In S.P. v. City of Takoma Park, 134 F.3d 260 (4th Cir. 1998), the United States Court of Appeals rejected the contention that a private physician and a private hospital were state actors for purposes of civil rights liability because they were compelled to involuntarily detain and admit an individual. The appellate court said: A review of Maryland's entire involuntary commitment statutory scheme . . . convinces us that it is permissive and leaves a great deal of discretion to the private medical provider. . . . Maryland does not mandate the initiation of involuntary commitment proceedings whenever the state-prescribed criteria are met. Rather, it states that such proceedings cannot be initiated absent the existence of the criteria. Id. at 270. The Court concluded "that the legislature's intent was to protect the individual and potentially the general public, not to coerce the involuntary commitment of the individual." Id. at 270 n.8.