Privacy Rights and Public Families

Abstract

This Article is based on eighteen months of anthropological fieldwork conducted among poor, pregnant women receiving prenatal care provided by the Prenatal Care Assistance Program (“PCAP”) at a large public hospital in New York City. The Prenatal Care Assistance Program (“PCAP”) is a special program within the New York State Medicaid program that provides comprehensive prenatal care services to otherwise uninsured or underinsured women. This Article attempts to accomplish two goals. The first goal is to argue that PCAP’s compelled consultations – with social workers, health educators, nutritionists, and financial officers – function as a gross and substantial intrusion by the government into poor, pregnant women’s private lives. Indeed, the families that these women seek to create or expand are made “public” in as much as the state insists upon expunging the highly-idealized line that is thought to protect the “private family” from state involvement in order to maintain a supervisory, regulatory, and occasionally punitive presence in poor women’s families. The second goal is to investigate why it is that indigent women and families fail to enjoy a presumption of privacy with regard to matters that have been imagined, within political and popular discourse, as private. The Article concludes that poor women and families do not enjoy a presumption of privacy because the inability to thrive within a capitalist economy, and the consequent reliance upon the state for financial survival, is thought to index a perceived moral laxity that results in the production of unplanned, unwanted children and their subsequent mistreatment and exploitation; moreover, the mistreatment and exploitation of children is sufficiently probable and expected that the prevention thereof justifies the violation or dramatic limitation of all poor, pregnant women’s rights to be free from state intervention in private matters.

Keywords: privacy, Medicaid, healthcare, prenatal care, pregnancy, anthropology

JEL Classification: K19, K32, K39, P19