DRUG TESTING Should Expectant Mothers Be Busted For Drug Use? In the early 1990s, the Medical University of South Carolina secretly tested some expectant mothers and turned over medical evidence of drug use to law enforcement officials for prosecution. The women had voluntarily come to the public university hospital for prenatal services and did not know until they were arrested that their urine samples had been tested for the presence of cocaine. The city of Charleston and the hospital, which jointly developed the policy, said it was instituted to help patients obtain drug counseling. But several of the women sued in federal court on grounds that the hospital infringed their right to avoid an improper search. The women also alleged racial discrimination because nearly all of those who tested positive were African-American. The Fourth Circuit Court of Appeals upheld the hospital's policy, contending it did not violate privacy or unreasonable search protections. The case, however, was appealed to the U.S. Supreme Court, which last week heard oral arguments. Although the hospital has since ended this policy, key constitutional issues about the limits of privacy and search and seizure protections remain unresolved. The high court is expected to rule later this term. Should hospitals be allowed to test pregnant women for illegal substances that might damage the fetus and report test results to police? "Yes" Most states, including Texas, require doctors to report gunshot wounds. Texas is also among states that require notification in suspected child abuse. This simply adds drug use by expectant mothers to the list of concerns that warrant intervention. Aggressive intervention protects the health and safety of an unborn child. The policy gives the women an opportunity to enter drug treatment. Intrusion into a woman's privacy is minimal. "No" The policy discourages women from voluntarily seeking prenatal care, a consequence that hurts unborn children more than it helps them. The policy compromises the long-standing principle of doctor-patient confidentiality. The hospital acted inappropriately as an arm of the police, effectively participating in an illegal search without a warrant or consent. The way the policy was applied unfairly targeted racial minorities. OUR VIEW: Policy undermines constitutional protections Drug abuse is a social and medical affliction, and is particularly distressing when irresponsible adults saddle their children with the consequences of their mistakes. The agony of a newborn addicted to drugs defies words. Nonetheless, the hospital's collaboration with law enforcement runs afoul of basic constitutional protections. These women had a reasonable expectation that seeking prenatal help would not subject themselves to arrest and prosecution. In practice, law enforcement officials used the hospital to gain extremely wide latitude to obtain evidence without a warrant or consent. This not only is wrong, it blatantly violates the confidential relationship between doctor and patient. Moreover, these kinds of policies discourage expectant mothers from seeking prenatal care. No hospital should chase away patients with the threat of arrest. The hospital's policy undermines long-accepted constitutional protections. The high court should clearly and forcefully reject the policy as improper.
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