FERGUSON V. CITY OF CHARLESTON
532 U.S. 67 (2001)
NATURE OF THE CASE: This was a dispute over whether a state hospital's performance of a
diagnostic test to obtain evidence of a patient's criminal conduct for law enforcement
purposes is an unreasonable search if the patient has not consented to the procedure.
FACTS: The public hospital, MUSC, became concerned about an increase in the use of
cocaine by patients who were receiving prenatal treatment. They began to order drug screens
performed on urine samples from maternity patients who were suspected of using cocaine. If a
patient tested positive, she was then referred by MUSC staff to the county substance abuse
commission for counseling and treatment. That policy failed. Counseling was abandoned and
law enforcement was instituted on the theory that such use harmed the fetus and was
therefore child abuse. The threat of law enforcement involvement was set forth in two
protocols, the first dealing with the identification of drug use during pregnancy, and the
second with identification of drug use after labor. Under the latter protocol, the police
were to be notified without delay and the patient promptly arrested. Under the former, after
the initial positive drug test, the police were to be notified (and the patient arrested)
only if the patient tested positive for cocaine a second time or if she missed an
appointment with a substance abuse counselor. In 1990, the policy was modified to give the
patient who tested positive during labor, like the patient who tested positive during a
prenatal care visit, an opportunity to avoid arrest by consenting to substance abuse
treatment. Ps are 10 women who received obstetrical care at MUSC and who were arrested after
testing positive for cocaine. Four of them were arrested during the initial implementation
of the policy; they were not offered the opportunity to receive drug treatment as an
alternative to arrest. The others were arrested after the policy was modified in 1990. Ps'
complaint challenged the validity of the policy under various theories, including the claim
that warrantless and nonconsensual drug tests conducted for criminal investigatory purposes
were unconstitutional searches. D advanced two principal defenses to the constitutional
claim: (1) that, as a matter of fact, Ps had consented to the searches; and (2) that, as a
matter of law, the searches were reasonable, even absent consent, because they were
justified by special non-law-enforcement purposes. The District Court rejected the second
defense because the searches in question 'were not done by the medical university for
independent purposes. The District Court submitted the factual defense to the jury with
instructions that required a verdict in favor of petitioners unless the jury found consent.
D got the verdict and Ps appealed; there was not enough evidence to support a finding of
consent. The majority of the appellate panel held that the searches were reasonable as a
matter of law under our line of cases recognizing that 'special needs' may, in certain
exceptional circumstances, justify a search policy designed to serve non-law-enforcement
ends.
ISSUE:
RULE OF LAW:
HOLDING AND DECISION:
LEGAL ANALYSIS:
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