Update on the Kansas Teen Sex Medical Records Case
A few days ago, I blogged about a case in Kansas where the Attorney General interpreted a law prohibiting sex with minors under the age of 16 as requiring doctors to report any sexual activity by people under 16 to the state authorities. Recently, the Kansas Supreme Court issued an opinion, Alpha Medical Clinic v. Anderson, strongly limiting the Attorney General’s reporting requirement. Relying in significant part on Whalen v. Roe, 429 U.S. 589 (1977) (discussed in depth in my earlier post), the Kansas Supreme Court reasoned:
It is beyond dispute that the State has a compelling interest in pursuing criminal investigations. . . . And an individual’s right to informational privacy is not necessarily “absolute; rather, it is a conditional right which may be infringed upon a showing of proper governmental interest.” . . . . Also, the fundamental right to obtain a lawful abortion may be regulated as long as the regulation does not constitute an undue burden. . . .
Our evaluation necessarily involves weighing of these competing interests, including the type of information requested, the potential harm in disclosure, the adequacy of safeguards to prevent unauthorized disclosure, the need for access, and statutory mandates or public policy considerations. See Lawall, 307 F.3d at 790 (citing United States v. Westinghouse Elec. Corp., 638 F.2d 570, 578 [3rd Cir. 1980]). . . .
Petitioners contend the attorney general has not shown a compelling need for unredacted patient files. Kline now takes the position that the patients’ identifying information may be redacted. Petitioners further assert that it is “inconceivable” the disclosure of entire patient files would be the least intrusive way to meet a compelling state interest in uncovering noncompliance with the criminal abortion and mandatory child abuse reporting statutes. Petitioners have pointed to the example of the many details of each patient’s sexual and contraceptive history that the files are likely to contain but that are equally likely to be irrelevant to the factors required to be considered and documented under the criminal abortion statute. With regard to the child abuse reporting statute, we expect that nearly all information except the identity and age of the male who impregnated the minor patient, his relationship to the minor patient, the circumstances surrounding the sexual intercourse that produced the pregnancy, and compliance or noncompliance with reporting requirements is likely to be irrelevant to Kline’s inquiry.
The type of information sought by the State here could hardly be more sensitive, or the potential harm to patient privacy posed by disclosure more substantial. Judge Anderson’s order does not do all it can to narrow the information gathered or to safeguard that information from unauthorized disclosure once it is in the district court’s hands. Although the criminal inquisition statutes do not speak to the need for such narrowing and safeguards, the constitutional dimensions of this case compel them. . . .
In sum, Judge Anderson must withdraw his order and first evaluate the inquisition and subpoenas in light of what the attorney general has told him regarding his interpretation of the criminal statutes at issue. If the judge requires additional information in order to perform this evaluation, he should seek it from the attorney general in the inquisition proceeding. As targets of the investigation, petitioners need not be included in any hearing or other communication to enable this evaluation.
Only if Judge Anderson is satisfied that the attorney general is on firm legal ground should he permit the inquisition to continue and some version of the subpoenas to remain in effect. Then he also must enter a protective order that sets forth at least the following safeguards: (1) Petitioners’ counsel must redact patient-identifying information from the files before they are delivered to the judge under seal; (2) the documents should be reviewed initially in camera by a lawyer and a physician or physicians appointed by the court, who can then advise the court if further redactions should be made to eliminate information unrelated to the legitimate purposes of the inquisition. This review should also determine whether any of the files demonstrate nothing more than the existence of a reasonable medical debate about some aspect of the application of the criminal abortion and/or mandatory child abuse reporting statutes, which the attorney general’s office has already acknowledged would not constitute a crime. If so, those files should be returned to petitioners; and (3) any remaining redacted files should be turned over to the attorney general.