Case Title: Burger v. Lutheran General Hospital

Citation: 

Docket Number: 89643, 89644

State: illinois

Court: Illinois Supreme Court

Date: 2001-10-18T00:00:00Z

Document:
Docket Nos. 89643, 89644 cons.-Agenda 19-March 2001.
DORIS BURGER, Appellee, v. LUTHERAN GENERAL
HOSPITAL et al., Appellants.
Opinion filed October 18, 2001.
	JUSTICE McMORROW delivered the opinion of the court:
	At issue in these consolidated cases is whether certain
provisions of section 6.17 of the Hospital Licensing Act (Act) (210
ILCS 85/6.17 (West 2000)), as amended by Public Act 91-526
(Pub. Act 91-526, eff. January 1, 2000), violate the Illinois
Constitution of 1970. The circuit court of Cook County held that
portions of sections 6.17(d) and (e) and all of section 6.17(h)
violate the doctrine of separation of powers (Ill. Const. 1970, art.
II, §1). The circuit court also found that portions of subsections (d)
and (e) of section 6.17 violate a patient's right to privacy with
respect to medical information (Ill. Const. 1970, art. I, §§6, 12).
However, the circuit court rejected plaintiff's contention that the
challenged provisions of the Act constituted impermissible special
legislation. Ill. Const. 1970, art. IV, §13. The circuit court severed
the provisions it found unconstitutional from the remainder of
section 6.17. Defendants appealed directly to this court. 134 Ill. 2d
R. 302(a). For the reasons that follow, we reverse in part, affirm
in part, and remand this cause to the circuit court for further
proceedings.

BACKGROUND
	During the early afternoon of December 12, 1996, plaintiff,
Doris Burger, went to the emergency room of Lutheran General
Hospital (Hospital) with a leg injury. Within a few hours, after
examination and treatment, plaintiff was released. On the evening
of December 13, 1996, plaintiff was admitted to the Hospital for
intravenous antibiotic therapy. On December 16, 1996, plaintiff's
leg was amputated at the knee. Plaintiff thereafter filed a medical
malpractice complaint in the law division of the circuit court of
Cook County, naming four doctors, the Hospital and the
Hospital's parent corporation as defendants. Plaintiff alleged that
the Hospital was negligent in the care provided to her in the
Hospital's emergency room on December 12, 1996. In addition,
plaintiff alleged that the Hospital was negligent in several respects
during her admission from December 13 to December 16, 1996.
	Discovery in plaintiff's case was ongoing at the time that
Public Act 91-526 became effective on January 1, 2000. This
Public Act, which was unanimously passed by the Illinois General
Assembly, amended section 6.17 of the Act, which governs
protection of, and confidential access to, a hospital patient's
medical records and information. Public Act 91-526 added several
new subsections to section 6.17, including subparagraphs (d) and
(e), which are challenged by plaintiff in this appeal. Public Act
91-526 also relettered the subsections which were originally part
of the preamended version of section 6.17. One of these
provisions, now lettered as subparagraph (h), is also challenged by
plaintiff at bar. Pertinent provisions of section 6.17 provide:
			"(a) Every hospital licensed under this Act shall
develop a medical record for each of its patients as
required by the Department [of Public Health of the State
of Illinois] by rule.
			(b) All information regarding a hospital patient gathered
by the hospital's medical staff and its agents and
employees shall be the property and responsibility of the
hospital and must be protected from inappropriate
disclosure as provided in this Section.
			***
			(d) No member of a hospital's medical staff and no
agent or employee of a hospital shall disclose the nature
or details of services provided to patients, except that the
information may be disclosed to the patient, persons
authorized by the patient, the party making treatment
decisions, if the patient is incapable of making decisions
regarding the health services provided, those parties
directly involved with providing treatment to the patient
or processing the payment for that treatment, those parties
responsible for peer review, utilization review, quality
assurance, risk management or defense of claims brought
against the hospital arising out of the care, and those
parties required to be notified under the Abused and
Neglected Child Reporting Act, the Illinois Sexually
Transmissible Disease Control Act, or where otherwise
authorized or required by law.
			(e) The hospital's medical staff members and the
hospital's agents and employees may communicate, at any
time and in any fashion, with legal counsel for the
hospital concerning the patient medical record privacy
and retention requirements of this section and any care or
treatment they provided or assisted in providing to any
patient within the scope of their employment or affiliation
with the hospital.
* * *
			(h) Any person who, in good faith, acts in accordance
with the terms of this Section shall not be subject to any
type of civil or criminal liability or discipline for
unprofessional conduct for those actions.
			(i) Any individual who willfully and wantonly discloses
hospital or medical record information in violation of this
Section is guilty of a Class A misdemeanor. As used in
this subsection, 'wilfully or wantonly' means a course of
action that shows an actual or deliberate intention to cause
harm or that, if not intentional, shows an utter
indifference to or conscious disregard for the safety of
others or their property." 210 ILCS 85/6.17(a), (b), (d),
(e), (h), (i) (West 2000).
	On January 19, 2000, plaintiff filed with the circuit court an
emergency motion to bar ex parte communication between the
Hospital's counsel and those members of its medical staff, agents,
and employees who provided health care to plaintiff but were not
named as defendants in plaintiff's complaint. Plaintiff's motion
also requested that the circuit court declare subsection (e) of
section 6.17 unconstitutional on the basis that it violates the
separation of powers and the personal privacy rights of Illinois
plaintiffs. The circuit court ordered that, pending disposition on
the merits of plaintiff's motion, counsel for the Hospital was not
to communicate outside the presence of plaintiff's attorney with
any of plaintiff's health-care providers, other than those who were
specifically alleged to be negligent in plaintiff's complaint and
whose negligence could be imputed to the Hospital. On February
3, 2000, plaintiff filed with the circuit court an amended motion
wherein plaintiff additionally sought the invalidation of
subparagraphs (d) and (h) of section 6.17 of the Act.
	At the time plaintiff filed these motions in the circuit court of
Cook County, several similar motions were pending in that court's
law division. On February 17, 2000, the presiding judge of the law
division of the Cook County circuit court entered an order
intended to "efficiently and fairly deal with the multitude of
motions" filed in the law division which challenged the
constitutionality of section 6.17 of the Act. The order stated that
the "interests of justice and judicial economy are best served by
the designation of one judge to hear the motions on a consolidated
basis." Plaintiff's case was thereafter designated the lead case in
the consolidated proceedings.
	With the leave of the circuit court, plaintiff filed a fifth
complaint at law on February 18, 2000, which added a fourth
count to plaintiff's action. Count I of plaintiff's complaint,
captioned "entity liability," alleges that on December 12, 1996,
and on December 13 through 16, 1996, the Hospital and its parent
corporations, "acting through their employees and agents,"
negligently failed to admit plaintiff to the hospital, failed to
provide "timely and competent physician care," failed to "properly
diagnose and treat her condition of ill being," failed to "obtain
timely and appropriate consultations," and negligently discharged
plaintiff from the emergency room. Plaintiff did not identify by
name any employee or agent of the Hospital as a defendant in this
count. Counts II and III of plaintiff's complaint alleged specific
acts of negligence by certain named physicians "acting within the
scope and course of their agency relationship" with the Hospital
and its parent corporations. The newly added count IV requested
that the circuit court declare Public Act 91-526 unconstitutional
and enjoin its operation. On that same day, plaintiff also filed a
motion for judgment on the pleadings as to count IV of her
complaint.
	On May 10, 2000, the circuit court issued a written
memorandum opinion and order. The court determined that its
decision was controlled by this court's rulings in Kunkel v.
Walton, 179 Ill. 2d 519 (1997), and Best v. Taylor Machine Works,
179 Ill. 2d 367 (1997), wherein this court held that several
provisions of the Civil Justice Reform Act of 1995 were
unconstitutional. Applying the reasoning of Kunkel and Best to the
matter at bar, the circuit court determined that portions of sections
6.17(d) and (e) and all of section 6.17(h) violated the doctrine of
separation of powers. The circuit court drew an analogy between
certain provisions contained in subparagraphs (d) and (e) of
section 6.17 and the amendment to section 2-1003(a) of the Code
of Civil Procedure (735 ILCS 5/2-1003(a) (West 1998)), which
was held to violate the separation of powers doctrine in Kunkel
and Best. The circuit court found that the provisions of subsections
(d) and (e), allowing ex parte communications between agents and
employees of the Hospital and the Hospital's risk managers and
legal counsel with respect to any care or treatment provided to a
patient of the Hospital within the scope of the treater's Hospital
employment, were "constitutionally problematic" because the
provisions fail to limit discovery to issues relevant to the
allegations raised by plaintiff in her medical malpractice action.
	In addition, the circuit court determined that the immunity
provisions contained within subparagraph (h) of section 6.17
violate the doctrine of separation of powers because these
provisions "clash" with Supreme Court Rule 219 (166 Ill. 2d R.
219), which authorizes a circuit court to impose a range of
sanctions for a party's failure to comply with supreme court rules
or court orders relating to discovery. Further, the circuit court
determined that "the presumed effect of [sub]section [h] would
prohibit, or at least impinge upon," the authority of the Attorney
Registration and Disciplinary Commission (ARDC) and this court
to review attorney conduct.
	The circuit court judge also determined that, pursuant to our
decisions in Kunkel and Best, subparagraphs (d) and (e) of section
6.17 constitute an unreasonable invasion of plaintiff's
constitutional privacy interest. The decision of the circuit court
was premised primarily upon the lack of relevancy restrictions in
both subparagraphs. In addition, the circuit court found that the
harm caused to a hospital patient's privacy interests outweighed
the public interest served by disclosure.
	The circuit court, however, rejected the argument proffered by
plaintiff that subsections (d) and (e) of section 6.17 constitute
impermissible special legislation, in violation of article IV, section
13, of the Illinois Constitution of 1970 (Ill. Const. 1970, art. IV,
§13). The circuit court disagreed with plaintiff that the statute
created an arbitrary classification between different types of
defendants. The circuit court stated that "[d]ue to the unique
nature of hospital defendants, this court finds them distinguishable
from other classes of defendants. A hospital's involvement in a
medical malpractice lawsuit is notably different from that of other
tort defendants." The circuit court further found that Public Act
91-526 rationally related to the legislative purpose sought to be
accomplished by the revisions to the Act.
	Finally, the circuit court concluded that the constitutionally
valid portions of section 6.17 of the Act were "substantial
measures, capable of standing independently of the invalidated
provisions." Accordingly, the circuit court severed the invalid
provisions from the remainder of section 6.17.
	On May 18, 2000, the circuit court entered a judgment order
in favor of plaintiff on count IV of her fifth complaint, "finding
that the challenged sections of 210 ILCS 85/6.17(d), (e) and (h)
are unconstitutional for the reasons set forth in the memorandum
opinion and order," and that the "operation and enforcement of the
challenged portions of subsections (d), (e) and (h) are enjoined."
In accordance with the order, the circuit court barred any ex parte
communication between hospital defense counsel or risk managers
and any health-care provider of plaintiff for "whose conduct
plaintiff does not seek to hold the hospital vicariously liable."
	Direct appeal was taken to this court by two groups of
defendants. 134 Ill. 2d R. 302(a). Those appeals have been
consolidated.(1) We allowed amicus curiae briefs to be filed by the
County of Cook, the Illinois Hospital and Healthsystems
Association, and the Illinois State Bar Association.

ANALYSIS
	This appeal presents the principal issues of whether the
provisions contained within subsections (d), (e) and (h) of section
6.17 of the Act violate the doctrine of separation of powers found
in article II, section 1, of the Illinois Constitution of 1970 (Ill.
Const. 1970, art. II, §1), and whether subparagraphs (d) and (e)
infringe upon a patient's privacy interest in confidential medical
information derived from article I, sections 6 and 12, of our
constitution (Ill. Const. 1970, art. I, §§6, 12). The constitutionality
of a statute is a question of law subject to de novo review. Miller
v. Rosenberg, 196 Ill. 2d 50, 57 (2001); Brown's Furniture, Inc.
v. Wagner, 171 Ill. 2d 410, 420 (1996). Statutes are presumed to
be constitutional, and the party challenging the validity of the
statute has the burden to clearly establish constitutional invalidity.
Arangold Corp. v. Zehnder, 187 Ill. 2d 341, 351 (1999); Russell
v. Department of Natural Resources, 183 Ill. 2d 434, 441 (1998).
A court must construe a statute so as to affirm its constitutionality
if the statute is reasonably capable of such a construction. Russell,
183 Ill. 2d  at 441. Accordingly, " 'if [a] statute's construction is
doubtful, a court will resolve the doubt in favor of the statute's
validity.' " Miller, 196 Ill. 2d  at 58, quoting People v. Shephard,
152 Ill. 2d 489, 499 (1992).
	Plaintiff at bar urges us to affirm the judgment of the circuit
court that, based upon the reasoning of our decisions in Kunkel
and Best, subsections (d), (e) and (h) of section 6.17 of the Act
violate the separation of powers doctrine and that, in addition,
subparagraphs (d) and (e) unconstitutionally infringe upon a
patient's protected privacy interests. Defendants and amici Cook
County and Illinois Hospital and Healthsystems Association
respond that both plaintiff in her argument and the circuit court in
its decision ignore the compelling health-care policy concerns that
support the enactment of Public Act 91-526 and err in exclusively
focusing upon the potential effect of these provisions in the event
a patient institutes medical malpractice litigation against a
hospital. Defendants and amici also respond that plaintiff and the
circuit court misapplied this court's rulings in Kunkel and Best to
the facts presented at bar. We begin our analysis by addressing
plaintiff's separation of powers claim.

I. Separation of Powers
	The Illinois Constitution provides that the legislative,
executive and judicial branches are separate, and that "[n]o branch
shall exercise powers properly belonging to another." Ill. Const.
1970, art. II, §1. Article VI, section 1, of the Illinois Constitution
of 1970 vests the judicial power of this state in the supreme court,
the appellate court, and the circuit courts.
	In " 'both theory and practice, the purpose of the [separation
of powers] provision is to ensure that the whole power of two or
more branches of government shall not reside in the same
hands.' " Best, 179 Ill. 2d  at 410, quoting People v. Walker, 119 Ill. 2d 465, 473 (1988). However, the doctrine of separation of
powers "was not designed to achieve a complete divorce among
the three branches of government" (In re J.J., 142 Ill. 2d 1, 7
(1991); accord Strukoff v. Strukoff, 76 Ill. 2d 53, 58 (1979)) and
does not require "governmental powers to be divided into rigid,
mutually exclusive compartments" (In re J.J., 142 Ill. 2d  at 7; In
re Estate of Barker, 63 Ill. 2d 113, 119 (1976)). Because the
"separation of the three branches of government is not absolute
and unyielding" (Best, 179 Ill. 2d at 411), the doctrine of
separation of powers "is not contravened merely because separate
spheres of governmental authority may overlap" (Best, 179 Ill. 2d 
at 411; see also People ex rel. Devine v. Murphy, 181 Ill. 2d 522,
530 (1998); McAlister v. Schick, 147 Ill. 2d 84, 94 (1992); In re
J.J., 142 Ill. 2d at 7).
	Indeed, we have previously observed that "[w]here matters of
judicial procedure are at issue, the constitutional authority to
promulgate procedural rules can be concurrent between the court
and the legislature. The legislature may enact laws that
complement the authority of the judiciary or that have only a
peripheral effect on court administration." Kunkel, 179 Ill. 2d  at
528; People v. Williams, 124 Ill. 2d 300, 306 (1988). If a statute
conflicts with a rule of the judiciary, a court will seek to reconcile
the legislation with the judicial rule, where reasonably possible.
Kunkel, 179 Ill. 2d  at 529; Williams, 124 Ill. 2d  at 306. This court,
however, retains primary constitutional authority over court
procedure, and the doctrine of separation of powers is violated
"when a legislative enactment unduly encroaches upon the
inherent powers of the judiciary, or directly and irreconcilably
conflicts with a rule of this court on a matter within the court's
authority." Kunkel, 179 Ill. 2d  at 528.

A. Subparagraphs (d) and (e)
	We first address plaintiff's separation of powers challenge to
subparagraphs (d) and (e) of section 6.17 of the Act. In her brief
to this court, plaintiff contends that "[t]he decision of Best v.
Taylor Machine Works and Kunkel v. Walton, through the
operation of stare decisis, control this issue." Thus, plaintiff's
constitutional challenge is almost exclusively premised upon the
general argument that just as the provisions of section 2-1003(a)
of the Code of Civil Procedure (735 ILCS 5/2-1003(a) (West
1996)) were found to violate the separation of powers doctrine in
Kunkel and Best, the provisions of subparagraphs (d) and (e)
should also be invalidated because they violate the separation of
powers "in the same manner." Because the primary focus of
plaintiff's separation of powers argument is that subsections (d)
and (e) of section 6.17 are analogous to section 2-1003(a), which
was invalidated in Kunkel and Best, we review those decisions in
some detail.
	In Kunkel v. Walton, 179 Ill. 2d 519 (1997), and Best v. Taylor
Machine Works, 179 Ill. 2d 367 (1997), the plaintiffs challenged
as unconstitutional section 2-1003(a) of the Code of Civil
Procedure (735 ILCS 5/2-1003(a) (West 1996)), which had been
amended by Public Act 89-7, a legislative package more popularly
known as the Civil Justice Reform Act of 1995.(2) The amended
section 2-1003(a) mandated that all plaintiffs filing personal
injury claims waive their physician-patient privilege and disclose
all medical records to any defendant party, irrespective of the
relevance of those medical records to the plaintiff's lawsuit.
Section 2-1003(a) provided, in pertinent part:
			"Any party who by pleading alleges any claim for
bodily injury or disease, including mental health injury or
disease, shall be deemed to waive any privilege between
the injured person and each health care provider who has
furnished care at any time to the injured person. *** Any
party alleging any such claim *** shall, upon written
request of any other party who has appeared in the action,
sign and deliver within 28 days to the requesting party a
separate Consent authorizing each person or entity who
has provided health care at any time to the allegedly
injured person to:
				(1) furnish the requesting party or the party's
attorney a complete copy of the chart or record of health
care in the possession of the provider ***;
				(2) permit the requesting party or the party's attorney
to inspect the original chart or record of health care
***;
				(3) accept and consider charts and other records of
health care by other, radiographic films, and
documents, including reports, deposition transcripts,
and letters, furnished to the health care provider by the
requesting party or the party's attorney, before giving
testimony in any deposition or trial or other hearing;
				(4) confer with the requesting party's attorney before
giving testimony in any deposition or trial or other
hearing and engage in discussion with the attorney on
the subjects of the health care provider's observations
related to the allegedly injured party's health, including
the following: the patient history ***; the health care
provider's opinions related to the patient's state of
health, prognosis, etiology, or cause of the patient's
state of health at any time ***.
* * *
			A request for a Consent under this subsection (a) does
not preclude such subsequent requests as may reasonably
be made seeking to expand the scope of the earlier
Consent which was limited to less than all the authority
permitted by subdivisions (1) through (4) of this
subsection (a) or seeking additional Consents for other
health care providers.
			The provisions of this subsection (a) do not restrict the
right of any party to discovery pursuant to rule." 735 ILCS
5/2-1003(a) (West 1996).
Section 2-1003(a) further provided that if a party claiming injury
refused to comply with a request for a consent, the trial court was
required to either issue an order authorizing the disclosure or
dismiss the plaintiff's case with prejudice. 735 ILCS 5/2-1003(a)
(West 1996).
	We determined in Kunkel and Best that section 2-1003(a)
violated the doctrine of the separation of powers on two grounds.
We held that the express terms of section 2-1003(a) precluded the
circuit court from exercising its inherent authority pursuant to
Supreme Court Rule 201 (166 Ill. 2d Rs. 201(b)(1), (c)(1)) to
assess the relevance of discovery and to issue protective orders,
where appropriate. Kunkel, 179 Ill. 2d at 531-32; Best, 179 Ill. 2d 
at 434-44. In addition, we held that section 2-1003(a) prevented
the circuit court from exercising its power to impose appropriate
sanctions for abuse of discovery procedures pursuant to Illinois
Supreme Court Rule 219 (166 Ill. 2d R. 219). We found that, by
virtue of the mandatory language used in the statute, section
2-1003(a) "obligate[d] the courts of this state to become party to
the forced disclosure of confidential medical information even if
such material is wholly unrelated to the lawsuit in issue, or, if the
plaintiff refuses to comply, to enter an order of involuntary
dismissal." (Emphasis in original.) Best, 179 Ill. 2d  at 442. We
further observed that, under this statutory scheme, a plaintiff
would face the ultimate penalty of forfeiting his or her right of
legal action as a consequence for not consenting to the blanket
disclosure of all confidential medical information. Best, 179 Ill. 2d 
at 442.
	Specifically, we held that the mandatory consent procedures
set forth in section 2-1003(a) circumvented the relevance
requirement found in Supreme Court Rule 201(b)(1) (166 Ill. 2d
R. 201(b)(1)), which provides that during discovery a party must
fully disclose "any matter relevant to the subject matter involved
in the pending action." We held that the disclosure mandated by
section 2-1003(a) was "described in the broadest possible terms"
(Kunkel, 179 Ill. 2d at 532), requiring "maximum disclosure"
(Best, 179 Ill. 2d at 444-45) of the plaintiff's medical information
by each person or entity who had provided health care to the
plaintiff at any time to all the defendant parties in the action. We
determined that absent language restricting the disclosure of
information to only that which was relevant to the particular
injuries upon which the plaintiff's lawsuit is based, the consent
procedure set forth in section 2-1003(a) went "well beyond the
legitimate objectives of discovery as reflected in this court's rules"
and, in fact, appeared to be "designed to discourage tort victims
from pursuing valid claims by subjecting them to the threat of
harassment and embarrassment through unreasonable and
oppressive disclosure requirements." Kunkel, 179 Ill. 2d  at 532.
	We also held that section 2-1003(a) conflicted with Supreme
Court Rule 201(c)(1) (166 Ill. 2d R. 201(c)(1)), which authorizes
the circuit court, when appropriate, to issue protective orders to
shield particularly sensitive materials from unnecessary disclosure.
Based upon the statute's clear and unequivocal language requiring
a plaintiff to disclose medical information without limitation, we
held that the "absolute and unqualified" disclosure mandated by
section 2-1003(a) completely foreclosed the circuit court from
regulating the scope of discovery, including the issuance of
protective orders. Kunkel, 179 Ill. 2d  at 534-36, Best, 179 Ill. 2d 
at 447.
	Finally, we held that section 2-1003(a) conflicted with
Supreme Court Rule 219 (166 Ill. 2d R. 219), which lists a
noninclusive range of sanctions which a circuit court, in its
discretion, may impose upon litigants to address discovery
violations and abuses. Best, 179 Ill. 2d  at 449. We concluded that
section 2-1003(a) unduly infringed upon the court's authority
under this rule by requiring the court to dismiss a plaintiff's
lawsuit, with prejudice, if the plaintiff failed to follow the statutory
disclosure requirements. Best, 179 Ill. 2d at 441-42; see also
Kunkel, 179 Ill. 2d  at 528-37. Section 2-1003(a) totally precluded
a circuit court from exercising its broad discretion in selecting an
appropriate sanction for violation of discovery abuses, instead
authorizing the court to impose only one harsh sanction for a
plaintiff's failure to comply with the statute.
	In the matter at bar, the primary focus of plaintiff's
constitutional challenge is that subparagraphs (d) and (e) of section
6.17 of the Act violate the separation of powers because they
impermissibly interfere with the judiciary's authority to regulate
discovery "in the same manner" as section 2-1003(a), which was
struck down in Kunkel and Best. Specifically, plaintiff contends
that the challenged provisions of the Act are analogous to the
provisions invalidated in section 2-1003(a) in two respects. First,
plaintiff contends, subsections (d) and (e) similarly violate
Supreme Court Rule 201 because they contain no limitation on the
scope of information that can be elicited ex parte from the
patient's doctor during discovery, thereby allowing medical care
entirely unrelated to the issue raised in a lawsuit to be fully
revealed. Second, plaintiff contends that the provisions of
subparagraph (d) and (e) are analogous to those invalidated in
section 2-1003(a) because the circuit court is foreclosed from
deciding discovery issues relating to ex parte contacts between
defense counsel and hospital health-care providers who are not
specifically named as defendants in plaintiff's medical malpractice
action. In addition, plaintiff contends that subparagraphs (d) and
(e) of section 6.17 of the Act "go[ ] further" than section
2-1003(a) because the Act provisions "permit the ex parte contact
long before any lawsuit is filed; in fact, irrespective of whether a
lawsuit is filed."
	Defendants maintain that plaintiff's argument, which echoes
the ruling of the circuit court, is inapposite. Defendants contend
that both plaintiff and the circuit court improperly ignore the
important nonlitigation aspects of subsections (d) and (e) of
section 6.17. In addition, defendants contend that both plaintiff
and the circuit court improperly applied this court's rulings in
Kunkel and Best to the matter at bar, because the challenged
provisions of the Act are fundamentally distinguishable in
character and scope from the provisions determined to violate the
separation of powers in section 2-1003(a). We agree.
	As stated, because all statutes carry a strong presumption of
constitutionality, the party challenging a legislative enactment
bears the burden of clearly establishing that the provision in issue
is unconstitutional. Arangold, 183 Ill. 2d  at 351; Russell, 183 Ill. 2d  at 441. We conclude that plaintiff has failed to meet this burden
with respect to her separation of powers argument. Plaintiff's
position is based upon the mistaken premise that subparagraphs
(d) and (e) of section 6.17 of the Act impermissibly infringe upon
the judiciary's inherent authority to regulate discovery. Contrary
to plaintiff's assertions, however, the provisions of the Act,
including subparagraphs (d) and (e) of section 6.17, do not
regulate "discovery." Instead, the Act provides standards and
regulations intended to safeguard the public's health and welfare.
We reject plaintiff's general assertions that subsections (d) and (e)
of section 6.17 of the Act are analogous to section 2-1003(a),
which consisted of provisions solely intended to regulate the
discovery process during litigation. We therefore conclude that
because plaintiff has failed to clearly establish that subparagraphs
(d) and (e) violate the doctrine of separation of powers, plaintiff
has not overcome the statute's strong presumption of
constitutionality.
	The fundamental rule of statutory construction is to ascertain
and give effect to the legislature's intent. Michigan Avenue
National Bank v. County of Cook, 191 Ill. 2d 493, 503-04 (2000).
A court, therefore, first looks to the language of the statute, which
is the most reliable indication of the objectives of the legislature
in enacting a particular law. County of Knox ex rel. Masterson v.
Highlands, L.L.C., 188 Ill. 2d 546, 556 (1999). The language of
the statute must be afforded its plain and ordinary meaning, and,
where the language is clear and unambiguous, we must apply the
statute without resort to further aids of statutory construction.
Davis v. Toshiba Machine Co., America, 186 Ill. 2d 181, 184-85
(1999). In construing a statute, all of the provisions of an
enactment are to be viewed as a whole. Words and phrases should
not be construed in isolation, but are interpreted in light of other
relevant provisions of the statute. Michigan Avenue National
Bank, 191 Ill. 2d  at 504. Courts may presume that the General
Assembly, in enacting the legislation, did not intend absurdity,
inconvenience or injustice. Michigan Avenue National Bank, 191 Ill. 2d  at 504.
	Section 2-1003(a) was part of the Code of Civil Procedure
and applied exclusively to the disclosure of a plaintiff's medical
information during discovery conducted in conjunction with
personal injury litigation. The provisions challenged in the matter
at bar are not a part of the Code of Civil Procedure, but are
contained within the Hospital Licensing Act (210 ILCS 85/1 et
seq. (West 2000)). The stated purpose of the Act "is to provide for
the better protection of the public health through the development,
establishment, and enforcement of standards *** for the care of
individuals in hospitals." 210 ILCS 85/2(a) (West 2000). Indeed,
the General Assembly has wide regulatory power with respect to
the health-care professions (Methodist Medical Center v. Ingram,
82 Ill. 2d 511, 523 (1980), citing Barsky v. Board of Regents of the
University of the State of New York, 347 U.S. 442, 98 L. Ed. 829,
74 S. Ct. 650 (1954); Klein v. Department of Registration &
Education, 412 Ill. 75 (1952)), and it is within the broad discretion
of the legislature "to determine not only what the public interest
and welfare require, but to determine the measures needed to
secure such interest" (Chicago National League Ball Club, Inc. v.
Thompson, 108 Ill. 2d 357, 364 (1985)).
	The provisions of the Act, including subparagraphs (d) and (e)
of section 6.17, apply to all licensed hospitals in the regular course
of their daily operations. These provisions provide specific
regulations and standards deemed by the General Assembly to be
necessary in order to safeguard the public health. Significantly, the
plain language of section 6.17 establishes that the communications
allowed under subsections (d) and (e) are not triggered by
litigation, but are intended to promote a limited, intrahospital
exchange of information that, in the legislature's reasonable
judgment, is beneficial to the general health and welfare of the
public.
	Pursuant to subsection (b) of section 6.17 of the Act, a
provision which is not challenged by plaintiff in the instant cause,
"[a]ll information regarding a hospital patient gathered by the
hospital's medical staff and its agents and employees shall be the
property and responsibility of the hospital." 210 ILCS 85/6.17(b)
(West 2000). The information-gathering agents of the hospital,
with respect to the hospital's patients, are its physicians, nurses
and other caregivers. The hospital, as a corporate entity, is only
aware of information about its patients as a result of the
recordkeeping performed by its own health-care professionals.
Therefore, it follows from subsection (b) that any information
known by any hospital caregiver with respect to a patient's care at
that hospital is hospital information.
	Defendants and amici Cook County and Illinois Hospital and
Healthsystems Association contend that in order to safeguard and
improve patient care, and to reduce morbidity and mortality,
hospitals must constantly investigate the quality of patient care,
especially when an unexpected adverse event occurs. A timely
investigation may involve the sharing of the hospital's information
with risk management personnel or counsel for the hospital.
Indeed, defendants and amici contend, if a hospital fails to engage
in ongoing quality review, it may jeopardize the accreditation of
the hospital. Defendants and amici note that the Joint Commission
on Accreditation and Healthcare Organizations mandates that
hospitals must collect data to "monitor the stability of existing
processes, identify opportunities for improvement, identify
changes that will lead to improvement, and sustain improvement."
Joint Commission on Accreditation of Healthcare Organizations,
Comprehensive Accreditation Manual for Hospitals: The Official
Handbook §1, pt. PI.3, at PI-9 (1999 ed. updated August 2000).
Further, occurrences involving death or physical or psychological
injury, or the risk thereof, must be responded to, analyzed and
followed up in a timely and thorough manner. Joint Commission
on Accreditation of Healthcare Organizations, Comprehensive
Accreditation Manual for Hospitals: The Official Handbook §1,
pt. PI.3, at SE-1 to SE-7 (1999 ed. updated February 2000).
	In light of the highly regulated environment in which hospitals
operate, we conclude that it is reasonable and logical that hospital
risk managers and hospital counsel interact on a regular basis with
hospital employees, agents and staff concerning a wide array of
issues which may require prompt legal guidance and which are not
related to litigation. As defendants and amici note, such issues
include the prompt investigation of adverse incidents, the
assessment of resuscitation orders and the validity of patient
consents, patient treatment issues, emergency room problems,
consultation requests, specialist involvement, follow-up
procedures, surgical and post-operative complications, staffing and
equipment issues, and payment processing for treatment. In each
of these instances, communication of a patient's medical
information to legal counsel or risk management personnel may be
necessary in order not only to adequately and appropriately
respond to the occurrence, but also to prevent any similar adverse
occurrence in the future.
	In addition, hospitals must comply with a panoply of complex
state and federal regulations and reporting requirements which
may require regular consultation with legal counsel. See, e.g., 42
C.F.R. §482.21 (2001) (Medicare and Medicaid regulations
require hospitals to engage in ongoing quality assurance
reporting); 21 C.F.R. §803.30 et seq. (2001) (failures of medical
devices that result in death or serious injury to a hospital patient
must be reported to the FDA); 77 Ill. Adm. Code §250.990 (2001)
(hospitals must file incident reports upon the occurrence of certain
events); 410 ILCS 325/4 (West 2000) (sexually transmissible
diseases must be reported to the Illinois Department of Health in
accordance with 77 Ill. Adm. Code 693.30 (2001)); 745 ILCS
45/0.01 et seq. (West 2000) (the Illinois Department of Public
Health must be notified if a hospital patient is afflicted with a
communicable disease in accordance with 77 Ill. Adm. Code
§693.30 (2001)); 410 ILCS 310/4 (West 2000) (cases of AIDS
must be reported to the Illinois Department of Public Health in
accordance with 77 Ill. Adm. Code §693.30 (2001)). The above
examples illustrate that a hospital's risk managers and counsel
have a legitimate and important interest in communicating with
the hospital's medical staff, agents and employees-an interest
which may be separate and apart from litigation.
	 In an effort to facilitate the goal of safeguarding and
improving the quality of health care, the Illinois General Assembly
unanimously enacted Public Act 91-526, in which it amended
section 6.17 of the Act to allow limited, confidential intrahospital
access to patient medical records and information, while also
assuring that the confidentiality of such information is protected.
Specifically, pursuant to subsection (d) of section 6.17, hospital
medical staff members, agents and employees are prohibited from
disclosing patient treatment information except in specifically
enumerated circumstances relating to patient welfare and consent,
hospital operations, including risk management or defense of
claims brought against the hospital arising out of the care, or other
public policy objectives authorized by law. 210 ILCS 85/6.17(d)
(West 2000). The legislature also clarified in subsection (e) of
section 6.17 that "[t]he hospital's medical staff members and the
hospital's agents *** may communicate, at any time and in any
fashion, with legal counsel for the hospital concerning the patient
medical record privacy and retention requirements of [section
6.17] and any care or treatment they provided or assisted in
providing to any patient," but only with respect to treatment and
care provided "within the scope of their employment or affiliation
with the hospital." 210 ILCS 85/6.17(e) (West 2000).
	We conclude that the limited intrahospital exchange of
information authorized by subsections (d) and (e) of section 6.17
of the Act, including the "risk management and defense of claims"
discussions, are intracorporate conversations with respect to
information which, statutorily, is the property and responsibility of
the hospital. Accordingly, we disagree with plaintiff's
characterization of the exchange of the hospital's own information
among the hospital's own medical staff, agents, and employees as
"discovery" with respect to the hospital. "Discovery" is defined as
"the disclosure of facts, deeds, documents, or other things in the
exclusive knowledge or possession of one party, which are
necessary to the party seeking discovery as part of a cause of
action or defense in an action pending." 27 C.J.S. Discovery §2(a)
(1999). Thus, in order for "discovery" to occur, a legal action must
be pending, and there must be a party to the action who seeks
information from an opposing litigant or from a third party. We
observe that the challenged provisions of the Act strictly confine
the communications to the intrahospital setting, and specifically
prohibit disclosure of patient information to any individual who is
not affiliated with the hospital or with respect to occurrences
outside of the hospital. Because the limited intrahospital
discussions contemplated under subsection (d) and (e) are not
properly characterized as disclosures to an opposing litigant or to
a third party not affiliated with the hospital, and do not necessarily
take place in a litigation setting, the information shared is not
"discovery" subject to supreme court rules. We conclude that the
plain language of subsections (d) and (e) of section 6.17 of the Act
do not purport to regulate discovery, and therefore do not impinge
upon the power of the judiciary.
	Plaintiff further asserts that because the challenged provisions
of the Act "permit the ex parte contact long before any lawsuit is
filed; in fact, irrespective of whether a lawsuit is filed,"
subsections (d) and (e) of section 6.17 "go[ ] further" than the
provisions invalidated upon separation of powers grounds in
section 2-1003(a). We find plaintiff's position untenable. Under
plaintiff's view, no information with respect to a hospital patient
could be shared with a hospital's risk managers or legal counsel
prior to the patient retaining an attorney and filing a lawsuit. Such
a rule would lead to absurd results. For example, plaintiff's
position would preclude the obtaining of prompt legal advice with
respect to questions concerning the validity of patient consents or
resuscitation orders, delays which could result in serious harm to
the hospital's patients. In addition, if we were to accept plaintiff's
view, a hospital would be required to formally depose its own
medical staff, agents and employees prior to investigating an
adverse incident occurring in the hospital, and for which the
hospital may potentially be liable. Such a procedure would hamper
the prompt investigation of the adverse event and the hospital's
ability to respond to the event and prevent a similar reoccurrence.
It is well settled that "[s]tatutes are to be construed in a manner
that avoids absurd or unjust results." Croissant v. Joliet Park
District, 141 Ill. 2d 449, 455 (1990); Stewart v. Industrial
Comm'n, 115 Ill. 2d 337, 341 (1987). We conclude that plaintiff's
argument conflicts with the intended purpose of subsections (d)
and (e) of section 6.17, which is to promote prompt intrahospital
communications in order to ensure quality patient care.
	Furthermore, plaintiff's argument ignores the fact that the
limited intrahospital communications allowed pursuant to
subsections (d) and (e) of section 6.17 are necessitated not only by
the federal and state regulations and reporting requirements, but
also by the decisions of this court. We have previously recognized
the independent duty of hospitals to review and supervise the
medical care administered to a patient. Gilbert v. Sycamore
Municipal Hospital, 156 Ill. 2d 511, 518 (1993); Darling v.
Charleston Community Memorial Hospital, 33 Ill. 2d 326, 332
(1965) (recognizing a hospital's duty to assume responsibility for
the care of its patients). Accordingly, hospitals have a right and a
duty, as "institutions holding themselves out as devoted to the care
and saving of human life" (Johnson v. St. Bernard Hospital, 79 Ill.
App. 3d 709, 716 (1979), to engage in the communications
prescribed by subparagraphs (d) and (e) in order to safeguard and
improve medical care services.
	Even if litigation ultimately ensues with respect to a patient's
care at a hospital, we do not believe that the institution of a lawsuit
by a plaintiff alters the fact that the hospital, through its risk
management personnel or counsel, may communicate, within the
limited parameters of subsections (d) and (e), with the patient's
caregivers prior to the suit regarding information that is, pursuant
to subsection (b) of section 6.17, the property and responsibility of
the hospital. In addition, upon the filing of suit, the plain language
of subsections (d) and (e) does not infringe upon the circuit court's
inherent powers to manage the orderly discovery of information
during litigation. The circuit court retains the full authority to enter
protective orders, where appropriate, pursuant to Supreme Court
Rule 201(c)(1), and to ensure compliance with discovery through
discretionary sanctions, pursuant to Rule 219.
	Plaintiff's attempt to equate subsections (d) and (e) of section
6.17 of the Act with invalidated section 2-1003(a) fails for several
additional reasons. Unlike section 2-1003(a), which required the
wholesale disclosure to all defendants of all medical records with
respect to any care ever received by a personal injury plaintiff,
section 6.17 allows only hospital employees, agents and medical
staff to discuss with the hospital's attorneys and risk managers the
treatment provided by the hospital's caregivers to a hospital
patient at the hospital and "within the scope of their employment
or affiliation with the hospital." The provisions in subsections (d)
and (e) are strictly confined to the internal hospital setting and thus
do not involve the type of wholesale, third-party disclosure which
was found objectionable under section 2-1003(a). Moreover, the
scope of disclosure authorized by the Act is limited. Unlike
section 2-1003(a), subsections (d) and (e) do not afford every
personal-injury defendant the unlimited opportunity to discover
the plaintiff's entire medical history.
	Further, in Kunkel and Best, we found it significant that
section 2-1003(a) mandated the circuit court to either order a
wholesale disclosure to all defendants of all medical records with
respect to any care ever received by a personal injury plaintiff, or
to dismiss the plaintiff's claim with prejudice for plaintiff's failure
to comply. We observed that section 2-1003(a) appeared to be
"designed to discourage tort victims from pursuing valid claims by
subjecting them to the threat of harassment and embarrassment
through unreasonable and oppressive disclosure requirements."
Kunkel, 179 Ill. 2d  at 532. In contrast, subsections (d) and (e) of
section 6.17 contain no similar disincentive to a hospital patient
who may be contemplating the filing of a claim. In addition,
subsections (d) and (e), unlike section 2-1003(a), do not mandate
action on the part of the circuit court and, therefore, is not a direct
legislative regulation of court procedure.
	Finally, we noted in Best that under section 2-1003(a), a
plaintiff would lose his or her right of action as a penalty for not
consenting to the blanket disclosure of all confidential medical
information. Best, 179 Ill. 2d  at 442. Conversely, a potential
plaintiff would not be deprived of a right of action as a result of
the provisions of subsections (d) and (e) of section 6.17 of the Act.
	In sum, plaintiff's argument that the challenged provisions of
section 6.17 of the Act are analogous to section 2-1003(a), which
was invalidated in Kunkel and Best, is misplaced. Further, the
constitutional prohibitions sought by plaintiff would interfere with
legitimate, limited intrahospital communications of hospital
information which are unrelated to litigation, but are essential to
the provision of high quality health care. Under subparagraphs (d)
and (e) of section 6.17 of the Act, the judiciary retains the full
discretion afforded to it under supreme court rules. As stated,
"[l]egislative enactments enjoy a strong presumption of
constitutionality, and the burden rests upon the challenger to
demonstrate the invalidity of a particular statute." Kunkel, 179 Ill. 2d  at 529. Plaintiff has failed to satisfy her burden of proof to
clearly establish that subparagraph (d) and (e) of section 6.17
constitute a violation of the separation of powers clause contained
in article II, section 1, of the Illinois Constitution of 1970.
Accordingly, we hold that section 6.17(d) and section 6.17(e) of
the Act do not violate the constitutional provision of the separation
of powers.

B. Subsection (h)
	We next turn to plaintiff's separation of powers challenge
with respect to subsection (h) of section 6.17 of the Act, which
provides that "[a]ny person who, in good faith, acts in accordance
with the terms of [section 6.17] shall not be subject to any type of
civil or criminal liability or discipline for unprofessional conduct
for those actions." 210 ILCS 85/6.17(h) (West 2000). Plaintiff
contends that subsection (h) violates the doctrine of separation of
powers because "it emasculat[es] judicial authority over the
activities of litigants and their counsel." Specifically, plaintiff
asserts, the provisions of subparagraph (h) prevent the circuit court
from prohibiting a lawyer's conduct by enforcing civil or criminal
contempt orders, and preclude this court from instituting
professional discipline proceedings against a lawyer. We reject
plaintiff's contentions.
	Plaintiff again attempts to analyze the statutory provision at
issue solely in terms of its potential litigation impact. As we fully
discussed above with respect to subparagraphs (d) and (e), the
health-care regulations found in section 6.17 of the Act are not
triggered by litigation and are intended to promote a limited,
intrahospital exchange of information that, in the legislature's
reasonable judgment, is beneficial to the general health and
welfare of the public. Subsection (h) of section 6.17 simply states
the self-evident proposition that if a party acts in good faith and
within the parameters of section 6.17, that party is not subject to
liability or disciplinary action. Contrary to the assertions of
plaintiff, subsection (h) of section 6.17 does not preclude the
exercise of judicial authority in imposing sanctions for those who
act in bad faith or violate any provision of the Act, and it creates
no conflict with any disciplinary or professional regulation.
Plaintiff has failed to satisfy her burden of clearly establishing that
the provision in issue is unconstitutional, and plaintiff has
therefore not rebutted the presumption of constitutionality. See
Arangold, 187 Ill. 2d  at 351; Russell, 183 Ill. 2d  at 441. We
conclude that the provisions of subsection (h) of section 6.17
facilitate the limited, permissible communications authorized in
subsections (d) and (e), and do not violate the separation of
powers.

II. Privacy
	We next address plaintiff's contention that subparagraphs (d)
and (e) of section 6.17 of the Act violate a patient's right to
privacy under the Illinois Constitution (Ill. Const. 1970, art. I, §§6,
12). In support of her constitutional challenge, plaintiff contends
that subparagraphs (d) and (e) of section 6.17 "more deeply
intrude" on a patient's privacy than section 2-1003(a), which was
invalidated on privacy grounds in Kunkel and Best. Plaintiff argues
that under the challenged provisions of the Act, "there is nothing
[plaintiff], or any patient, could do to keep her doctors and nurses
from talking to hospital counsel or risk management about any
care they ever provided to her." Plaintiff concludes that, "for the
same reasons" this court found section 2-1003(a) unconstitutional,
we should also invalidate subparagraphs (d) and (e) of section 6.17
on privacy grounds. In addition, plaintiff argues that the
challenged provisions of the Act violate the holding of our
appellate court in Petrillo v. Syntex Laboratories, Inc., 148 Ill.
App. 3d 581 (1986), that ex parte discussions between defense
counsel and a plaintiff's treating physician shall be conducted only
through authorized methods of discovery.
	Defendants contend that plaintiff in her argument, and the
circuit court in its ruling, again improperly ignore the important
nonlitigation purposes of subsections (d) and (e) of section 6.17 of
the Act. In addition, defendants maintain, the challenged
provisions of the Act are distinguishable from section 2-1003(a)
in scope and effect. Finally, defendants contend that although they
do not contest the validity of the appellate court's holding in
Petrillo, they nevertheless assert that subsections (d) and (e) are
not violative of the principles which support the Petrillo holding.
We agree.
	Because plaintiff's constitutional challenge to subparagraphs
(d) and (e) is again principally grounded on our analysis in Kunkel
and Best, we examine the relevant portions of those decisions. In
Kunkel, we noted that article I, section 6, of the Illinois
Constitution of 1970 (Ill. Const. 1970, art. I, §6) "goes beyond
federal constitutional guarantees by expressly  recognizing a "zone
of personal privacy." Kunkel, 179 Ill. 2d  at 537. We further stated
in Best that "the privacy interest referred to in the 'certain remedy'
clause of section 12 [of article I of the Illinois Constitution of
1970] provides a constitutional source for the protection of the
patient's privacy interest in medical information and records that
are not related to the subject matter of the plaintiff's lawsuit."
Best, 179 Ill. 2d  at 458. This court emphasized that "[t]he
confidentiality of personal medical information is, without
question, at the core of what society regards as a fundamental
component of individual privacy." Kunkel, 179 Ill. 2d  at 537.
	However, we specifically held in Kunkel and Best that the
right to privacy is not absolute. Only unreasonable invasions of
privacy are constitutionally forbidden. Kunkel, 179 Ill. 2d  at 538;
Best, 179 Ill. 2d  at 450. Applying this rule, we determined that
section 2-1003(a) constituted a "substantial and unjustified"
invasion of an individual's right to privacy in personal medical
information because that provision allowed wholesale disclosure,
to a host of third-parties, of confidential information unrelated to
the subject matter of the plaintiff's lawsuit. Kunkel, 179 Ill. 2d  at
539; see also Best, 179 Ill. 2d  at 458-59.
	As stated, it is the burden of the party challenging the validity
of a statute to rebut the presumption of constitutionality. Arangold,
187 Ill. 2d  at 351; Russell, 183 Ill. 2d  at 441. We hold that plaintiff
in the matter at bar has failed to clearly establish that the
provisions contained within subsections (d) and (e) of section 6.17
of the Act unreasonably violate a hospital patient's right to
privacy. The limited intrahospital communications allowed
pursuant to subsections (d) and (e) in order to assure quality
patient care do not unreasonably invade a hospital patient's
expectation of privacy.
	Significantly, in the modern hospital setting, health-care
services are provided to the patient not only by physicians, but by
a wide array of hospital personnel. Individuals who may require
information with respect to the patient's medical history, current
condition, and treatment include direct caregivers such as nurses
and attendants; specialists such as radiologists, anesthesiologists
and surgeons; and administrative personnel such as individuals
responsible for compiling medical records and preparing billing
statements. Indeed, because "the reasonable expectations of the
public have changed" with the advent of modern hospital care
(Petrovich v. Share Health Plan of Illinois, Inc., 188 Ill. 2d 17, 32
(1999)), hospital patients today often regard the institution of the
hospital itself, rather than the individual treating physician, as the
patient's primary caregiver. Gilbert, 156 Ill. 2d  at 525-26. In
Gilbert, we noted that if an individual voluntarily enters a hospital
without objecting to his or her admission, and without seeking
care from a specific physician, that person " 'is seeking care from
the hospital itself.' " Gilbert, 156 Ill. 2d  at 525, quoting Pamperin
v. Trinity Memorial Hospital, 144 Wis. 2d 188, 211-12, 423 N.W.2d 848, 857 (1988). We reasoned that this was especially true
in the case where an individual seeks treatment from a hospital's
emergency room, as plaintiff did in the matter at bar. We stated
that " '[a]n individual who seeks care from the hospital itself, as
opposed to care from his or her personal physician, accepts care
from the hospital in reliance upon the fact that complete
emergency room care-from blood testing to radiological readings
to the endless medical support services-will be provided by the
hospital through its staff.' " Gilbert, 156 Ill. 2d  at 525-26, quoting
Pamperin, 144 Wis. 2d at 211-12, 423 N.W.2d  at 857.
	In light of the reality of contemporary hospital operations, we
conclude that a hospital patient could not reasonably expect a
member of the hospital's medical staff, or the hospital's agents
and employees, to refrain from discussing, within the narrow
parameters set forth in subsections (d) and (e) of section 6.17 of
the Act, the medical care provided to the patient with the hospital,
which is ultimately responsible for the patient's care. Under these
circumstances, it follows that a patient who enters such a highly
regulated environment, necessarily involving a number of
caregivers, would have a reduced expectation of privacy with
respect to the communication of their hospital medical information
within the hospital setting. The provisions of section 6.17 of the
Act, however, protect a patient's justifiable expectation of privacy
with respect to the release of medical information to third parties,
outside of those hospital personnel specifically enumerated in
subsection (d). The Act explicitly prohibits disclosure of medical
information to outsiders and makes it a misdemeanor for "[a]ny
individual [to] wilfully or wantonly disclos[e] hospital or medical
record information in violation of" the Act. 210 ILCS 85/6.17(i)
(West 2000). The provisions of section 6.17 of the Act, therefore,
afford hospital patients protection against disclosure of medical
information to individuals beyond those identified in subsection
(d).
	Contrary to plaintiff's assertions that our decisions in Kunkel
and Best mandate invalidation of subparagraphs (d) and (e) of
section 6.17 of the Act on privacy grounds, we determine that the
challenged provisions are distinguishable from section 2-1003(a)
of the Code of Civil Procedure. As we have explained above, the
provisions contained within section 2-1003(a) unreasonably
invaded an individual's right to privacy because they authorized
unlimited disclosure of a personal injury plaintiff's entire lifetime
medical history to third parties who had no prior relationship with
the plaintiff or the plaintiff's medical care. In sharp contrast,
subparagraphs (d) and (e) of section 6.17 specifically provide what
information may be discussed, with whom it may be discussed, and
how those discussions are to be conducted. The communications
authorized by the challenged provisions of the Act are strictly
limited to the intrahospital setting, and the provisions explicitly
prohibit disclosure of a patient's medical information to outside
third parties. Further, the authorized communications are narrowly
circumscribed to include only medical care and treatment rendered
to the patient at the hospital, by the hospital's own medical staff,
agents or employees. Finally, the authorized communications
involve information which is already known to the hospital by
virtue of the provisions contained within subsection (b) of section
6.17 of the Act (provisions not challenged by plaintiff at bar),
which state that "[a]ll information regarding a hospital patient
gathered by the hospital's medical staff and its agents and
employees" is the property and the responsibility of the hospital.
210 ILCS 85/6.17(b) (West 2000). Accordingly, because
subsections (d) and (e) of section 6.17 of the Act do not
unreasonably invade a hospital patient's right to privacy, they are
distinguishable from the provisions of section 2-1003(a) which
were invalidated on privacy grounds in Kunkel and Best.
	In addition to her constitutional challenge, plaintiff further
contends that subsections (d) and (e) of section 6.17 of the Act
violate the holding of our appellate court in Petrillo v. Syntex
Laboratories, Inc., 148 Ill. App. 3d 581 (1986). In Petrillo, the
minor plaintiff filed a product liability action against Syntex
Laboratories, Inc., the manufacturer of two infant formulas. The
plaintiff alleged that he was injured as a result of his consumption
of these formulas. During the discovery process, a defense attorney
for Syntex informed the circuit court that he had engaged in ex
parte conferences with the plaintiff's treating physician. The
plaintiff's attorney thereafter moved the trial court to bar defense
counsel for Syntex from engaging in any future ex parte
conferences with any of the plaintiff's treating physicians. The
circuit court granted the motion, finding that public policy barred
such conferences. Nevertheless, Syntex's defense counsel
continued to engage in ex parte conferences with the plaintiff's
treating physicians and was held in direct contempt of court. On
appeal, the appellate court affirmed the judgment of the circuit
court.
	The Petrillo court held that "ex parte conferences between
defense counsel and a plaintiff's treating physician jeopardize the
sanctity of the physician-patient relationship and, therefore, are
prohibited as against public policy." Petrillo, 148 Ill. App. 3d at
588. The Petrillo court explained that "the confidential
relationship existing between a patient and physician demands that
information confidential in nature remain, absent patient consent,
undisclosed to third parties." Petrillo, 148 Ill. App. 3d at 591. The
Petrillo court observed that by engaging in ex parte conferences
with defense counsel without the patient's consent, "the physician
divulges to a third party information which the patient originally
disclosed to the physician with the belief that the information
would remain confidential unless the patient gave his consent
otherwise." Petrillo, 148 Ill. App. 3d at 591. The Petrillo court
concluded, therefore, that defense counsel was to communicate
with a plaintiff's treating physician only through court-approved
discovery methods.
	Plaintiff acknowledges that the appellate court subsequently
recognized an exception to the Petrillo holding, allowing a
hospital's attorneys to communicate ex parte with health-care
employees who are specifically alleged to be negligent and whose
negligence a plaintiff seeks to impute to the hospital. In Morgan
v. County of Cook, 252 Ill. App. 3d 947, 952 (1993), the court held
that if a plaintiff attempts to hold a hospital liable for the conduct
of a hospital's own treating caregivers, "the defendant hospital is
included within the physician-patient privilege and the patient has
impliedly consented to the release of his medical information to
the defendant hospital's attorneys." Morgan, 252 Ill. App. 3d at
954. The court reasoned that the " 'exclusion of the hospital from
the physician-patient privilege would *** effectively prevent the
hospital from defending itself by barring communication with the
physician for whose conduct the hospital is allegedly liable.' "
Morgan, 252 Ill. App. 3d at 953, quoting Ritter v. Rush-Presbyterian-St. Luke's Medical Center, 177 Ill. App. 3d 313,
317-18 (1988). According to plaintiff, however, the principles
underlying Petrillo prevent ex parte communications between a
hospital's defense counsel and plaintiff's hospital caregivers who
have not yet been specifically named by plaintiff in her complaint,
but for whose conduct the hospital could be potentially liable. We
disagree with plaintiff's interpretation of the Petrillo decision as
it applies to the specific facts presented at bar.
	We continue to adhere to the belief that "the rationale of the
Petrillo court is sound." Best, 179 Ill. 2d  at 458. Significantly, the
Petrillo holding is animated by the important public policy
concern of protecting a patient's privacy by preventing
confidential medical information from being divulged to parties
who otherwise would not be privy to this sensitive information.
Indeed, the Petrillo court repeatedly focused upon the fact that the
plaintiff possessed an expectation that his medical information
would be protected from disclosure to a "third party." For
example, the Petrillo court explained that the physician-patient
relationship remains confidential only as long as a patient must
first provide consent before any information "is released to third
parties," and that "at the very minimum, the confidential
relationship existing between a patient and physician demands that
information confidential in nature remain, absent patient consent,
undisclosed to third parties." Petrillo, 148 Ill. App. 3d at 590.
	Unlike Petrillo, however, where confidential information was
divulged during discovery to parties who otherwise would not
possess the information absent the disclosure, in the matter at bar,
the challenged provisions of the Act authorize limited intrahospital
communication of information that is already the property of the
hospital and is already known to the hospital's agents, including
hospital counsel, irrespective of the filing of a lawsuit. The
hospital is not a third party with respect to its own medical
information, which is compiled by the hospital's own caregivers.
	Furthermore, if and when a patient institutes a legal action
against a hospital, the patient cannot validly claim any greater
expectation of privacy after the lawsuit is filed than prior to its
filing. Indeed, under Petrillo, the filing of a lawsuit diminishes,
rather than increases, a patient's expectations of privacy in
information related to the mental or physical condition which the
plaintiff has placed at issue in the legal action. Petrillo, 148 Ill.
App. 3d at 591. We find it significant that the act of instituting a
lawsuit against a hospital does not alter the fact that, pursuant to
subsection (b) of section 6.17 of the Act, the hospital may
communicate with the plaintiff's caregivers about the plaintiff's
care before the commencement of the legal action. Accordingly,
if the hospital may access this patient information before litigation
ensues because it is hospital information, it remains hospital
information after the initiation of litigation. The filing of a lawsuit
affects neither the nature of this information nor the hospital's
right or ability to access its own information about the care and
treatment rendered to the patient at the hospital by its own
caregivers.
	Indeed, accepting plaintiff's interpretation of Petrillo, under
the facts presented at bar, would lead to absurd results. For
example, if Petrillo prevented the limited intrahospital
communications authorized by subsections (d) and (e) of section
6.17 of the Act, hospitals would face the dilemma of having to
choose between ceasing to communicate with all hospital
caregivers with respect to a hospital patient's treatment,
communicating only with those caregivers the hospital assumes
were not negligent and risk a subsequent Petrillo violation if the
hospital's assumption was incorrect, or deposing all of the
patient's hospital caregivers. Further, if we were to accept
plaintiff's view, hospitals, which are statutorily obligated to create,
maintain and protect private medical records, would be forced to
subpoena their own records in the event of litigation. As stated, we
must interpret statutes in a manner that avoids absurd results.
Croissant, 141 Ill. 2d  at 455.
	Finally, we observe that the provisions contained in
subsections (d) and (e) of section 6.17 of the Act allow, rather than
mandate, the specified intrahospital communications. Specifically,
subsection (d) provides that the patient's information "may be
disclosed," pursuant to the enumerated circumstances, by the
hospital's medical staff, agents and employees, Similarly,
subsection (e) provides that the hospital's medical staff, agents and
employees "may communicate" with hospital counsel. We note
that a physician always remains bound by his or her Hippocratic
Oath, as well as the modern principles of medical ethics derived
from it, to use discretion and judgment in deciding what
information should be disclosed and under what circumstances.
See Kunkel, 179 Ill. 2d  at 537; Best, 179 Ill. 2d  at 456 & n.12.
	We conclude that, in enacting subparagraphs (d) and (e) of
section 6.17 of the Act, the General Assembly reasonably balanced
a hospital patient's interest in privacy against the strong public
interest in allowing limited intrahospital communications of
patient information. As fully explained earlier in this opinion, the
communications authorized pursuant to subparagraphs (d) and (e)
of section 6.17 are an important tool in not only assisting the
hospital's compliance with a multitude of government regulations
and reporting requirements, but also in promoting the compelling
societal interest in assuring quality health care. We observed that,
as part of a hospital's daily operations, and apart from any
litigation concerns, legal consultations may be necessary between
the hospital's counsel and the hospital's medical staff, agents and
employees, during which certain patient information may be
discussed. Our decision today is consistent with the principles
underlying Kunkel, Best and Petrillo. We strongly adhere to the
principle, stated in those decisions, that unreasonable invasions of
an individual's privacy are constitutionally forbidden. Kunkel, 179 Ill. 2d  at 538; Best, 179 Ill. 2d  at 450. Plaintiff has failed to satisfy
her burden to clearly establish that the challenged provisions of the
Act unreasonably violate a hospital patient's privacy. Accordingly,
we conclude that subparagraphs (d) and (e) of section 6.17 of the
Act do not authorize the kind of "substantial and unjustified"
invasion of privacy that is prohibited by the Illinois Constitution.
See Kunkel, 179 Ill. 2d  at 539.

III. Special Legislation
	In her brief to this court, plaintiff raises an argument,
consisting of one paragraph, that subsection (e) of section 6.17 of
the Act violates the prohibition against special legislation set forth
in article IV, section 13, of the Illinois Constitution of 1970 (Ill.
Const. 1970, art. IV, §13). Plaintiff generally contends that
subsection (e) should be invalidated because "[c]ounsel for
hospital defendants receive a distinct litigation advantage over
non-hospital defendants by this legislation." Plaintiff also
generally contends that subsection (e) "favors plaintiffs of every
kind of injury cases compared with plaintiffs who sue hospitals
*** in the matter of doctor-patient privileges."
	Because subsection (e) of section 6.17 neither affects a
fundamental right nor involves a suspect classification, the
appropriate standard for our review of plaintiff's special
legislation challenge is the rational basis test. Best, 179 Ill. 2d  at
393. Under the rational basis standard, judicial review of a
legislative classification is limited and generally deferential.
Miller, 196 Ill. 2d  at 59. In employing a rational basis analysis, a
court must determine whether the challenged statutory
classification is rationally related to a legitimate state interest.
Best, 179 Ill. 2d  at 393. "A legislative classification must be
upheld if any set of facts can reasonably be conceived which
justify distinguishing the class to which the statute applies from
the class to which the law is inapplicable." Miller, 196 Ill. 2d  at
59.
	The circuit court determined that the challenged provision of
the Act satisfied the rational basis test and, therefore, did not
constitute impermissible special legislation. The circuit court held
that "[d]ue to the unique nature of hospital defendants," they are
"distinguishable from other classes of defendants." Specifically,
the circuit court held that "[a] hospital's involvement in a medical
malpractice lawsuit is notably different from that of other tort
defendants." In addition, the circuit court concluded that "Public
Act 91-526 rationally relates to the legislative purpose sought to
be accomplished in the revisions of the Hospital Licensing Act."
We agree.
	As we have explained above, the limited intrahospital
communications authorized under the Act are necessary to assist
a hospital in complying with federal and state regulations and
reporting requirements and in maintaining and improving patient
care. Nonhospital defendants neither face these government
requirements nor have these same public policy interests. In
addition, as also previously explained, unlike other defendants,
hospitals may be held liable for the actions of their health-care
providers. See Gilbert, 156 Ill. 2d  at 524-25. Further, unlike other
types of defendants, the hospital and its agents and employees are
statutorily bound to respect the confidentiality of patient
information. Accordingly, we agree with the circuit court and find
that the classification is reasonably related to a legitimate
governmental purpose and does not constitute special legislation.
	As a final matter, we note that the Illinois State Bar
Association has filed an amicus brief in this matter which proffers,
as its sole argument, the contention that the provisions of Public
Act 91-526 violate the single subject rule contained in article IV,
section 8(d), of the Illinois Constitution of 1970 (Ill. Const. 1970,
art. IV, §8(d)). Amicus states in its brief that "it seeks to bring to
the attention of this court additional argument which may be of
interest to the court, but which is unlikely to be raised by either
party." This court has repeatedly rejected attempts by amicus to
raise issues not raised by the parties to the appeal. Frye v.
Medicare-Glaser Corp., 153 Ill. 2d 26, 30 (1992); Archer Daniels
Midland Co. v. Industrial Comm'n, 138 Ill. 2d 107, 117 (1990). It
is well settled that "[a]n amicus curiae is not a party to the action
but is, instead, a 'friend' of the court. As such, the sole function of
an amicus is to advise or to make suggestions to the court." People
v. P.H., 145 Ill. 2d 209, 234 (1991); see also Zurich Insurance Co.
v. Raymark Industries, Inc., 118 Ill. 2d 23, 59 (1987). Indeed,
"[a]n amicus takes the case as he finds it, with the issues framed
by the parties." People v. P.H., 145 Ill. 2d 209, 234 (1991).
Accordingly, because the issue of the single subject rule was not
raised by the parties to this action, we decline to address it.

CONCLUSION
	For the foregoing reasons, we hold that subsections (d), (e)
and (h) of section 6.17 of the Hospital Licensing Act (210 ILCS
85/6.17(d), (e), (h) (West 2000)) do not violate the separation of
powers clause set forth in article II, section 1 of the Illinois
Constitution of 1970 (Ill. Const. 1970, art. II, §1). We also hold
that subsections (d) and (e) of section 6.17 do not violate a
patient's right to privacy derived from article I, sections 6 and 12,
of the Illinois Constitution of 1970 (Ill. Const. 1970, art. I, §§6,
12). Finally, we agree with the circuit court and hold that
subsection (e) of section 6.17 does not violate the special
legislation clause contained in article IV, section 13, of the Illinois
Constitution of 1970 (Ill. Const. 1970, art. IV, §13). Accordingly,
the judgment of the circuit court is reversed in part and affirmed
in part. We remand this cause to the circuit court for further
proceedings.
Circuit court judgment reversed in part
 and affirmed in part;
cause remanded.
	CHIEF JUSTICE HARRISON, dissenting:
	Petrillo v. Syntex Laboratories, Inc., 148 Ill. App. 3d 581
(1986), prohibits defendants and their attorneys from engaging in
ex parte discussions with an injured plaintiff's treating physicians.
That prohibition is rooted in the right to privacy guaranteed by
sections 6 and 12 of article I of the Illinois Constitution of 1970
(Ill. Const. 1970, art. I, §§6, 12). Best v. Taylor Machine Works,
179 Ill. 2d 367, 450-59 (1997). Because it is constitutionally
based, the prohibition is not subject to limitation or revision by the
General Assembly. The General Assembly has no power to enact
legislation which is contrary to the provisions of our constitution.
Tully v. Edgar, 171 Ill. 2d 297, 308 (1996); People ex rel. Chicago
Bar Ass'n v. State Board of Elections, 136 Ill. 2d 513, 539 (1990)
(Ryan, J., specially concurring).
	When the General Assembly last attempted to abrogate the
Petrillo doctrine through legislative enactment, our court correctly
found the legislation to be unconstitutional and void. Best, 179 Ill. 2d 367; Kunkel v. Walton, 179 Ill. 2d 519 (1997). Contrary to the
majority, I would reach the same conclusion with respect to
subparagraphs (d) and (e) of section 6.17 of the Hospital Licensing
Act (210 ILCS 85/6.17 (West 2000)). In my view, those provisions
trench on constitutionally protected privacy rights no less than
section 2-1003(a) of the Code of Civil Procedure (735 ILCS
5/2-1003(a) (West 1994)), as amended by the Civil Justice
Reform Amendments of 1995, the statute we declared void and
unenforceable in Best and Kunkel.
	The majority attempts to differentiate subparagraphs (d) and
(e) of section 6.17 from the now invalidated section 2-1003(a) of
the Code of Civil Procedure by arguing that subparagraphs (d) and
(e) of section 6.17 authorize far more limited disclosure of a
patient's medical information than did section 2-1003(a). In the
context of disclosure to counsel defending personal injury claims,
however, there is no meaningful distinction between the statutes.
As with section 2-1003(a), subparagraphs (d) and (e) confer on
defense counsel unrestricted access to all aspects of a patient's
medical history, regardless of its relevance.
	When it drafted section 6.17, the legislature apparently hoped
to avoid section 2-1003(a)'s constitutional infirmities by
redefining ownership rights in a patient's records to make them the
property of the hospital. The idea, apparently, was that if the
medical records are deemed to belong to the hospital rather than
the patient, disclosure of those records to the hospital's lawyers
would amount to nothing more than the hospital sharing its own
information with its own people. By definition, no improper
disclosures to third parties would occur.
	Although the majority has embraced this rationalization, it
suffers from two fundamental flaws. First, it fails to recognize that
a patient's constitutionally protected privacy interest in his or her
own medical records (see Best, 179 Ill. 2d at 458-59) exists
regardless of who is deemed to own the physical documents in
which the patient's confidential medical information is recorded.
Who owns the actual physical documents is unimportant. What
matters is who has ultimate control over the medical information
contained in those documents. Under our state constitution, that
person is the patient. Accordingly, the legislature cannot sidestep
the limitations imposed by Petrillo by decreeing that the records
are the property of the hospital.
	The second flaw in the majority's approach is that it appears
to assume that hospitals occupy the same position with respect to
patients as do the patients' physicians. They do not. While
hospitals may employ physicians and possess an independent duty
to insure that those physicians provide patients with appropriate
medical care (Berlin v. Sarah Bush Lincoln Health Center, 179 Ill. 2d 1, 19 (1997)), hospitals do not themselves diagnose ailments or
prescribe treatments. They cannot. They are corporate entities. The
care is given by individual physicians, and the hospitals maintain
records as a necessary service to those physicians and their
patients. With respect to the physician-patient relationship,
hospitals are not the doctor's alter ego. They are a third party.
	There is no question that defense counsel employed by other
third parties cannot obtain medical records from a patient's
treating physician unless they utilize the discovery process
authorized by Supreme Court Rule 201. Petrillo, 148 Ill. App. 3d
at 591. That being so, it would be anomalous to hold that the
discovery process authorized by Supreme Court Rule 201 is not
similarly required to obtain access to the medical records
generated by a physician who provided care at a hospital simply
because the lawyers seeking access are employed by the hospital.
That, however, is precisely what the majority's disposition
permits. In the context of care provided in a hospital setting, the
Petrillo doctrine has been abandoned.
	In view of that result, I find it perplexing that my colleagues
purport to embrace the principles underlying Kunkel, Best and
Petrillo. See slip op. at 31. If they truly believed in those
principles, as I do, the disposition of this case would have been
straightforward. The court would have affirmed that portion of the
circuit court's judgment invalidating the challenged sections of the
Hospital Licensing Act and barring any ex parte communication
between hospital defense counsel or risk managers and any health
care providers for whose conduct the plaintiff was not seeking to
hold the hospital vicariously liable.
	The majority is also wrong to reject plaintiff's contention that
subsection (e) of section 6.17 violates our state's constitutional
prohibition against special legislation. My colleagues assess the
validity of the law under a rational basis test on the grounds that
"subsection (e) of section 6.17 neither affects a fundamental right
nor involves a suspect classification." Slip op. at 31. The problem
with the majority's view is that its premise is incorrect. The law
does affect a fundamental right.
	One's physical health and medical condition are among the
most intimate and personal aspects of one's life. Our court has
specifically held that the right to privacy regarding such matters is
a fundamental right. Committee for Educational Rights v. Edgar,
174 Ill. 2d 1, 35 (1996); People ex rel. Tucker v. Kotsos, 68 Ill. 2d 88, 97 (1977). That fundamental right to privacy necessarily
embraces the right to privacy in one's medical records, which this
court has previously recognized. Indeed, as we held in Kunkel, 179 Ill. 2d  at 537, "[t]he confidentiality of personal medical
information is, without question, at the core of what society
regards as a fundamental component of individual privacy."
	Subsection (e) of section 6.17 directly affects a patient's
fundamental right of privacy in his personal medical information
by authorizing when, by whom and to whom such information can
be disclosed by a hospital's medical staff, agents and employees.
Because the statute does affect a fundamental right, it must be
subjected to strict scrutiny. Harris v. Manor Healthcare Corp.,
111 Ill. 2d 350, 368 (1986); Kotsos, 68 Ill. 2d  at 97. Statutes
affecting fundamental rights and subject to strict scrutiny are
presumptively invalid. Village of Oak Lawn v. Marcowitz, 86 Ill. 2d 406, 416 (1981). For a statute to survive strict scrutiny, it must
advance a compelling state interest and be narrowly tailored to
serve that compelling interest. Lulay v. Lulay, 193 Ill. 2d 455, 470
(2000).
	To the extent that subsection (e) of section 6.17 permits
unrestricted disclosure of a patient's confidential medical
information to a hospital's lawyers, the statute does not meet this
exacting standard. Such unrestricted access is not necessary to
enable the hospital to meet statutory reporting obligations and is
not necessary to assure quality health care. Defense lawyers are not
physicians, after all. They do not provide medical treatment, they
do not help prepare or present morbidity and mortality reports, and
it is not their function to establish health care standards.
	With respect to the hospital's lawyers, the primary purpose of
subsection (e) of section 6.17 is to assist them in representing the
institution against possible malpractice claims. While that is an
entirely legitimate objective, the needs of a hospital's lawyers in
investigating personal injury claims are no different and no more
compelling than those of other defense counsel, who are required
by the Petrillo doctrine to conduct their discovery in accordance
with the formal proceedings set forth in our rules of court.
Accordingly, there is no basis for affording them special treatment.
The exemption from Petrillo created by subsection (e) for a
hospital's lawyers must therefor fall.
	For the foregoing reasons, I dissent.
 
1.      1Each group of defendants has submitted a separate brief to this
court. One brief is submitted on behalf of defendants Rush-Presbyterian-St. Luke's Medical Center, Resurrection Hospital,
Northwestern Memorial Hospital, Michael Reese Hospital and Medical
Center, Hoffman Estates Medical Center, Northwest Community
Hospital, Sherman Hospital, Holy Cross Hospital, Alexian Brothers
Medical Center, Norwegian American Hospital, Oak Park Hospital, St.
Mary of Nazareth Hospital, Swedish Covenant Hospital, and Westlake
Community Hospital. A second brief is submitted on behalf of
defendants Loyola University Medical Center, The University of
Chicago Hospitals, Lutheran General Hospital, Advocate Health Care
Network, Children's Memorial Hospital, and the Rehabilitation Institute
of Chicago. In this opinion, we collectively refer to the two defendant
groups as "defendants." 

2.      2Both Kunkel and Best were under advisement by this court at the
same time.