The Supreme Court held that the Fourth Amendment prohibits hospitals from testing pregnant women for illegal drugs without their consent if the purpose is to notify the police of illegal behavior.

A public hospital of Charleston, South Carolina, reacting to the growing number of “crack babies,” instituted a program of automatically testing maternity patients for cocaine and other illegal drugs, and then alerting the police when the test results were positive. The police used the threat of prosecution to coerce the women into substance abuse treatment. A small number of noncooperative women were prosecuted. In a suit against the city, Crystal Ferguson and nine other plaintiffs alleged that the tests were unconstitutional in the absence of either a warrant or informed consent. The city argued that the program was justified by the “special need” of preventing pregnant women from endangering their fetuses.

By a 6-3 vote, the U.S. Supreme Court agreed with the plaintiffs. Writing for the majority, Justice John Paul StevensStevens, John Paul;Ferguson v. City of Charleston explained that the “special needs” exception to the Fourth Amendment, which the Court had allowed to protect the public safety in special circumstances, did not apply to programs which were so directly connected to law enforcement. While the ultimate goal of the program might have been to coerce the women into treatment, the immediate objective of the searches was to obtain evidence of wrongdoing that would be admissible in criminal prosecutions. The question of whether any of the ten plaintiffs had voluntarily consented to the tests was left to the lower courts to decide.

Fourth Amendment

Gender issues

Search warrant requirement

Stevens, John Paul