The issue of drug use amongst pregnant women presents a conundrum with no easy answer in sight. In a world where abortion is legal, prosecuting and criminalizing drug addicted mothers may seem a double standard. Drs. and other heath care personnel are now being put into a position of upholding the law while still trying to honor the best wishes of their patients. Many ask the question, is upholding the law discouraging women from seeking the help they need for fear of facing charges or loss of their child?
Each state, its justice system, and the Drs. responsible for treating pregnant women are faced with difficult ethical questions regarding how to treat, penalize, and determine if a woman is using illicit substances while pregnant. Over the past two decades, prosecutions for mothers using drugs during pregnancy has tripled. For the most part, states have avoided criminalizing drug addicted women, but have instead went in the backdoor and prosecuted them based upon both child endangerment laws and drug laws already in place within their state.
These women face very harsh consequences if found to be using illicit substances during their pregnancy including incarceration, loss of parental rights at the time of the child’s birth, and denial of welfare benefits to aide in raising their child.
All these factors create a host of ethical problems as Drs. become responsible for enforcing the law. They are required to conduct drug tests, often without the patient’s knowledge or consent and report the results to appropriate law enforcement agencies. This becomes particularly dicey when most physicians have been extensively trained in the medical model that recognizes addiction as a medical illness. Thus, physicians may be required to either disobey the law or violate their own conscience and beliefs about the impossible nature of addiction.
Furthermore, women who are addicted may fear legal consequences and therefore choose to avoid prenatal care altogether. This is further damaging to the well-being of the child. Studies have proven that the likeliness of a healthy birth is increased for women who receive prenatal care even if they suffer from drug addiction throughout the course of their pregnancy. Additionally, women no longer are free to speak openly with their health care provider to receive the necessary help to stop abusing substances during their pregnancy as they will then face legal repercussions. These issues are difficult to mediate as the law is simply seeking to protect unborn children, even though it may inadvertently harm them further. Future legal repercussions must consider the entire picture when considering policies that target drug addicted mothers.