Question

Should a Pregnant Woman Be Punished for Exposing Her Fetus to Risk?

(Exp. Alcohol and or drugs)

How should society respond to pregnant women using recreational or addictive drugs that may harm their future children?

Some argue   YES that they should be punished and jailed right away if tested positive for drugs whereas other argue NO, that they should be given treatment as the first option

Example:

Liles Burke sets out the majority opinion of the Alabama Court of Criminal Appeals in a case involving a pregnant woman who was found to have used cocaine while pregnant. Burke argues that Alabama law that forbids adults from exposing children to controlled substances applies in cases involving pregnant women and their fetuses. Attorney Lynn M. Paltrow argues that treating drug-using pregnant women as criminals targets poor, African American women while ignoring other drug usage and fails to provide the resources to assist them in recovery.

Assume that you are a healthcare administrator, and you find yourself dealing with this exact issue regarding a patient giving birth in your facility. What will you do?

Prepare a 500-word paper, double-spaced and in APA style

presents the most important legal and ethical issues relevant to this topic from both perspectives. And then state your position on this issue and describe how you will handle it in your hospital.

It is important to present this information in an objective and factual manner. You may use research other than the Kaebnick text to support your analysis and summary paper.

                *****NOTE FROM STUDENT ****

CAN YOU PLEASE HAVE THIS DONE BY TOMORROW , SUNDAY . THANK YOU!

Answer 1

When a woman becomes pregnant, it is very important for her to lead a healthy life: to eat plenty of nourishing food, get plenty of rest, and exercise regularly. It is also vital that she avoid anything that might harm her or her baby-to-be. For a pregnant woman, drug abuse is doubly dangerous.

For more than a decade, law enforcement personnel, judges, and elected officials nationwide have sought to punish women for their actions during pregnancy which may affect the fetus they’re carrying. Women who are having children despite substance abuse problems have been a particular target, finding themselves prosecuted for such non-existent crimes as “fetal” abuse and delivery of drugs through the umbilical cord. In addition, pregnant women are being civilly committed or jailed, and new mothers are losing custody of their children even when they would be capable parents. Meanwhile, state legislators have repeatedly introduced substance abuse and child welfare proposals that would penalize only pregnant women with addiction problems.

The cases of women who are charged and convicted of child abuse even before they are born reflect an interesting intersection between the conservative War on Drugs and the conservative effort to restrict reproductive freedoms.

Some drugs can directly impair prenatal development, most of the body organs and systems of the baby-to-be are formed within the first ten weeks or so of pregnancy during this stage. After about the tenth week, the fetus should grow rapidly in weight and size. At this stage, certain drugs may damage organs that are still developing, such as the eyes, as well as the nervous system. Continuing drug use also increases the risk of miscarriage and premature delivery. But the greatest danger drugs pose at this stage is their potential to interfere with normal growth “low-birth weight babies require special care and run a much higher risk of severe health problems or even death”.

Some proponents of these efforts are motivated by the misguided belief that they are promoting fetal health and protecting children. Others hope to gain legal recognition of “fetal rights” the premise that a fetus has separate interests that are equal to or greater than those of a pregnant woman. Creation of such rights would require women to subordinate their lives and health including decisions about reproduction, medical care, and employment to the fetus. In fact, doctors and hospital officials have already relied on this theory to seek court orders to force pregnant women to undergo cesarean sections or other medical procedures for the alleged benefit of the fetus. Some advocates of fetal rights have argued that children should be able to sue their mothers for “prenatal injuries.” In some industries, employers have adopted “fetal protection” policies, which barred fertile women of childbearing age from certain high-paying, unionized jobs.

Another issue that has not been addressed is smoking which is legal. Will smoking while pregnant constitute child endangerment since it has also been known to cause many health issues with babies? The American Medical Association and other leading medical groups have concluded that drugs and alcohol addictions are diseases that should be treated not punished. Federal and states experts have concluded that there is no evidence that the threat of jail succeeds in reducing drug use and improve birth outcomes. Instead, there is evidence that it frightens women away from prenatal care and drug treatment that can be helpful for these women and their future babies.

Use of illicit drugs like cocaine and opioids during pregnancy can cause complications and serious problems in the developing fetus and the newborn. Growth of fetus is likely to be inadequate and premature birth defects are more common. Cocaine crosses the placenta, constricts the blood vessels reducing blood flow to the fetus. The reduced blood and oxygen supply to the fetus slows the growth of bones and intestine. Use of cocaine can also cause complications during pregnancy. Among women who use cocaine throughout pregnancy, 31% have preterm delivery and 15% have premature detachment of placenta. The chances of miscarriage also increase. Drugs that a pregnant woman takes can affect the fetus in several ways. They can act directly on the fetus causing damage or abnormal development leading to birth defects or death. They can also alter the function of the placenta usually by constricting blood vessels and reducing the blood supply of oxygen and nutrients to the fetus from the mother and thus resulting in a baby that is underweight and underdeveloped.

Women’s and children’s advocates agree that women should engage in behaviors that promote the birth of healthy children. Nevertheless, they recognize that a woman’s substance abuse involves complex factors that must be addressed in a constructive manner. Punitive approaches fail to resolve addiction problems and ultimately undermine the health and wellbeing of women and their children. For this reason, public health groups and medical organizations uniformly oppose measures that treat pregnant women with substance abuse problems as criminals. Moreover, with one notable exception, courts have repeatedly rejected attempts to prosecute women under existing criminal laws for their behavior during pregnancy that poses a risk of harm to the fetus, or to coerce women to undergo medical procedures to benefit their fetuses. Some of these decisions have explicitly recognized that the fetal rights theory poses a significant threat to women’s reproductive rights and the best interests of
children.

Although no state has enacted a law that specifically criminalizes conduct during pregnancy, prosecutors have used statutes prohibiting abuse or neglect of children to charge women for actions that potentially harm the fetus. Some have also argued that pregnant women “delivered” drugs to “minor” children fetuses through the umbilical cord. In addition, a mother’s or newborn’s positive drug test has led to charges of assault with a deadly weapon (cocaine), contributing to the delinquency of a minor, and possession of a controlled substance. In cases in which infants tested positive and died soon after birth, women have been charged with homicide or feticide. Some women have even been prosecuted for drinking alcohol or failing to follow a doctor’s order to get bed rest or refrain from sexual intercourse during pregnancy.

Criminal charges based on conduct during pregnancy also raise serious constitutional concerns. In dismissing these cases, some courts have recognized that the prosecutions violated women’s rights to due process and privacy. Due process prohibits prosecutors and courts from interpreting or applying an existing law in an unforeseeable or unintended manner. A number of courts have thus found that the unprecedented application of statutes such as child abuse provisions to behavior during pregnancy violates due process guarantees because women did not have the required notice that such laws would be applied to fetuses or conduct during pregnancy. Other courts have recognized that interpreting a child abuse statute to include conduct during pregnancy would render the measure unconstitutionally vague because women would not know what behavior would be criminal.

While no state has enacted specific legislation criminalizing behavior during pregnancy that poses a risk of harm to the fetus, many states have modified their civil child protection laws to mandate reporting to child welfare authorities or to define child neglect to encompass cases in which a newborn is “physically dependent on,” tests positive for, or was harmed by an illegal drug and/or by consumption of alcohol. One state statute specifically provides that a lone positive drug test at the time of delivery is not in and of itself a sufficient basis for reporting child abuse or neglect, and several others prohibit basing criminal proceedings solely on a positive toxicology. Another state, recognizing that such reporting raises serious issues of doctor-patient confidentiality, provides reporting to the health department for “service coordination,” but only if the woman consents. Still another state provides that, if a woman is informed, health care providers may test new mothers and newborns for alcohol and other drugs, but allows a physician discretion in determining whether abuse or neglect has occurred and reporting is required.

Leading public health organizations, including the American Medical Association and the American Public Health Association, oppose the prosecution of pregnant women who use drugs. These groups recognize that such an approach undermines maternal and fetal health because the threat of criminal charges and the fear of losing their children deter women from seeking prenatal care and drug treatment.

Both the World Health Organization and the American Psychiatric Association classify substance abuse as a disease. The American Medical Association explains that “addiction is not simply the product of a failure of individual willpower. It is caused by complex hereditary, environmental, and social factors.” Substance abuse is difficult to overcome, even for pregnant addicts who are especially motivated to stop. Moreover, according to experts, such factors as a history of abuse specifically affect a woman’s drug use and thus raise important issues for treatment.

Despite the fact that drug treatment programs tailored for pregnant and parenting women help them overcome their addiction problems, greatly improve birth outcomes, and are cost-effective, such programs are extremely rare and overburdened. The Federal General Accounting Office (GAO) Report found that the most critical barrier to women’s treatment “is the lack of adequate treatment capacity and appropriate services among programs that will treat pregnant women and mothers with young children. The demand for drug treatment uniquely designed for pregnant women exceeds supply.”

Conclusion
Punitive approaches to the problem of substance abuse during pregnancy threaten the health of women and children and seriously erode women’s rights to privacy. Further, they ignore the serious shortage of drug treatment programs for pregnant and parenting women and fail to address the overall lack of access to reproductive health care services. Policymakers, legislators, and those who purport to care about the well-being of women and their children must work to find better ways to address the needs of women with drug and alcohol abuse problems. As the author of a study on the effectiveness of mandatory treatment concluded, “the children of drug-using mothers may be most effectively served by the development of available, efficacious, and welcoming services for women and families.”