In West v. Atkins, the U.S. Supreme Court ruled that a private physician under contract with a state to provide medical services at a prison acted under "color of state law" for purposes of 42 USC Section 1983 when treating an inmate. The case arose after an inmate was injured during basketball and subsequently developed complications due to inadequate treatment by Dr. Atkins, the contracted physician. The court held that because Dr. Atkins was performing a function which is normally the State's responsibility (providing medical care to prisoners), he could be sued as if he were a State employee despite being technically employed by another entity outside of government service.

In the dissenting opinion for West v. Atkins, Justice Scalia argued that a private physician under contract with a state prison does not act under "color of state law," and thus cannot be sued as a state actor in federal court for civil rights violations. He contended that the majority's decision expanded the definition of "state action" too broadly, potentially making any private party who contracts with the government liable as a state actor. Furthermore, he expressed concern about potential negative impacts on medical professionals' willingness to provide services to prisons due to increased liability risks.