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Ps claims that they as Medicaid recipients were being required to consent to undergo a tubal ligation if they were delivering a third living child. D professed a clear policy with people who were unable to financially support themselves, whether they be on Medicaid or just unable to pay their own bills. If they were having a third child, D requested that they voluntarily submit to sterilization following the delivery of the third child. If they did not wish this as a condition for his care, then the patient would be asked to seek another physician. Ps accused D of a violation of their Constitutional rights of privacy, due process of law, and equal protection of the law as well as of their statutory privileges against discrimination on account of their race and color, all by subjecting or threatening them as citizens of the United States with involuntary sterilization. Ps claim that these threats were under color of State law, that is, under the Medicaid program administered by South Carolina. D's co-defendants were the Chairman of the Board of Trustees of the Hospital, its Administrator, the Director of the Department of Social Services of Aiken County, the State Commissioner of the Department of Social Services of South Carolina, and the Hospital. Ds were charged with conspiring or acting in concert with D in the unlawful acts imputed to him. Walker (P) had completed the seventh grade, was separated from her husband, and was receiving Aid to Families with Dependent Children and Medicaid benefits. She first went to Pierce on January 7, 1972. During this consultation, he discussed family planning and his sterilization policy. Walker (P) refused to consent. The issue again came up at the second visit and she again declined. Walker (P) testified that D threatened to have her State assistance terminated unless she cooperated. Walker (P) could not find another doctor and eventually signed a consent form for sterilization. Her fourth child was delivered by Dr. Billy Burke. Burke discussed tubal ligation with Walker (P). Her response was that she did not want additional children and understood that it would be a permanent sterilization. Two more consent forms were then signed. Pierce performed the operation. Under the South Carolina plan operated by the Department of Social Services, the patient-physician relationship is one of free choice for both parties. Brown (P) consulted D regarding her third pregnancy. She paid D $50.00. Sterilization was not discussed. A $250.00 balance due on his fee was satisfied in part by Brown and her husband and partially by a health insurance plan. Brown (P) qualified for Medicaid benefits. She was delivered of her third child by a doctor other than D. The hospital bills were to be paid by Medicaid. D requested his nurse to obtain Brown's (P) consent to sterilization, and she refused. Upon word of her refusal, D ordered her discharge and release from the Hospital. Ds got directed verdicts. D was found liable under Brown’s (P) section 1981 with $5 in nominal damages. Ps and D appealed.

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