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On The Front Lines

U.S. Supreme Court Protects Expectant Mothers' Fourth Amendment Rights

Washington - The U.S. Supreme Court ruled today in favor of the Fourth Amendment rights of expectant mothers who sought gynecological care from physicians at Charleston's Medical University of South Carolina (MUSC).

The Rutherford Institute filed a "friend of the court" brief on behalf of the expectant mothers. In its 6-3 decision, the Court stated that the mothers' Fourth Amendment rights protecting them against unreasonable searches and seizures were violated when their gynecologists conducted drug tests on them without their consent and then reported the patients who tested positive for cocaine use to local prosecutors.

MUSC had a policy of conducting drug urinalysis (which detects cocaine usage) on maternity patients who were deemed to be at risk for drug abuse. Signs of possible drug abuse, according to MUSC, include prenatal care that is absent, late (care initiated after 24 weeks of gestation), or regarded as incomplete (fewer than five visits); a history of cocaine use; abruptio placentae (separation of the placenta from the uterus); unexplained growth, retardation or fetal death; and unexplained birth defects. When any of these factors was present, a treating physician was obligated by MUSC policy to order a drug urinalysis. The tests, conducted without obtaining a warrant, relied on a general consent form that failed to mention the results could be reported to criminal authorities. When an expectant mother tested positive for cocaine use, she was reported to the City of Charleston Police Department and arrested for distributing cocaine to a minor. While the hospital policy was amended in 1990 to allow these expectant mothers the option of entering a drug abuse treatment program, they were still monitored by the Solicitor General for subsequent punitive action and arrest if they failed to comply with the drug abuse treatment obligations or tested positive again.

Agreeing with arguments made by The Rutherford Institute's amicus brief, the high court stated that the primary purpose of the hospital policy was to use the threat of arrest and prosecution in order to force women into treatment, rather than ensuring care to unborn infants at risk. The Court additionally determined that the factors used to determine whether or not a urine test was needed were not sufficient to conduct a search on these women. Without proper consent, these urine tests were an invasion of the patient's privacy rights and their reasonable expectation of privacy in the physician-patient relationship.

"The Ferguson decision is a line in the sand beyond which the police power of the state may not intrude," said John W. Whitehead, president of The Rutherford Institute. "The Supreme Court has made it clear that the state may not threaten citizens with drug tests and arrests to further its own government agenda, regardless of how well-intended or noble its agenda may be."

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Nisha N. Mohammed
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Email: Nisha N. Mohammed


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