Pregnancy test results are not considered part of confidential medical records.

July 18, 2002 2:25 PM

Pregnancy test results are not considered part of confidential medical records. Why, you say? Because the cops wanted to find out who dumped an abandoned baby, and subpoenaed Planned Parenthood's records to see who had gotten positive pregnancy test results recently. The rationale for the judge's ruling? "...the records aren't medical records because the staff who provide pregnancy tests aren't required to be doctors or nurses."
posted by beth (14 comments total)

I'd bet my shirt it won't hold up on appeal.
posted by zekinskia at 2:31 PM on July 18, 2002

Great, zekinskia. ANOTHER topless thread!?
posted by Danelope at 2:32 PM on July 18, 2002

Hasn't this issue been brought up before on the 'filter?

What is the legal relationship between private medical records and subpoena's anyway? I'm not informed about this issue.
posted by insomnyuk at 2:35 PM on July 18, 2002

I find this a bit creepy. Sort of like the idea that records about which books you read are something that the government considers openly viewable during an investigation.

I mean, on the one hand I can see how there would be legitimate cases where this is a tool that the authorities should have, but these days the authorities aren't acting as though they are worthy of our good faith much.

The rationale seems kinda shakey, too. I thought anything that happens under a doctor's direction and supervision (and thus authority) is considered under their purview, so to speak. This should all be part of the confidential record.

What else do "allied health professionals" do that doctors and nurses don't do themselves? Urine and blood checks? Are doctors directly involved in DNA tests?
posted by beth at 2:36 PM on July 18, 2002

so, where do i donate money to help pay for the defense?
posted by th3ph17 at 2:52 PM on July 18, 2002

I find this a bit creepy. Sort of like the idea that records about which books you read are something that the government considers openly viewable during an investigation.

Actually, they've ALWAYS had that right, Beth. Take a look into the FBI files on Einstein, etc.

What's recently come into the news is the new allowance for the FBI to see what library books you've read without any evidence against you. And that, I agree, is quite creepy...
posted by zekinskia at 3:24 PM on July 18, 2002

nurses don't do any tests really, other than the ones they can do on the floors, these are called point-of-care tests, and are under the control of the allied-health people in the clinical labs. the people in clinical labs are called medical technologists (or med techs, or clinical laboratory scientists, abbreviated MT or CLS often) they basically do every test you are familiar with. i can't think of any test of the top of my head that nurses or doctors do.

med techs do everything, blood, urinalysis, molecular tests (DNA) chemistry tests, microbiology tests (HIV etc...) flow cytometry, blood bank typing and matching, many more...

there are other tests that are not done by med techs, like pap smear interpretations, and cytogenetics (a group of DNA tests that will show heritable disorders, if i assume correctly that's a concern from this case) that are done by other allied health people, still not doctors or nurses though.

almost all of the above tests to not require analysis by a doctor at all, for the ones that do it's more for legal reasons when interpretation is more subjective, the allied health person still has performed the entire test alone. (example 40 allied health people may be reviewed by one doctor, he/she signs off on things, but doesn't do the work)

all of these positions are certified through accrediting agencies, and the people are tested fairly often (much more so than nurses) they are at least BS degrees.

tests are broken down into categories of complexity, blood, dna (everything above) are higher complexity tests and require certification, pregnancy tests are considered waived tests though, and do not. the labs that perform waived tests however are accredited (labs as a whole, just not individual proficiency) so it's still silly. i think drug tests are waived, and certainly i think everyone agrees (hopefully?) that should be protected.
posted by rhyax at 3:30 PM on July 18, 2002

I believe what Beth is referring to is the Patriot Act, which forces libraries to turn over patron history to the the FBI, and then forces the librarian to keep their mouth shut.
posted by bradth27 at 3:33 PM on July 18, 2002

*argh* I can't belive the judges ruling, as said here before the mother who dumped her baby could have a) not known she was pregnant , hence the dramatic dumping, b) not ever once been to planned parenthood and/or c) have bought a pregnancy test from a regular pharmacy.

so the investigation itself seems to be the daftest of it all. Spend more time arguing in court over medical records than getting on with it?
posted by dabitch at 4:02 PM on July 18, 2002

rhyax, thanks for weighing in with the details on that stuff. It's much more extensive than I had known of personally.

I actually did a few tests myself a couple weeks ago when I worked as a CNA (nurse aide) at a hospital. I did vital signs, in & out reporting (food and drink in and urine & bm out), and Accuchecks.

I understand that medical records are and should be available with a subpoena, i.e. that a judge has at least signed off on the fact that there is probable cause to peek at the data.

What I worry about is some sort of precedent being set that anything not directly done by the doctor or nurse is wide open fair game where a subpoena is not even needed.

Yeah yeah, I know this sounds like a "slippery slope" argument. I'm a paranoid. But I figure we gotta be alert to these trends these days, lest we get some nasty surprises when we think what's private and just between us and our doctor becomes easier for unscrupulous officials to rifle through.
posted by beth at 4:17 PM on July 18, 2002

I remember the thread about the case that was here before, and I must say I'm pretty amazed the judge is doing this. Just that thread alone brought up countless reasons why this is total crap.

Also, I find it quite valiant that the president of the Greater Iowa chapter is willing to go to jail. ;P Go Planned Parenthood.
posted by swank6 at 4:26 PM on July 18, 2002

I actually did a few tests myself a couple weeks ago when I worked as a CNA (nurse aide) at a hospital. I did vital signs, in & out reporting (food and drink in and urine & bm out), and Accuchecks.

oh yea, the tests overseen by the MTs in clinical lab would only include the Accucheck, i don't ever think of things like vital signs and height/weight etc as being "tests" i guess i should. all that stuff is done by nurses... see, i'm biased :)

(by overseen i don't mean supervision, but keeping the machine calibrated, testing the machines, doing quality control on it, deciding which machines should be used etc)
posted by rhyax at 4:36 PM on July 18, 2002

For reference, relevant section of the Iowa code. It seems as if the rationale upheld was the idea that some of the records might be confidential under the law, but that others were not, because the persons involved weren't doctors, which annulled the protections for all the records. That's a little goofy.

Local coverage indicates the criminal investigation is quite serious, though: the baby in question was found after going through a trash shredder; apparently its condition has precluded a determination of homicide vs. concealed-death, but you kind of get the feeling why the prosecutors are damned serious about the investigation. I don't see how that justifies a fishing expedition, though; there's nothing, so far as I can tell, to link the clinic to the dead baby, and usually the "compelling interest" principle would require an affirmative link. Apparently they subpoenaed the records of all hospitals and clinics, and Planned Parenthood was the only one who didn't comply; which makes it worse in at least two ways I can see.
posted by dhartung at 8:13 PM on July 18, 2002

zekinskia: Those records have not always been open to the government, dumbass.


And, why do they even keep records? Seriously?

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Oh well, better than in england where they just geneticaly tested every single teenage girl...
posted by delmoi at 10:02 PM on July 18, 2002