January 09, 2006

Prenatal Child Abuse

One of four pieces of draft egislation (PDF, see p. 19) to be considered in the 2006 session of the West Virginia State House proposes to expand the definition of child abuse to include prenatal abuse related to drugs and alcohol. The legislation is still being worked on (it's on today's agenda for the Select Committee A - Child Protective Services and Other Matters in the WV Legislature). An excerpt from the Interim Highlights (emphasis mine):

The third measure would relate to examining prenatal exposure to drugs and alcohol and include prenatal exposure of methamphetamine and other illegal drugs as well as alcohol to the definition of child abuse The Department of Health and Human Resources, stated that there are roughly 65 meth referrals monthly, but that doesn’t mean an exact number of addicted infants, since some children are covered in multiple reports.

Note that the summary does not address women's health or fetal health, merely the expansion of child abuse to include certain behaviors by pregnant women.

This is only one of four pieces of legislation the committee is working on, including another establishing a registry of convicted child abusers, similar to that for sex offenders:

Finally, a fourth proposed bill would set up a registry of convicted child abusers similar to the registry of sex offenders maintained by the State Police. An internal registry of such offenders would be used to track them within various agencies of government, it was explained. It wouldn’t however be available to the public, drawing a distinction between the proposal and the current sex offender registry that appears on-line.

A representative from the Department of Health and Human Resources stated creating a registry would be helpful but said the special State Police unit shouldn’t be viewed as the sole realm for digging into abuse, and must be used in coordination with other agencies.

Theoretically, if both pass, a woman could have a permanent child abuser record for being caught having one drink while pregnant.

We've been around the issue of fetal alcohol syndrome in our comments before, and before we get sidetracked on that issue again, I will point out a few things.

First, I can't find a copy of the draft legislation. If and when it becomes available, I hope to get a look at it and update this post. Second, from the summary, it appears that this legislation is all about punishment, and does nothing to actually protect children or pregnant women. Third, it addresses only a small part of legal and illegal drugs that might affect - the might because of a very large question mark about the scientific certainty about effects - fetal development. No mention is made, for example, of legal prescription drugs with damaging side effects. Finally, it's yet another example of a backdoor attempt to get elevate fetal "rights" above the health and autonomy of women.

And from the looks of it, this legislation won't even do much to protect the children born to mothers with addiction problems at the same time it casts a wide net and infringes on women's reproductive autonomy. It will punish "bad mothers" but does nothing to help them improve their health or provide better opportunities for their children.

. Posted by binky at January 9, 2006 08:36 AM | TrackBack | Posted to Reproductive Autonomy | West Virginia


Comments

Binky,
So, you're saying this measure would punish bad mothers, but does nothing to protect the children of bad mothers (like maybe those who you'd say just happen to sprout full grown from a woman's uterus about nine months after pregnancy and just happen to have fetal alcohol syndrome)? You're saying just because this measure doesn't include every possible non-prescription drug that could harm infants (which presumably if they're non-prescription, they do have some therapeutic effect that doctors may not be able to prescribe if included in legislation like this for fear of legal consequences even if by medical opinion the benefits outweigh the costs), we should wait until that time before we do anything, despite everything we already know about the harmful effects alcohol (and we really don't know that a single drink isn't harmful, we just know that several drinks are harmful)? We should hold off describing women who use meth while pregnant as bad mothers because it infringes on their autonomy? So, basically you're saying that the law only punishes, therefore it's not helpful? What percentage would you say of laws have a rehabilitative aspect built into them? Are you saying we should take all other laws off the books because they don't protect citizens?

Posted by: Morris at January 9, 2006 10:40 AM | PERMALINK

I'm saying that a lawmaker shouldn't claim to be protecting the children when there's nothing in the law to protect children.

Posted by: binky at January 9, 2006 11:25 AM | PERMALINK

Binky,
It's true, there may be a better strategy involving teaching more appropriate behaviors, but that doesn't change the fact that, to use another example, most people don't speed as much as they would if there were no penalty for it. Stealing would be a lot more common if there were no police who'd come after a person. And whether it's a punitive God or a punitive state a person is afraid of, that fear can encourage people to avoid certain behaviors. I admit that if the threat of punishment is removed, a behavior will occur as much in the punished group as in a group that wasn't punished. However, as long as we don't remove that threat of punishment, that threat will suppress behaviors that are destructive to our society. Ergo, if we threaten to punish mothers for drinking too much when pregnant, or even when they're engaging in behaviors that may lead to them being pregnant, there's no reason to believe this won't lead to less drinking during pregnancy and, ergo, less children with developmental disabilities which correlate with FAS. I believe that's called protecting children from FAS, meth addiction, cocaine addiction, etc.

Posted by: Morris at January 9, 2006 02:37 PM | PERMALINK

Mo -

You do realize you are overstating things, right? Your assertion is contingent on both the behaviors involved and the punishments demanded. Sometimes requiring punishments leads to a change in behavior, sometimes not. And this proposed law could be such a tremendous overreaction (even to those in society who consider those cell clusters to be children) that I doubt a lot of women will really think - "huh, I could have a glass of wine, but I might get arrested for child abuse so I better not". It strikes me as such a patently absurd overreaction that it's not going to be taken seriously by most of the potential "abusers" (and those extreme cases are likely to be so far beyond the ability to stop themselves that a piece of official paper surely isn't going to be the thing to do it), and I can't imagine there are lots of DA's in the state who want to start locking up ladies for drinking a glass of wine.

So - all in all - it looks to me like this law serves no purpose whatsoever, beyond establishing a legal framework to assert that fetuses are "children" - so that pushy and overbearing folks like you can require women to endure pregnancy and give birth - much like so many cows in South Dakota.

Posted by: Armand at January 9, 2006 03:47 PM | PERMALINK

Bro,
By definition, a punishment is not a punishment unless it changes behavior. While true that the threat of certain punishments will not alter behavior unless it is perceived to a person as uncomfortable, there are very few people who don't perceive spending time in jai as uncomfortable (and a good portion of this very few is already in jail). I'm not saying that all meth addicts having sex are suddenly going to stop using when this law is passed, but the best way to end up with the status quo numbers of meth addicted babies is to do nothing. Maybe this won't affect them all, but maybe it will affect some of them, and maybe it will affect some of the crackhead moms, and some of the moms who think their autonomy is more important than their future child's well being, so they continue to drink. Or maybe you don't think it's important just to help the ones we can help? And I would hope that even pro-choice people would understand that drinking during pregnancy is reckless behavior because this affects the children once they are born, whether or not they believe they're children during pregnancy.

Posted by: Morris at January 9, 2006 04:00 PM | PERMALINK

By what definition does punishment change behavior? Punishment is served in response to an act. Check the M-W if you don't believe me. Retribution. Rough treatment. Injury. Penalty. No behavioral change of the punished is implied.

Not only is the goal of punishment not to change the behavior of the punished, it's generally also a poor deterrent to the general popuation. Otherwise we'd have no murder and no drugs in this country, given the re-establishment of the death penalty and the war on drugs.

"maybe it will affect some of them"

Well, gee, that's a great way to make public policy. Maybe. Who knows? Let's violate the law of the land by declaring fetuses to be people, violate women's rights, and use a crane to crush a fly to punish women who have the bad taste to be addicted to low class non-prescription drugs, while their affluent sisters can pop all the Accutane they want. And maybe, just maybe, it might accomplish something. Plenty of demonstrable downsides, but nice big "hope so" on the positive outcomes. Please.

Just helping the ones we can help sure sounds nice, but this law isnt going to help anyone. It's a wolf in sheep's clothing, sneaking in a redefinition of "fetus" to mean child.

Posted by: binky at January 9, 2006 06:34 PM | PERMALINK

In the language of behavioral psychology, punishment removes something positive or adds something negative to a situation, and the organism in response has a lower probability of behaving in that way again. If the behavior is not changed, there's no reason to believe that the organism perceived whatever negative was added to a situation as being negative, or perceived whatever was removed from the situation as being a positive. Therefore observably, if a behavior is not decreased, there's no empirically observable way of concluding that the organism experienced whatever was added to or taken away from their situation as being a punishment.

And this goes exactly to the heart of your next argument. Prison only works on those people who experience it as worse than the rest of their life, and many people in prison either come from circumstances worse than prison. Also, many criminals have narcissistic personalities, so they believe that they are so great they won't get caught or they'll be able to talk people out of sending them to jail if they are. Others have antisocial personalities which can be characterized by an indifference to pain, so of course punishment would not work on personalities like this. That's why the death penalty isn't any more effective than jail, because the population you're drawing conclusions from is not representative of the population of America, just the population of people who kill other people. In general, the legal system works not by keeping these kind of people from criminal behavior, because with their personalities neither prison nor therapy will tend to be effective at anything except increasing their ability to manipulate the system. The legal system works by keeping the other 95+% of the population from criminal behaviors, and it tends to be fairly effective. You portray this as though if a medicine doesn't work on one person, we should throw it away because it's not an effective medicine. It's not that black and white.

Of course you realize there's no requirement that fetuses be people for a law like this to exist. Drunk driving laws exist because of reckless behavior that may lead to a certain outcome, and even if the reckless behavior doesn't lead to that outcome, the behavior itself is reckless and thus regulated by law, punished even. Or maybe you don't think drunk driving should be against the law? Or maybe you don't think there's a correlation between a mother drinking during pregnancy and a child magically having fetal alcohol syndrome a few months later.

Posted by: Morris at January 9, 2006 07:18 PM | PERMALINK

If the concern of lawmakers is for the prevention of fetal alcohol syndrome, perhaps they might establish programs that would encourage women to seek treatment, and then make sure that treatment is available and affordable. The information in the summary I linked to suggests nothing of the sort. The infant will still be born with fetal alcohol syndrome. So that leaves us with a useless, punitive policy that as a kicker erodes women's reproductive autonomy. As policy, that's a loser on all counts.

Look Morris, you seem to have no fear of the nanny state. Great! Then why not let the nanny state really help, and provide treatment and prevention for the women. We'll be saving her too, not just the fetus fetish.

Posted by: binky at January 9, 2006 07:30 PM | PERMALINK

Binky,
I don't see how it can come as a shock to you that millions of women of child bearing age see alcohol as more of a solution to boredom and anxiety than a problem that leads to developmental disabilities in their children. It's a well publicized fact that alcohol kills brain cells and does liver damage, yet most of this country still drinks, so your idea that most Americans tend to do the healthy thing when given the opportunity (an uncoerced choice) doesn't really hold up. That's why (I hope) laws exist, to protect people from themselves and each other.

Posted by: Morris at January 9, 2006 10:45 PM | PERMALINK

Millions of humans see alcohol as a solution to boredom and anxiety. It leads to all kinds of problems, but we don't seek to remove the autonomy of others who drink in such imbalanced ways except in the case of women.

Posted by: binky at January 9, 2006 10:48 PM | PERMALINK

Binky,
We absolutely do remove the autonomy of other drinkers who drink in such imbalanced ways, we arrest people for drunk driving, and only people who have access to a car get arrested for drunk driving. Remember during Katrina how the poor were disadvantaged because they didn't have access to cars to leave the city. Well, DWIs disproportionately target the rich (unless you know of people who've gotten ten year sentences for drunk intoxication while walking home). We target any behavior, anytime if it recklessly causes harm to another person.

Posted by: Morris at January 9, 2006 10:56 PM | PERMALINK

Morris - You write: "We target any behavior, anytime if it recklessly causes harm to another person". You are, thank the Lord, so wrong it boggles the mind. A huge array of reckless behaviors are not made illegal. As to drunk driving in particular - that's an astonishly ineffective way to try to "help" people with drinking problems.

Posted by: Armand at January 10, 2006 09:00 AM | PERMALINK

Bro,
I'm certainly not saying that as a society we target all behaviors that recklessly cause harm to another person, what I said is we target any. Fifty or a hundred years ago very little was known about fetal alcohol syndrome. If we don't know that one behavior tends to correlate with harm to another person, then of course we wouldn't target it. But if we learn something new about a person's behavior recklessly harming other people, a harm that would not exist without that reckless behavior, we have the chance to protect children from growing up and never getting to be a doctor or a lawyer or an astronaut. You're often bashing Bush, saying there aren't as many professional jobs anymore and it's his fault that people can't get into these careers. Well if it's such a harm that you believe Bush to be doing, as you see it he's depriving people of professional careers, then why isn't it a harm when a woman drinks while pregnant, depriving her children of having the intellect necessary for a professional career?

Posted by: Morris at January 10, 2006 09:50 AM | PERMALINK

1. The latter comparison is pretty ridiculous. 2. I hardly ever post on the "professional" job market - I've simply noted that job growth sucks under this president, which it does, but how that's comparable to locking up ladies who drink ... I'm not clear on. 3. Not every woman who has a glass of wine is killing off the professional career of some potential professional. 4. Passing a raft of laws banning behaviors simply b/c they correlate with some potentially negative consequence - good freaking grief you are opening the door to the kind of state Stalin would have dreamt of - authoritarianism in its wildest extreme. 5. Though if you really believe the latter I look forward to you shutting down Mardi Gras and New Years and Halloween, and locking the doors of every fast food joint in America.

Posted by: Armand at January 10, 2006 10:16 AM | PERMALINK

Bro,
Let me congratulate you on doing a great job of arguing with what I'm not saying, you're beating the straw man down. I'm not saying we should arrest a woman for having a glass of wine with dinner. Of course, because there is no safe amount of alcohol to drink during pregnant, that would be ideal. But the research tends to indicate FAS is more common with women who have a higher blood alcohol content, like from drinking several in a row. So if a bartender sees a pregnant woman getting tanked, why not call the cops on her so they can give her a breathalizer and arrest her if she's over the legal limit, instead of just cutting her off so she goes to another bar or a liquor store. It is child abuse to behave this way, because it is recklessly jeopardizing her child's future, her child's journey in life is threatened just as if she were pregnant and got behind the wheel.
As to your other arguments, the unemployment rate is below 5%, which if you'll check your economics books falls under the "pretty bad ass" heading rather than the "sucks" heading you suggest. It's significantly lower than the average rate of the 70's, 80's, and 90's. As I've said before, it's significantly lower than it was in 1996 when Clinton talked about the strongest economy in history.
If you don't remember talking about the President's jobs, check October 12,2004:
"But the president's record and claims are equally detached from reality when it comes to the nature of his tax policies and the number of private-sector jobs that have vanished during his presidency."
It seems by this you're implying that private sector jobs are important, otherwise why would it matter you think Bush is to blame for there being less of them at that time? And if it matters that certain types of jobs are more important than other types of jobs, it would be consistent for you to be concerned about children who because of memory, attentional, and social difficulties are not able to get those kinds of jobs.
Because I want to punish behaviors that recklessly endanger children that means I'm Stalin? Well, it could; or it could mean I'm George Washington, Abraham Lincoln, or pretty much any leader of any society governed by law.

Posted by: Morris at January 10, 2006 10:49 AM | PERMALINK

Tell you what, why don't we arrest poor people too, and steralize them, because inadequate nutrition is one of the most common causes of permanent developmental delays, and lack of access to clean water is the most common cause of death for infants.

Oh wait, I know why not. Those don't keep women in their place.

Posted by: binky at January 10, 2006 10:52 AM | PERMALINK

1. Wow, you found one thing I said over a year ago - one thing that didn't say a thing about "professional jobs" - quite the investigator you are. 2. Stalin would have worshiped the kind of giant all-powerful state you seem to cherish deep in your cold, balck heart (I kid). I don't recall Washington or Lincoln ever seeking the power to right every wrong that MIGHT occur on their watch. 3. The unemployment rate isn't bad, it's job growth that's been lame. Thankfully it's getting better. But of course this post wasn't intended to have anything to do with this topic - so let's leave it. 4. Uh, how are we supposed to know who's pregnant and who's not? What sort of exams are you going to require bartenders to give?

But all that said - it would be great if you'd stick to Binky's original post/point. This is singling out woman in a really disturbing way. Are you defending that?

Posted by: Armand at January 10, 2006 11:02 AM | PERMALINK

Binky,
Actually, you've stumbled onto a good point here. If someone chose not to eat when they were pregnant, to go on a hunger strike, that is equivalent to neglect (not feeding their children). That's what WIC is for, so a woman will be able to get food if she's pregnant and can't afford it. If she trades her WIC for crack, uses rather than eats, then she's endangering the life of her child. "Fetal alcohol syndrome (FAS) is recognized as the foremost preventable condition involving neurobehavioral and developmental abnormalities (1)." It's not the poverty, it's the drinking.
Bro,
You set up an argument about how certain jobs are more desirable than other jobs, otherwise it wouldn't have mattered that at that point there weren't as many private sector jobs. If this is true, the limiting of career choices by FAS causes a significant harm to children.
As far as this Stalin argument of yours, nobody hated Stalin because he wanted to protect children from reckless parents. They hated him because he killed fifty million people. I know and you cherish how you can make this slippery slope/incrementalism high school debate argument about how every time a government acts it puts us one step closer to totalitarianism. But that is disproved by experience because even though the government has acted millions of times since its inception, we still don't have a totalitarian government. But of course suddenly passing a law to keep pregnant women from drinking will be the straw that breaks the camel's back. Right.
I'll admit we can't always tell when someone's pregnant. But if someone mentions being pregnant and they're having several drinks, whether they mention it at a bar or to someone with whom they're drinking at their home, we ought to have mandatory reporting because this is child abuse. This can do just as much damage as hitting a child or negecting one. This isn't about a might as you suggest, there are real people out there with FAS, and research puts the number of FAS cases at one of every 750 births.
I'm confused as to how this is singling out women in a very disturbing way. One out of every 750 women has a better chance to go through life without FAS. How is that disturbing? The only women singled out by this are those abusing their children. We single out all people who abuse their children, men and women.

[edited to fix your linky]

Posted by: Morris at January 10, 2006 12:59 PM | PERMALINK
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