Apparently your dog is Big Brother’s best friend, too. A bill in the Colorado legislature would allow veterinarians to snoop into some of people’s medical records—specifically those listed in the Colorado Prescription Monitoring Program—without asking. The bill also would expand the ability of health care providers, pharmacists, and “designees” of doctors and pharmacists to look up those records without permission.
The bill—SB17-146—passed unanimously out of the Senate Health and Human Services Committee on February 16. It is scheduled for a floor vote February 27.
Anyone concerned with privacy and with the sanctity of the doctor-patient relationship might wonder why the legislature would consider this. The answer given by the bill’s supporters, including senate sponsor Cheri Jahn, is that the bill would help curb the opioid “epidemic” resulting from prescription drug misuse.
But, not only would the bill violate patients’ privacy, it would do little to address the problem of drug abuse, and it would impose some unintended harms.
The bill modifies existing statutes. As I wrote a couple years ago, the Prescription Monitoring Program, access to which the new bill would expand, has been around since 2005. I still have the same concerns about the program as a whole: It violates privacy, makes it harder for some people to get the drugs they need for severe pain, and promotes dangerous black markets in drugs.
The language of this year’s bill raises a new set of concerns. Start with the language about veterinarians. Currently vets are not allowed to snoop into people’s medical records. The bill would allow a vet to look up a human client’s records in the drug database, if the vet has the “authority to prescribe controlled substances” and if the vet “has a reasonable basis to suspect the client has committed drug abuse or has mistreated an animal.”
In other words, the bill expects veterinarians, who are trained in animal health, to also evaluate human health and psychology, for which they have no specific training or expertise. Veterinarians acting as human doctors may be great if you’re in an episode of The Walking Dead, but we’re not quite there yet.
Part of the idea here is that some drug addicts intentionally injure their pets in order to get drugs from a vet. As Jahn put it during committee testimony, “We actually have had people harming their animals so that they could actually get the drugs and painkillers for their animals, and then they’re taking them themselves.”
But notice the bill’s loose language: Even if someone brings in a perfectly happy and healthy pet for a routine check-up, the vet has the authority to look up the person’s medical records, if the vet thinks the person has ever abused any drug. Again, letting vets act as human doctors or social workers just isn’t appropriate.
What about the welfare of the pets? The bill likely would end up hurting some pets, because people with drug problems would be less likely to take their sick or injured animals to the vet for fear of getting tangled up with the authorities. Apparently neither Jahn nor the veterinarians she says support the bill thought very hard about such likely unintended consequences.
Regardless, there’s little reason to think that letting vets check human medical records would help them determine if a pet has been intentionally harmed. During testimony, one of the bill’s supporters referenced a Washington Post article. But that article does not indicate a widespread problem. Instead it states “it is not known how widespread the problem really is,” and it discusses one vet who “has not seen any instances of ‘vet shopping’ at his clinic.” In the main case discussed by the article (from Kentucky), the vet saw that a dog’s “cut looked sharp and clean,” as made by a knife.
Suspicious wounds, coupled with a pet’s owner asking for drugs, might indeed tip off a vet to animal abuse. But vets already are empowered to report such suspected abuse to the authorities. It is far more likely that the new bill will result in more animal suffering by discouraging vet visits than in better animal care due to snooping through owners’ medical records.
The bill also expands the powers of doctors to snoop through patients’ records. Current law says doctors can access the drug database only when “prescribing or considering prescribing any controlled substance.” The new bill would let doctors (and others who can prescribe drugs, as well as their designees) look through the records of any current patient at will.
So, for example, if you go to an emergency clinic for strep throat, the bill says the doctor there, who isn’t your primary doctor and who has never seen you before, gets to check out your records in the Colorado Prescription Monitoring Program, when all you need are antibiotics. That’s crazy.
One concern mentioned during testimony is that doctors need to be able to know what drugs you’re already on so they don’t prescribe other drugs that don’t mix well. But there’s already an obvious way for doctors to learn what drugs you’re taking: Ask you or your other doctors with your consent. This is only a problem when people lie to their doctors. But why should responsible people have to sacrifice more of their their privacy for the sake of drug abusers who lie to their doctors?
Finally, the new bill expands the ability of pharmacists, who know almost nothing about your interactions with your doctor, to access your records in the database. Currently, pharmacists can can access the records only when “dispensing a controlled substance.” The new bill says they can snoop in your records if they prescribe any drug, even antibiotics. But why should pharmacists have the power to snoop through your records and to second-guess your doctor’s advice?
Realistically, most people will not even notice whether SB17-146 passes. The impacts to most people would be minor and hidden. Still, the bill is yet one more step toward an all-seeing surveillance state. The bill violates patients’ rights to privacy for benefits that are tiny at best and that are offset, if not overwhelmed, by unintended harms. Jahn herself points to a key problem with the program when she points out that “an addict will do whatever it takes to get the drug that they need to get.”
Her bill won’t fix that.