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Is pregnancy a privacy issue?

(Court TV) -- When an infant's body was discovered at a recycling plant in northwest Iowa, police began looking for the child's mother. But with few clues and no good leads, they turned to local hospitals and clinics. Their question: Who was pregnant during the time of the baby's gestation?

One clinic, Planned Parenthood, refused to turn over its pregnancy records, citing patient-doctor confidentiality, and the police investigation became an instant legal controversy — how to balance a patient's rights to privacy with the pursuit of justice.

"This was a heinous crime that demands justice," said Jill June, director of Planned Parenthood of Greater Iowa. "I feel horrible and this needs to be solved and we want to help, but what they are asking for is illegal and unethical. This is a blatant violation of a patient's rights to privacy."

A district court judge disagreed and ordered Planned Parenthood to turn over the records by August 17 or face contempt of court charges. Last week the Iowa Supreme Court granted a temporary stay of the judge's order until it decides whether to hear Planned Parenthood's appeal of the case. August 19 was set as the deadline for any written responses to the appeal.

Local prosecutor Phil Havens argues that privacy is not an absolute right. "If the rights of society are greater, then those rights should prevail ... We have a dead baby and there is no way we can investigate the crime without knowing who the mother is."

The discovery

On May 30, a load of garbage was being processed at the recycling plant in Buena Vista County, just outside the Storm Lake city limits, when a worker noticed several small body parts.

Police questioned plant employees, and asked doctors at local hospitals about women who had recently given birth. They received a few leads from the public. But the leads went nowhere.

With no other information and the investigation at a standstill, the county attorney asked at least five area hospitals and clinics for the names of women with positive pregnancy test results between August 2001 and May, the period of the mother's pregnancy. Some complied with the request and at least one hospital turned over birth information that was already public, but Planned Parenthood refused.

An autopsy concluded the dark-haired boy was born up to two days before the body was found. But further tests failed to reveal information about the boy's race, cause of death or whether he was born alive, said Buena Vista County Sheriff Chuck Eddy.

Investigators concede the baby's mother may never have gone to Planned Parenthood and could have come from another area to dispose of the body. "We need to check every possibility. By getting the records, we can continue the process of elimination. We can start to eliminate people as suspects," Eddy said.

What would the authorities do with the records if they were released?

The question raises a host of others: Would the women named have to produce a baby or proof of a miscarriage or abortion to prove their innocence? And what if the women refused to be interviewed? Would police then start talking with neighbors or friends?

"Can you imagine someone knocking on your door and asking you about some of the most intimate decisions that you have made in your life and then writing a report on it?" asked Robert Rigg, a law professor at Drake University.

Sheriff Eddy contends authorities do not intend to interview every woman. "We used some of the records obtained from clinics and asked doctors, 'Do you remember so-and-so? Did she have the baby?' They would say yes and everything is fine. So we do not have to talk with that woman."

Eddy, who has been sheriff for 14 years, has to pause and think about the last time the sheriff's department investigated a murder. He can't recall one.

Most people in Storm Lake, a middle-class community 162 miles from Des Moines, work in agriculture or at two local meat packing plants. The city is home to a 3,000-acre lake and to Buena Vista College. For many residents, the controversy may not be as important as how a drought has affected the lake, but they have shown division over the legal dispute.

"It's like the debate nationally over the authority of Attorney General Ashcroft," said Art Cullen, editor of the local Storm Lake Times. "People are skeptical of prosecutors having too much authority but then again we want to capture Bin Laden."

The legal battle

The legal debate began June 17 after Buena Vista District Court Judge Frank B. Nelson granted authorities' request to obtain the records of pregnancy tests taken from August 2001 to May 30. Planned Parenthood estimates nearly 1,000 women received treatment during that period.

In the past, Planned Parenthood has received subpoenas seeking information about a client suspected of a crime. But in those cases, "they came to us with a name and this time they want us to give them the names," said June, a 17-year veteran of the organization. "But this is unprecedented. Nobody in Planned Parenthood has ever heard of a case like this."

To gather the information they wanted, prosecutors obtained what is known as a prosecuting attorney subpoena, which must be approved by a judge, although the standard of proof is less than that required for a search warrant.

To obtain such a warrant, prosecutors must prove the existence of an ongoing bona fide criminal investigation. The investigation must meet these requirements: it is for lawful purposes (it does not have to be a specific crime); the documents or information is relevant to the inquiry; and prosecutors must inform people what they are looking for (in this case, pregnancy test records from a specific time period), Rigg explained.

Though medical records are typically protected by doctor-patient privilege, prosecutor Havens argues that names of women who took pregnancy tests are not protected because Planned Parenthood staffers who administer the tests do not have to be doctors or nurses.

"Our position is that we want the information," said Havens, the county attorney since 1995. "It's not records, it's information."

Planned Parenthood attempted to quash the subpoena, but Judge Nelson agreed with county attorneys in his ruling, saying that Planned Parenthood failed to provide the court with information about whether a doctor or advanced nurse practitioner administered the tests.

In a scathing ruling issued on July 15, the judge wrote:

"Astonishingly, PPGI apparently considers itself and its personnel to be above the law and not required to respond to a valid issued and served subpoena. (No Motion to Quash the subpoena has been served; it has simply been ignored)..."

. Planned Parenthood's problem, according to Rigg and others, is that it did not present evidence to support its claims that the records are privileged under the state statute which protects "a practicing attorney, counselor, physician, surgeon, physician assistant, advanced registered nurse practitioner, mental health professional, or the stenographer or confidential clerk of any such person."

According to Rigg, Planned Parenthood needed to describe the procedure for treating a patient and show how the information is generated for a medical diagnosis. Since the state Supreme Court uses the same arguments as the lower court to make a decision, the issue is whether Planned Parenthood placed enough information into the court record to win an appeal.

Planned Parenthood's problems were compounded when its attorney told a witness, the director of the group's Storm Lake clinic, not to appear at a hearing despite a court order. Staff attorney Sandra Suarez said the director was not the proper representative for the group in court, adding that the dispute about the pregnancy tests as a medical record surfaced after an earlier hearing.

The Iowa Supreme Court could decide to ask for oral arguments or simply review the legal briefs. The court could then rule on the case or send it back to district court for additional hearings.

The court's ruling granting the stay came a day after Havens had offered to limit the scope of his request by only requesting names of those known to have given birth, for example — but Planned Parenthood refused the offer.

Meanwhile, as the legal battle rages, a memorial service was held August 7 for the unidentified baby.

"Every human being deserves a proper resting place," said Eddy, who organized the ceremony. "It also will help bring some partial closure to everyone who has been working on the case."