
in this manner.
As we have noted, the ADA
must be construed to be consistent with
regulations
issued
to implement
the
Rehabilitation
Act. See 42
U.S.C. § 12201(a). Rather
than enunciating a general principle for determining what is and is not a major
life activity, the Rehabilitation Act regulations instead provide a representative
list, defining term to include “functions such as caring for one’s
self, performing manual tasks, walking, seeing, hearing, speaking, breathing,
learning, and working.” 45 CFR § 84.3(j)(2)(ii) (1997); 28 CFR § 41.31(b)(2)
(1997). As the use of the term “such as” confirms,
the list is illustrative, not exhaustive.
These regulations are contrary
to petitioner’s attempt to limit the meaning
of the term “major” to public activities. The inclusion of activities
such as caring for one’s self and performing manual tasks belies the suggestion
that a task must have a public or economic character in order to be a major life
activity for purposes of the ADA. On the contrary, the Rehabilitation Act regulations
support the inclusion of reproduction as a major life activity, since reproduction
could not be regarded as any less important than working and learning. Petitioner
advances no credible basis for confining major life activities to those with
a public, economic, or daily aspect. In the absence of any reason to reach a
contrary conclusion, we agree with the Court of Appeals’ determination
that reproduction is a major life
activity for the purposes of the
ADA.
3
The final element of the
disability definition in subsection (A)
is whether
respondent’s
physical impairment was a substantial
limit on the major life
activity she
asserts.
The
Rehabilitation
Act regulations
provide no
additional guidance. 45 CFR pt. 84,
App. A, p. 334 (1997).
Our evaluation of the medical
evidence leads us to conclude that respondent’s
infection substantially limited her ability to reproduce in two independent ways.
First, a woman infected with HIV who tries to conceive a child imposes on the
man a significant risk of becoming infected. The cumulative results of 13 studies
collected in a 1994 textbook on AIDS indicates that 20% of male partners of women
with HIV became HIV-positive themselves, with a majority of the studies finding
a statistically significant risk of infection. Osmond & Padian, Sexual Transmission
of HIV, in AIDS Knowledge Base 1.9—8, and tbl. 2; see also Haverkos & Battjes,
Female-to-Male Transmission of HIV, 268 JAMA 1855, 1856, tbl. (1992) (cumulative
results of 16 studies indicated 25% risk of female-to-male transmission). (Studies
report a similar, if not more severe, risk of male-to-female
transmission. See,
e.g., Osmond & Padian, AIDS Knowledge Base 1.9—3, tbl. 1, 1.9—6
to 1.9—7.)
Second, an infected woman risks
infecting her child during gestation
and childbirth,
i.e.,
perinatal
transmission. Petitioner concedes
that women
infected with
HIV face about a 25% risk of transmitting
the virus to
their children. 107 F.3d,
at 942; 912 F. Supp., at 387, n.
6. Published reports available
in 1994
confirm the
accuracy of this
statistic. Report
of a Consensus Workshop,
Maternal
Factors Involved in Mother-to-Child
Transmission of HIV—1, 5 J. Acquired Immune
Deficiency Syndromes 1019, 1020 (1992) (collecting 13 studies placing risk between
14% and 40%, with most studies falling within the 25% to 30% range); Connor et
al., Reduction of Maternal-Infant Transmission of Human Immunodeficiency Virus
Type 1 with Zidovudine Treatment, 331 New Eng. J. Med. 1173, 1176 (1994) (placing
risk at 25.5%); see also Strapans & Feinberg,
Medical Management of AIDS 32 (studies
report 13% to 45% risk
of infection, with
average of approximately
25%).
Petitioner points to evidence
in the record suggesting that antiretroviral
therapy can lower the risk of perinatal
transmission to about 8%. App.
53; see also Connor,
supra, at 1176 (8.3%); Sperling
et al., Maternal Viral Load, Zidovudine
Treatment, and the Risk of Transmission
of Human Immunodeficiency Virus
Type
1 from Mother
to Infant, 335 New Eng. J. Med.
1621, 1622 (1996) (7.6%). The Solicitor
General questions the relevance
of
the 8% figure, pointing to regulatory
language requiring
the substantiality of a limitation
to be assessed without regard to
available mitigating measures.
Brief for United States as Amicus
Curiae
18, n. 10 (citing
28 CFR pt. 36, App. B, p. 611 (1997);
29 CFR pt. 1630, App., p. 351 (1997)).
We need not resolve this dispute
in order to decide this case, however.
It cannot be said as a matter of
law that an 8% risk of transmitting
a dread and fatal disease to one’s
child does not represent a substantial
limitation on reproduction.
The Act addresses substantial
limitations on major life activities, not
utter
inabilities. Conception
and childbirth
are not
impossible for an
HIV victim
but, without doubt, are dangerous
to the public
health. This meets the definition
of a substantial limitation.
The decision
to reproduce
carries
economic and
legal
consequences as well. There are
added costs for antiretroviral
therapy,
supplemental insurance, and long-term
health
care for the child who
must be examined and,
tragic to think, treated for the
infection. The
laws of some States, moreover,
forbid persons
infected with HIV
from having
sex with
others, regardless
of consent. Iowa Code §§139.1, 139.31 (1997); Md. Health Code Ann. §18—601.1(a)
(1994); Mont. Code Ann. §§50—18—101, 50—18—112
(1997); Utah Code Ann. §26—6—3.5(3) (Supp. 1997); id., §26—6—5
(1995); Wash. Rev. Code §9A.36.011(1)(b) (Supp. 1998); see also N. D. Cent.
Code §12.1—20—17
(1997).
In the end, the disability
definition does not turn on personal choice.
When significant
limitations
result from the impairment,
the definition
is met
even if the difficulties are not
insurmountable. For the statistical
and other reasons
we have cited, of course, the limitations
on reproduction may be insurmountable
here. Testimony
from the
respondent
that
her HIV
infection controlled
her decision not to have a child
is unchallenged. App. 14; 912 F.
Supp.,
at
587; 107 F.3d,
at 942. In the context of reviewing
summary judgment, we must take
it to be true.
Fed. Rule Civ. Proc.
56(e). We
agree with
the District
Court
and
the
Court of
Appeals that no triable issue of
fact impedes a ruling on the question
of
statutory coverage.
Respondent’s
HIV infection is a physical impairment
which substantially limits
a major
life activity, as
the ADA defines it.
In view of our holding,
we need not address the second
question presented, i.e., whether
HIV infection
is a per se disability
under the
ADA.
B
Our holding is confirmed
by a consistent course of agency interpretation
before and after enactment
of the ADA.
Every agency to consider
the issue under the
Rehabilitation Act found statutory
coverage for persons
with asymptomatic HIV. Responsibility
for administering the Rehabilitation
Act was
not delegated to
a single agency, but we need
not pause to inquire whether this causes
us to
withhold deference
to agency interpretations
under
Chevron
U.S. A. Inc.
v.
Natural Resources
Defense Council, Inc., 467 U.S.
837, 844 (1984). It is enough
to
observe
that the
well-reasoned
views of
the
agencies implementing
a statute “constitute
a body of experience and informed judgment to which courts and litigants may
properly resort for guidance.” Skidmore v. Swift & Co., 323 U.S. 134,
139—140 (1944).
One comprehensive and significant
administrative precedent is a
1988 opinion issued
by the Office of Legal Counsel
of the Department
of
Justice (OLC)
concluding that the Rehabilitation
Act “protects symptomatic and asymptomatic HIV-infected
individuals against discrimination in any covered program.” Application
of Section 504 of the Rehabilitation Act to HIV-Infected Individuals, 12 Op.
Off. Legal Counsel 264, 264—265 (Sept. 27, 1988) (preliminary print) (footnote
omitted). Relying on a letter from Surgeon General C. Everett Koop stating that, “from
a purely scientific perspective, persons with HIV are clearly impaired” even
during the asymptomatic phase, OLC determined asymptomatic HIV was a physical
impairment under the Rehabilitation Act because it constituted a “physiological
disorder or condition affecting the hemic and lymphatic systems.” Id.,
at 271 (internal quotation marks
omitted). OLC determined further
that asymptomatic
HIV imposed
a substantial
limit on the major
life activity
of reproduction.
The Opinion said:
“
Based on the medical knowledge available to us, we believe that it is reasonable
to conclude that the life activity of procreation … is substantially limited
for an asymptomatic HIV-infected individual. In light of the significant risk
that the AIDS virus may be transmitted to a baby during pregnancy, HIV-infected
individuals cannot, whether they are male or female, engage in the act of procreation
with the normal expectation of bringing forth a healthy child.” Id.,
at 273.
In addition, OLC indicated
that “[t]he life activity of engaging in sexual
relations is threatened and probably substantially limited by the contagiousness
of the virus.” Id., at 274. Either consideration was sufficient to render
asymptomatic HIV infection a handicap for purposes of the Rehabilitation Act.
In the course of its Opinion, OLC considered, and rejected, the contention that
the limitation could be discounted as a voluntary response to the infection.
The limitation, it reasoned, was the infection’s manifest physical effect.
Id., at 274, and n. 13. Without exception, the other agencies to address the
problem before enactment of the ADA reached the same result. Federal Contract
Compliance Manual App. 6D, 8 FEP Manual 405:352 (Dec. 23, 1988); In re David
Ritter, No. 03890089, 1989 WL 609697, *10 (EEOC, Dec. 8, 1989); see also Comptroller
General’s Task Force on AIDS in the Workplace, Coping with AIDS in the
GAO Workplace: Task Force Report 29 (Dec. 1987); Report of the Presidential Commission
on the Human Immunodeficiency Virus Epidemic 113—114, 122—123 (June
1988). Agencies have adhered to this conclusion since the enactment of the ADA
as well. See 5 CFR § 1636.103 (1997); 7 CFR §15e.103 (1998); 22 CFR § 1701.103
(1997); 24 CFR § 9.103 (1997); 34 CFR § 1200.103 (1997); 45 CFR §§2301.103,
2490.103 (1997); In re Westchester County Medical Center, [1991—1994 Transfer
Binder] CCH Employment Practices Guide ¶5340, pp. 6110—6112 (Apr.
20, 1992), aff’d, id., ¶5362, pp. 6249—6250 (Dept. of Health & Human
Servs. Departmental Appeals Bd., Sept. 25, 1992); In re Rosebud Sioux Tribe,
No. 93—504—1, 1994 WL 603015 (Dept. of Health & Human
Servs. Departmental Appeals Bd.,
July 14, 1994); In re David T.
Martin, No.
01954089,
1997 WL 151524, *4 (EEOC, Mar.
27, 1997).
Every court which addressed
the issue before the ADA was enacted
in July
1990, moreover,
concluded that
asymptomatic HIV infection
satisfied
the
Rehabilitation Act’s definition of a handicap. See Doe v. Garrett, 903 F.2d 1455, 1457
(CA11 1990), cert. denied, 499 U.S. 904 (1991); Ray v. School Dist. of DeSoto
County, 666 F. Supp. 1524, 1536 (MD Fla. 1987); Thomas v. Atascadero Unified
School Dist., 662 F. Supp. 376, 381 (CD Cal. 1987); District 27 Community School
Bd. v. Board of Ed. of New York, 130 Misc. 2d 398, 413—415, 502 N. Y. S.
2d 325, 335—337 (Sup. Ct., Queens Cty. 1986); cf. Baxter v. Belleville,
720 F. Supp. 720, 729 (SD Ill. 1989) (Fair Housing Amendments Act); Cain v. Hyatt,
734 F. Supp. 671, 679 (ED Pa. 1990) (Pennsylvania Human Relations Act). (For
cases finding infection with HIV to be a handicap without distinguishing between
symptomatic and asymptomatic HIV, see Martinez ex rel. Martinez v. School Bd.
of Hillsborough Cty., 861 F.2d 1502, 1506 (CA11 1988); Chalk v. United States
Dist. Ct., 840 F.2d 701, 706 (CA9 1988); Doe v. Dolton Elementary School Dist.
No. 148, 694 F. Supp. 440, 444—445 (ND Ill. 1988); Robertson v. Granite
City Community Unit School Dist. No. 9, 684 F. Supp. 1002, 1006—1007
(SD Ill. 1988); Local 1812, AFGE
v. United States Dept. of State,
662 F.
Supp. 50,
54 (DC 1987); cf. Association
of Relatives and Friends of AIDS
Patients
v. Regulations
and Permits
Admin.,
740 F. Supp.
95,
103 (PR 1990)
(Fair Housing
Amendments Act).)
We are aware of no instance prior
to the enactment of the ADA in
which a
court or
agency ruled
that HIV infection
was not
a handicap
under
the Rehabilitation
Act.
Had Congress done nothing
more than copy the Rehabilitation
Act definition
into
the ADA,
its action would indicate
the new statute
should be
construed in light
of this unwavering line of administrative
and judicial interpretation.
All indications are
that Congress
was well aware of the position
taken by OLC
when enacting the
ADA and intended to give that
position its active endorsement.
H. R. Rep.
No. 101—485, pt. 2, p. 52 (1990) (endorsing the analysis and conclusion of
the OLC Opinion); id., pt. 3, at 28, n. 18 (same); S. Rep. No. 101—116,
pp. 21, 22 (1989) (same). As noted earlier, Congress also incorporated the same
definition into the Fair Housing Amendments Act of 1988. See 42 U.S.C. § 3602(h)(1).
We find it significant that the implementing regulations issued by the Department
of Housing and Urban Development (HUD) construed the definition to include infection
with HIV. 54 Fed. Reg. 3232, 3245 (1989) (codified at 24 CFR § 100.201 (1997));
see also In re Willie L. Williams, 2A P—H Fair Housing-Fair Lending ¶25,007,
pp. 25,111—25,113 (HUD Off. Admin. Law Judges, Mar. 22, 1991) (adhering
to this interpretation); In re Elroy R. and Dorothy Burns Trust, 2A P—H
Fair Housing-Fair Lending ¶25,073, p. 25,678 (HUD Off. Admin. Law Judges,
June 17, 1994) (same). Again the legislative record indicates that Congress intended
to ratify HUD’s interpretation when it reiterated the same definition in
the ADA. H. R. Rep. No. 101—485, pt. 2, at 50; id., pt. 3, at 27; id.,
pt. 4, at 36; S. Rep. No. 101—116,
at 21.
We find the uniformity of
the administrative and judicial precedent
construing
the definition significant.
When
administrative and judicial interpretations
have settled the meaning of an
existing statutory provision,
repetition of
the same language
in a new statute indicates,
as a general matter,
the intent
to
incorporate its administrative
and judicial interpretations
as well.
See, e.g., Lorillard
v. Pons, 434 U.S.
575, 580—581
(1978). The uniform body of administrative
and judicial precedent confirms
the
conclusion we
reach today
as the most faithful
way to effect the congressional
design.
C
Our conclusion is further
reinforced by the administrative guidance
issued by the
Justice
Department to
implement the public accommodation
provisions
of Title
III of the ADA. As the agency
directed by Congress to issue implementing
regulations, see 42 U.S.C. § 12186(b), to render technical assistance explaining the
responsibilities of covered individuals and institutions, §12206(c), and
to enforce Title III in court, §12188(b), the Department’s
views are entitled to deference.
See Chevron, 467 U.S., at 844.
The Justice Department’s interpretation of the definition of disability
is consistent with our analysis. The regulations acknowledge that Congress intended
the ADA’s definition of disability to be given the same construction as
the definition of handicap in the Rehabilitation Act. 28 CFR § 36.103(a)
(1997); id., pt. 36, App. B, pp. 608, 609. The regulatory definition developed
by HEW to implement the Rehabilitation Act is incorporated verbatim in the ADA
regulations. §36.104. The Justice Department went further, however. It added “HIV
infection (symptomatic and asymptomatic)” to the list of disorders constituting
a physical impairment. §36.104(1)(iii). The technical assistance the Department
has issued pursuant to 42 U.S.C. § 12206 similarly concludes that persons
with asymptomatic HIV infection fall within the ADA’s definition of disability.
See, e.g., U.S. Dept. of Justice, Civil Rights Division, The Americans with Disabilities
Act: Title III Technical Assistance Manual 9 (Nov. 1993); Response to Congressman
Sonny Callahan, 5 Nat. Disability L. Rep. (LRP) ¶360, p. 1167 (Feb. 9, 1994);
Response to A. Laurence Field, 5 Nat. Disability L. Rep. (LRP) ¶21, p. 80
(Sept. 10, 1993). Any other conclusion, the Department reasoned, would contradict
Congress’ affirmative
ratification of the administrative
interpretations
given previous
versions of the same
definition. 28 CFR pt. 36,
App. B, p. 609, 610 (1997)
(citing
the OLC Opinion and HUD regulations);
56 Fed.
Reg.
7455,
7456 (1991) (same) (notice
of proposed
rulemaking).
We also draw guidance from
the views of the agencies authorized
to administer
other
sections
of the
ADA. See 42 U.S.C. § 12116 (authorizing EEOC to issue
regulations implementing Title I); §12134(a) (authorizing the Attorney General
to issue regulations implementing the public services provisions of Title II,
subtitle A); §§12149, 12164, 12186 (authorizing the Secretary of Transportation
to issue regulations implementing the transportation-related provisions or Titles
II and III); §12206(c) (authorizing the same agencies to offer technical
assistance for the provisions they administer). These agencies, too, concluded
that HIV infection is a physical impairment under the ADA. 28 CFR § 35.104(1)(iii)
(1997); 49 CFR §§37.3, 38.3 (1997); 56 Fed. Reg. 13858 (1991); U.S.
Dept. of Justice, Civil Rights Division, The Americans with Disabilities Act:
Title II Technical Assistance Manual 4 (Nov. 1993); EEOC, A Technical Assistance
Manual on the Employment Provisions (Title I) of the Americans with Disabilities
Act II—3 (Jan. 1992) (hereinafter EEOC Technical Assistance Manual); EEOC
Interpretive Manual §902.2(d), pp. 902—13 to 902—14 (reissued
Mar. 14, 1995) (hereinafter EEOC Interpretive Manual), reprinted in 2 BNA EEOC
Compliance Manual 902:0013 (1998). Most categorical of all is EEOC’s conclusion
that “an individual who has HIV infection (including asymptomatic HIV infection)
is an individual with a disability.” EEOC Interpretive Manual §902.4(c)(1),
p. 902—21; accord, id., §902.2(d), p. 902—14, n. 18. In the
EEOC’s view, “impairments … such as HIV infection, are inherently
substantially limiting.” 29 CFR pt. 1630, App., p. 350 (1997); EEOC Technical
Assistance Manual II—4; EEOC Interpretive Manual §902.4(c)(1), p.
902—21.
The regulatory authorities we cite
are consistent with our holding
that HIV infection, even in the
so-called
asymptomatic phase, is an impairment
which substantially
limits the major life activity
of reproduction.
III
The petition for certiorari presented
three other questions for review.
The questions stated:
“3. When deciding under title III of the ADA whether a private health care
provider must perform invasive procedures on an infectious patient in his office,
should courts defer to the health care provider’s
professional judgment, as long
as it is reasonable in light
of then-current
medical knowledge?
“4. What is the proper standard of judicial review under title III of the
ADA of a private health care provider’s
judgment that the performance
of certain invasive procedures
in his office
would
pose a direct
threat to the health
or safety of others?
“5. Did petitioner, Randon Bragdon, D. M. D., raise a genuine issue of
fact for trial as to whether he was warranted in his judgment that the performance
of certain invasive procedures on a patient in his office would have posed a
direct threat to the health or safety of others?” Pet.
for Cert. i.
Of these, we granted certiorari
only on question three. The
question is
phrased in an awkward
way, for it conflates
two
separate inquiries.
In
asking whether
it is appropriate to defer
to petitioner’s judgment, it assumes that petitioner’s
assessment of the objective
facts was reasonable. The central
premise
of
the question and
the assumption on which it
is based merit separate
consideration.
Again, we begin with the
statute. Notwithstanding the protection
given respondent by
the ADA’s definition of disability, petitioner could have refused to
treat her if her infectious condition “pose[d] a direct threat to the health
or safety of others.” 42 U.S.C. § 12182(b)(3). The ADA defines a direct
threat to be “a significant risk to the health or safety of others that
cannot be eliminated by a modification of policies, practices, or procedures
or by the provision of auxiliary aids or services.” Ibid. Parallel provisions
appear in the employment provisions of Title I. §§12111(3),
12113(b).
The ADA’s direct threat provision stems from the recognition in School
Bd. of Nassau Cty. v. Arline, 480 U.S. 273, 287 (1987), of the importance of
prohibiting discrimination against individuals with disabilities while protecting
others from significant health and safety risks, resulting, for instance, from
a contagious disease. In Arline, the Court reconciled these objectives by construing
the Rehabilitation Act not to require the hiring of a person who posed “a
significant risk of communicating an infectious disease to others.” Id.,
at 287, n. 16. Congress amended the Rehabilitation Act and the Fair Housing Act
to incorporate the language. See 29 U.S.C. § 706(8)(D) (excluding individuals
who “would constitute a direct threat to the health or safety of other
individuals”); 42 U.S.C. § 3604(f)(9) (same). It later relied on the
same language in enacting the ADA. See 28 CFR pt. 36, App. B, p. 626 (1997) (ADA’s
direct threat provision codifies Arline). Because few, if any, activities in
life are risk free, Arline and the ADA do not ask whether a risk exists, but
whether it is significant. Arline, supra, at 287, and n. 16; 42 U.S.C. § 12182(b)(3).
The existence, or nonexistence,
of a significant risk must
be determined from
the standpoint
of the person
who refuses
the
treatment or
accommodation, and
the risk assessment must be
based on medical or other objective
evidence. Arline, supra,
at 288;
28 CFR § 36.208(c) (1997); id., pt. 36, App. B, p. 626. As
a health care professional, petitioner had the duty to assess the risk of infection
based on the objective, scientific information available to him and others in
his profession. His belief that a significant risk existed, even if maintained
in good faith, would not relieve him from liability. To use the words of the
question presented, petitioner receives no special deference simply because he
is a health care professional. It is true that Arline reserved “the question
whether courts should also defer to the reasonable medical judgments of private
physicians on which an employer has relied.” 480 U.S., at 288, n. 18. At
most, this statement reserved the possibility that employers could consult with
individual physicians as objective third-party experts. It did not suggest that
an individual physician’s
state of mind could excuse
discrimination without regard
to the objective
reasonableness
of his actions.
Our conclusion that courts
should assess the objective
reasonableness
of the
views of health
care professionals
without deferring
to their individual
judgments
does not answer the implicit
assumption in the question
presented, whether
petitioner’s
actions were reasonable in light of the available medical evidence. In assessing
the reasonableness of petitioner’s actions, the views of public health
authorities, such as the U.S. Public Health Service, CDC, and the National Institutes
of Health, are of special weight and authority. Arline, supra, at 288; 28 CFR
pt. 36, App. B, p. 626 (1997). The views of these organizations are not conclusive,
however. A health care professional who disagrees with the prevailing medical
consensus may refute it by citing a credible scientific basis for deviating from
the accepted norm. See W. Keeton, D. Dobbs, R. Keeton, & D. Owen, Prosser
and Keeton on Law of Torts §32,
p. 187 (5th ed. 1984).
We have reviewed so much
of the record as necessary to
illustrate
the application
of
the rule to
the facts of
this case. For
the most part,
the Court of
Appeals followed the proper
standard in evaluating the
petitioner’s position and
conducted a thorough review of the evidence. Its rejection of the District Court’s
reliance on the Marianos affidavits was a correct application of the principle
that petitioner’s actions
must be evaluated in light
of the available,
objective
evidence.
The record
did not
show that
CDC
had published
the conclusion set out in the
affidavits at the time petitioner
refused
to treat respondent.
107 F.3d, at 946, n. 7.
A further illustration of a
correct application of the
objective
standard is the Court
of Appeals’ refusal to give weight to the petitioner’s
offer to treat respondent in
a hospital. Id., at 943, n.
4. Petitioner
testified
that he
believed hospitals
had
safety measures, such
as air filtration, ultraviolet
lights, and respirators, which
would reduce the risk of HIV
transmission. App. 151.
Petitioner made no
showing, however,
that any area
hospital had these
safeguards or even that he
had hospital
privileges. Id., at
31. His expert also admitted
the lack of any scientific
basis for the conclusion that
these
measures would lower
the risk of
transmission.
Id.,
at 209.
Petitioner failed
to present
any objective, medical evidence
showing that treating
respondent in a hospital would
be safer
or more efficient in preventing
HIV transmission
than treatment
in a
well-equipped dental office.
We are concerned, however,
that the Court of Appeals might
have
placed
mistaken
reliance upon two other
sources. In
ruling no
triable issue
of fact existed
on this point, the Court of
Appeals relied on the 1993
CDC Dentistry
Guidelines and the
1991
American
Dental
Association Policy on
HIV. 107 F.3d, at 945—946.
This evidence is not definitive. As noted earlier, the CDC Guidelines recommended
certain universal precautions which, in CDC’s view, “should reduce
the risk of disease transmission in the dental environment.” U.S. Dept.
of Health and Human Services, Public Health Service, CDC, Recommended Infection
Control Practices for Dentistry, 41 Morbidity & Mortality Weekly Rep. No.
RR—18, p. 1 (May 28, 1993). The Court of Appeals determined that, “[w]hile
the guidelines do not state explicitly that no further risk-reduction measures
are desirable or that routine dental care for HIV-positive individuals is safe,
those two conclusions seem to be implicit in the guidelines’ detailed delineation
of procedures for office treatment of HIV-positive patients.” 107 F.3d,
at 946. In our view, the Guidelines do not necessarily contain implicit assumptions
conclusive of the point to be decided. The Guidelines set out CDC’s
recommendation that the universal
precautions are the best way
to combat the risk
of HIV transmission. They do
not assess the level
of risk.
Nor can we be certain, on this
record, whether the 1991 American
Dental
Association Policy
on HIV carries
the
weight the Court
of Appeals attributed
to it. The
Policy does provide some evidence
of the medical community’s
objective assessment of the
risks posed by treating people
infected
with HIV
in dental offices. It
indicates:
“
Current scientific and epidemiologic evidence indicates that there is little
risk of transmission of infectious diseases through dental treatment if recommended
infection control procedures are routinely followed. Patients with HIV infection
may be safely treated in private dental offices when appropriate infection control
procedures are employed. Such infection control procedures provide protection
both for patients and dental personnel.” App.
225.
We note, however, that the
Association is a professional
organization,
which, although
a respected source
of information on the dental
profession, is not
a public health authority.
It is not clear the extent
to which
the
Policy
was based
on the Association’s assessment of dentists’ ethical and professional
duties in addition to its scientific assessment of the risk to which the ADA
refers. Efforts to clarify dentists’ ethical obligations and to encourage
dentists to treat patients with HIV infection with compassion may be commendable,
but the question under the statute is one of statistical likelihood, not professional
responsibility. Without more information on the manner in which the American
Dental Association formulated this Policy, we are unable to determine the Policy’s
value in evaluating whether petitioner’s
assessment of the risks was
reasonable as a matter of law.
The court considered materials
submitted by both parties on
the cross motions
for summary
judgment.
The petitioner
was
required
to establish
that there
existed a genuine issue of
material fact. Evidence which
was merely
colorable or
not significantly probative
would not have been
sufficient. Anderson v. Liberty
Lobby, Inc., 477 U.S. 242,
249—250
(1986).
We acknowledge the presence
of other evidence in the record
before the
Court of Appeals
which, subject
to
further arguments
and
examination, might support
affirmance of the trial court’s ruling. For instance, the record contains
substantial testimony from numerous health experts indicating that it is safe
to treat patients infected with HIV in dental offices. App. 66—68, 88—90,
264—266, 268. We are unable to determine the import of this evidence, however.
The record does not disclose whether the expert testimony submitted by respondent
turned on evidence available in September 1994. See id., at 69—70
(expert testimony relied in
part on materials published
after
September 1994).
There are reasons to doubt
whether petitioner advanced
evidence
sufficient to raise
a triable issue of
fact on the significance
of the risk.
Petitioner relied
on two principal points: First,
he asserted that the use of
high-speed drills and
surface cooling
with water
created
a
risk of airborne
HIV transmission. The study
on which
petitioner relied was inconclusive,
however, determining
only
that “[f]urther work is required to determine whether such a risk exists.” Johnson & Robinson,
Human Immunodeficiency Virus-1 (HIV—1) in the Vapors of Surgical Power
Instruments, 33 J. of Medical Virology 47, 47 (1991). Petitioner’s
expert witness conceded, moreover,
that no evidence suggested
the spray could
transmit HIV. His opinion on
airborne risk was based
on
the absence of contrary evidence,
not on positive data.
App. 166.
Scientific evidence and
expert testimony
must have a traceable, analytical
basis in
objective fact before it may
be considered on summary judgment.
See General
Electric Co. v. Joiner, 522
U.S. ___, ___, ___
(1997) (slip
op.,
at 7, 9).
Second, petitioner argues
that, as of September 1994, CDC had
identified seven
dental workers
with possible
occupational
transmission of
HIV. See U.S. Dept.
of Health and Human Services,
Public Health Service, CDC,
HIV/AIDS Surveillance Report,
vol. 6,
no.
1, p. 15, tbl. 11 (Mid-year
ed. June
1994).
These dental workers were
exposed to HIV in the
course of their employment,
but CDC could not determine
whether
HIV infection
had resulted. Id., at 15,
n. 3. It is
now known that CDC could
not ascertain whether
the seven dental workers
contracted the disease because
they did
not present
themselves for
HIV testing at an
appropriate
time after their initial
exposure. Gooch et al., Percutaneous
Exposures to HIV-Infected
Blood
Among Dental Workers
Enrolled in the CDC
Needlestick Study,
126 J. American
Dental Assn. 1237, 1239 (1995).
It is not clear
on this record, however,
whether this information was
available
to petitioner
in September
1994. If not, the
seven cases might have provided
some, albeit not necessarily
sufficient, support for
petitioner’s position.
Standing alone, we doubt
it would meet the
objective, scientific
basis
for
finding a significant
risk to
the petitioner.
Our evaluation of the evidence
is constrained by the fact
that on these
and other
points we have
not had
briefs and
arguments
directed
to the
entire record. In
accepting the case for review,
we declined to grant certiorari
on question
five,
which asked
whether
petitioner raised
a genuine issue
of fact
for trial.
Pet.
for Cert. i. As a result, the
briefs and arguments presented
to us did
not concentrate
on the
question of sufficiency
in light all of
the submissions
in the summary
judgment proceeding. “When attention has been focused on other issues,
or when the court from which a case comes has expressed no views on a controlling
question, it may be appropriate to remand the case rather than deal with the
merits of that question in this Court.” Dandridge
v. Williams, 397 U.S. 471,
476, n. 6 (1970). This consideration
carries
particular
force
where, as
here, full briefing directed
at the issue would help place
a complex
factual record
in proper
perspective. Resolution
of the
issue will
be of importance
to health care workers not
just
for
the result but
also for
the precision and comprehensiveness
of the reasons given for the
decision.
We conclude the proper course is
to give the Court of Appeals the
opportunity to determine whether
our analysis of some of the studies
cited by the parties
would change its conclusion that
petitioner presented neither objective
evidence nor a triable issue of
fact on the question of risk. In
remanding
the case, we
do not foreclose the possibility
that the Court of Appeals may reach
the same conclusion it did earlier.
A remand will permit a full exploration
of the issue
through the adversary process.
The determination of the Court
of Appeals that respondent’s
HIV infection was a disability
under the ADA
is affirmed. The judgment is vacated,
and the case is
remanded for further proceedings
consistent with this opinion.