After reading the attachment file, write a one paragraph as a class discussion. Please answer one of the questions in the last paragraph in your own words and what are your thought about it.

For this discussion, please read the following section on Alcohol and Drug Use During Pregnancy and answer or comment on the questions at the end. The discussion is about the use of alcohol and drugs during pregnancy and if such behaviors should be regulated. My own research shows that even low amounts of alcohol during prenatal development can cause memory problems during adulthood (e.g., https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1530-0277.2011.01449.x, https://www.sciencedirect.com/science/article/abs/pii/S0306452212000280 ). Although alcohol researchers contend that there is no "safe" amount of alcohol that can be consumed during pregnancy, exposure to alcohol in utero may or may not result in impairments. Further, those https://slate.com/human-interest/2017/08/states-that-punish-pregnant-women-for-drinking-are-more-likely-to-restrict-reproductive-rights.html. These are difficult issues to address. As with any discussion, please attempt to provide support for your arguments from the text; for example, how does your understanding of brain development affect your view of these issues?

Alcohol and Drug Use During Pregnancy

One cause of intellectual disabilities in the Western world is prenatal alcohol exposure, which can result in FAS (Centers for Disease Control and Prevention, 2018). Alcohol interferes with normal brain development and can cause permanent brain damage, especially to the neocortex, hippocampus, and cerebellum. The resulting impairments can negatively affect learning, attention, the inhibition and regulation of behavior, memory, causal reasoning, and motor performance (Guerri, 2002). In the United States, the prevalence of FAS is estimated to be between 0.2 and 1.5 cases per 1,000 live births, though the actual numbers could be higher (Centers for Disease Control and Prevention, 2018).

The use of recreational drugs, such as opiates, cocaine, or cannabis, during pregnancy can also affect a child’s development. Premature birth and other complications have been associated with the use of all these drugs during pregnancy (Gillogley et al., 1990; Sherwood et al., 1999). Infants of women taking opiates, particularly methadone, have two to three times greater risk for unexplained sudden death in infancy (Davidson Ward et al., 1990), and cocaine use has also been linked to sudden infant death (Kandall & Gaines, 1991; Hulse, Milne, English, & Holman, 1998). Among infants exposed to opiates in utero, 55 percent to 94 percent show symptoms of newborn withdrawal (American Academy of Pediatrics, 1998), including irritability, high-pitched crying, tremors, vomiting, diarrhea, and rapid breathing. However, some heavy drug users have normal infants, while some moderate users have infants with serious effects, so we cannot say that a baby born to a drug user will necessarily be impaired. For any case in which prenatal drug or alcohol use puts an infant at high risk of injury, death, or lifelong disability, Norman Fost (1989), a medical ethics professor, poses three questions:

1. “Does a woman have a duty to abstain from using drugs that are likely to harm the fetus?”

2. “Does the state have an obligation to protect the fetus/newborn from harm?”

3. “Should there be legal measures to reduce the incidence of or to prevent such harm from occurring?”

The central conflict is between, on the one hand, the personal rights and autonomy of the woman and, on the other, the effects of her behavior on both the infant and society. According to the bioethics professor Ruth Macklin (1990), most people would agree that it is better for a baby to be healthy than not healthy and therefore pregnant women are morally obligated to do all they can to produce healthy infants. However, many pregnant women are not willing and able to comply.

The ethics committee of the American College of Obstetricians and Gynecologists (2004) has concluded, on the side of patient autonomy, that forcing therapy on pregnant women is almost never justified. For women who abuse drugs, the committee urges screening by physicians, counseling, and treatment. The American Academy of Pediatrics bioethics committee (1988) is more willing to challenge women’s decisions and resort to the courts under certain circumstances: (1) The fetus will suffer irrevocable harm without the treatment, (2) the treatment is clearly indicated and likely to be effective, and (3) the risk to the woman is low.

Many psychologists, physicians, and ethicists worry that legally coercive measures will drive pregnant women away from the health care system when they need it most and will result in more harm to both the woman and the fetus. Fost (1989) argues that although this consideration is important, it is difficult to weigh the effects of women’s not seeking prenatal health care against the known risks of drug and alcohol use during pregnancy. He makes an analogy to child abuse laws, which may similarly deter some parents from seeking medical care for their children; however, few people would advocate the abolition of child abuse laws because of these potentially harmful effects.

Questions:

What do you think? Does an unborn infant’s right to a healthy life outweigh a pregnant woman’s right to personal autonomy? Should pregnant drug users be placed in facilities where they cannot take drugs until their babies are born, and if so, should taxpayers pay for these women’s care? What might be some alternative options?