Pubdate: Thu, 21 Jun 2001 Source: State, The (SC) Copyright: 2001 The State Contact: http://www.thestate.com/ Details: http://www.mapinc.org/media/426 Author: Robert L Maginnis Note: Mr. Maginnis is the Family Research Council's vice president for policy and a member of the National Parents' Advisory Council on Drug Abuse. HOMICIDE AND DRUG HABITS: PREGNANT WOMEN BEWARE A recent homicide case sets the stage for new laws to protect the unborn and hold drug-addicted moms accountable. But there is much work still to be done before taxpayers will stop being forced to pay for preventable medical services. Regina McKnight of Horry County is a 24-year-old mother of three whose crack cocaine habit resulted in the death of her unborn child. In May, she was convicted of homicide and sentenced to 12 years in prison. McKnight is the first woman convicted of murder under these circumstances, although other addicted mothers of stillborn children have pleaded guilty to involuntary manslaughter. The McKnight case raises a number of questions. Is the fetus a person deserving protection? Should women be prosecuted for harmful health habits that endanger their unborn children? Should abusers be coerced into treatment? Drug-addicted newborns are generally premature and often require hundreds of thousands of dollars worth of health care in just the first year. If they survive, they frequently suffer developmental problems. Not surprisingly, many jurisdictions are turning to coercion, proven to be the most effective tool to get addicts into treatment. Perhaps the best example of a coercion-based program is drug courts, which give convicted abusers the choice of jail or a sentence structured by the judge that usually includes treatment, a job-training program and frequent drug tests to ensure abstinence. But the linchpin for drug courts or, for that matter, most treatment programs, is addict motivation. The addict must really want help, and the program must be comprehensive and long term. Unfortunately, the United States has only a quarter of the treatment programs needed, and many of these aren't comprehensive. The best programs, which are often expensive and privately run, are not available to homeless abusers like McKnight. And while McKnight's case involves an illegal drug, there are, perhaps, millions of pregnant women who drink alcohol or smoke cigarettes. These behaviors by their mothers endanger the unborn children and create health problems that impose huge health costs on the public. For years, S.C. officials have tried to solve the problem of drug-addicted mothers who give birth to very sick babies. And many states have considered tough laws to punish mothers who, like McKnight, demonstrate poor judgment. No state, however, has passed such a law because the medical community contends that punitive approaches to health problems during pregnancy are counterproductive. Regrettably, doctors have offered no viable alternatives to the status quo. An unborn child in South Carolina is a protected person under a 1997 state Supreme Court ruling involving a woman who tested positive for cocaine after giving birth and pleaded guilty to violating child-abuse laws. In a strange twist of logic, had McKnight chosen to kill her baby intentionally by having it legally aborted, she would have escaped prosecution. The U.S. Supreme Court's tragic Roe vs. Wade decision established a fundamental constitutional right to abortion but lets states decide at what stage abortion is no longer legal. McKnight did right to choose life over abortion. But she is being punished, and justifiably so, for living a lifestyle that resulted in the death of her unborn child. It is not too much of a stretch to reason that, just as a mother is responsible for the care of her child after it is born, she is responsible for its care while it remains helpless within the womb. While it would be a tragedy if the threat of prosecution for substance abuse drove more women to abort their babies, it would be equally tragic if no mechanism is found to facilitate treatment for drug-addicted pregnant women who seek help. Those who refuse to seek treatment and bear damaged children as a result certainly merit punishment. In the future, all who are concerned about life before and after birth will have to wrestle with these sticky issues. State legislatures ought to establish a prenatal standard of care that involves drug testing and extends protection to the unborn, mandates effective drug treatment for drug-abusing moms, saves the taxpayer from high public assistance medical costs-and does this without violating individual liberties. - --- MAP posted-by: Andrew