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Criminal Charges for Child Harm from Substance Use in Pregnancy
Cara Angelotta1, Paul S Appelbaum2
1Dr. Angelotta is Instructor of Psychiatry and Behavioral Sciences, Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL. Dr. Appelbaum is Elizabeth K. Dollard Professor of Psychiatry, Medicine, and Law, Department of Psychiatry, Columbia University, and Director, Division of Law, Ethics, and Psychiatry, Columbia College of Physicians and Surgeons, and NY State Psychiatric Institute, New York, NY. cara.angelotta@northwestern.edu.
Most women prosecuted for substance use during pregnancy had charges dismissed or convictions overturned. Judicial decisions hinged on whether a fetus is legally considered a child, highlighting the need for legislative clarity.
Area of Science:
- Legal Studies
- Public Health
- Medical Ethics
Background:
- Several state legislatures are considering laws to criminalize substance use during pregnancy.
- This trend faces opposition from medical and public health professionals.
- Criminal charges for prenatal substance exposure raise complex legal and ethical questions.
Purpose of the Study:
- To review legal decisions concerning women prosecuted for substance use during pregnancy.
- To analyze judicial outcomes and the legal reasoning behind them.
- To inform advocacy efforts regarding legislative approaches to prenatal substance exposure.
Main Methods:
- A systematic review of judicial opinions was conducted.
- 24 published judicial opinions between 1977 and 2015 were identified.
- Cases involved 29 women prosecuted in 19 states for crimes against a fetus or child due to substance use.
Main Results:
- Charges included various offenses like child endangerment, abuse, neglect, and homicide.
- Substances involved ranged from illicit drugs to prescription medications.
- 86.2% of the women experienced dismissal of charges or overturned convictions.
Conclusions:
- Judicial decisions predominantly turned on the legal definition of a fetus as a child within criminal statutes.
- The trend in court decisions favors treating substance use during pregnancy as a medical issue, not a criminal one.
- Advocacy efforts should focus on state legislatures to clarify legal definitions and policies.
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