HIGH COURT TO HEAR CASE OF PREGNANT DRUG ABUSERS

WASHINGTON - The Supreme Court on Monday agreed to decide if the
constitutional rights of expectant mothers are violated when a hospital
tests them, without their consent, for illegal drug use and gives the
results to law enforcement.

Ten pregnant women who tested positive for cocaine use in a Charleston,
S.C., hospital are challenging the facility's since-suspended policy as a
violation of their right against unreasonable searches by police. The women
- - nine of whom are black and one of whom is white - are suing the city,
police and hospital administrators, alleging they violated the women's
Fourth Amendment rights.

The nine black women were subsequently arrested but agreed to attend
drug-treatment programs instead of facing prosecution. The white woman was
not arrested, prompting the women to say the policy targets African-Americans.

The issue of racial discrimination, although not alleged directly in the
Supreme Court appeal, was an impetus for the policy, the women argue. They
noted the policy was in force at only one hospital, the Medical University
of South Carolina Medical Center, which serves a predominantly black
population.

The policy was implemented in 1989, a time when the scourge of crack
cocaine, an inexpensive by-product of the harmful drug, began afflicting
primarily low-income, black communities. News broadcasts were rife with
stories of "crack babies" being born with deformities or addicted to the
drug their mothers took during pregnancy.

But the city, which says race was not an issue, counters that the
Constitution permits the drug tests and their disclosure because they are
so critically necessary to protect the health of expectant mothers and
their unborn. In its brief to the justices, the city called cocaine use by
expectant mothers a "national epidemic" that has been linked to
miscarriages, stillbirths and a host of congenital problems.

A spokeswoman for the Houston Health Department, which operates seven
medical facilities in the city, said it never releases drug-test results
without a court order or the patient's permission.

"Patient records are strictly confidential," said spokeswoman Kathy Barton.

Charleston, in its brief, said that an expectant mother's use of cocaine
can cause birth defects, including damage to the brain, kidneys and
reproductive systems; increased risk of infant death; low birth weight;
seizures; strokes; heart attacks; behavioral problems and learning
disabilities.

The medical cost for treating babies born to a mother who used cocaine can
exceed $1 million during the life of the child, including $50,000 in the
first year alone, Charleston argued.

In the late 1980s, about 15,000 babies in South Carolina annually suffered
ill effects from prenatal exposure to illegal drugs, the city said.

Charleston's argument has been victorious so far, as the 4th U.S. Circuit
Court of Appeals ruled last year that the city's desire to protect the
health of the unborn superseded the women's right to have drug tests kept
confidential.

The women then appealed to the Supreme Court, which is expected to render
its decision by July 2001.

Under the city's policy, which was suspended in 1993 because of the
litigation, only pregnant women suspected of illegal drug use are tested.
Expectant mothers arouse suspicion from health care workers under the
policy by seeking little, late or no prenatal care; having a history of
drug or alcohol abuse; or going into early labor for "no obvious" reason.

After first testing positive, the women are given information on the
harmful effects of drug use on themselves and their unborn and referred to
drug counseling.

The hospital will notify the local prosecutor's office only if the women
fail a second drug test or decline to attend the counseling sessions or
prenatal medical appointments.

Women arrested under the policy could be charged with drug possession,
child neglect or distribution of drugs to a child. Under state law, a fetus
is considered a child if the pregnancy had progressed to the point of
viability, or when a fetus could survive outside the womb.

The 10 women also argued that the policy unconstitutionally permits police,
in cooperation with hospital staff, to conduct warrantless searches for
drug use.

The policy, if upheld, could lead to a host of other police efforts to
skirt the Fourth Amendment by subjecting unconsenting citizens to
warrantless searches under the guise of protecting their health and safety,
the women argued. For example, hospital workers submitted the drug tests to
the police secretly, after leading the women to believe results would
remain confidential, they added.

In their brief, the women also said several new mothers arrested under the
policy were placed in custody "while still bleeding, weak and in pain from
having just given birth."

The American Public Health Association, joined by other medical groups,
filed a brief urging the justices to hear the women's appeal.

The groups argued that the threat of prosecution under the policy would
upset the trust patients must have in their doctors and discourage pregnant
women from seeking prenatal care.

But Charleston countered that its policy of telling law enforcement of
failed drug tests is a justifiable way to protect the health of pregnant
women and their unborn by encouraging expectant mothers to seek early
treatment.

Of the 253 patients who tested positive for drug use under the policy, only
30 were subsequently arrested. Of those 30, only two were prosecuted, and
they were sentenced to probation and ordered to complete drug treatment,
the city said in its brief.