Sterling v. City of Jackson: Bodily-Integrity Liability for Toxic Municipal Water and the Fifth Circuit’s Formal Adoption of the State‑Created Danger Doctrine

I. Introduction

In Sterling v. City of Jackson, No. 24‑60370 (5th Cir. Nov. 17, 2025), the Fifth Circuit confronted allegations that the City of Jackson, Mississippi, knowingly delivered lead‑contaminated drinking water to residents, misrepresented its safety, and thereby caused serious, lasting health harms reminiscent of the Flint, Michigan water crisis. The case presents high‑stakes questions at the intersection of environmental catastrophe, municipal governance, and constitutional law.

The panel (Judge Haynes writing for the majority; Judge Dennis concurring in part and dissenting in part; Judge Engelhardt dissenting except as to qualified immunity) splits sharply on how far substantive due process extends—and what counts as “conscience‑shocking” governmental misconduct—when the alleged wrong consists of disastrously mismanaged municipal services coupled with misleading public assurances.

Doctrinally, the decision is important for two principal reasons:

Bodily integrity in the municipal services context. The majority holds that residents have plausibly alleged a violation of the Fourteenth Amendment right to bodily integrity where city officials allegedly:
- knowingly delivered corrosive, lead‑leaching water;
- required residents to purchase and use that water absent alternative sources;
- concealed and downplayed the risks; and
- affirmatively told residents the water was safe to drink, cook with, and bathe in.
The claim survives as to the City, but not as to individual officials, who are granted qualified immunity.
Formal adoption of the state‑created danger doctrine. After decades of internal uncertainty, the Fifth Circuit explicitly adopts and defines the state‑created danger theory as a cognizable form of substantive due process liability under 42 U.S.C. § 1983—at least for municipal entities. Again, the doctrine opens the door to municipal liability but individual defendants receive qualified immunity.

Along the way, the court:

reaffirms that Dobbs v. Jackson Women’s Health Organization did not disturb the longstanding constitutional protection of bodily integrity;
clarifies how the “shocks the conscience” / deliberate-indifference standard applies outside the usual policing and prison contexts; and
articulates limits, insisting it is not creating a generalized constitutional right to “high‑quality” or “competent” city services.

Yet the dissent argues that is precisely what the court in substance has done. Understanding where the majority and dissent diverge is key to grasping the decision’s reach and potential ripple effects for future environmental-justice and municipal‑services litigation.

II. Overview of the Holdings

The panel’s disposition can be summarized as follows:

Bodily‑integrity claim (substantive due process)
- As to the City (municipal liability): Reversed. The complaint plausibly alleges that the City’s actions violated plaintiffs’ Fourteenth Amendment right to bodily integrity under the “shocks the conscience” standard. The claim proceeds on remand under Monell (official‑policy municipal liability).
- As to City officials in their individual capacities: Affirmed. The court agrees that the pleaded facts plausibly allege a constitutional violation but holds that the right, in this specific context of municipal water contamination and misrepresentation, was not clearly established at the relevant time. Qualified immunity applies.
State‑created danger claim (substantive due process)
- The court formally adopts the state‑created danger doctrine for the Fifth Circuit and articulates a four‑part test.
- As to the City: Reversed. The panel remands for the district court to decide in the first instance whether the facts as pleaded state a plausible state‑created danger claim against the municipality.
- As to officials: Affirmed on qualified immunity. Because the doctrine was never before adopted in this circuit, no official had fair notice that their conduct could give rise to liability on that theory.
State‑law claims
- Because at least some federal claims revive, the panel vacates the district court’s dismissal of state‑law claims for lack of supplemental jurisdiction and remands for further proceedings.

Judges Haynes and Dennis thus agree on the existence of a constitutional violation and on adoption of the state‑created danger doctrine; they divide only on qualified immunity. Judge Engelhardt takes a more fundamental view: in his view, there is no constitutional violation at all; plaintiffs are attempting to constitutionalize what is at most tortious mismanagement of city services.

III. Factual and Procedural Background

A. Jackson’s Aging, Corrosive Water System

The City of Jackson operates the primary public water system, including two treatment plants—the O.B. Curtis plant drawing from the Ross Barnett Reservoir, and the J.H. Fewell plant drawing from the Pearl River—as well as a system of wells. Most service lines likely contain lead, and many homes have lead pipes or fixtures. Lead in plumbing is not automatically dangerous; danger arises when corrosive, low‑pH water dissolves lead into the drinking supply.

The Mississippi State Department of Health (MSDH) recommends maintaining the water at a pH of 8.5 to allow protective oxide layers to form on pipes. The City’s surface‑water sources, however, were significantly more acidic (pH under 6.5), making them highly corrosive if not properly treated with lime or similar agents.

B. Escalating Lead Levels and the 2014 Source Switch

By 2011, MSDH had labeled Jackson “high risk” for lead poisoning. Between 2010 and 2013, lead levels in city water trended upward, with the 95th percentile rising from 8.8 ppb (2009) to 33.5 ppb (2013). Crucially, Interim Public Works Director Willie Bell identified a clogged lime injection system at the O.B. Curtis plant, which meant corrosive water was not being properly treated. He warned that this condition would cause lead to leach into the water and proposed a $400,000 repair.

According to the complaint, the then‑Mayor approved Bell’s repair plan but died soon thereafter. His successor, Mayor Tony Yarber, scrapped the fix and instead appointed Kishia Powell as Director of Public Works.

The plaintiffs allege that, with knowledge of the system’s fragility and the corrosive nature of the surface water, the City then made a pivotal decision: in 2014 it switched roughly 16,000 connections from relatively high‑pH, protective well water to low‑pH surface water, without effective corrosion control and without supportive studies or regulatory documentation. That “shocked” the aging system, allegedly destabilizing pipe scale and releasing lead into the water delivered to people’s homes.

C. Testing, Non‑Disclosure, and Public Messaging

Testing in June 2015 reportedly showed that:

22% of sampled homes exceeded the EPA’s lead action level of 15 ppb; and
the 90th percentile lead level was 28 ppb, nearly double the regulatory action level.

Plaintiffs allege:

City officials became aware of the results in 2015;
the City took no immediate remedial action and did not promptly notify residents; and
MSDH did not publicly notify residents until January 29, 2016.

Even after the crisis became public, key officials—including Mayor Yarber, Director Powell, and subsequent Director Robert Miller—allegedly:

downplayed the extent of the problem;
emphasized that Jackson was “not Flint” and that the problem was limited to a small number of homes with lead service lines; and
assured residents the water was “safe to drink,” at times encouraging continued tap‑water use.

Meanwhile, the City issued boil notices ostensibly to address microbiological contamination. But boiling water concentrates lead (which does not evaporate), so the plaintiffs argue this advice increased exposure to the very toxin at issue.

The complaint further alleges internal dissent: a City engineer who publicly contradicted the official narrative by explaining that many lines had solid lead bands every twenty feet was promptly terminated for “possibly creating unwarranted public fear.”

D. Health Consequences

The complaint describes severe and long‑term health consequences associated with lead exposure, especially for children:

impaired brain development and lower IQ;
ADHD and behavioral disorders, including increased risk of delinquency and violent crime;
seizures, coma, and death at relatively low levels in children; and
cardiovascular, kidney, reproductive and fetal‑development issues in adults.

Plaintiffs allege concrete harms: children diagnosed with lead poisoning and learning disabilities; unexplained itching and skin issues; impacts on livelihoods (e.g., water‑dependent employment like laundromats); and increased costs for medical, educational, and disability services.

E. Litigation History

Plaintiffs brought a putative class action in federal court asserting:

Two federal claims under 42 U.S.C. § 1983:
- Violation of the Fourteenth Amendment right to bodily integrity (also described as bodily autonomy); and
- Violation of the Fourteenth Amendment under a state‑created danger theory.
Three supplemental state‑law claims (not described in full in the opinion, but likely negligence, nuisance, and related theories).

The defendants included:

the City of Jackson;
sitting and former mayors (Chokwe Lumumba, Tony Yarber);
current and former public works officials (Powell, Miller, Smash); and
a private engineering firm involved in the water system (Trilogy Engineering Services, L.L.C.).

The district court granted judgment on the pleadings (Rule 12(c)):

It held that plaintiffs failed to state a substantive due process claim against the City;
Held that the individual City defendants were entitled to qualified immunity; and
Declined supplemental jurisdiction over the state‑law claims.

Plaintiffs appealed. On appeal, the Fifth Circuit accepted the complaint’s well‑pleaded facts as true and construed all factual inferences in plaintiffs’ favor under the ordinary Rule 12(b)(6)/12(c) plausibility framework.

IV. Substantive Due Process and Bodily Integrity

A. What Is the “Right” at Issue?

The majority begins by identifying the specific constitutional interest at stake. Rather than a generalized “right to clean water,” the court frames the right as the longstanding Fourteenth Amendment protection of bodily integrity or bodily autonomy—“the right of every individual to the possession and control of his own person, free from all restraint or interference of others, unless by clear and unquestionable authority of law.” Union Pac. Ry. Co. v. Botsford, 141 U.S. 250, 251 (1891).

This right has deep roots:

Magna Carta guarantees personal security except by “law of the land” (later “due process of law”).
Botsford (1891): Court refuses to compel a plaintiff to undergo involuntary surgical examination, emphasizing the sanctity of one’s control over one’s body.
Ingraham v. Wright, 430 U.S. 651 (1977): recognition that unjustified intrusions on bodily security fall within the historic liberty protected by due process.
Rochin v. California, 342 U.S. 165 (1952): forced stomach pumping to obtain evidence “shocks the conscience” and violates due process.
Schmerber v. California, 384 U.S. 757 (1966): compelled blood draws are serious intrusions implicating bodily integrity (though permitted under certain conditions).
Washington v. Harper, 494 U.S. 210 (1990): forcible medication with antipsychotics implicates a “significant liberty interest” in avoiding unwanted drugs with serious side effects.
Cruzan v. Director, Missouri Dep’t of Health, 497 U.S. 261 (1990): majority and concurring/dissenting opinions recognize a liberty interest in refusing life‑sustaining medical care, including artificially administered food and water.

The central theme is informed consent and control over what enters or is done to one’s body. Courts scrutinize even potentially beneficial interventions if they occur without meaningful consent.

The majority then reasons:

If the Constitution protects an individual’s right to refuse life‑sustaining hydration and nutrition (Cruzan), and to avoid involuntary administration of therapeutic antipsychotic medications despite potential benefits (Harper), it logically also protects the right not to ingest lead‑contaminated water unknowingly introduced by the state into one’s home and body.

In that sense, this case “arguably” presents a more serious invasion than some prior bodily‑integrity cases: there is no therapeutic purpose at all, only a toxic intrusion into the body via a medium essential for life, coupled with alleged deception that deprives residents of true choice.

B. Dobbs, Glucksberg, and the “History and Tradition” Inquiry

The court confronts the shadow of Dobbs v. Jackson Women’s Health Organization, 597 U.S. 215 (2022), which repudiated abortion as a fundamental right but reaffirmed that unenumerated rights must be “deeply rooted in this Nation’s history and tradition” and “implicit in the concept of ordered liberty” (Washington v. Glucksberg).

The majority and Judge Dennis both emphasize:

Dobbs expressly limited its reasoning to abortion and stated that “nothing in this opinion should be understood to cast doubt on precedents that do not concern abortion. . . . It is hard to see how we could be clearer.”
Post‑Dobbs Fifth Circuit cases, such as Tyson v. Sabine, 42 F.4th 508 (5th Cir. 2022), and Doe v. Jewell (5th Cir. 2025), continue to recognize bodily integrity as a well‑established fundamental right.

Thus, the debate is not over whether bodily integrity is a historically grounded right—it is. The dispute is whether these particular facts fall within that right’s scope.

C. Applying the Right to the Facts: Consent, Coercion, and Government Services

The majority rejects two lines of defense argued by the City and developed extensively in Judge Engelhardt’s dissent:

“No constitutional right to clean water.” The City correctly notes that the Constitution does not impose a general duty on government to provide potable water (just as it does not require states to fund legal education or maintain police forces). But the court turns to a familiar principle:
While a government may have no obligation to provide certain benefits or services, once it chooses to do so, it must administer them consistent with constitutional constraints.
Examples include:
- Missouri ex rel. Gaines v. Canada, 305 U.S. 337 (1938): no obligation to operate law schools, but if the state does so, it must not discriminate on the basis of race.
- Espinoza v. Montana Dep’t of Revenue, 591 U.S. 464 (2020): no obligation to subsidize private education, but if it chooses to, it may not do so in a manner that violates the Free Exercise Clause.
- M.L.B. v. S.L.J., 519 U.S. 102 (1996): no constitutional right to an appeal, but once a state provides appellate review, it may not deny it selectively due to inability to pay in certain cases.
So, while there is no “right to clean water” as such, the City cannot provide water in a way that violates fundamental bodily‑integrity protections.
“No forcible intrusion—residents chose to drink the water.” Defendants argue that bodily integrity cases typically involve overtly forced intrusions (surgery, injections, physical contact), whereas here residents chose to drink municipal water.

The majority emphasizes that physical force is not a sine qua non of bodily‑integrity violations:
- Tyson v. Sabine held that mental coercion could suffice in a sexual‑exploitation case.
- Petta v. Rivera recognized substantive due process claims where police officers inflicted only psychological harm with no physical contact.
Here, the City:
- had a monopoly on essential drinking water for most residents;
- required residents to purchase that water absent alternative sources;
- represented it as safe; and
- allegedly knew those representations were false.
The majority analogizes that combination of monopoly power, affirmative misrepresentation, and resulting ingestion of toxins to a kind of constructive coercion: residents did not meaningfully consent to putting lead into their bodies.

On this reasoning, the majority holds the complaint adequately alleges a deprivation of the constitutional right to bodily integrity.

D. The Dissent’s Narrower View of Bodily Integrity

Judge Engelhardt does not dispute that bodily integrity is a fundamental right with deep roots. Rather, he insists that:

When defined at the requisite level of specificity, the “right” asserted is not bodily integrity but a “right to the competent administration of municipal water services”, which has no historical or constitutional pedigree.
Bodily‑integrity cases historically involve compelled medical or quasi‑medical procedures (forced injections, surgeries, restraints), or egregious physical/sexual abuse by state actors—not mismanagement of infrastructure coupled with mixed messaging.

For him, the plaintiffs’ real complaint is about the quality of a government service, for which the Constitution provides no remedy beyond what state tort law supplies. To recognize a bodily‑integrity violation here, he warns, is to convert ordinary negligence—or even gross negligence—by municipal agencies into federal constitutional torts, contrary to Paul v. Davis and Collins v. City of Harker Heights.

V. “Shocks the Conscience” and Deliberate Indifference

A. The Standard

Both majority and dissent accept that when substantive due process claims target executive action (including municipal decisionmaking), liability requires conduct that is:

“so egregious, so outrageous, that it may fairly be said to shock the contemporary conscience,” County of Sacramento v. Lewis, 523 U.S. 833, 847 n.8 (1998); and
in non–split‑second contexts, at least deliberately indifferent rather than merely negligent or even grossly negligent.

Deliberate indifference means the official:

knew of and disregarded an excessive risk to health or safety; or
the risk was so obvious that knowledge can be inferred.

In fast‑moving emergencies (e.g., high‑speed chases), only conduct involving an “intent to harm” typically suffices. But in extended, deliberative policy settings, Lewis holds that deliberate indifference can meet the conscience‑shocking threshold.

B. Majority’s Application: From Knowledge to Deception

The majority finds the deliberate-indifference / conscience‑shocking standard plausibly met. Several features of the alleged conduct are pivotal:

Prolonged knowledge of serious risk. The City had notice, at least by 2013, that:
- its water sources were dangerously acidic;
- the lime injection system was not functioning, meaning corrosive water was flowing into the distribution system; and
- lead levels in testing were trending upward, ultimately surpassing regulatory thresholds.
Policy choice that foreseeably worsened the problem. Rather than implementing Bell’s repair plan, the City allegedly:
- scrapped the repair proposal;
- switched a protective well‑water system onto corrosive surface water for 16,000 customers; and
- did so knowing or deliberately ignoring that treatment plants were not equipped for the increased, corrosive load.
This is the heart of plaintiffs’ “state introduced toxins into the water” narrative.
Delayed disclosure followed by deceptive assurances.
- After June 2015 testing showed serious exceedances of lead action levels, the City allegedly sat on the results for months while residents continued normal consumption;
- When the crisis eventually became public (January 2016), officials publicly assured residents the water was “safe” and distanced Jackson from Flint, despite internal knowledge of systemic problems; and
- Officials allegedly punished internal whistleblowing (e.g., firing the engineer who contradicted the City’s claim that it lacked records of lead lines).
Harm‑exacerbating “solutions.” Boil‑water notices may mitigate microbiological risks but concentrate lead, because water volume reduces while lead remains. Plaintiffs allege the City knew of widespread lead issues yet recommended boiling without warnings about the lead‑increasing effect.

Taken together, the majority sees “ample opportunity for cool reflection” and a pattern of complete disregard for a known, grave risk to human health. On those alleged facts, the court finds:

The alleged conduct—knowingly distributing toxic water and misrepresenting its safety over an extended period, in the absence of any legitimate governmental interest—plausibly “shocks the conscience” in the constitutional sense.

The opinion, echoing the Sixth Circuit’s Guertin v. Michigan decision about Flint, underscores that “jealously guarding the public’s purse” or avoiding political embarrassment cannot justify exposing an entire community to a neurotoxin while concealing the danger.

C. The Dissent’s Counter‑Narrative and the Role of Extrinsic Materials

Judge Engelhardt’s dissent focuses heavily on factual nuance and on the procedural question of how strictly courts should treat documents that plaintiffs cite or attach to their pleadings.

He argues, among other points, that:

The switch from wells to surface water was not a naked, cost‑driven gamble but part of a longer‑term plan to use a new booster station to improve pressure and flow—i.e., a policy decision balancing infrastructure needs. He bases this in significant part on an EPA investigative report plaintiffs attached as an exhibit.
MSDH, not the City, held key testing information in 2015 and did not immediately share it with the City because no regulation required prompt notification.
Contrary to the majority’s narrative of concealment, City and state authorities repeatedly issued public warnings about potential lead and recommended precautions (flush taps, avoid hot tap water, use filtering or bottled water for pregnant women and children, etc.), as well as urging blood‑lead testing for children.

On this view, the story is not one of knowing, calculated deception, but of flawed, evolving responses to complex water‑quality issues under resource constraints—exactly the sort of imperfect policymaking that Collins and DeShaney mark as outside substantive due process.

The majority pushes back on methodology. It accepts the standard rule that exhibits can control over contradictory allegations when the document is central and the contradiction is direct (e.g., the text of a contract in a contract suit). But it refuses to treat:

newspaper articles;
third‑party reports; or
non‑final administrative investigative reports

as binding statements of truth or as evidence that plaintiffs “adopted” every factual assertion merely by citing or incorporating them for limited purposes. Relying heavily on Goines (4th Cir.) and Banneker Ventures (D.C. Cir.), the majority insists such documents can:

show what plaintiffs knew or when they learned it;
illustrate context; but
cannot be used at the pleading stage to override plaintiffs’ contrary allegations about what really occurred.

That disagreement about how to treat these materials underlies much of the divergence on whether the conduct “shocks the conscience.” The majority reads the complaint’s allegations at face value; the dissent treats plaintiffs as “enmeshed in their own prolixity,” bound by every unfavorable fact in the incorporated materials.

VI. Qualified Immunity: Liability for the City, Immunity for Officials

A. The Qualified Immunity Framework

Qualified immunity shields individual government actors from § 1983 damages liability unless:

the plaintiff shows a violation of a constitutional right; and
the right was “clearly established” at the time, meaning:
- existing precedent—Supreme Court or robust, on‑point circuit authority—put the unlawfulness of the conduct “beyond debate,” and
- “every reasonable official” would have understood that what he was doing violated the Constitution.

Courts may address the two prongs in either order (Pearson v. Callahan), but here the majority follows the sequence: first violation, then clearly established law.

B. Majority: Right Violated, Not Clearly Established

The majority accepts that Supreme Court decisions like Botsford, Rochin, Harper, Cruzan, and related bodily‑integrity cases, when taken together, “show that, under the facts alleged here, Defendants plausibly violated the Constitution.” But it concludes those cases do not clearly establish the specific proposition that:

City officials violate the Fourteenth Amendment when they mishandle municipal water treatment, cause lead contamination, and misrepresent the safety of tap water.

Nor does the Sixth Circuit’s Guertin decision help, in its view, because:

It is not controlling authority in the Fifth Circuit; and
It was decided in 2019, after much of the alleged misconduct in Jackson occurred.

Accordingly, the right is not “clearly established” for qualified immunity purposes, and all individual City officials are shielded from damages liability, even though the underlying conduct is held unconstitutional.

C. Judge Dennis: Bodily Integrity Was Clearly Established

Judge Dennis, concurring in part and dissenting in part, agrees entirely with the majority’s substantive due process analysis but parts ways on qualified immunity. He reasons that:

Harper unambiguously recognized a liberty interest in avoiding involuntary administration of antipsychotic drugs; and
Cruzan recognized a liberty interest in refusing life‑sustaining hydration and nutrition, grounded in common‑law informed‑consent principles; and
Together, these decisions—and related bodily‑integrity jurisprudence—give officials “fair warning” that forcing people to ingest harmful substances (here, lead) without informed consent violates the Constitution, regardless of the specific delivery mechanism.

He endorses the Sixth Circuit’s qualified‑immunity analysis in Guertin, which concluded that:

Taking affirmative steps to contaminate a community’s water supply with lead, while falsely assuring its safety, is an invasion of bodily integrity “of the highest magnitude,” and any reasonable official would know it to be unconstitutional.

For Judge Dennis, requiring nearly identical precedent in this context improperly narrows the “clearly established” inquiry and conflicts with cases like Hope v. Pelzer, which eschew a demand for factually indistinguishable prior decisions.

D. Judge Engelhardt: No Violation, QI is Redundant

Judge Engelhardt agrees that if no constitutional violation occurred, there is no need for qualified immunity analysis. He would affirm on the simpler ground that, properly construed, the complaint fails to state a substantive due process claim at all. Thus, he “concurs” in the QI outcome (officials not liable) but on a fundamentally different basis.

VII. The State‑Created Danger Doctrine: Now Official in the Fifth Circuit

A. Background and Confusion in the Fifth Circuit

In DeShaney v. Winnebago County, the Supreme Court held that the Due Process Clause does not generally require the state to protect individuals from private violence, absent a “special relationship” (e.g., custody). But in dicta, the Court noted that no liability arose there because the state:

“played no part in [the] creation” of the danger; and
did not “do anything to render [the child] any more vulnerable” to the abuse.

From that language—and from pre‑DeShaney lower‑court decisions like White v. Rochford and Bowers v. DeVito—most circuits developed the state‑created danger doctrine: when state actors, through affirmative conduct, create or substantially increase the danger of private violence or harm, they may be liable under the Fourteenth Amendment.

Within the Fifth Circuit, the doctrine’s status was muddled:

Scanlan v. Texas A&M Univ., 343 F.3d 533 (5th Cir. 2003), and Morris v. Dearborne, 181 F.3d 657 (5th Cir. 1999), applied something like state‑created danger without formally adopting it.
Later cases, including Fisher v. Moore, 73 F.4th 367 (5th Cir. 2023), acknowledged the doctrine’s widespread acceptance elsewhere but declined to adopt or reject it, citing Dobbs and a need for a robust historical showing.

B. Adoption and Elements

Sterling ends the equivocation: the majority formally adopts state‑created danger as a viable substantive due process theory in this circuit and expressly embraces the First Circuit’s formulation from Irish v. Fowler:

A state‑created danger claim requires:

that a state actor or state actors affirmatively acted to create or enhance a danger to the plaintiffs;

that the act or acts created or enhanced a danger specific to the plaintiffs and distinct from the danger to the general public;

that the act or acts caused the plaintiffs’ harm; and

that the state actor’s conduct, when viewed in total, shocks the conscience.

The court emphasizes this doctrine is distinct from bodily integrity:

State‑created danger focuses on increasing risk of harm from some condition or third party, often private actors or environmental hazards.
Bodily integrity focuses on direct interference with personal autonomy, regardless of whether the interference ultimately proves harmful.

C. Application in Sterling

The majority does not itself apply the new test to the pleadings. Instead, it:

Reverses the district court’s wholesale dismissal of the state‑created danger claim (which had rested on the mistaken premise that the doctrine was unavailable in the Fifth Circuit); and
Remands for the district court to consider whether the alleged conduct meets the four elements as to the City.

However, it does hold that state‑created danger was not “clearly established” law in this circuit at the relevant times. By definition, a “never‑established right cannot be clearly established”; therefore, individual officials again receive qualified immunity on that claim.

D. Judge Dennis’s Historical and Statutory Rationale

Judge Dennis adds a layer to the doctrinal justification by tying state‑created danger to the text and history of § 1983 itself. He points to the statute’s phrase:

“Every person who, under color of [law] subjects, or causes to be subjected, any citizen ... to the deprivation of any rights ... shall be liable....”

In his view (drawing on scholarship like David Pruessner and Professor Steinglass), this language was enacted in the Ku Klux Klan Act of 1871 specifically to target state and local officials who effectively facilitated private terror (e.g., by Klan members) against freedmen. That history, he argues, supports the principle that state actors can incur liability when their affirmative conduct “causes” private harm in a constitutional sense—not merely when they themselves wield the weapon, but when they help load it.

E. The Dissent’s Critique

Judge Engelhardt objects to the doctrine’s adoption in this case for several reasons:

Lack of historical grounding under Dobbs/Glucksberg. He sees no Founding‑era or Reconstruction‑level tradition of such a right, and he views reliance on § 1983’s causation language as too slender a reed.
Doctrinal incoherence across circuits. He catalogues varying formulations in different circuits (e.g., requiring private violence vs. any harm, requiring specific plaintiffs vs. general public), arguing that such inconsistency demonstrates the doctrine’s judge‑made, non‑textual nature.
Inapplicability to these facts. Even under the majority’s adopted test, he believes:
- There is no “private violence” component, which many circuits require.
- The danger—lead in the municipal water system—is generalized, not specific to any particular plaintiff or discrete class.

Nonetheless, the doctrine is now on the books in the Fifth Circuit; future litigants and district courts will have to navigate its contours under the Irish/Sterling formulation.

VIII. Supplemental State‑Law Claims

Because the court revives federal constitutional claims against the City (bodily integrity; potentially state‑created danger), it vacates the district court’s decision to decline supplemental jurisdiction over plaintiffs’ state‑law claims. Under 28 U.S.C. § 1367, district courts ordinarily may (and often should) exercise supplemental jurisdiction where state and federal claims arise from a common nucleus of operative fact.

On remand, the district court will now handle:

the revived § 1983 claims against the City; and
the state‑law claims (possibly negligence, nuisance, statutory violations under state drinking‑water law) alongside discovery directed to the water crisis as a whole.

IX. Simplifying Key Doctrinal Concepts

A. Substantive vs. Procedural Due Process

Procedural due process asks: Has the government given appropriate procedures (notice, hearing) before depriving someone of life, liberty, or property?
Substantive due process asks: Are there some governmental actions that are so arbitrary or egregious that, regardless of procedures, they violate fundamental rights or exceed constitutional bounds?

Sterling is purely about substantive due process: plaintiffs allege that the City’s actions were themselves unconstitutional, not merely that procedures were lacking.

B. Bodily Integrity vs. State‑Created Danger vs. Ordinary Tort

Bodily integrity: Direct interference with personal autonomy and control over one’s own body (forced medical treatment; non‑consensual touching; poisoning). Harm is often physical, but the key is the invasive nature of the intrusion without consent.
State‑created danger: Government conduct that affirmatively places an individual or defined group in greater danger than they would otherwise face, often by exposing them to private actors or hazards, with the degree of culpability rising to deliberate indifference and “shocking the conscience.”
Ordinary tort: Negligent or even grossly negligent conduct by public actors that may be wrongful under state law but does not reach the constitutional threshold (e.g., garden‑variety slip‑and‑fall due to poor maintenance; simple misjudgment in engineering design).

The majority emphasizes it is not holding that every defective municipal service implicates constitutional bodily integrity. The leap from tort to constitutional tort depends on both:

the invasion of a fundamental right (e.g., bodily autonomy) and
a conscience‑shocking level of culpability (deliberate indifference or worse).

C. Monell Liability vs. Individual Liability

Under Monell v. Department of Social Services, a municipality can be sued under § 1983 when:
- an official “policy or custom” or decision by a final policymaker
- causes a constitutional violation.
Municipalities have no qualified immunity; if a violation is proven and traced to policy, the city may be liable.
Individual officials, in contrast, are shielded by qualified immunity unless the law was clearly established and their conduct objectively unreasonable under that law.

In Sterling:

The City (through mayor and public works leadership) is alleged to have adopted or ratified policies (e.g., the 2014 water‑source switch; public messaging) that caused the violations; thus, the City faces potential Monell liability.
Officials themselves avoid damages liability due to qualified immunity, although their conduct is alleged to be unconstitutional.

D. The “Shocks the Conscience” Test

This test is notoriously amorphous but has guardrails:

Not enough: simple negligence; professional mistakes; suboptimal policy choices; failure to enforce state laws; mere lack of due care.
Potentially enough: acts intended to cause harm; deliberate indifference to known, grave risks in contexts where officials had time to deliberate and alternatives to choose from; cover‑ups or affirmative misrepresentations that foreseeably cause serious physical harm.

Sterling is significant in showing that protracted environmental contamination combined with misleading official assurances about safety can be framed as conscience‑shocking executive action, at least when the allegations suggest knowledge of severe risks over a long period.

X. Precedents and How They Shaped the Decision

A. Baseline Substantive Due Process Cases

Washington v. Glucksberg, 521 U.S. 702 (1997): sets the modern test for unenumerated rights; influences the court’s framing of bodily integrity as a historically grounded liberty.
Dobbs v. Jackson Women’s Health Org., 597 U.S. 215 (2022): tightens the historical‑tradition requirement but disclaims any effect on non‑abortion precedents.
County of Sacramento v. Lewis, 523 U.S. 833 (1998): provides the “shocks the conscience” template and the distinction between split‑second decisions (intent to harm required) and policy decisions (deliberate indifference may suffice).
Collins v. City of Harker Heights, 503 U.S. 115 (1992): warns against turning the Due Process Clause into a general guarantee of safe working conditions or minimal levels of safety, and emphasizes deference to local policymaking in resource allocation.
DeShaney v. Winnebago Cty., 489 U.S. 189 (1989): establishes that the state’s failure to protect individuals from private harm, standing alone, does not violate due process; the state’s duty arises mainly in custody or when it “creates” the danger.

B. Bodily Integrity and Medical Cases

Union Pac. Ry. v. Botsford (1891); Rochin (1952); Schmerber (1966); Ingraham (1977); Harper (1990); Cruzan (1990); Riggins (1992); Parham (1979); Whalen v. Roe (1977): collectively build the body of law recognizing bodily integrity as a fundamental substantive due process right.
The majority leverages these cases to link “forced medication” or unwanted medical interventions to “unknowing ingestion of toxins” via municipal water.
Judge Dennis argues that these cases, particularly Harper and Cruzan, clearly establish the bodily‑integrity right in a way that should defeat qualified immunity.

C. Flint and Other Environmental Catastrophe Cases

Guertin v. Michigan, 912 F.3d 907 (6th Cir. 2019): Flint water crisis; the Sixth Circuit found a bodily‑integrity violation and denied qualified immunity to many officials. The majority here follows Guertin’s substantive reasoning but declines to import its qualified‑immunity holding.
In re Flint Water Cases (Waid v. Earley), 960 F.3d 303 (6th Cir. 2020): reinforces the viability of bodily‑integrity and state‑created danger theories under Flint‑like facts.
Mitchell v. City of Benton Harbor, 137 F.4th 420 (6th Cir. 2025): emphasizes that there is “rarely a justification for misleading the public about the extent of a lead‑water crisis.” Cited by the majority here to underscore that prolonged misrepresentations about water safety lack a legitimate governmental purpose.
Stewart v. MTA, 566 F. Supp. 3d 197 (E.D.N.Y. 2019): state‑created danger / bodily‑integrity claim based on lead‑paint flaking from elevated subway tracks; distinguishes emergency response contexts from chronic, preventable environmental harms.

D. Misrepresentation and Disaster Response: Lombardi & Benzman

Lombardi v. Whitman, 485 F.3d 73 (2d Cir. 2007), and Benzman v. Whitman, 523 F.3d 119 (2d Cir. 2008): claims that EPA and other federal officials misled the public about air quality around Ground Zero after 9/11. The Second Circuit rejected substantive due process claims, emphasizing the fluid, high‑pressure context and the absence of conscience‑shocking intent.
The majority in Sterling distinguishes those cases vividly:
- 9/11 posed an unprecedented, fast‑moving disaster with evolving knowledge;
- Water contamination in Jackson developed over years with stable, accumulating data;
- Thus, Jackson’s case fits the “ample opportunity for cool reflection” paradigm, where deliberate indifference is actionable—unlike emergency response settings where a higher intent threshold applies.

E. Exhibit‑Prevails Cases and Pleading Standards

Goines v. Valley Community Servs. Bd., 822 F.3d 159 (4th Cir. 2016); Banneker Ventures v. Graham, 798 F.3d 1119 (D.C. Cir. 2015); Carroll v. Yates, 362 F.3d 984 (7th Cir. 2004): caution that attachments and references to third‑party documents do not automatically mean the plaintiff adopts every assertion within them.
The majority cites these to reject the dissent’s heavy reliance on newspaper articles and a preliminary EPA report as controlling facts at the Rule 12 stage.

XI. Implications and Future Litigation

A. Environmental Justice and Public‑Health Infrastructure

Sterling is likely to become a key citation in litigation arising from:

water contamination crises;
lead and other heavy‑metal exposures tied to aging infrastructure;
pollution events where public agencies manage, rather than merely regulate, the harmful medium.

Key takeaways for such cases:

Monell exposure for municipalities: Cities that operate water, gas, or housing systems may face § 1983 liability where a pattern of decisions by officials with final policymaking authority knowingly exposes residents to toxins while misrepresenting safety.
High bar remains for official‑capacity suits: Individual officials will often be insulated by qualified immunity unless there is close factual precedent or extremely clear constitutional warnings.
Importance of honest public communication: Even without a general duty to protect, affirmative misstatements about dangerous conditions, especially where the government monopolizes an essential resource, may cross the constitutional line.

B. The Scope of Bodily Integrity Beyond Policing and Medical Contexts

Before Guertin and now Sterling, bodily‑integrity doctrine was largely developed in:

criminal procedure (e.g., forced blood draws, body cavity searches), and
mental health / prison / medical treatment contexts.

Sterling extends that doctrine explicitly into the realm of basic city services. The court is careful to announce that it does not recognize a constitutional right to “high‑quality” municipal services. But at the same time, it confirms that:

when the state uses its control over indispensable life necessities (water) to effectuate, through misrepresentation, an unwanted invasion of citizens’ bodies, bodily‑integrity principles apply; and
this is true even absent physical force or explicit threats.

How far that rationale can be extended—to other environmental hazards, to public housing with known toxic conditions, to vaccines or other public‑health measures—will be the subject of future litigation and likely appellate and Supreme Court scrutiny. The dissent’s vivid hypotheticals about potholes, COVID‑19 vaccines, and border‑security announcements are intended to illustrate potential spillover; the majority and concurrence insist those scenarios lack the deliberate indifference and “no legitimate governmental purpose” features present here.

C. State‑Created Danger in the Fifth Circuit: A New Tool with Uncertain Contours

By adopting the Irish four‑part test, Sterling gives plaintiffs in Texas, Louisiana, and Mississippi a doctrinal route long available elsewhere to challenge:

police decisions that increase victims’ exposure to private criminals;
child‑welfare decisions that knowingly leave children in dangerous environments;
housing or code‑enforcement decisions that residents allege expose them to violence or hazards.

But it does so while:

leaving the doctrine’s precise boundaries for future cases; and
rendering it unavailable for damages against individual officials for past conduct (due to qualified immunity) until further clearly establishing case law develops.

In the near term, the doctrine will likely play out most prominently in suits against municipalities and agencies rather than individual policymakers.

D. Litigation Strategy After Sterling

For plaintiffs’ counsel:

Expect a mixed battlefield:
- Robust municipal‑liability opportunities via Monell and state‑created danger.
- Strong qualified‑immunity shields for individuals absent very on‑point precedent.
Plead facts carefully to:
- show extended knowledge of risk;
- link policy decisions to the harm; and
- document misrepresentations or omissions that plausibly coerced or misled residents.

For municipalities and their counsel:

Re‑examine crisis communications protocols: incomplete or misleading assurances about safety may now carry constitutional as well as political and tort consequences.
Ensure that final decisionmakers’ roles are clearly delineated; avoid informal practices that could be construed as official policies.
Maintain transparent documentation of the cost‑benefit and risk‑assessment analyses underpinning major infrastructure decisions. While not a shield per se, they may help demonstrate good faith and rebut “deliberate indifference” allegations.

XII. Conclusion: Sterling’s Place in the Substantive Due Process Canon

Sterling v. City of Jackson is a major Fifth Circuit precedent on two fronts.

First, it confirms that the constitutional right to bodily integrity reaches beyond the familiar arenas of criminal procedure and forced medical treatment, into certain egregious failures of municipal stewardship over essential public resources. When a city allegedly:

knows its water is corrosive and lead‑leaching;
chooses a policy course that worsens contamination;
delays or obscures disclosure; and
affirmatively reassures residents that the water is safe—

the combination can, at least as pleaded, amount to a substantive due process violation. In doing so, the Fifth Circuit aligns itself substantively with the Sixth Circuit’s approach in Flint‑related cases, while diverging on the question of qualified immunity for individuals.

Second, the opinion finally settles, for this circuit, the availability of the state‑created danger doctrine. Though controversial in the dissent’s view and still nascent in its Fifth Circuit contours, its adoption reflects a broader national consensus that the Fourteenth Amendment can reach not only direct state violence but also some state‑facilitated harms where official acts “cause [someone] to be subjected” to constitutional deprivations.

At the same time, the sharp division among the panel judges underscores the fragility and contestability of substantive due process in the post‑Dobbs era. Where the majority sees “one of the greatest public health emergencies” and a textbook invasion of bodily autonomy, the dissent sees a dangerous transformation of tort mismanagement into constitutional doctrine, with the potential to flood federal courts with claims about potholes, vaccines, and beyond.

Whether the Supreme Court will eventually weigh in on these issues—particularly the interplay between bodily integrity, environmental disasters, and substantive due process constraints on local governance—remains to be seen. For now, Sterling stands as both a warning to municipalities about the constitutional stakes of their infrastructure decisions and a significant new tool for residents seeking accountability when environmental mismanagement directly invades their bodies and lives.