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Court: Medical Board's Right to Records Outweighs Patients' Privacy Rights

The California Supreme Court said the state medical board did not need a warrant or subpoena to obtain a doctor's prescription history for his patients.

In Lewis v. Superior Court, the court said that the board's interest in protecting the public outweighed any privacy rights. The board acquired the patient information through the state's Controlled Substance Utilization Review and Evaluation System, "CURES."

"[W]e find that the balance tips in favor of the Board's interests in protecting the public from unlawful use and diversion of a particularly dangerous class of prescription drugs and protecting patients from negligent or incompetent physicians," Justice Goodwin Liu wrote.

CURES

CURES was created in 1996 to move California's drug monitoring system online. It is maintained by the state Department of Justice to ensure appropriate prescribing and dispensing of controlled substances.

The system allows doctors to check if patients are receiving drugs from other physicians, and also gives law enforcement and regulators access to the information.

The California Supreme Court considered the law after the medical board suspended Dr. Alwin Carl Lewis for unprofessional conduct, negligence, and failure to maintain adequate records. Lewis challenged the board's action in state court, alleging the board had violated "fundamental privacy protections."

A court of appeals ruled against him, and the supreme court affirmed in a unanimous opinion. Justice Liu, however, also wrote a concurring opinion to say that the doctor had properly alleged an invasion of privacy claim.

Invasion of Privacy

"The fact that the government regulates controlled substances does not eliminate patients' reasonable expectation of privacy," he wrote.

Liu said a pervasive regulatory scheme has "less significance when the area being regulated is particularly sensitive." Moreover, the patients did not choose to participate in the drug monitoring program.

"The electorate was concerned about more than public disclosure when it passed the Privacy Initiative in 1972," he said. "The voters were concerned that their privacy was violated whenever their personal information was used or accessed without reason."

In disclosing CURES data, however, Liu said the government's interests in monitoring controlled substances outweighed the patients' privacy rights.

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