HIPAA, the Police, and Goffman’s On the Run

Some people are calling Steven Lubet’s new review of Alice Goffman’s On the Run “troubling” and even “devastating” but I am non-plussed. Lubet questions the plausibility of some of Goffman’s accounts:

She describes in great detail the arrest at a Philadelphia hospital of one of the 6th Street Boys who was there with his girlfriend for the birth of their child.  In horror, Goffman watched as two police officers entered the room to place the young man in handcuffs, while the new mother screamed and cried, “Please don’t take him away. Please, I’ll take him down there myself tomorrow, I swear – just let him stay with me tonight.” (p. 34). The officers were unmoved; they arrested not only Goffman’s friend, but also two other new fathers who were caught in their sweep.

How did the policemen know to look for fugitives on the maternity floor?  Goffman explains:

According to the officers I interviewed, it is standard practice in the hospitals serving the Black community for police to run the names of visitors or patients while they are waiting around, and to take into custody those with warrants . . . .

The officers told me they had come into the hospital with a shooting victim who was in custody, and as was their custom, they ran the names of the men on the visitors’ list.

This account raises many questions.  Even if police officers had the time and patience to run the names of every patient and visitor in a hospital, it would violate the federal Health Insurance Portability and Accountability Act (HIPAA) for the hospital simply to provide an across-the-board list….

In addition, Lubet contacted a source in the Philadelphia police department and asked if there was any such policy.

When I asked if her account was possible, he said, “No way. There was never any such policy or standard practice.”  In addition, he told me that all of the trauma centers in Philadelphia – where police are most likely to be “waiting around,” as Goffman put it, for prisoners or shooting victims – have always been extremely protective of their patient logs.  He flatly dismissed the idea that such lists ever could have been available upon routine request as Goffman claims.  “That’s outlandish,” he said.

It would also be outlandish for police to beat and kill people without cause but since Goffman’s book has appeared we have plenty of video evidence that the type of actions she claims to have witnessed do in fact happen.

Moreover, HIPAA does not provide privacy against the police. HIPAA was written specifically so that the police can request information from hospitals. Here is the ACLU on HIPAA:

Q: Can the police get my medical information without a warrant?

A: Yes. The HIPAA rules provide a wide variety of circumstances under which medical information can be disclosed for law enforcement-related purposes without explicitly requiring a warrant.[iii] These circumstances include (1) law enforcement requests for information to identify or locate a suspect, fugitive, witness, or missing person (2) instances where there has been a crime committed on the premises of the covered entity, and (3) in a medical emergency in connection with a crime.[iv]

In other words, law enforcement is entitled to your records simply by asserting that you are a suspect or the victim of a crime.

Finally, the records in question in this case were not even patient records but visitor records. Whether or not there is an official policy on what to do while waiting at a hospital for other reasons (say to speak to a suspect) it’s plausible to me that the police in Philadelphia can and do sneak a peek at visitor records when the opportunity arises. It’s certainly the case that people who have warrants against them avoid hospitals and other institutions that keep such records for fear of arrest (and here).

I was confused by Lubet’s other big reveal, “Goffman appears to have participated in a serious felony in the course of her field work – a circumstance that seems to have escaped the notice of her teachers, her mentors, her publishers, her admirers, and even her critics.” But this didn’t escape my notice. How could it? Goffman’s crime is the climax of the book! Lubet is talking about Goffman’s action after her friend, Chuck, is murdered:

…This time, Goffman did not merely take notes – on several nights, she volunteered to do the driving.  Here is how she described it:

We started out around 3:00 a.m., with Mike in the passenger seat, his hand on his Glock as he directed me around the area.  We peered into dark houses and looked at license plates and car models as Mike spoke on the phone with others who had information about [the suspected killer’s] whereabouts.

One night, Mike thought he saw his target:

He tucked his gun in his jeans, got out of the car, and hid in the adjacent alleyway.  I waited in the car with the engine running, ready to speed off as soon as Mike ran back and got inside (p. 262).

Fortunately, Mike decided that he had the wrong man, and nobody was shot that night.

The fact that Goffman had become one of the gang is the point. A demonstration that environment trumps upbringing. She only narrowly escaped becoming trapped by the luck of the victim’s absence. The sociology professor and the thug, entirely different lives, separated by the thinnest of margins.

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