BOSTON -- A while ago, Planned Parenthood ran an ad with a picture of a woman facing two policemen at her door. The caption read: "How would you like the police to investigate your miscarriage?"
Pregnancy police? It must have seemed a bit over-the-top: fund-raising hyperbole for planned paranoia. But not anymore. Not in Iowa.
In May, a newborn baby boy was found dismembered in a county recycling center. The gruesome story shook the 10,076 citizens of Storm Lake. The police didn't find out if the baby was born alive or even if he was born in the county. They didn't know if the mother who bore him had ever been to a local clinic or to any doctor at all.
Nevertheless, when the investigation reached a dead end, the police went on a fishing expedition ... through the lives of the women of Buena Vista County. They subpoenaed the medical records of every woman who had taken a pregnancy test between August and May.
Mind you, the police had already knocked on the door of a 17-year-old Mexican immigrant based on nothing more than a false high school rumor that she'd been pregnant. They swabbed the mouth of the frightened girl to get a DNA sample.
But there wasn't even a rumor to justify these clinic subpoenas. It was what lawyers call a "suspicionless search." It was what others would call a fertility dragnet. With no suspect, every woman who took a pregnancy test became one.
The surprise was that most health care providers turned over records, names, addresses and phone numbers. Without a peep and without a patient's consent.
Maybe the clinic folks wanted to help. Maybe they didn't know they had a choice. But the pregnancy test results must have made amazing reading to law enforcement officers in a small city where everyone knows everyone else. It must have raised eyebrows when the pregnancy police -- excuse me -- the patrol cars appeared outside at least a handful of houses.
Sometimes paranoia turns out to be good preparation. The clinic that refused to let the police fish in their pond was Planned Parenthood.
Jill June, the head of Iowa's Planned Parenthood, remembers thinking, "They can't be serious. There wasn't a shred of evidence that this woman was a patient of ours. What would happen if we did give the names? They would go door to door and say, 'You were pregnant in October, where's your baby?'"
Planned Parenthood refused the subpoena on the grounds of patient-doctor privacy. But the prosecutor went on to argue successfully in county court that a pregnancy test wasn't covered by confidentiality laws because it didn't have to be administered by a doctor or nurse.
Now the Iowa Supreme Court has agreed to hear this case. Planned Parenthood will file its brief Sept. 30. There will be a friend-of-the-court brief as well, filed by the Iowa Civil Liberties Union for a woman whose pregnancy ended in a miscarriage and whose records ended up in the hands of the cops. And anyone with hopes for shoring up the crumbling walls around medical privacy better become a friend of the friend of the court.
Privacy and Planned Parenthood? Put those words together and a lot of folks assume the subject is abortion. But here we get down to the heart of the argument. In Iowa, they will argue about privacy as Justice Louis Brandeis once defined it: the right to be let alone.
Should law enforcement follow a lead? Of course. But if the police have the right to blindly search through the records of every woman who had a pregnancy test in a clinic, they can search through the pharmacy records of every woman who bought a home kit. If they can set out a dragnet for every pregnant woman, why not for every diabetic or epileptic or cancer patient? Why not keep our medical files in the police station?
We protect the doctor-patient relationship because health rests on trust. Today, one in every six patients already resists revealing facts to doctors out of privacy fears. Those fears are sure to get much worse under new regulations put out recently by the Bush administration that allow patient information to be shared with others in the huge health care industry -- from insurers to pharmacists -- without our prior consent.
When news leaked out that the prosecutor had subpoenaed the records, says Ms. June, "women panicked. Our phones rang off the hook. 'What's going on?' 'Don't turn my records over.'"
Now the Iowa Supreme Court will decide whether the pursuit of a crime means that you can treat every patient like a criminal.
Ellen Goodman is a columnist for The Boston Globe. Her column appears in The Sun Mondays and Thursdays. She can be reached via e-mail at firstname.lastname@example.org.