State can catalog names of abortion patients

WASHINGTON -- The Supreme Court cleared the way Monday for health authorities in South Carolina to collect names, addresses and other information about women seeking abortions, a power doctors say violates a fundamental duty to protect patient privacy.

The high court rejected a challenge to the state's plan to catalog medical records from clinics and abortion doctors. The court's action, taken without comment, ends a lengthy legal challenge that had kept the law on hold.

South Carolina is the only state whose law allows regulators to see, copy and store abortion patients' medical records without stiff requirements that the information be kept confidential, lawyers representing the clinic and outside medical organizations said.

"For every individual, having your private medical records kept confidential is important. In the abortion context, it's even more important," said Bonnie Scott Jones, a lawyer for the Center for Reproductive Rights, which represented a Greenville, S.C., abortion clinic. "Women are subjected to harassment, violence, if their abortion decision is disclosed."

South Carolina wants abortion clinics to open all files, including patient medical records, if state investigators ask to see them. Supporters say the new regulations will improve state oversight of abortion providers, and are part of ordinary state record keeping.

Trey Walker, spokesman for the South Carolina attorney general's office, said he was pleased the legal challenges were over.

"The state regulations are reasonable health and safety measures that do not infringe on anyone's constitutional rights," he said.

Patient medical records ordinarily are a private matter, although there are exceptions. Doctors, hospitals and insurers can share information among themselves, and police or other authorities can seek records in criminal investigations, public health emergencies or, for example, when child abuse is suspected.

Ethics codes endorsed by the American Medical Association and other professional medical organizations require doctor-patient confidentiality, in part to encourage patients to be forthcoming with potentially embarrassing information.

The Supreme Court case arose from a 1995 law that imposed new, heavier regulations on abortion providers in South Carolina. The state said the changes would improve standards at abortion clinics and make the procedure safer. Clinics and doctors contended the regulations were really intended to hurt providers financially or force them out of business.

A federal appeals court ruled the medical records plan offered enough patient safeguards, a ruling that medical groups said could encourage other states to follow South Carolina's lead.

Doctors in South Carolina cannot comply with the new law and also adhere to the code of conduct of the American College of Obstetricians and Gynecologists, that organization told the Supreme Court in a friend-of-the-court filing.

"The decision below is a harbinger for the erosion of doctor-patient confidentiality in all areas of medicine," the group said in its filing. "As a result, patients in South Carolina and elsewhere will face the prospect of never knowing whose eyes may be inspecting their medical records."

The Greenville clinic argued there was no guarantee the abortion information would remain confidential once it was in the state's hands and there was no penalty to the state or its employees for public disclosure.

The clinic also contended the regulation would allow release of patient records, apparently including names and addresses, when a clinic or its staff is under investigation by state licensing authorities.

Dr. Georges Benjamin, executive director of the American Public Health Association and former health secretary in Maryland, said states can have legitimate reasons for data collection. But he said South Carolina's practice is worrisome. "Once you photocopy a record, you never know where it's going," he said.

The Supreme Court rejected an earlier appeal in the case, and most of the new regulations took effect in 2001.

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On the Net:

Supreme Court: http://www.supremecourtus.gov

American College of Obstetricians and Gynecologists code of professional ethics: http://www.acog.org/from--home/acogcode.pdf

South Carolina Attorney General: http://scattorneygeneral.org