The United States Supreme Court has ruled that hospital workers cannot test pregnant women for use of illegal drugs without their informed consent or a valid warrant if the purpose is to alert the police to a potential crime.
The court's 6 to 3 decision stemmed from a 10 year old lawsuit brought against the city of Charleston, South Carolina, by women who were arrested, under a cooperative programme between a public hospital and the police department, after a positive urine test for cocaine.
The Supreme Court ruled that the facts of the women's pregnancy and of possible danger to their fetuses through use of illegal drugs did not change their basic constitutional rights. Justice John Paul Stevens said for the court majority that the hospital's test to get evidence of a patient's criminal conduct was an unreasonable search if the patient had not consented.
In the ruling, the Supreme Court overturned a 1999 decision by a lower federal court that said that regardless of whether the women provided informed consent, the clandestine drug testing programme was justified by the “special needs” of stopping drug use by pregnant women and getting the women into treatment.
In the current opinion, the Supreme Court said that the “special needs” exception to the fourth amendment—which the court has recognised in limited circumstances to justify drug testing for health and safety purposes, such as the testing of airline pilots and train drivers—did not apply to a programme that was so directly connected to law enforcement.
“While the ultimate goal of the programme may well have been to get the women in question into substance abuse treatment and off drugs,” the Supreme Court said, “the immediate objective of the searches was to generate evidence for law enforcement purposes in order to reach that goal.”
Medical organisations, including the American Medical Association and the American Public Health Association, filed briefs with the court on behalf of the plaintiffs that made that argument. In its judgement, the Supreme Court took explicit note of these briefs, saying that in light of them, “it is especially difficult to argue that the programme here was designed simply to save lives.”