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Do You Know Where Your Pap Smear Is Tonight?

This ought to make women uncomfortable. Kansas law enforcement officials apparently obtained a court order to obtain tissue samples taken for a pap smear from the accused BTK killer's daughter and used the samples for comparison with DNA the BTK perpetrator left at the scene of some of the crimes. Without her knowledge, of course.

The agents' strategy was to use a DNA sample from the daughter to see whether it would link her father to DNA left at BTK's crime scenes. The agents went to prosecutors in the Sedgwick County district attorney's office, and a judge in Sedgwick County issued a subpoena for the 26-year-old daughter's medical records in Kansas, a source said. It wasn't clear where in Kansas the records and the tissue sample had been held. DNA was extracted from the daughter's tissue sample, and it was processed within the week before Rader's arrest, the source said.

Federal privacy law restricts access to medical records. Among the exceptions is when law enforcement needs medical records for investigations, Wichita lawyer Chuck Millsap said. The principle is that the need to conduct an investigation outweighs a need for privacy, he said.

What kind of tissue tied to a woman's medical records could be kept on file at a lab?

Bruce Bammel, a Wichita doctor obstetrics and gynecology, said that could include various tissue samples -- everything from a skin biopsy to a Pap smear -- that can be preserved indefinitely and provide DNA.

Isn't there a difference between "medical records" and bodily tissue? Ethan Ackerman writes over at Politech:

In developments straight out of GATTACA's handshake scene, A Kansas City Star report indicates that the suspected "BTK" killer was tentatively linked to crime scene evidence by acquiring genetic material from the suspect's daughter's medical records - the tissue samples being taken without her knowledge.

The article goes on to give a brief but factually accurate explanation of how a request for "medical records" is entirely within the framework of the federal medical privacy laws (HIPAA), and also gives a likely source of the tissue - a routine pap smear. The article suggests that a judge issued a secret order for the records, though the article does not state if it was a formal 4th Amendment "probable cause" warrant, or some lesser standard subpoena, or even go into whether the police were required to acquire an order under HIPAA (there are circumstances where agents can just the recordholder.)

BUT the article also doesn't raise the fact that what was apparently requested was NOT "health information" - what HIPAA protects - but actual tissue from the suspect's daughter's file samples.

This seems quite an interesting breach of privacy expectations, independent of how it may legally turn out. On one hand, court-compelled physical examinations have been ruled Constitutionally sound (thus, you can be compelled to give a tissue sample, or even forcibly sampled.)

On the other hand, how many American women even know labs keep pap smear samples, much less would think it reasonable that their pap smears would one day be turned over to police to tentatively connect their sons or daughters to crimes?

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    Re: Do You Know Where Your Pap Smear Is Tonight? (none / 0) (#1)
    by Talkleft Visitor on Thu Mar 03, 2005 at 09:35:27 AM EST
    This is supremely creepy. Is the right of any person with a potentially criminal relative to seek medical care going to be taken away? One more step down the road towards a country with a "criminal class" that has no rights. The right to protect against self-incrimination obviously doesn't apply to relatives, but shouldn't that cooperation at least have to be voluntary?

    Re: Do You Know Where Your Pap Smear Is Tonight? (none / 0) (#2)
    by Talkleft Visitor on Thu Mar 03, 2005 at 09:45:40 AM EST
    We need to make sure doctors destroy tissues like this after they are no longer needed for medical purposes. Beyond creepy is right. If they suspected the guy they should have gotten the dna from him. Does this mean they have dna from every woman who seeks medical care? Perhaps I won't go have any of those procedures the govt. says we are supposed to have every year after all. They can just stay the hell out of my body.

    Re: Do You Know Where Your Pap Smear Is Tonight? (none / 0) (#3)
    by Talkleft Visitor on Thu Mar 03, 2005 at 09:49:31 AM EST
    Without the explicit consent by the daughter to this DNA comparison test, the authorities clearly trampled her 4th Amendment Rights. As such, it is abhorent.

    Re: Do You Know Where Your Pap Smear Is Tonight? (none / 0) (#4)
    by Jlvngstn on Thu Mar 03, 2005 at 09:52:10 AM EST
    It started with cameras to enforce traffic laws and "prevent crime", now our gov't can seize dna through medical files? I don't like it.

    I'm not surprised that authorities would use extraordinary measures to capture BTK, a vicious, predatory killer. Wasn't there any way to get a DNA sample directly from the suspect?

    Re: Do You Know Where Your Pap Smear Is Tonight? (none / 0) (#6)
    by Talkleft Visitor on Thu Mar 03, 2005 at 10:21:46 AM EST
    Wasn't there any way to get a DNA sample directly from the suspect?
    remember the gov't strategy, always testing the limits of the law, to see how far they can go. the continuing erosion of civil liberties does not make us any safer.

    Re: Do You Know Where Your Pap Smear Is Tonight? (none / 0) (#7)
    by libdevil on Thu Mar 03, 2005 at 10:40:53 AM EST
    Good grief. What a horrible idea. The time to test the limits of the law on evidence collection and admissibility is certainly not when you're going after a guy who's killed 10 people. What if this evidence gets tossed by the courts?

    Re: Do You Know Where Your Pap Smear Is Tonight? (none / 0) (#9)
    by Talkleft Visitor on Thu Mar 03, 2005 at 11:17:49 AM EST
    What the ....? No fragging way. This just screams "violation of the 4th Amendment". The daughter wasn't even involved, and she gets her DNA snagged? Great way to get the entire case against this sadist thrown out. Idiots.

    Definitely creepy!! And it wasn't the daughter who was a suspect. Her medical records/tissue should never have been used.

    Quaker & Libdevil, I do concur; when this evidence gets tossed out on grounds on infringing in the 4th Amendment, it could unravel the Govm't's case against this beast.

    Unless I'm terribly mistaken, this evidence is not going to be thrown out on 4th Amendment grounds. The daughter's rights might have been violated, but her father will not have standing to assert her rights. That is, a court will likely say that since HIS rights weren't violated by this, he has no right to ask for exclusion. If anyone has a different view, I would certainly be interested in reading it.

    Re: Do You Know Where Your Pap Smear Is Tonight? (none / 0) (#13)
    by Patrick on Thu Mar 03, 2005 at 12:37:10 PM EST
    Spainster, That's how I've heard it play out before. This will be interesting. Perhaps there are some facts surrounding the aquisition of the DNA which are missing and will make it less shocking. I'm hardly inclined to take talkleft's version of events as gospel.

    I'm hardly inclined to take talkleft's version of events as gospel.
    yeah question every right of the individual, but the gov't is infallible, above reproach. comment to the facts available, not the facts you wish you had. lets see what wing-cheerleader arises?

    But doctor's destroying tissue samples might hurt your future health. They are kept in case they need to be reexamined should disease be later detected. Suppose a family member were suspected of a crime. Should you not be able to go to the doctor for fear of giving police a DNA sample?

    I would think that the wording of the Court Order is crucile: if law enforcement was given permission to seize records and they sua sponte expanded the permission to include tissues, it might get thrown out.

    I think things should be reworded in the law to make actual tissue samples or other such physical collections of specimens a seperate entity from simply plain info, and requiring a higher threshold. I have no idea, per se, that THIS situation would meet such a threshold. But what I'm concerned about is the possibility of something bordering on that law about not reporting miscarriages in so many hours, and some overly zealous pro-life AG, going buck wild with collecting womens private samples.

    Re: Do You Know Where Your Pap Smear Is Tonight? (none / 0) (#18)
    by Kitt on Thu Mar 03, 2005 at 05:00:26 PM EST
    This is sounding more and more like 'Handmaid's Tale'. This is scary....between this, the faith-based jobs deal, the ID cards for just about everyone and - what next? The draft will be coming back.

    Spare me the indignation. I didn't hear this kind of complaining from the Left when prosecutors supoenaed Rush Limbaugh's medical records on a fishing expedition. Mind you, I'm talking about going through his records looking to see if he'd been doing anything they didn't know about. A lot of people in this country were happy to watch him twist because of his politics. Now that it's someone more agreeable everyone's upset. I realize that Rush is the Great Evil in the minds of many on this forum. But the point is that if we're going to stand on a principle, we need to stand on it consistently. If we're going to claim the right to organize a gay rights parade, we need to support the rights of the Nazi party to march as well, distasteful as it may be. The problem with constitutional freedoms is they need to apply to everyone, regardless of whether you like them. And in case anyone misunderstands my position on this, I agree that it's wrong to grab confidential medical information without patient consent.

    True Blue, TalkLeft complained plenty about the search of Rush Limbaugh's medical records. Do a search for him in our searchbox on the right.

    Re: Do You Know Where Your Pap Smear Is Tonight? (none / 0) (#21)
    by Kitt on Thu Mar 03, 2005 at 11:08:01 PM EST
    Yes, we did - trueblue. You (or at least, the name) weren't around.

    TalkLeft: Then I do apologize. I wasn't following this site then and was basing my comments on other media sources and sound bites I saw at the time. Kudos to those willing to stand on principle over personality. I'm with you on this one.

    The irony of course, is that the ACLU is a favorite target of the right, despite it coming to the aid of Limbaugh on this one, as it rightly should have. Many wanted to see Limbaughs medical records paraded about, and I must admit, considering his opinions on drug use in the past, he richly deserved it. But my main opposition to the drug war is based on the absolutely ridiculous invasion of privacy it demands for it to "hunt down the bad guys" and so no, I don't want people rifling through my medical records.

    Re: Do You Know Where Your Pap Smear Is Tonight? (none / 0) (#24)
    by Sailor on Fri Mar 04, 2005 at 11:47:26 AM EST
    trueblue - they searched Limbaughs medical records. They didn't take tissue samples of his daughter. what kind of a judge would sign this secret order? What kind of medical facility would let them without a huge public court battle? Seems if they had probable cause for her, they had probable cause for him. p.s. They already had testimony implicating Limbaugh, it wasn't a fishing expedition.

    The ACLU did the right thing defending Rush's right to privacy. And while on a superficial level I was happy to see that hypocrite taking heat for his drug problems, I knew that it was just a sign of times to come...further erosion of privacy and civil liberties, all in the name of "getting tough on crime". The day may come when the average citizen will tolerate any measure undertaken by police and investigators if there is a possibility of crime. The day may come when "suspect" is synonomous with "criminal".

    Sailor, if you hadn't noticed, I retracted the Limbaugh comment since many on the Left actually did champion his cause. The two are one and the same -- unauthorized search and seizure of private information. If I'm not mistaken, the doctor-patient privilege is protected by law. Is there an attorney in the house?