In the case of Youngberg v. Romeo (1981), the U.S. Supreme Court ruled that individuals who are involuntarily committed to state mental institutions have constitutionally protected rights, including freedom from bodily restraint and a right to reasonably safe conditions of confinement, as well as minimal training for self-care and safety. The case involved Nicholas Romeo, a mentally disabled man with an IQ between 8-10, who was voluntarily committed by his mother to Pennhurst State School and Hospital in Pennsylvania due to her inability to care for him at home. After being injured multiple times while institutionalized, his mother filed suit alleging violation of constitutional rights under the Fourteenth Amendment's Due Process Clause because he had not received adequate treatment or protection from harm. The court held that decisions made by professional caregivers about these matters should be given deference unless it can be proven they were not based on professional judgment.

In the dissenting opinion for Youngberg v. Romeo, Justice Rehnquist argued that the Court's decision to grant constitutional rights to involuntarily committed mental patients was a significant departure from precedent and an overreach of judicial power. He contended that such decisions should be left to state legislatures and professional administrators who have more expertise in managing institutions for mentally disabled individuals. Furthermore, he expressed concern about potential litigation costs resulting from this ruling, as it could lead to numerous lawsuits against state officials by institutionalized persons claiming violations of their newly recognized rights. In essence, his dissent emphasized deference towards legislative judgment and administrative expertise while expressing concerns about judicial activism and its consequences.