Utah’s Department of Health survey shows institutional failures

This op-ed was originally published in the Salt Lake Tribune.

Why did the Utah Department of Health require new parents to fill out an eight-page form with more than 100 questions to get their infant’s birth certificate?

Speaking last month with KUTV, Ivy Eastbrooke said that after giving birth she did not want to fill out a survey brought to her by her nurse because of the personal and sensitive information requested. This information included answers to questions such as whether mothers used prenatal vitamins or became pregnant through a sperm donation. Because she could not get her newborn’s birth certificate unless she filled out the form, Eastbrooke told KUTV she answered the questions despite her concerns.

Eastbrooke’s story is one of thousands. As reported by KUTV, until recently, parents of newborns had to provide sensitive information to the Utah Department of Health through a mandatory survey.

Parents uncomfortable with the questions had no option but to fill out the survey because the forms made it clear that parents’ ability to acquire their child’s birth certificate hinged on its completion.

As KUTV’s investigative series shows, Eastbrooke was pressured to fill out the forms while still in the hospital post-birth, meaning she was coerced into providing detailed personal information in the immediate aftermath of giving birth.

Of course, the answers to survey questions are irrelevant to the issuance of a birth certificate, but they are quite useful for research purposes. The DOH admits the data gathered from surveys is released to researchers, who pay the DOH to access information gathered from the survey, including personally identifiable information.

The Department of Health clearly overstepped its authority. Tom Hudachko, the director of communications for DOH, told KUTV that DOH is now working with attorneys to revamp the forms parents fill out to acquire their children’s birth certificates. According to Hudachko, changes will likely mirror requirements for U.S. birth certificates.

Although updates will be made, DOH has not discussed a timeline for when new forms will be available. Hudachko told KUTV the department will launch a website allowing new mothers who filled out the survey the option to request the removal of their information.

However, given the scope of institutional failures which allowed this abuse of citizens’ privacy to occur, the department’s response is insufficient and further accountability is needed. Absent additional information, it appears the DOH is solely responsible for the creation and implementation of the survey. The actions of the DOH breach trust between it and the public. The DOH demanded answers to deeply private questions and used coercive tactics to obtain answers to them.

Furthermore, the department’s actions breached long-standing research ethics surrounding informed consent by forcing individuals to participate in research.

The Department of Health is staffed by professionals working in a variety of capacities to conduct its objectives. The creation and administration of a detailed survey as a requirement for issuing birth certificates almost certainly involved significant departmental planning.

In fact, the department’s actions show aspects of this planning. Information from the DOH shows how the survey changed over time. From 2016 to 2019, the department updated the survey yearly, adding questions to gather additional information.

Those who serve in administrative agencies are not elected and therefore are not directly accountable to the people harmed by abuses of agency authority. Nevertheless, those abuses demand corrective action.

The Utah Legislature creates and funds the Department of Health. It is the Legislature’s role to ensure agencies are not engaging in violations of ethics or law.

To restore trust between the department and the public and prevent future abuses of agency authority, citizens and legislators should ask tough questions related to the management of the Department of Health.