The rock . . .

December 11, 1990

Johns Hopkins Hospital has announced a new drug-testing program aimed, it appears, at reassuring uneasy patients. Under the new, modified policy all applicants for the medical staff will be tested for cocaine, alcohol, opiates, tranquilizers, barbiturates, marijuana and PCP; current employees will continue to be tested only if there is cause to suspect they are impaired. It is a policy that is certain to generate ongoing controversy.

Surely there is nothing wrong with a patient's wanting assurance that the surgeon who holds the scalpel isn't stoned on drugs or alcohol. And surely it is the hospital's responsibility to provide it. But the dragnet approach to drug-testing quickly gets into uncertain terrain. While the Fourth Amendment prohibits "unreasonable searches and seizures," reasonableness remains an indistinct notion. Wide latitude is permitted with regard to drug-testing when public safety is involved -- in the case of airline pilots or train engineers, for instance. An argument could well be made that the same imperatives apply when patients entrust their lives to doctors.

Hopkins Hospital is seeking rational compromises in this legal and ethical quagmire by proposing the mandatory testing only for a "limited" time during which education, counseling and rehabilitation programs will be developed for medical staff members. Despite the best efforts of hospital administrators, whether the present procedures achieve that result remains an unsettled question.

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