Administration Sets Forth a Limited View on Privacy
By ROBERT PEAR and ERIC LICHTBLAU
NY Times
Published: March 6, 2004

WASHINGTON, March 5 — In a sharp departure from its past insistence on the sanctity of medical records, the Bush administration has set forth a new, more limited view of privacy rights as it tries to force hospitals and clinics to turn over records of hundreds and perhaps thousands of abortions.

What began late last year as a fairly modest government effort to obtain records appears to have ballooned into a systematic effort in courts around the country to define the limits of medical privacy.

Health care professionals and privacy advocates say the government's position has broad implications beyond abortion. If patients have no reasonable expectation of privacy, the critics say, the government may be more aggressive in seeking records from hospitals, insurance companies and other businesses in criminal, civil and administrative cases.

The Justice Department says it needs the records to defend a new law that prohibits what opponents call partial-birth abortions. Doctors and clinics have challenged the law, saying it bars them from performing certain medically needed abortions. A spokesman for the White House, Trent D. Duffy, defended the subpoenas. The administration is "strongly committed to medical privacy," and the subpoenas are "completely consistent" with federal privacy rules, Mr. Duffy said. A spokeswoman for the Justice Department, Monica M. Goodling, said, "We are respecting patient privacy by having hospitals delete any information that identifies specific patients."

President Bush was elected on a platform that proclaimed support for medical privacy. In April 2001, he said he would protect "the right of every American to have confidence that his or her personal medical records will remain private." At the time, Tommy G. Thompson, secretary of health and human services, said, "We are giving patients peace of mind in knowing that their medical records are confidential and their privacy is not vulnerable to intrusion."

The federal rules, adopted under a 1996 law, have touched off a quiet revolution in health care. Doctors, hospitals and drugstores routinely give "notices of privacy practices" to patients, assuring them that personal information will be protected. Privacy advocates say the administration has rolled back some safeguards adopted by President Bill Clinton, and the Justice Department says now that the 1996 law is no obstacle to its efforts to obtain abortion records. In court papers, the Justice Department says the records are needed to show that the banned procedure is almost never medically necessary and "poses serious risks."