The Chief Justice's opinion attacked this conclusion by focusing on the language in the ADA that demands that the determinations of disability and accommodation be individualized. This language was put into the ADA to prevent employers from excluding disabled workers based on stereotypes of what persons with a specific disability can do. The employer must give the employee a chance to do the job, rather than have blanket exclusions based on laundry lists of disabilities. The Chief Justice argued that this standard of individualized determination of disability should also be applied to the plaintiff. The plaintiff rejected this individualized determination and denied that she, personally, suffered any impairment to a major life function:

"There is absolutely no evidence that, absent the HIV, respondent would have had or was even considering having children. Indeed, when asked during her deposition whether her HIV infection had in any way impaired her ability to carry out any of her life functions, respondent answered "No." It is further telling that in the course of her entire brief to this Court, respondent studiously avoids asserting even once that reproduction is a major life activity to her. To the contrary, she argues that the "major life activity" inquiry should not turn on a particularized assessment of the circumstances of this or any other case."

Unfortunately, the Court's opinion ignored the issue of whether the determination of effect on a major life activity must be specific to the plaintiff. Instead, the court presented a barrage of information about what a bad disease HIV is and how it is clear that HIV-infected persons are impaired. It is clear that HIV infection does affect several major life activities and that this case is correctly decided. However, the Chief Justice's concern with individualized determinations is well founded. Not every disability is so clear-cut as to its effects on the major life activities. Many diseases have a spectrum of effects, ranging from minor alterations in diagnostic tests with little chance of progression, to full-blown disease with major illness and death. This is especially problematic in mental illnesses, with their highly variable course. In these cases, the question of whether the individual plaintiff need show an effect of the disease is very relevant. The Court gives no guidance on this very difficult issue. (Although not discussed by any judge, the converse problem is also possible: if the standard is a generic one, what happens to a plaintiff who is personally disabled by a condition that usually does not disable others.)