Friday, March 23, 2001
WHILE state and federal rules protecting medical privacy await implementation, the U.S. Supreme Court has constructed a wall against medical information being used to bring criminal charges against patients. In a South Carolina case, the high court has ruled that hospital workers may not test maternity patients for illegal drug use without their consent and then to alert police about positive test results.
The issue: As isle legislators ponder medical-
privacy regulations, the U.S. Supreme Court
says patients should be assured of protection.
The ruling has wide-ranging implications regarding the so-called "special-needs exception" to the right to be protected against unreasonable searches under the Fourth Amendment. However, it also addresses deeper questions about medical privacy and the rights of pregnant women.
The ruling should be taken into account particularly as legislators in Hawaii decide whether to allow state restrictions on the sharing of medical records to go into effect on July 1 or to await possible implementation of federal medical-privacy standards approved by President Clinton in the final days of his administration. President Bush has yet to decide whether to try blocking those standards.
In the South Carolina case, urine samples of pregnant women were tested "absent warrants or probable cause" for cocaine, and positive results were shared with law-enforcement officials. Some women were then arrested and threatened with prosecution if they did not complete drug treatment.
The Supreme Court had ruled previously that the special-needs doctrine permitted such warrantless searches to protect health and safety. For example, the court approved drug testing of student athletes, customs agents and railroad workers.
However, Justice John Paul Stevens, who authored the majority opinion in the 6-3 decision, noted that "the immediate objective" of the urine tests of the South Carolina women "was to generate evidence for law enforcement purposes," even though the goal may have been to get the women off drugs.
Many government and private institutions often try to fashion government policies for what they consider to be the public good, including assistance to law-enforcement agencies. That is what happened in South Carolina when the hospital entered into a cooperative program with police.
The Supreme Court's ruling should generate a review of Hawaii's pending medical-privacy rules to make sure that any efforts to cooperate with law enforcement would not encroach on patients' rights under the Fourth Amendment.
THE president's assessment of the coming scarcity in energy appears to overlook new technology and conservation that could be adopted without damaging the environment.
Energy plan needs jolt
The issue: President Bush says the nation's
demand for energy exceeds the supply and
has focused solutions on increasing supplies.
The Secretary of Energy, Spencer Abraham, contended in a speech earlier this week that an energy crisis that "will threaten our nation's economic prosperity." He appeared to be laying the groundwork for President Bush's policy to be unveiled shortly.
The policy will likely include opening the Arctic National Wildlife Refuge and other protected lands to oil and natural gas exploration, expanding reliance on coal to produce electricity, and loosening environmental restrictions in building power plants.
Senate Democrats yesterday proposed more conservation in their own energy plan.
Hawaii will not be immune to an energy shortage. The state depends on imported petroleum for most of its energy, with only 7 percent of the state's electricity coming from renewable resources such as geothermal and solar power.
Solutions could be found on several levels.
New technology includes H2 Power Systems' hydrogen-fuel cells that will soon power the National Tropical Botanical Gardens on Maui, a source of clean energy that contains no toxic products and has only one byproduct, water clean enough to drink, according to H2 Power's Michael Veith. Hawaiian Electric's offshoot, ProVision Technologies is making progress in designing solar energy cells.
On a national level, there are ways to meet needs that will mesh with environmental protection. Increased fuel efficiency for vehicles would cut demand. Daniel Lashof, a scientist at the Natural Resources Defense Council, points out that if cars were to get 39 miles per gallon through the next decade, 51 billion gallons of oil would be saved, which would be 15 times the yield the U.S. Geological Survey estimates would come from the Arctic refuge.
Another example: Eight billion cubic feet of natural gas produced daily from Prudhoe Bay in Alaska is being pumped back into the ground for lack of a pipeline, Abraham said. A safe conduit would provide 13 percent of the gas the nation consumes daily.
Residents of Hawaii could ease the strain by adopting small conservation measures -- trading incandescent light bulbs for energy-saving fluorescents, lowering water-heater temperatures to 120 degrees, turning off power users such as televisions and stereos when not in use, installing energy-efficient appliances, and walking two blocks to the store instead of driving.
Small stuff individually, but collectively they would add up.
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