Opinion ID: 1860963
Heading Depth: 2
Heading Rank: 1

Heading: Patients' Right to Privacy

Text: In Roe v. Wade, 410 U.S. 113, 93 S.Ct. 705, 35 L.Ed.2d 147 (1973), the court held that a woman has a right of personal privacy that encompasses the decision whether or not to terminate her pregnancy. This right is not absolute, but is subject to the states' compelling interests in the protection of maternal health, medical standards, and prenatal life. The states' interests in maternal health, however, do not become compelling until the second trimester, and their interests in prenatal life do not become compelling until the fetus is viable. Thus, a state may not interfere with the patients' and physicians' decision to abort during the first trimester and, during the second trimester, may regulate abortions only in ways reasonably related to the health of the mother. 410 U.S. 164, 93 S.Ct. 732, 35 L.Ed.2d 183. In Planned Parenthood of Central Missouri v. Danforth, 428 U.S. 52, 96 S.Ct. 2831, 49 L.Ed.2d 788 (1976), the court upheld a provision of a Missouri statute that required doctors to make and keep records on all abortions for the use of local, state, and national public health officers. The records were to be confidential and used only for statistical purposes to enhance medical knowledge for the preservation of maternal health. The recordkeeping requirement was challenged on the ground that it constituted an unconstitutional restriction on the patients' abortion decision during the first trimester. The court, however, found that the records served the state's interest in protecting the health of its female citizens and that, because the records were confidential, there was no legally significant impact or consequence on the abortion decision or on the physician-patient relationship. 428 U.S. 81, 96 S.Ct. 2846, 49 L.Ed.2d 812. Amicus M.C.L.U. contends that the proposed disclosure of the names of physicians who performed abortions will have the legally significant impact not found in Danforth. First, there is the danger that patients' names will be accidentally disclosed. Second, any disclosure will have a chilling effect in that women may be prevented from obtaining an abortion by the fear that their names might be accidentally disclosed. Third, a woman may be deterred from seeking an abortion from the doctor named because people might correctly infer the reason she saw that doctor. Fourth, disclosure may cause some doctors to discontinue performing abortions, thus making it more difficult for women to find a willing doctor and infringing their freedom of choice in the selection of a physician. M.C.L.U. also notes that the confidentiality of the physician-patient relationship is protected under state law. Nevertheless, the M.C.L.U.'s speculations on the possible effects of the disclosure of the doctors' names on women seeking abortions are not sufficient grounds for injunctive relief. Whenever the state acquires confidential information, the possibility of accidental disclosure exists. That possibility is not sufficient to preclude the state from acquiring the information, Whalen v. Roe, 429 U.S. 589, 97 S.Ct. 869, 51 L.Ed.2d 64 (1977), and should also not be sufficient to deprive the public of access to other, nonconfidential information. Beyond simply presenting the possibility of accidental disclosure of patients' names, amicus offers nothing to show that the procedures followed by the department in this case are insufficient to protect patient anonymity. Similarly there is no evidence to support the speculation that the mere possibility of disclosure of patient identities, however slight, will be a significant factor in a medical assistance patient's decision not to seek an abortion. The guilt-by-association argument is also without evidentiary support and appears even less reasonable. The validity of that argument must rest on the assumption that once a doctor is known to have performed abortions, it may be inferred that all, or at least the majority, of his female patients employ him to perform abortions. Only if the doctor provides almost no services except abortions, does such an assumption have merit. In such a case, it is likely that the nature of the doctor's practice would be known even without disclosure of the department's information. Thus, it is improbable that disclosure will have any significant effect on the inferences that can be drawn from the fact that a woman visits a particular physician. A radical restriction in the number of Minnesota physicians willing to perform abortions resulting from disclosure would present a more difficult problem than the more direct effect on women themselves. Amicus contends that such a reduction would infringe on a woman's right to make an independent abortion decision by making abortions less available. Here again, however, there is no evidence that such a reduction will occur. Robert G. Randle, director of the Medical assistance division of the state Medicaid program, states in his deposition that disclosure of physicians' names could have some kind of an impact on participation of medical providers in the medical assistance program. He goes on to state, however, that his primary concern was the relationship between the providers and the program. Nowhere does he forecast a radical restriction in the number of participating providers. The affidavit of plaintiff Dr. Chester Anderson states that disclosure of the names of physicians and the nature of the treatments they provided would also discourage physicians and other medical providers from providing treatment covered by the Medical Assistance program to patients eligible for Medical Assistance and discourage physicians and other medical providers from performing necessary medical procedures which are controversial from a nonmedical point of view. He does not allege any significant reduction in the number of doctors willing to participate in the medical assistance program. Neither Randle nor Anderson offers any support for his speculations. Moreover, it seems unlikely that mere disclosure of the fact that a doctor has performed abortions will cause him to stop providing that service. Once that fact is known, the doctor has little reason to stop. In fact, disclosure could aid women seeking abortions to find a doctor willing to provide the service. Of course, disclosure may also permit those who oppose abortions to focus pressure on the named doctors to convince them that it would be in their best interests to cease providing the service. The propriety of such action, however, is not before this court, which is concerned on this appeal only with the effect of the disclosure itself. The United States Supreme Court has indicated that any state action that interferes with a woman's right to make an independent abortion decision or with her physician's exercise of medical judgment constitutes an invasion of her right to privacy, at least during the first trimester of pregnancy. See, Planned Parenthood of Central Missouri v. Danforth, 428 U.S. 52, 81, 96 S.Ct. 2831, 2846, 49 L.Ed.2d 788, 812, where the court stated:    We naturally assume, furthermore, that these recordkeeping and record-maintaining provisions will be interpreted and enforced by Missouri's Division of Health in the light of our decision with respect to the Act's other provisions, and that, of course, they will not be utilized in such a way as to accomplish, through the sheer burden of recordkeeping detail, what we have held to be an otherwise unconstitutional restriction.  (Italics supplied.) The disclosure sought to be prevented in this case would not constitute such an otherwise unconstitutional restriction. Disclosure places no burden on the doctor, does not destroy the confidentiality of his relationship with patients, and does not restrict his freedom to exercise his medical judgment. Disclosure itself does not have any effect on the moral or ethical considerations that affect his decision whether or not to perform abortions. If antiabortion factions of the public convince him to stop performing abortions, his decision will be the result of private, not state, actions. Therefore, even if the ultimate consequence of disclosure is a reduction in the number of physicians willing to perform abortions, that reduction will not constitute an unconstitutional infringement of women's rights of privacy. Plaintiffs thus have failed to establish that failure to grant the requested injunction will result in a deprivation of female medical assistance patients' rights to privacy in making an independent decision to seek termination of pregnancy.