– Affirming the right to confidential medical care for all Americans, the United States Supreme Court today struck down a drug testing scheme targeting pregnant women developed by local police and prosecutors in collaboration with doctors in a South Carolina hospital.
In its 6-3 decision in Ferguson v. City of Charleston, the Court found that the Medical University of South Carolina drug testing scheme was in direct violation of the Fourth Amendment, which provides all Americans with protection from unreasonable searches.
"This decision slams the door against police searches of private medical information in your doctor’s office," said Priscilla Smith, lead counsel in the Ferguson case and Deputy Director of Litigation with the Center for Reproductive Rights. "The Court confirmed that pregnant women have the same constitutional rights as other Americans, including the right to maintain a confidential doctor-patient relationship," Smith added.
In a majority opinion written by Justice John Paul Stevens, the Supreme Court determined that the searches, which were conducted without warrants or probable cause, violated the Fourth Amendment in the absence of consent. The Court reversed the decision of the United States Court of Appeals for the Fourth Circuit excusing the lack of warrants based on a limited "special needs" exception to the Fourth Amendment. This decision maintains the Court’s steady determination that the "special needs" balancing test should not be applied to the law enforcement searches of citizens, who have a reasonable expectation of privacy in medical and other personal matters.
The majority opinion draws on the Supreme Court’s Miranda decision, which affirms that citizens should know their rights. "While state hospital employees, like other citizens, may have a duty to provide the police with evidence of criminal conduct that they inadvertently acquire in the course of routine treatment, when they undertake to obtain such evidence from their patients for the specific purpose of incriminating those patients, they have a special obligation to make sure that the patients are fully informed about their constitutional rights, as standards of knowing waiver require."
The majority decision was joined by Justices O’Connor, Souter, Ginsburg and Breyer. Justice Kennedy wrote a separate opinion concurring in the judgment. Justice Scalia’s dissenting opinion was joined by Chief Justice Rehnquist and Justice Thomas.
"Today’s decision is a victory for all women who are now assured that the Constitution protects their privacy when seeking prenatal care," said Sue Frietsche, Staff Attorney at WLP and co-counsel in the case. "Protecting privacy in medical care will improve pregnant women’s health and improve their chances of having a healthy baby."
The High Court’s decision was largely informed by the nation’s leading medical, public health and children’s groups, which uniformly oppose the use of punitive methods to address the problem of substance abuse during pregnancy. Seventy-five groups - including the American Medical Association and the American Public Health Association - signed amicus briefs urging the Court to find South Carolina’s policy unconstitutional. The consensus from the groups is that threatening women with arrest and jail time deters them from seeking critical prenatal care and drug treatment and could thereby actually harm their health and the health of their children. Additionally, these groups assert that those who promote prosecutions ignore the severe shortage of drug treatment programs, especially those that will accept pregnant women or provide services needed by women with young children at home.
On October 4, 2000, the Center for Reproductive Rights and the Women’s Law Project (WLP) argued that the Medical University of South Carolina, local police and prosecutors violated the constitutional rights of pregnant women seeking medical care by collaborating to secretly search their urine for cocaine use and arrest them if results were positive. In July, 1999, the United States Court of Appeals for the Fourth Circuit found the drug testing scheme constitutional based on the "special needs" exception to the Fourth Amendment. This exception to the requirements of a warrant and probable cause has never been applied by any other court to a search primarily serving normal law enforcement needs.
The "Search and Arrest" policy was initiated in 1989 as a joint effort between the hospital and local law enforcement officials. A targeted group of pregnant women was subject to secret urine searches to test for cocaine use without a warrant or consent. Results were reported to police who arrested 30 women over a 5-year period. Some of the women were handcuffed and arrested from their hospital beds immediately after giving birth; others were arrested and jailed while still pregnant.
In addition to the Center for Reproductive Rights, the Petitioners are also represented by the Women’s Law Project, Philadelphia attorneys David Rudovsky and Seth Kreimer, and Charleston attorney Susan K. Dunn. The briefs filed in the case Ferguson v. City of Charleston (99-936) can be found on the Center for Reproductive Rights' website here.
Read U.S. Supreme Court Decision online (PDF format)
Court filings including Amicus Briefs in Ferguson v. City of Charleston
Ferguson v. City of Charleston Case Summary
