South Carolina Drug Testing Policy Unconstitutional

Case in Brief:

South Carolina Drug Testing Policy Unconstitutional

In October 2000, the U.S. Supreme Court considered whether the City of Charleston's policy of state hospitals working with police to identify and seize pregnant women who used cocaine during pregnancy amounts to a search under the Fourth Amendment of the U.S. Constitution. In this case, pregnant women were unknowingly tested for drug use during what was allegedly a confidential medical visit and arrested in cases in which the woman tested positive.

This policy raises the possibility of even broader consequences for women receiving TANF assistance, due to the fact that a drug-related conviction could lead to permanent disqualification from food stamps and other public assistance benefits.

Upon issuing a final ruling in March 2001, the U.S. Supreme Court concluded that drug testing pregnant women without first obtaining their consent is a violation of the Fourth Amendment of the U.S. Constitution's protection against unreasonable searches and seizure.

What was the case about?

Staff of the Medical University of South Carolina (MUSC) began testing pregnant women for drug use in the course of routine medical visits as part of an agreement between the hospital, the city of Charleston and local police. MUSC's general counsel offered to turn the evidence over to the police in order to help prosecute mothers who tested positive for drugs at the birth of their child, on the theory that drug use during pregnancy was a form of child abuse. As a result, a task force--comprised of MUSC representatives, police and local officials--was created to:

develop a policy establishing criteria for identifying and testing pregnant women suspected of drug use,

establish a chain of custody pertaining to the handling of patient's urine samples,

provide for education and treatment referral for patients testing positive,

establish police procedures for arresting patients who test positive and

assign prosecutions for drug offenses and/or child neglect, depending on the advanced stage of defendant's pregnancy.

Lawyers for the hospital argued that the doctors performing tests are preventing these women from doing irreparable harm to their children, while counsel for the plaintiffs raised concerns that such a practice will deter some women from seeking prenatal care at all.

The MUSC patients arrested for testing positive for cocaine use argued that the hospital's drug testing policy amounted to a warrantless, nonconsensual search that violates the Fourth Amendment.

MUSC argued that the drug tests did not violate the constitutional rights of the affected women in that they had consented to the searches and the searches were reasonable, even without consent, because they were justified by a special non-law-enforcement purpose.

What did the U.S. District Court say?

The U.S. District Court rejected MUSC's argument that the tests served a special non-law-enforcement need given that the tests were not conducted for an independent purpose and, instead, were given over to police through a specific agreement with the hospital. The District Court asked the jury to determine whether petitioners' consent was given and instructed members of the jury to find in favor of the respondents if consent was found. The jury ruled in favor of MUSC.

What did the U.S. Court of Appeals say?

Petitioners appealed the ruling to the U.S. Court of Appeals for the Fourth Circuit on the basis that the evidence was insufficient to support the jury's consent finding. The Fourth Circuit affirmed the decision of the District Court on the grounds that the searches were reasonable as a matter of law due to legal precedent which recognizes that "special needs" can justify a warrantless search, under certain circumstances. The Court did not address the issue of consent.

What did the U.S. Supreme Court say?

In March 2001, the Supreme Court ruled that hospitals cannot test pregnant women for drugs without first obtaining a search warrant or the consent of the patient. Failure to do so and then turn information over to police violates the Constitutional prohibitions against unreasonable search and seizures.

Lawyers for the women successfully argued that the practice was counter-productive and would serve to deter women from seeking prenatal medical care.

The Court ruled that the hospital was acting as an arm of law enforcement without first obtaining a search warrant before conducting the drug tests. The Fourth Amendment of the U.S. Constitution requires that searches be authorized by a court warrant based on reasonable suspicion that a crime has been committed, unless the government can demonstrate "a special need." The Court reasoned that drug testing pregnant women without their consent in order to protect the fetus is not a "special need".

The Supreme Court reversed the ruling and remanded the case to the Fourth Circuit to determine whether the affected patients had given informed consent.

In October 2002, the Fourth Circuit Court of Appeals ruled that most of the pregnant women who sued the South Carolina hospital for administering the drug tests and handing the results over to the police never agreed to be tested.

What does this ruling mean for other states?

To date, the City of Charleston is the only locality to adopt such a policy. Since other states or cities have not followed their lead, the Court's ruling should not have a significant impact on other states. This ruling is important for states to consider, however, as they implement new drug testing policies or review their existing policies in order to ensure that state practices do not to violate the constitutional rights of affected women or create eligibility problems for low-income mothers in need of public assistance.

Case Citation:

Ferguson v. City of Charleston, 532 U.S. 67, 121 S.Ct. 1281, 149 L.Ed.2d 205 (2001)

For More Information:

Contact Andrea Wilkins of NCSL's Welfare Reform Project at 303-856-1558 or andrea.wilkins@ncsl.org.

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