Ferguson v. City of Charleston, 532 U.S. 67 (2001), is a United States Supreme Court decision that found Medical University of South Carolina's policy regarding involuntary drug testing of pregnant women to violate the Fourth Amendment.

Soon after the urine screenings began, the case manager in the hospital's obstetrics department heard that police in Greenville, South Carolina, were arresting pregnant women who used cocaine for child abuse.

After reviewing the idea with counsel, the MUSC hospital began referring pregnant women who tested positive for cocaine to Charleston police for prosecution.

Acting together, hospital staff and the police department developed a written policy for determining which pregnant women would be screened and, if they tested positive, prosecuted.

Women would be selected for urine screening if they met certain criteria, such as prior lack of prenatal care, known history of drug or alcohol abuse, intrauterine fetal death, or abruptio placentae.

[2] It reasoned that the interest in curtailing pregnancy complications and reducing the medical costs associated with maternal cocaine use outweighed what it characterized as a "minimal intrusion" on the women's privacy.

In Skinner v. Railway Labor Executives Association, National Treasury Employees Union v. Von Raab, and Vernonia School District 47J v. Acton, the Court had sustained drug testing under the special needs doctrine in light of the subjects' consent; in Chandler v. Miller, the Court had struck down drug testing under the special needs doctrine despite the subjects' consent.

By turning over the results of these medical tests to the police without the women's consent, MUSC violated this reasonable expectation of privacy.

In this case, unless the special needs doctrine applied, this intrusion upon the women's expectation of privacy would amount to a violation of the Fourth Amendment.

Because the MUSC plan used the threat of arrest as the means to accomplish its overall goal of inducing pregnant women to abstain from using cocaine, "this case simply does not fit within the closely guarded category of 'special needs.'"