Toxicology testing in neonates. Is it ethical, and what does it mean?

A positive toxicology screen in a newborn may provide some explanation for signs and symptoms affecting the newborn's problems in the NICU. But, simply stated, it does not prove cause; it does not prove child neglect; it does not prove inadequate parenting capabilities. The evidence of maternal illicit substance use may provide us with information that a variety of risk factors associated with drug use may be interacting that could interfere with the infant's long-term well-being. The objective of screening must be focused on medical and health care issues, not on political or legal issues, and never intended for punitive actions toward the mother. Resources should be available to provide the mother with educational information, treatment programs, psychosocial counseling, and household support systems to assist her in her role as principal caregiver to her infant. Follow-up care for the baby should be provided by physicians and clinics familiar with high-risk infants and include ongoing neurodevelopmental surveillance in specialized programs if available.