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May 12, 2014 | Posted By Wayne Shelton, PhD

Recently, the Governor of Tennessee signed into law a bill, SB 1391, which criminalizes a woman who has had a baby with drug-related complications.  As a result babies born with addictions due to drug use by the mother during pregnancy will be grounds for the mother being charged with aggravated assault, which could result in sentence of up to 15 years in prison for the mother. The concerns of the state legislators who promoted and passed this bill were over a condition in newborns called neonatal abstinence syndrome (NAS).  This condition results from exposure to addictive drugs while in the mother’s womb. In 2013 the Tennessee state Health Department reported 921 babies born with NAS and 278 cases so far in the past four months. The stated goal of the law was to reduce the number of babies born with this condition. But is criminalizing drug use during pregnancy, in this first of its kind state law, the most effective way of accomplishing this goal?

It is important to note that the bill was passed against the strong objections of women’s rights groups as well as health care and addiction specialty groups. First of all these experts agree that cause more harm to babies as pregnant women will be afraid to seek medical care.

And even more important, healthcare specialists in obstetric medicine and addiction actually claim that the risks of addiction to newborn babies have been exaggerated. Conversely, the bill would disproportionately and adversely affect the most vulnerable women in the state, i.e. poor, rural, and women of color. Medical researchers in this area actually say that the actual effects of NAS are rather short lived and are easily treatable.

In short, there are no rational reasons, i.e. reasons that are known through scientific knowledge and expertise, to justify this law. So why were these legislators in Tennessee so eager to pass this bill and why did the governor sign it with so many sound reasons not to? The answer to this question, in my opinion, points to a dark side of contemporary American life.

By passing SB 1391 into law the impression will be given to the public that an irresponsible pregnant woman, probably a minority woman of color, will be made accountable for her actions. Sadly, the outcome could be just the opposite. The chances are more likely now that she will not enter the healthcare system, which could lead to several negative outcomes. The chances of medical complications for the mother are greatly increase which could impact her life and health as well as healthcare costs. And possibly because she fears entering the healthcare system she may more quickly elect to have an abortion. Like so many other issues about which there is proposed remedy, this law will likely have unintended consequences and actually creates additional burdens and harms to the targeted population. This population already has a multitude of socioeconomic stressors to deal with such as high unemployment, poverty, poor education, limited opportunities, limited access to primary healthcare and limited drug treatment resources, etc. The fact that these women are vulnerable individuals and might benefit from greater resources and empowerment apparently was not a consideration.

As someone who spent many years living in Tennessee after growing up in North Carolina and experiencing first hand the segregated south during the 50’s and 60’s, my sense is that this law and others like it reflect a stagnant moral culture in which a political majority clings to past racial identity politics and resentment toward minorities.  The application of scientific data and professional expertise that would help us understand and address such complex social issues are simply ignored, or even worse, viewed as left wing bias.

SB 1391 is a mean spirited, flawed law that was passed and apparently supported by many state citizens. It will do nothing to alter the underlying social and moral conditions which the bill targets. It is more likely that these conditions will continue to deteriorate and human suffering will increase.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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