A state hospital tested pregnant women (who met one of nine criteria) for cocaine, and if those testing positive refused or failed a substance abuse program, they were arrested and charged with a crime. The court held that a state hospital’s performance of a diagnostic test to obtain evidence of a patient’s criminal conduct for law enforcement purposes is an unreasonable search if the patient has not consented to the procedure. The interest in using the threat of criminal sanctions to deter pregnant women from using cocaine cannot justify a departure from the general rule that an official nonconsensual search is unconstitutional if not authorized by a valid warrant. The court distinguished other cases involving drug testing (such as railroad employees involved in accidents or students participating in sports), because there the “special need” was one divorced from the state’s general law enforcement interest. While the ultimate goal of the program may have been to get the women involved into treatment programs, the immediate objective of the searches was to generate evidence for law enforcement purposes. J. Scalia, J. Thomas, and C.J. Rehnquist dissented.