Prison medical care and disability accommodation

• Pages: 1255-1270
• Date: 01 October 2025
• Published date: 01 October 2025
• Author: Samuel Weiss

PRISON MEDICAL CARE AND DISABILITY ACCOMMODATION

Samuel Weiss*

INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1255

I. BRYANT V. MADIGAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1255

A. The Opinion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1255

B. Bryant as Anti-Textualist. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1259

C. Spreading Throughout the Circuits . . . . . . . . . . . . . . . . . . . . 1261

II. TENSION BETWEEN THE ADA AND THE REGULATION OF P RISONS THROUGH

LITIGATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1263

A. How Courts and Congress Dam the Flood . . . . . . . . . . . . . . . 1263

B. Disability Law’s Clash with the Floodgates Concern . . . . . . . 1265

III. IF THE RULE MUST EXIST. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1268

INTRODUCTION

In its 1996 opinion Bryant v. Madigan, the Seventh Circuit held that incarcer-

ated plaintiffs could not challenge the prison’s failure to provide medical care

under the Americans with Disabilities Act (ADA). The court grounded the rule not

in the text of the ADA, which contradicts it, but instead in the policy goals of the

panel. Despite the opinion’s methodological f‌laws, nearly every circuit has adopted

its rule, often with little or no analysis, and district courts often expand their hold-

ings to abrogate the ADA entirely as to incarcerated plaintiffs. In Part I, this

Article explains Bryant, its f‌laws, and its consequences. In Part II, this Article

attempts an explanation at Bryant’s inf‌luence, specif‌ically how its invented rule

allows courts to square prison ADA claims—which are diff‌icult to resolve before

trial—with their ref‌lexive impulse to resolve prison claims at early stages carried

over from constitutional claims. Finally, in Part III, this Article attempts to provide

some guidelines that courts should use to faithfully apply the rule from Bryant for

as long as courts are stuck with it rather than expanding it to abrogate disability

law for people most reliant on it.

I. BRYANT V. MADIGAN

A. The Opinion

Ronald Bryant was a prisoner with paraplegia in an Illinois state prison.

1

He suf-

fered leg spasms and therefore requested guardrails for his bed to stop him from

* Samuel Weiss is the Founder and Executive Director of Rights Behind Bars, where he litigates conditions of

conf‌inement cases. Thank you to the editors of the American Criminal Law Review and to my colleagues—

including Sophie Angelis, D Dangaran, Amaris Montes, Lily Novak, and KJ Popkin—for discussing this issue

with me over the last several years. © 2025, Samuel Weiss.

1. Opening Brief of Plaintiff-Appellant at 3, Bryant v. Madigan, 84 F.3d 246 (7th Cir. 1996) (No. 95-2349).

1255

falling out of it during an episode.

2

The prison never responded.

3

Bryant started

falling from his bed during spasms,

4

and after his third fall, he broke his leg.

5

He

f‌iled a lawsuit pro se challenging the failure to accommodate his disabilities under,

inter alia, the ADA.

6

The district court rejected his disability law claim and the Court of Appeals for

the Seventh Circuit aff‌irmed that rejection. The Seventh Circuit’s 1996 decision,

Bryant v. Madigan, does not have the trappings of a landmark opinion at the inter-

section of disability law and prison law. The opinion—from the Seventh Circuit,

not the Supreme Court—takes up only three pages of the federal reporter and cov-

ers several different issues therein.

7

The appellant proceeded pro se and typed his

briefs on a typewriter from a prison law library.

8

The panel did not hear oral argu-

ment and neither the district court nor the parties’ briefs mention the rule that the

Bryant court invented and which determined Bryant’s fate.

9

This rule, however,

which exempts medical treatment from the ADA,

10

has shaped and circumscribed

prison disability law in the decades since.

The Seventh Circuit’s treatment of Bryant’s ADA claim begins by suggesting

that Title II of the ADA, which applies to “public entities,” likely does not apply to

public prisons.

11

Judge Richard Posner, writing for the court, explained that many

constitutional and statutory rights are limited in their application to incarcerated

people, noting that “[j]udge-made exceptions ... to laws of general applicability

are justif‌ied to avoid absurdity.”

12

While it technically left the question open,

Bryant strongly hinted that the ADA does not cover prisons full-stop.

13

The next two paragraphs are the origin of the doctrine considered in this Article,

so they are worth considering in full. The court distinguished between medical

care and disability accommodation, carving out the former from the ADA:

2. Id. at 3–4.

3. Id. at 4.

4. Id.

5. Id.

6. Bryant v. Madigan, 84 F.3d 246, 248 (7th Cir. 1996).

7. See generally id.

8. The brief‌ing in this case is from the Seventh Circuit archives and they are on f‌ile with the author.

9. Id.

10. See Bryant, 84 F.3d at 249.

11. Id. at 248.

12. Id. at 248–49.

13. Id. In a strange turn, the Northern District of Indiana cited Bryant in support of the conclusion that the

ADA does not apply to state prisoners in Crawford v. Indiana Department of Corrections, only for the Seventh

Circuit to reverse. 115 F.3d 481, 485–87 (7th Cir. 1997). In justifying its decision, the Seventh Circuit explained

that it “doubt[ed]” that “Congress could speak much more clearly than it did” in the ADA and explained that it

lacked conf‌idence that applying the ADA to prisoners was “absurd,” which “might enable [it] to exercise a

creativity fairly describable as interpretive rather than legislative.” Id. The author of Crawford was none other

than Judge Posner, thirteen months after he wrote the opposite in Bryant, with no intervening precedent to

explain his about-face. One plausible explanation for this U-turn is simply that Crawford was briefed and argued

by an attorney, not a pro se prisoner.

1256 AMERICAN CRIMINAL LAW REVIEW [Vol. 62:1255