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Journal Issue: Drug-Exposed Infants Volume 1 Number 1 Spring 1991

Perspective of a Reproductive Rights Attorney
Lynn Paltrow

Punitive Approaches Undermine Medical Care

Punitive approaches typically require doctors to report all positive drug test results and admissions by mothers of drug use during pregnancy to state authorities. Deputizing doctors to be police informers, however, will not help women or their babies. "The therapeutic process, if it is to be at all effective, depends on a bond of trust between a program's staff and patients. Confidentiality is vital to that trust, for without it no patient is likely to share with staff the personal information needed to formulate and implement a workable treatment plan."18 In Florida, for example, after uniformed officers wearing guns went to a hospital to investigate new mothers suspected of cocaine abuse, doctors reported that they could no longer "depend on the mothers to tell them the truth about their drug use . . . because the word ha[d] gotten around that the police will have to be notified."19

Because punitive approaches undermine good health care, national health groups, including the American Medical Association, the American Academy of Pediatrics, the American Public Health Association, the American College of Obstetricians and Gynecologists, and the American Society of Law and Medicine, are opposing prosecutions and universal neonatal screening for illegal drug use during pregnancy.20