Heller v. Doe

In Heller v. Doe (1993) 509 U.S. 312, the Supreme Court examined the State of Kentucky's involuntary commitment statutes, which, like California's, establish different procedures for committing the mentally retarded and the mentally disordered. Under the Kentucky scheme, the burden of proof for the commitment of the mentally retarded is lower ("clear and convincing") than for the mentally disordered ("beyond a reasonable doubt"). And close relatives and guardians are permitted to participate in proceedings to commit the mentally retarded but not the mentally ill. Although these procedural differences make it easier for Kentucky to commit people who are mentally retarded than those who are mentally ill, the Supreme Court found this does not violate equal protection. Regarding the burden of proof, the court determined a reduced burden for the commitment of the mentally retarded was justified because mental retardation is generally easier to diagnose, allows for a more accurate prediction of future dangerousness, and is less invasive to treat than mental illness. (Heller v. Doe, supra, 509 U.S. at pp. 321-328.) The court found "each of these rationales, standing on its own, would suffice to establish a rational basis for the distinction in question." (Id. at p. 328.) The court also upheld the close relative/guardian participation distinction, reasoning that such persons were more likely to assist the trier of fact in proceedings involving the mentally retarded than in proceedings involving the mentally ill. (Id. at pp. 329-330.) In so finding, the court recognized "'the assumptions underlying these rationales could be erroneous, but the very fact that they are "arguable" is sufficient, on rational-basis review, to "immunize" the legislative choice from constitutional challenge.'" (Heller v. Doe, supra, 509 U.S. at p. 333.) This speaks to the deferential standard of review applicable in cases involving disparate treatment of the mentally retarded. Indeed, as appellant admits, "to withstand equal protection review, legislation that distinguishes between the mentally retarded and others must only be rationally related to a legitimate governmental purpose." (City of Cleburne v. Cleburne Living Center, Inc. (1985) 473 U.S. 432, 446; see also Marshall v. McMahon (1993) 17 Cal.App.4th 1841, 1851 although the mentally retarded have immutable disabilities, they are not a suspect class deserving of heightened protection for equal protection purposes.) The law in question must be accorded "a strong presumption of validity," and "'the burden is on the one attacking it to negative every conceivable basis which might support it.'" (Heller v. Doe, supra, 509 U.S. at pp. 319, 321.) In Kentucky, among other differences, the burden of proof with respect to those with mental retardation is lower (clear and convincing) than that for those with mental disorders (beyond a reasonable doubt). Although the differing procedures made it easier to commit those with mental retardation, the Supreme Court found no equal protection violation. (Heller, supra, 509 U.S. at pp. 322-330.) Among the factual differences between the two classes of persons that the Supreme Court found relevant to its analysis were the greater difficulty in detecting and diagnosing mental illness and predicting dangerousness from it (Heller, supra, 509 U.S. at pp. 322-324) and the more intrusive medical and psychiatric treatment methods frequently imposed on the mentally ill (id. at pp. 324-325). The court further noted that as distinct from mental illness, "mental retardation is a developmental disability that becomes apparent before adulthood." (Id. at p. 321.) It "results in 'deficits or impairments in adaptive functioning,' that is to say, the person's effectiveness in areas such as social skills, communication, and daily living skills, and how well the person meets the standards of personal independence and social responsibility expected of his or her age by his or her cultural group.' " (Id. at p. 329.) " ' "Mental retardation is . . . a learning disability and training impairment rather than an illness" ' " and it is therefore not subject to treatment that is available to the mentally ill. (Id. at p. 325.) The court found that these differences established a rational basis for justifying disparate treatment with respect to the burden of proof required to commit. (Id. at pp. 321-328.) In doing so, the court recognized that the " 'assumptions underlying these rationales could be erroneous, but the very fact that they are "arguable" is sufficient, on rational-basis review, to "immunize" the legislative choice from constitutional challenge.'" (Id. at p. p. 333.)