Legal Issues

    The New York case, whether from an individual or philosophical perspective, must be considered a significant victory for American constitutional interpretation and the integrity of the judicial system.  It has been noted, for example, that the policy underlying the taking clause has consistently referred to the benefits of a public use the problem, however, has been defining what constitutes the type of public use that will justify a taking pursuant to the American constitution.

This was the essential issue in the instant case.  Columbia University was unable to secure the private property through negotiations so it resorted to lobbying the State of New York to exercise its power of eminent domain in order to attempt to take through condemnation what could not be secured through open market negotiations.  The court wisely rejected the elitist argument that Columbia University would put the land to better use than simple citizens.  Several ethical issues are raised.  First, the State of New York stood to make a profit on the condemnation process.  This creates a conflict of interest.  Second, validating such a broad interpretation would open the door for other influential organizations to offer low amounts of money in negotiations because they could always use their political influence to threaten or pursue condemnation proceedings.  This is not meant to suggest that there are not circumstances in which eminent domain is appropriate and truly beneficial to the public more generally.  Indeed, for large infrastructure projects delivering water, oil, electricity, and other widely distributable public goods, eminent domain is a valuable tool for governance and public administration.  Very localized exercises, as in the instant case, risk the substitution of coercive government powers and unethical negotiation practices.  The taking clause ought to be narrowly defined with a public use concept that stresses privacy as a preeminent right while simultaneously demanding a general rather than specific or localized type of public use. 

United States Department of Health and Human Services Regulation
Pursuant to Congressional authorization, the Secretary of the United States Department of Health and Human Services is authorized to adopt uniform national standards for the secure electronic exchange of health information.  262, 110 Stat. at 2021-26 (Citizens for Health v. Leavitt, 2005, p.8). This particular authorization, allowing the Secretary to issue rules and regulations regarding the use and disclosure of health information, is part of a larger legislative framework known as the Health Insurance Portability and Accountability Act (HIPAA).  This federal legislative framework was designed and subsequently voted into law by Congress in 1996 in an effort to create a balance between two competing objectives of HIPAAimproving the efficiency and effectiveness of the national health care system and preserving individual privacy in personal health information (Citizens for Health v. Leavitt, 2005, p.7).  How this balance is achieved, between efficiency and privacy, has been a main source of contention and litigation.

Health consumers and individual plaintiffs alleged that this regulatory rule violated federal statutory law, American constitutional law, and that in the alternative the Secretary has exceeded the scope of his authority.  They argued, in short, that the use and the disclosure of private health information through an electronic clearinghouse without the consent of patients is illegal despite the ostensible benefits for administrative and business purposes.  The Court of Appeals probably decided the case fairly because the regulatory rule does have important business and administrative purposes and because the rule is permissive rather than mandatory.  The court stated that this regulation does not impose an affirmative obligation on the State to ensure that those interests do not come to harm through other means (Citizens for Health v. Leavitt, 2005, p.20).  This is the pivotal distinction because the language in the privacy rule is permissive rather than compulsory.  This means, in the Courts view, that the privacy rule cannot be characterized as unconstitutional if it does not create an unconstitutional deprivation or infringement on its own.  The permissive nature of the rule allows for patient consent to be sought and secured any abuse will be the result of actions beyond the scope of the rule itself.  In short, businesses will benefit and individuals and health care providers will still have legal recourse if the use and disclosure of the health information is abused.  This is a fairly reasonable balancing act and harms none of the parties while achieving the regulations underlying policy objectives.