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PDMP case pits patient privacy against law-enforcement intrusion
Fear that law-enforcement scrutiny may deter a patient from seeking medical treatment or make a physician reluctant to prescribe pain medications to patients is "speculative," a federal appeals court ruled recently in a case regarding the privacy of records held in prescription drug-monitoring databases. Concern about potential privacy intrusion doesn't qualify as an imminent injury that can be addressed in court, the court said.
On this and other procedural grounds, a three-judge panel from the 9th U.S. Circuit Court of Appeals reversed a U.S. District Court ruling that prohibited the U.S. Drug Enforcement Administration (DEA) from accessing records in the Oregon Prescription Drug Monitoring Program (PDMP) without a warrant based on probable cause.
The legislation that created the Oregon PDMP in 2009 stipulated that law-enforcement access be allowed only after the issue of a court order based on probable cause requested by a law-enforcement investigation involving the "person for whom the requested information pertains."
So, when the DEA attempted to access the database using administrative subpoenas not subject to judicial review, the Oregon PDMP refused to comply—stating that it would be against state law to do so. The state agency also sued in federal court for a judgment on whether the federal subpoena could override state law.
The American Civil Liberties Union Foundation of Oregon, along with a physician and four patients, intervened in the case arguing that the Fourth Amendment of the U.S. Constitution granted them a reasonable expectation of privacy over their confidential medical records.
"It is difficult to conceive of information that is more private or more deserving of Fourth Amendment protections," U.S. District Judge Ancer Haggerty wrote in his Feb. 11, 2014, ruling.
The DEA appealed, arguing that the risk of public disclosure stemming from a future records request was "especially non-imminent and speculative" and that their request for PDMP data did not "unreasonably intrude upon any legitimate privacy expectation" as medical information is "regularly shared with a variety of third parties."
"Whatever right to privacy an individual may have in his medical information, it is not absolute," the DEA stated in its appellate reply brief.
The Litigation Center of the American Medical Association and the medical association from the states covered by the 9th Circuit (Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada and Oregon) filed an amicus brief in support of the Oregon PDMP and the interveners. The brief advised the court that unwarranted disclosure of PDMP data could compromise care.
The brief specifically argued against the DEA point that patient information is already regularly shared.
"The patient's high expectation of privacy is not diminished when a patient fills a prescription provided by her physician for her treatment, merely because the state then collects and centralizes that data," the Litigation Center brief stated.
Read more at AMA Wire.
