Is forced medication constitutional? Does the HIPAA privacy rule (which permits over 600,000 covered organizations to exchange patients' personal health information without patients' consent in many circumstances) violate federal constitutional rights? These are some of the cases that IHF has covered over the past years.
In regards to forced medication, the U.S. Supreme Court upheld the right to refuse unwanted psychotropic medication in its 2003 landmark decision Sell v. United States. Ruling in favor of a St. Louis dentist who resisted government attempts to forcefully medicate him with anti-psychotic drugs, the Court held that while involuntary medication solely for trial competence purposes may be appropriate in some instances, those instances would likely be "rare."
In 2005, the U.S. Court of Appeals for the Third Circuit held in Citizens for Health v. Leavitt that the HIPAA privacy rule does not violate federal constitutional rights because it only permits, but does not require, the sharing of health information without patient consent. The Court based its affirmance on two other legal interpretations: (1) under the HIPAA privacy rule, patients have a right to request restrictions on uses and disclosures of their health information, although doctors and other covered entities do not have to comply [thus the rule does not guarantee patients true confidentiality] and (2) the federal rule does not preempt more stringent state privacy laws.
Given the Court’s view that more stringent state medical-privacy laws would not be preempted by the federal rule, citizens across the country have an important opportunity to make sure their state laws are more protective of privacy than the weak federal rule.
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(Summary updated November 2009)