USCA1 Opinion

March 31, 1993

UNITED STATES COURT OF APPEALS

FOR THE FIRST CIRCUIT
____________________

No. 92-1343
ROBERT E. CAMERON,
Plaintiff, Appellee,
v.
HENRY TOMES, ET AL.,
Defendants, Appellants.
____________________
APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF MASSACHUSETTS
[Hon. Robert E. Keeton, U.S. District Judge]
___________________
____________________
Before
Selya, Circuit Judge,
_____________
Coffin, Senior Circuit Judge,
____________________
and Boudin, Circuit Judge.
_____________
____________________

of

Elisabeth J. Medvedow, Assistant Attorney General, Commonwea

______________________
Massachusetts, with whom Scott Harshbarger, Attorney Gener
__________________

Commonwealth of Massachusetts, was on brief for appellant.

David M. Rocchio with whom Robert D. Keefe, Mark G. Matusch
_________________
________________
_______________
and Hale and Dorr were on brief for appellee.
_____________
____________________
March 31, 1993
____________________

BOUDIN, Circuit Judge.

_____________
Cameron,

who

is

Treatment Center
Center").

substance,

Cameron

and

his

bench

was brought by Robert

in the

Massachusetts

Dangerous ("the Treatment

whom we refer to as

who are responsible for

complains

confinement violate the Due

Amendment

detained

for the Sexually

The defendants,

are officials
In

currently

This case

that

"the state,"

the Treatment Center.

his

conditions

of

Process Clause of the Fourteenth

asserted

constitutional

"right

to

treatment."
After

trial

the

district

court

granted

injunctive

relief and

the state

injunction in accordance with

appealed.

affirm most of the

by

Our

court.

district court's findings

modify the

this opinion and, with certain

clarifications, otherwise
the district

We

decision

relief ordered

is based

but rests upon somewhat

upon

the

different

legal grounds.
I.

THE FACTS AND PRIOR PROCEEDINGS

On December
of

aggravated

13, 1978, Cameron was

assault

assault--apparently
of

six

to

Massachusetts
assault with
and

with

deadly

convicted in Vermont
weapon

and

attempted rape--and sentenced

twenty

years.

and

convicted

intent to

sentenced to a term

He

was

on

then

September

rape, kidnapping, and

of ten to

after the Vermont sentence.

sexual

to a term

extradited
12,

1979,

to
for

other crimes,

twenty years, commencing

On being paroled by

Vermont on

-2-2-

July

12,

1982,

Cameron

began

serving

his

Massachusetts

sentence, which at the time of trial was set to expire in the

year 2002.1
After serving several
Cameron

on

Massachusetts
person

November

years in a

14,

Superior

1985,

Court

under M.G.L. c. 123A,

Massachusetts prison,
was

to be

several

not described.

facilities

located

sexually

by

the

dangerous

and committed to the Treatment

Center for a period of one day to life.

commitment is

adjudged

The occasion for the

The Treatment Center,

at

MCI

Bridgewater,

one of
has

checkered history, much of

it embroiled in litigation, e.g.,

___

Langton
_______

F.2d 1206

v. Johnston,
________

928

(1st

Cir. 1991),

M.G.L. c.

123A itself has an uncertain future.2

Treatment

Center's

convictions,

and

inhabitants
it

is

Departments of Mental Health

the

have

Most of the

underlying

administered

and

jointly

criminal
by

the

and Corrections to address both

medical and security aims of the Center.

Cameron's stay

____________________
1The
district
court
opinion
recites
that
the
Massachusetts sentence ended in February 1992; but the
parties advise us that Cameron's release date at the time of
trial was 2002. Cameron's brief says that this period may be
shortened by good time credits and possible parole.
2The statute is one of the
laws enacted in the 1940s in a

so-called sexual psychopath

number of states.
See C.
___
Tenney, Sex, Sanity and Stupidity in Massachusetts, 42 B.U.L.
__________________________________________
Rev. 1 (1962).
In 1990, the Massachusetts legislature
curtailed new admissions into the Treatment Center.
See
___
Langton, 928 F.2d at 1209.
_______

-3-3-

at

the

Treatment

Center appears

to

have

been even

more

unhappy than normal.

Although the
that

Cameron who

parties agree
is

50 years

on little else,
old

and a

Vietnam

suffers from severe psychological disorders.

the

district court,

mixed

personality

disorder.
may

"Cameron suffers
and

veteran

In the words of

from a

borderline or

post-traumatic

stress

There is also no dispute that as a result . . . he

often act

Cameron
_______

disorder

it appears

in

a paranoid

v. Tomes, 783 F.
_____

and confrontational

Supp. 1511, 1517

manner."

(D. Mass. 1992).

Psychological treatment is available at the Treatment Center-indeed,

its availability

judgment entered many years

offered unsuitable

is provided

for under

a consent

ago3--but Cameron found what was

until 1989 when he

established a working

relationship with a therapist.

In

the meantime,

Cameron brought

1986 challenging his conditions

assigned,

his

claims

evolved,

the present

of confinement.
and in

December

suit in

Counsel was
1991

and

January 1992,

the district

court conducted a

six-day bench

trial

in the case.

In his

opinion issued

on February 14,

1992,

the

judge

declared

Cameron

district

that

had

____________________
3Regulations adopted pursuant to the decree provide that
"[e]very patient shall be offered treatment to effect his
early return to public society. Such treatment shall consist
of medical, psychiatric [and other services] . . .
Such
treatment
shall be administered . .
. in the least
restrictive
conditions which are
consistent with [the
patient's] security needs." Langton, 928 F.2d at 1211.
_______
-4-4-

"constitutional

right to

minimally adequate

treatment [for

his mental disorders] based upon the exercise of professional

judgment."

783

F. Supp.

at 1516.

The

court rejected

motion to dismiss by the state, which had argued that no such

constitutional

right existed.

Id.
__

state's res judicata defense, id.

_____________
__
Langton case where
_______
the

Treatment

It

also rejected

at 1516-17, based

the

on the

a different district judge had found that

Center was

in

general

compliance with

the

consent decree.
The
issues,

district
those in

judgments
without,

See Langton, 928 F.2d at 1208-16.

___ _______
court then
charge of

about Cameron
or

ruled
the

to,

the

number of

Treatment Center

and enforced

contrary

that, on

policies

advice

of

against him
the

in his

1518-25.

court made specific findings relating

to

Cameron's

access to

outside

783 F.

medical

professionals involved
The district

treatment.

had made

medical care,

shackles and an armed guard in transporting

in

the

matters.

facility,
The

physical

court then

different matters.

searches of

the

Supp. at

use of

him, his housing

him,

granted injunctive

and

similar

relief on

ten

Id. at 1526-27.
__

First, and most broadly, the court ordered the pertinent

administrative board within
an immediate
appropriate

review

of his

treatment and

participate in

the Treatment Center to

current
conditions,

what is called the

-5-5-

sexual

conduct

dangerousness,

and his

request

to

community access program.

783 F. Supp.

at 1526.

stating:

"All

treatment,

including

This injunctive

final

decisions
his

provision ended

on

Cameron's

participation

in

long-term

the

community

access program, must be made by a qualified professional,

with due respect and
professional."

regard for the judgment of

by

or

a qualified

Id.
__

Several other decree provisions are similarly qualified.

The court suspended the use of shackles and an armed guard in
transporting Cameron
until

"a qualified

exercise

for

outside medical

decision

of professional

professionally

care

maker determines

judgment that such

acceptable,

based

on

unless

and

through

the

restraints are

weighing

of

state's] needs along with Cameron's treatment needs."

Supp. at 1526.

Prohibited, under a

[the
783 F.

similar condition, were

subjecting Cameron to a restrictive internal movement policy,

to

an intrusive

called

"oral

search
cavity

procedure previously
searches,"

disciplinary system" of the

and

to

Treatment Center.

used and
the

so-

"current

Id. at
__

1526-

27.
Finally,
judgment, the
treatment

without any

qualification as

court ordered that Cameron

to professional

be allowed medical

at Veterans Administration facilities for specific

medical conditions, that he be allowed housing in the maximum

privilege unit of the
share

room, and

Treatment Center without consenting to

that

a handicapped

accessible

room be

-6-6-

immediately made available

This

to him.

last direction, as well

related

to

physical

including the

783 F.

as several of

disabilities

amputation of

Supp. at

the others, was

suffered

leg due

1526.

by

Cameron,

to infection

while

Cameron was in the care of the state.

II. DISCUSSION
Res Judicata.
____________
suit

is

that

litigation

Cameron's

and

Emphasizing the
the

The

are

state's threshold objection

claims are

therefore

encompassed

barred

"claim preclusion" branch

as

by

to the
prior

res judicata.
_____________

of res judicata,
_____________

state's brief says that one of the consolidated district

court cases
class action
persons

embraced by

Langton--Bruder v. Johnston--was
_______ ______
________

suit concerning the right to

confined

Cameron, says the

at

the

Treatment

state, was a

treatment for all

Center

as

member of the class

of

1987.
and the

state prevailed in that case on the ground that treatment was

adequately provided.
We agree with the district court that the state has made
no showing that

Cameron's claim is

barred by res judicata.

_____________

Cases on res judicata, ample in many areas, are fairly sparse

____________
where preclusion

of distinctive

based upon an earlier

individual claims

class action judgment.

But

is urged
in Cooper
______

v. Federal Reserve Bank of Richmond, 467 U.S. 880 (1984), the

________________________________
Supreme Court

confirmed what

common sense would

suggest: a

class action judgment--there, in a discrimination case--binds

-7-7-

the class members as

to matters actually litigated

not resolve any claim

based on individual circumstances that

was not addressed in the class action.

Under Cooper,
______
not apply in

but does

we think

this instance.

Id. at 880-82.
__

that res judicata

____________

plainly does

The several law suits and years

of proceedings embraced by Langton require pages to describe,

_______
but

the

suits were

concerned

with

fairly general

(e.g., physical plant, sequestration, equality

___
and with specific claims
The

in

authorized
rejection

absence
of

requirement.
of

came to this

a general requirement of

state regulations,

(2) rejection

program

general

was

attack

anything else in

of the

charge that

underutilized,
on

Treatment

common with

case was (1)

treatment set forth

of a

the

These claims dealt with

inhabitants

of treatment)

of individuals other than Cameron.4

closest that that litigation

endorsement of

issues

and

"double

the
(3)

bunking"

the general condition

Center.

If

this case, the

Langton has
_______

state has

not

mentioned it.
This
claims

case, by
that

his

accommodations:
affects his

contrast, rests
unusual

primarily

situation

specifically, that his

need for outside medical

on Cameron's

requires

special

physical disability

visits, freer movement

____________________
4A detailed history of the litigation and the issues
decided is contained in the thorough, 171-page, unpublished
decision of Judge Mazzone, which this court in Langton
_______
affirmed on all issues apart from attorney's fees.
-8-8-

within

the

Treatment

arrangements

adapted to

condition

(what lay

Center,

and

separate

his handicap,

people

and that

would probably

searches, disciplinary

and

unsuitable,

other

constraints

dangerous, for him.

these issues

his mental

call

makes ordinary physical

indeed

bunking

paranoia)

arrangements

psychologically

There is no suggestion by the state that

peculiar to Cameron were

actually litigated in

the Langton case.

_______
Thus, the
that

Cameron

state's claim reduces itself

had to
___

cases or forever
to refute

it:

litigate those

hold his peace.

issues in

To describe

class action institutional

addresses general circumstances,

of someone claiming special

to the argument
the earlier
this claim is

litigation often

not the distinctive

needs or status.

To

plight

the extent

individual concerns were addressed in Langton, Cameron is not

_______
even mentioned

in the

district court

earlier

cases deal with

part of

Cameron's present case.

is

possible

where

an

decision.

later occurring
_____

earlier

Nor

could

events that

are a

In theory, claim preclusion

class

action

claim

is

essentially the same as a later action for individual relief,

and issue preclusion is possible where a fact resolved in the

class

action

Cooper,
______

proves important

467 U.S. at 880-82.

in

the later

action.

See
___

No such overlap has been shown

here.

-9-9-

its

The Merits.
__________

The district court

decision

what

on

constitutional
Center:

"a

it

rights possessed

constitutional

treatment [for

deemed
by

right

in this case
to

be

two

those at
to

established
the Treatment

minimally

mental disorders] based upon

premised

adequate

the exercise of

professional

judgment," 783 F. Supp. at 1516, and a right to

be free from

"[b]odily restraints" except

extent

professional judgment deems

Id. at 1520.
__

It

is not entirely

this necessary .
clear whose

judgment--medical or administrative--the
in

mind; but the implication

"when and to

. . ."

professional

district court

of its discussion

the

had

is that the

administrators of
judgment of

the facility

are bound

to listen

the medical professionals and to

they offer good reason for

to the

heed it unless

refusing to do so.

Id.
__

at 1519-

20.
Both

sides

on this

constitutional "right

appeal

seek

to treatment," the

none exists

and Cameron supporting

our view, a

decision on

treatment" is not
and

decision

of "a right

a remote connection

We address this

background

prior

"right

In
to

this case;

to the actual

point briefly, against

to

the
that

the district court.

necessary for a disposition of

relief sought.

on

state urging

the abstract issue

the concept has only

of

treatment"

law,

the

before

considering Cameron's own situation and the proper touchstone

for appraising his claims.

-10-10-

It

is settled that those who are confined by the state,

for whatever
food,

reason, are entitled under

clothing,

medical

care,

and

the Constitution to

reasonable

efforts to

secure

physical

safety.

Beyond

however, guidance from the

to

such obvious

Supreme Court is largely confined

one cautiously phrased decision.

457

U.S.

retarded

307

"soft"

(1982), a

mother,

child, placed him

discovering

that he was

shackles

and

skills," she sued.

taught

not dictate the

"professional judgment."

cases
broad

left

and academic

of

care for

her
Then,

restrained by

"basic

self-care
under those

constitutionally entitled to
restraints and had

much, the Court

be

a right

to

mobility.

As

said that judges

choice among acceptable alternatives

correctness must be attached

to

Id. at 321-23.
__

in limbo

a prior

literature that

constitutional

treatment

in

to secure safety and

and that a "presumption" of

Youngberg
_________

to

state institution.

little

but necessary

deciding when and how

should

unable

The Supreme Court held that

basic self-care training

for

in a

In Youngberg v. Romeo,
_________
_____

sometimes physically

circumstances the child was

free from any

essentials,

"right

the psychological

to

had

line of

sought to

treatment,"

ills of

lower court
shape a
including

confined persons.5

____________________
5See Stefan, Leaving Civil Rights to the "Experts": From
___
___________________________________________
Deference to Abdication Under the Professional Judgment
_____________________________________________________________
Standard, 102 Yale L.J. 639, 686-90 (1992).
Treatment, in
________
any curative sense, was not even an issue in Youngberg since
_________
the retardation was not curable.
The Court expressly

-11-11-

Since

Youngberg,
_________

a few

circuits

have

constitutional territory, returning with

We ourselves may

Youngberg
_________

871 (1st Cir. 1986), this

extended beyond

the retarded

years later,

this court

whether there

was a

the Treatment

Center,

such

to protect

Id. at 884.
__

explicitly refused

"constitutional right to
remarking

the constitutional

One reason why

the consent

decree

similar

In Langton,
_______

that

"the

to decide

treatment" at
trial

it was unnecessary in
"set a

judge's

thicket was appropriate"

issues should be decided only when necessary.

at 1217.
that

court, under

ill persons civilly committed to

a different Bridgewater facility.

skirting of

In Doe
___

"constitutional right to treatment," agreed that

interests of those mentally

four

this

different answers.6

have seemed to send mixed signals.

v. Gaughan, 808 F.2d

_______
the caption

ventured into

higher

as

928 F.2d

Langton was
_______

standard than

the

____________________
declined to devise any general
rights to ameliorative
programs beyond basic self-help training to assure safety and
mobility, saying "we need go no further in this case." 457
U.S. at 319.
6Compare, e.g., Ohlinger v. Watson, 652 F.2d 775 (1980),
_______ ____ ________
______
with Bailey v. Gardebring, 940 F.2d 1150 (8th Cir. 1991),
____ ______
__________
cert. denied, 112 S. Ct. 1516 (1992). See generally, Woe v.
____ ______
_____________ ___
Cuomo, 729 F.2d 96, 105 (2d Cir. 1984) ("The Supreme Court
_____
has not
directly
addressed the
question
whether
a
constitutional right to treatment exists . . . .").

-12-12-

Constitution"

in

Treatment Center.

affording

treatment

for

those

in

the

Id.7
__

Although the parties seek to litigate the abstract issue

of a right to treatment, we prefer to plow a
than

the case demands.

Cameron's claims for

furrow no wider
the most part

are

not really

"right to

receiving

substantial

condition,

and most of

housing,

treatment" claims
psychological

the arguments

mobility, transportation,

at all:

treatment
he is

he is

for

his

making concern

and security.

Further,

under existing state law, there is already a regulation-based

right to

treatment at

exceeds anything

the Treatment Center

that the Supreme Court

under the Due Process Clause.

It

that equals

or

would likely impose

See Langton, 928 F.2d at 1217.

___ _______

is also unclear whether, if the Supreme Court did provide

a general "right to treatment" for civilly committed persons,

it

would

apply

that right

criminal sentence.

to

Youngberg,
_________

those

held

as well

457 U.S. at 321-22.8

under
At the

____________________
7In Cortes-Quinones v. Jimenez-Nettleship, 842 F.2d 556
_______________
__________________
(1st Cir.), cert. denied, 488 U.S. 823 (1988), and Torraco v.
____ ______
_______
Maloney, 923 F.2d 231 (1st Cir. 1991), this court addressed
_______
claims that authorities had not taken the precaution against
suicide of individual prisoners.
While both decisions spoke
of the state's obligation to provide for medical needs, the
context was very far removed from any generalized right to
treatment for psychological conditions.
8Whatever other significance it may have, we think that
Cameron's criminal sentence does refute any claim that he is
entitled under the Constitution to minimum physical restraint
based on the judgment of his doctors. Quite unlike the child
in Youngberg,
Cameron is under
criminal sentence
of
_________
imprisonment for serious and violent crimes. To that extent,
-13-13-

very least, the Court's approach in Youngberg suggests hewing

_________
to the case-by-case approach.
Taking that

approach here, we think

the touchstone for

Cameron's claims is the Due Process Clause of the

Amendment, requiring

conditions that

do not fall

minimum standards of civilized decency.

v.

California,
__________

342 U.S.

165

will expire in 2002

below the

See generally Rochin

_____________ ______

(1952).

context works in Cameron's favor.

Fourteenth

Under

While

this rubric,

his prison sentence

or even earlier, his confinement

Treatment Center is from

one day to life and

in the

will never end

unless his condition improves and he is found to be no longer

sexually dangerous.
the

state's

Thus,

ordinary

Cameron's best argument

procedures

and

constraints

affirmatively and needlessly worsening his

_________
so that
expired.

he may well be confined

is that
are

mental condition,

long after his sentence has

This is a claim with some bite, no

matter how much

latitude states ordinarily have to run their institutions.

Further, the

findings

of

the

district

control unless clearly erroneous, Fed. R.

court,

which

Civ. P. 52(a); Doe

___
v.

Gaughan,
_______

argument.
district

808 F.2d
The

court

applied--such

877,

lend

support to

findings amount

to a

determination by

that

at

procedures

as certain

that might

of the

Cameron's

ordinarily

searches and

the
be

the internal

____________________
he lacks the
Youngberg.
_________

same

"liberty"

interest

as

the

child

in

-14-14-

movement controls--worsen Cameron's condition and may well be

___
unnecessary in

this case.

See 783 F. Supp. at 1523-25.9

___

both points,

effect and

that this is

the judgment of

that

no

adequate

administrators.
The
pointing

state

necessity, the district

response

On

court says

the medical professionals

and

has

the

been

obtained

from

Id.
__
broadly

disputes this

to other evidence

showing how

version
much it

of

events,

has helped

Cameron

and tried to accommodate his special needs.

It does

not, however, make much effort in its brief to rebut specific

findings as to
conflict in the

specific episodes.

We think

evidence but also that

there is

some

the district judge's

findings

are not clearly erroneous.

findings

were made in the framework of a legal analysis that

we do not adopt, but the

process framework and
supported by evidence.

It is

true that these

findings fit well enough into a due

this court may

See Doe
___ ___

affirm on any

v. Anrig,
_____

grounds

728 F.2d 30,

32

(1st Cir. 1984).

____________________
9For example,
the court invoked the testimony of
Cameron's therapist that the shackling was "harmful to
Cameron's mental health" and the court found it unnecessary
based on "uncontroverted evidence."
783 F. Supp. at 1520.
The court determined that the Treatment Center's internal
movement policy, allowing free movement for only 10 minutes
each hour, was unworkable for Cameron as an amputee, creating
"undue pressure [that] . . . compromises his treatment." Id.
__
at 1522.
A forcible search of Cameron while handcuffed,
which the court found may well have been unnecessary, drove
Cameron into moods of "helplessness, anger, despair and
hopelessness . . . ." Id. at 1523.
__
-15-15-

Relief Ordered by the District Court.

_______________________________________
relief

ordered by

exceptions,

the district

fairly

consideration

modest,

primarily

of Cameron's

Importantly, the

court is,

with one

requiring

case and some

court has ordered a

The immediate
or two
further

interim measures.

general reappraisal of

Cameron's treatment and conditions, with decisions to be made

by the administrators

"with due respect

judgment of a qualified professional."

and regard for

the

783 F. Supp. at 1526.

But given the district court's use in several contexts of the

"professional judgment" standard, a word is
guidance

of the parties

and for any

in order for the

future litigation that

may ensue.
In an institution
ordinary prison,
clash with
district

like the Treatment

security

and administrative

the welfare and

court recognized.

issue in Youngberg, 457 U.S.

_________
the

Treatment Center

Center, as in

comfort of
This

concerns

may

individuals, as

the

was so in

the facility at

at 320, and it is surely

where most

if not all

so in

those detained

have been convicted of crimes and many may be dangerous.

professional
conditions

judgment
of

that

confinement

decides
_______
must

an

an
embrace

issue

Any

involving

security

and

administration, and not merely medical judgments.

Thus when
administrators,

it comes to

appraising the judgments

of the

it does not follow that they are bound to do

what the doctors say is best

for Cameron even if the doctors

-16-16-

are

unanimous.

The administrators

are responsible

to the

state

and to the public for making professional judgments of

their

own, encompassing

institutional

concerns as

well as

individual welfare.

Nothing in the Constitution mechanically

gives

weight

controlling

to

one

set

of

professional

judgments.

Indeed, when it comes

to constitutional rights,

none of the

professionals has the

last word.

Professional

judgment, as the Supreme Court has explained,

"presumption"

of

responsibility

correctness;

belongs to

welcome

the courts.

or

creates only a
not, the

See
___

final

Youngberg, 457
_________

U.S. at 323.
With this clarification as
judgment," we
ordered

by

sustain the first injunctive

the

district

reappraisal of Cameron's
general

to the role of "professional

court

relief provision

directing

personal dangerousness

conditions of confinement.

the

general

and of

his

Para. 1 (783 F. Supp. at

1526).

The findings noted

in the

district court's decision support

directive.

above and the evidence

portrayed

this fairly modest

In framing equitable relief, a district court has

substantial

latitude,

and

we

think its

"remand"

to

the

Treatment Center administration is well within its authority.

We

also conclude that, on

same clarification
the

the same basis

as to the role

of professional judgment,

district court's findings, see 783

___

support

several other

and with the

F. Supp. at 1522-24,

conditioned decree provisions:

that

-17-17-

administrators

consider

requests by

Cameron

for treatment

outside the Treatment Center, para. 4 (id. at 1526); that the

__
ten-minute movement
suspended

as

decision-maker
Cameron; and

to

restriction and oral-cavity

Cameron

concludes

unless
that

they

and
are

that the "Extraction Team"

until

searches be
a

qualified

appropriate

for

searches of Cameron

be barred unless there is prior consultation with a Treatment

Center clinician.

Paras. 5, 6 and 8 (id. at 1526).

__

On two other decree provisions, we believe modifications

are

required.

armed

First,

the district

court ordered

that an

guard and shackles no longer be used when transporting

Cameron

outside the

facility unless

and until

decision-maker determines this to be necessary.

F. Supp.

at 1526).

In matters

a qualified
Para. 3 (783

of security, as

opposed to

administrative convenience, the administrators' discretion is

at

its

zenith

sentence.10

and

An armed

Cameron

is

still

guard and shackles

precautions for an amputee,

under

criminal

may seem needless

but we think that the

Treatment

Center should not be obliged to suspend its specific security

measures

for outside

reexamined.

If the

visits while
district court

Cameron's case
wishes to

is being

require this

____________________
10M.G.L. c. 123A,
6A, provides that, subject to
exceptions entrusted to an administrative board, "any person
committed as a sexually dangerous person . . . shall be held
in secure custody." Discharge from the Treatment Center does
not "terminate . . . any . . . unexpired sentence." Id.
9.
__
-18-18-

armed-guard-and-shackles

requirement to be re-examined on an

expedited basis, that is within its province.

Second, we similarly modify the district court's general
injunction
the

preventing the

current

Correction

Treatment Center

disciplinary

system,

personnel, against

run

1526).

that

the

administrators

a new

of

system

Para. 7 (783 F.

consider

current system

that a

whether

as applied

medical judgments be weighed

think

Department

Supp.

We have no problem with the decree's requirements

warranted in the
that

by

Cameron" until

suitable to his needs is constructed.

at

"from enforcing

generally phrased

changes

are

to Cameron

and

in this process.
suspension of

But we

"the current

disciplinary system" in the meantime cuts too broadly and may

raise security issues as well.
Finally, we sustain
made by

the

district

three unqualified decree provisions

court: that

Cameron

continue, as apparently he is at present,

Administration

facilities

related

be

allowed

to

visits to Veterans

to

his

amputation,

circulatory problems, and possible cancer; that the "consent"

to

double bunking

be waived

being

largely symbolic;

room,

including

available to him.

as

and that

hospital

bed

to Cameron,

the "consent"

a handicapped
if

accessible

necessary,

be

made

Paras. 2, 9, 10 (783 F. Supp. at 1526-27).

These specifics of relief lie largely within the

judgment of

-19-19-

the district court, and

the state's brief makes

no targeted

showing that these provisions are improper.

III. CONCLUSION
No one who reviews this record can dispute that
has

done

afflicted

harm in

the

past,

nor doubt

with serious mental illness.

that

Cameron

he has

been

The findings of the

district court suggest that, without special attention to his

peculiar circumstances,
mental condition.
Process
competing
to which

Clause

further damage

will be done

to his

We conclude that the state does have a Due

obligation,

to

be

balanced

by

it

with

demands and interests, to seek to limit the extent

it worsens Cameron's condition

his detention indefinitely.

and thereby extends

Needless to say, there can be no

precision in such a Due Process Clause "standard" nor any way

to

avoid

further

dispute

about its

application,

if

the

parties are bent on dispute.

The district
directing

judge,

the Treatment

we think,
Center

had the

to undertake

right idea
a good

in

faith

reappraisal

of its policies as applied to Cameron.

swiftly the

matter

perspective,
state, it

is returned

the better

to

that forum,

off Cameron

will be.

may regard the district judge's

heedless of

with
As

that

for the

strictures on its

attitude

as unfair

Cameron.

But the injunction, at least as we have adjusted it

and delimited

and

The more

its future

its

effect, is not

past efforts

for

unduly burdensome.

-20-20-

Like

Cameron,

the

state

has

an

evident

interest

in

resolution that avoids further litigation.

The district court's injunction is modified as set forth
________
above and is otherwise
upon

the

attorneys'

grounds

affirmed, with the clarifications and

________

stated in

fees shall

appeal.
It is so ordered.
________________

be

this

opinion.

awarded in

No costs

connection with

or
this

-21-21-