A decade-long legal fight to protect the rights of pregnant women has resulted in a sweeping victory in the Supreme Court. The court ruled that hospitals cannot test pregnant women for illegal drug use without their consent and then turn results over to the police. The case grew out of a Charleston, South Carolina, hospital's plan, drawn up with police and prosecutors in the midst of the crack-baby hysteria of the late 1980s, to drug test pregnant patients and turn positive results over to the police.
Because the hospital, the Medical University of South Carolina, served a poor, predominantly black population, issues of race and class justice as well as the rights of pregnant women came prominently into play. Before the hospital modified its policy in 1994, 30 women -- all of them black except one -- were arrested, with some being dragged off to jail in shackles shortly after giving birth.
Lynn Paltrow, executive director of National Advocates for Pregnant Women, originated the case and represented the plaintiffs in the lower courts. "We're just thrilled," she told DRCNet. "It's a wonderful decision for anyone who goes to a health provider. They can be sure that the questions asked and the tests performed are for a diagnosis, not a criminal prosecution."
In a prepared statement, Paltrow elaborated. "The decision affirms that the Fourth Amendment to the US Constitution protects every American -- even those who are pregnant, even those with substance abuse problems -- from warrantless, unreasonable searches," she said. "This case represented the intersection of the war on abortion and the war on drugs -- using claims of fetal rights and false and alarmist assertions about drug use to justify unprecedented violations of patients rights to the detriment of women and children."
Writing for the majority in Ferguson v. the City of Charleston, Justice John Paul Stevens held that, "A state hospital's performance of a diagnostic test to obtain evidence of a patient's criminal conduct for law enforcement purposes is an unreasonable search if the patient has not consented to the procedure. The interest in using the threat of criminal sanctions to deter pregnant women from using cocaine cannot justify a departure from the general rule that an official nonconsensual search is unconstitutional if not authorized by a valid warrant."
The court's ruling overturned the 4th US Circuit Court of Appeals in Richmond, which in 1999 held that regardless of the women's consent, warrantless drug testing was "minimally intrusive" and justified by the "special needs" of stopping drug use among pregnant women. The Supreme Court has recognized the "special needs" exception to Fourth Amendment search and seizure protections in limited circumstances for health and safety purposes, such as highway drunk-driving checkpoints.
But Stevens wrote that "special needs" could not apply to a program so directly connected to law enforcement ends. "The central and indispensable feature of the policy from its inception was the use of law enforcement to coerce the patients into substance-abuse treatment. While the ultimate goal may have been to get the women in question into substance-abuse treatment and off drugs, the immediate objectives of the searches was to generate evidence for law enforcement purposes in order to reach that goal."
The fact was, Stevens wrote, that the policy "was designed to obtain evidence of criminal conduct by the tested patients that would be turned over to the police and that could be admissible in subsequent criminal prosecutions."
The decision was 6-3, with Justices Rehnquist, Scalia, and Thomas dissenting.
The text of the Supreme Court decision is available at http://supct.law.cornell.edu/supct/html/99-936.ZS.html online.