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File Under: Get pregnant, lose your civil liberties

Ah, the things politicians will do in the name of protecting babies! Now, we all know that the term “protecting babies,” when uttered by a “pro-life” individual, is usually code for “reminding women that they are simply vessels who, once occupied,* cease to possess the basic rights that non-vessels are entitled to (non-vessels being “men,” otherwise known as “actual human beings”) .”

There’s the classic example of the pregnant drug addict being prosecuted after she gives birth, despite the fact that neither being a drug addict nor being pregnant is actually a crime. There’s penalizing low-income women for giving birth by limiting their welfare benefits if they have more children. There are state laws which require that pregnant brain-dead women be kept on life support until they give birth, even if they have living wills which specify that they wish to be taken off under those conditions.

In other words, stripping women of their rights as soon as they become pregnant is nothing new. So Georgia’s proposal to require that doctors offer HIV tests to all pregnant women — and make a note in their medical records if they refuse — should not surprise us.

At first glance, this bill doesn’t seem all that egregious — after all, who doesn’t support cutting the risk of HIV transmission? But this puts pregnant women in a unique category of people who must be offered the test, and who will be on record as to accepting it or not. If we’re really worried about HIV transmission, why not require that doctors offer an HIV test to every sexually active boy or man they treat, and make a permanent note if he refuses? After all, men are pretty good at spreading STIs to their partners (far better than women). But we don’t do that because men, as a class, are assumed to be responsible enough to request a test if they feel they need it. Unless they’re men who are part of a social underclass and whose liberties have already been largely taken away, like prisoners — and even then we hesitate (thank God).

Of course doctors should be telling all of their patients about the risks of any medical condition — including telling pregnant women that HIV transmission to their fetus is a possibility if they’re infected with the virus. Of course they should offer a test. But mandating that a test is offered, and recording the results or the refusal, is part of a dangerous pattern taking shape, which considers pregnant women to be a class that deserves fewer rights, fewer liberties, and fewer social protections than full-fledged human beings.

*Of course, in a conservative anti-choice utopia, once the occupier is born and exists as an actual human person, s/he would be automatically entitled to fewer rights than s/he had while in utero. Like health care, which is under federal law given to fetuses but not to pregnant women. Or the right to use someone else’s body without their consent to sustain your own existence.


46 thoughts on File Under: Get pregnant, lose your civil liberties

  1. There are state laws which require that pregnant brain-dead women be kept on life support until they give birth, even if they have living wills which specify that they wish to be taken off under those conditions.

    That is fucking ghoulish. What states?

  2. The more I realize the treatment given to pregnant women in this country, the more I begin to hesitate in planning my own family. Not only because I will not take being treated as an incubator lightly, but if my child is a girl, I can’t imagine bringing her into a world that is steadily beginning to resemble A Handmaid’s Tale to a scary degree, with each law or regulation passed.

    I’m already “pre-pregnant”, in any case.

  3. I read somewhere, I can’t remember where, that you also stand a higher chance of a false positive on an HIV test if you’re pregnant.

  4. Amber, I can’t point you to the exact states, but *many* states have laws declaring a living will void if a woman is pregnant. And of course there’s the case of Angela Carder, who found out about 6 months into her pregnancy that she had a relapse of an aggressive cancer that would be fatal in a matter of days. She and her family decided that though the child was wanted, they would put her life first, and do whatever they could to prolong it. When staff at her hospital (in D.C.) overheard this, they got a court order mandating a c-section, and over Ms. Carder’s objections, performed the operation. The baby died a couple of days later, as did Angela Carder, with the c-section listed on the autopsy report as a contributing factor.

    In terms of this Georgia bill, I think you are right, Jill, to point out that it’s good for doctors to offer an HIV test to anyone who is sexually active. It’s the combination of the mandate and the reporting here that’s not right. HIV test records are among the most private of medical records; to list on a woman’s chart that she has refused a test would not only betray her confidence, but it could also come back to haunt her in, say, child custody proceedings.

  5. This is very troubling. I need to investigate this further over the weekend.

    Mandatory testing for HIV and AIDS is nothing new, the military does it. But, they do it across the board. What they do after someone tests positive, I don’t know.

    I’m all for protecting babies from HIV and AIDS, but this is too much. Women earn much less than men and we shouldn’t have to fight issues like this.

    Anyone know the chances of the Georgia bill passing?

  6. “When staff at her hospital (in D.C.) overheard this, they got a court order mandating a c-section, and over Ms. Carder’s objections, performed the operation.”

    How in holy blue fuck did they get a judge to give them that order? I mean, seriously. That is insane.

  7. while this is certainly violating, it’s more a matter of public health than jesus. this is brewing here in NYC, because children born with HIV have a better chance the earlier they are treated. however, if this does go down here, i am sure this will be administered with far more dignity at Mount Sinai than at any of the public hospitals.

  8. I can’t for the life of me think of a reasonable argument for this other than to villainize women/ future mothers. Of course it’s good to be tested, but to hold it against you if you’re not? And how the hell is it anybody’s business what any person chooses to get tested for or not? Goddamn bass-ackwards idiots. Did anyone see Pan’s Labyrinth and the treatment of the general’s wife? Really reminds me of this. fuck the wife’s life, give me my son.
    cripes.

  9. There’s the classic example of the pregnant drug addict being prosecuted after she gives birth, despite the fact that neither being a drug addict nor being pregnant is actually a crime. There’s penalizing low-income women for giving birth by limiting their welfare benefits if they have more children. There are state laws which require that pregnant brain-dead women be kept on life support until they give birth, even if they have living wills which specify that they wish to be taken off under those conditions.

    Actually, these are kind of different cases.

    One can be perfectly pro-choice, for example, and still say the prosecution is right in the first case, provided the woman did not make a good faith effort to seek help for her drug addiction. One pro-choice argument is that of bodily autonomy: your body is your property. However, property rights do not extend to, e.g., grant you the right to dump chemicals on your property: if you do so and later on someone dies from exposure to those chemicals, you still might get charged with criminally negligent homocide. So it is with your body, nu?

    OTOH, it would be very odd for a pro-life person to be comfortable with either cases one or two. Conservatives are always going on about the perverse effects of government regulations. In both of these cases, the, from the anti-abortion point of view, the perverse effect of the regulation is to encourage abortions. So you’d think if abortions were the chief concern of the single-issue “pro-life” crowd, they’d be up in arms about this — but they aren’t. What does that say about their motivations? I think we know the answer …

    In case 3, however, this is one of those things where legislating morality is dangerous because laws which try to be moral can often end up being immoral. E.g. certain people, in good faith, see giving up your life for that of your child-to-be as a saintly thing to do. OTOH, some of us would consider that a sin. So this law is forcing people into what, e.g. from the Jewish perspective, is a sin? How is forcing people to give up their chance at living “pro-life”? How is it moral?

    I should think that if a Jewish woman runs into trouble with the sorts of laws in your third case, they would sue for violation of religious freedom. Such an approach would be good because it would not only put abortion rights on a firmer constitutional basis but it would also demonstrate clearly that abortion is (arguably at least sometimes) a moral good. Too many fundies think that we pro-choice people simply get off on killing babies or something — but they, for all their moral posturing and calling themselves “pro-life”, evidently don’t fully consider the moral issues involved in preserving life.

  10. I’m afraid I can’t get as excited about this one as I can about most pregnancy related restrictions of civil rights. There is a good reason for wanting to know whether a pregnant woman is HIV positive or not: prevention of transmission to the fetus. If no treatment is given, the fetus has a 25-50% chance of being born with HIV. If AZT is given, the chances are dramatically reduced. Treatment after birth is not nearly as effective so knowing whether a pregnant woman is HIV+ or not can save the life of the baby. And the documentation more or less has to be done or either the woman will get asked at every pre-natal visit, because no one’s sure whether she’s been asked or not or she’ll never get asked because everyone assumes someone else has done it and be at risk of having a baby with HIV and of the extra complications of having two immunosuppressive conditions at once (HIV and pregnancy.) With HIPAA, no one should be able to get her medical records anyway. (Yeah, I know, such faith in the system…) It’s a restriction of civil rights, but one of the more justified ones in terms of public health, IMHO.

  11. With HIPAA, no one should be able to get her medical records anyway. (Yeah, I know, such faith in the system…)

    Given that they’re still trying to use medical records obtained from abortion clinics in Kansas to investigate whether or not the clinics can be prosecuted for any of the late-term abortions that may have been done there, I’m sorry to say that I think you’re being naive if you think there’s purely a public health motive behind this.

    After all, if it’s purely public health, then the prospective father should be tested, too. It’s possible that he’s infected but she’s not, but that he could pass the infection along to her later in the pregnancy. We’d need to know that so we can start her on AZT to prevent a possible infection that would affect both her and the fetus. But you won’t see that law coming down the pipes anytime soon, because only the woman is responsible for the health of the fetus, even in the man works in a battery factory.

  12. I think you’re being naive if you think there’s purely a public health motive behind this.

    I don’t. I’d as soon trust a Georgia legislator to have pure motives as I’d trust a Texas legislator (and I’ve read Molly Ivin’s descriptions of the Texas lege.) I just think that this one more or less accidently does have some potentially good public health consequences. Giving anti-retrovirals during pregnancy reduces the chances of the fetus being born with HIV from 25-50% to 1-2%. It’s a non-trivial public health issue, regardless of the lege’s motives.

    if it’s purely public health, then the prospective father should be tested, too. It’s possible that he’s infected but she’s not, but that he could pass the infection along to her later in the pregnancy

    It’s not a bad idea, actually. The OB couldn’t provide the test because the father is not her/his patient, but s/he could recommend that he be tested and write a note saying, something like, “Offered HIV testing to pt (accepted/refused.) Recommended that pt’s partner get HIV test from his doctor and bring results for documentation in chart (accepted/refused.)” But you’re quite right that a law requiring this wouldn’t go anywhere. In fact, perhaps an amendment requiring that the father, if known, be offered testing would be a way to kill the bill?

  13. DAS, there are several problems with your comment (#9) that really jump out at me:
    “One can be perfectly pro-choice, for example, and still say the prosecution is right in the first case, provided the woman did not make a good faith effort to seek help for her drug addiction.”

    First, many treatment centers won’t take pregnant women at all. Second, a woman addicted to drugs may not realize she is pregnant until it is too late to terminate the pregnancy, in which case an effort to treat the drug addiction would be too late as well (in terms of harm to the fetus). That brings me to my third point, which is — what is a good faith effort? Who gets to decide that? It’s easy to say what “should” constitute a good faith effort to seek treatment if you’ve never suffered from an addiction, which in some cases can occur in conjunction with other difficult circumstances (homelessness, poverty, violence, etc.).

  14. Mnemosyne:

    Unfortunately, with the way HIPAA works, as long as the identities of the women receiving the abortions are concealed, what Kansas is doing is “legal.” Awful, but legal.

  15. “There is a good reason for wanting to know whether a pregnant woman is HIV positive or not: prevention of transmission to the fetus. If no treatment is given, the fetus has a 25-50% chance of being born with HIV. If AZT is given, the chances are dramatically reduced.”

    Does Georgia provide subsidized treatment for HIV+ people? I know some states do, but a lot of states only provide subsidized meds for indigent HIV+ people. So assuming they don’t, what happens if the woman is too poor to afford treatment? Or the woman refuses treatment due to other concerns? Is she to be prosecuted as the pregnant addict is prosecuted? If she refuses the test and the baby turns up HIV+, is she charged with endangerment?

    I really don’t see much point to this as it stands. It reads too much like one of those oh-so-harmless measures that opens the door to all sorts of idiotic bullshit, particularly if the state also significantly restricts access to abortion.

  16. Unfortunately, with the way HIPAA works, as long as the identities of the women receiving the abortions are concealed, what Kansas is doing is “legal.” Awful, but legal.

    Except that they then want to use that information for prosecutions. I really don’t see how they’d be able to keep it confidential and still be able to prosecute the clinic — the women who’d had the abortions would have to testify. We don’t allow secret testimony in this country. At least, not yet.

  17. Does Georgia provide subsidized treatment for HIV+ people?

    I thought that HIV was one of the conditions that made one automatically eligible for medicaid, regardless of income. But I may be either out of date or simply wrong.

  18. “Or the right to use someone else’s body without their consent to sustain your own existence.”

    This is a very helpful statement of the competing ‘rights’ at stake in reproductive freedoms. Imposing pregnancy on an unwilling woman can’t not be seen as a reinforcement that she is property and labor, to be used up without remuneration for purposes larger than herself. The religious right has worked very hard to constitute fetuses as persons and, in so doing, have constructed reproductive rights as a ‘special’ case, because in their twisted thinking abortion involves rights for multiple stakeholders: the pregant woman (and all women, really) and the fetus (or ‘unborn baby,’ as they propagandize).

  19. One can be perfectly pro-choice, for example, and still say the prosecution is right in the first case, provided the woman did not make a good faith effort to seek help for her drug addiction. One pro-choice argument is that of bodily autonomy: your body is your property. However, property rights do not extend to, e.g., grant you the right to dump chemicals on your property: if you do so and later on someone dies from exposure to those chemicals, you still might get charged with criminally negligent homocide. So it is with your body, nu?

    Well, no. The United States Supreme Court has held that being a drug addict is not a crime. A non-pregnant drug addict cannot be prosecuted for their addiction or for their drug use; they can only be prosecuted for purchasing, selling or distributing drugs. Pregnancy is also not a crime. But if you are a pregnant drug addict, you can be prosecuted for crimes like child abuse after you give birth, even if there is no evidence that the baby was harmed. At least one woman has been found guilty of homicide. Others have been charged with distributing drugs to minors — the minor in question being the fetus.

    In other words, the fetus is assumed to be a human being with full rights, despite long-standing criminal law doctrines (and Constitution law doctrines) which say differently.

    Drug addiction isn’t a crime, but being drug-addicted and pregnant is a prosecutable offense. What about being a pregnant smoker? At least one state has tried to make that a crime. A pregnant coffee-drinker? That’s not good for the baby. A pregnant tuna-eater? Occasional wine-drinker? Do we really want to get started down a path which says that a woman can be prosecuted for perfectly legal activities if she is pregnant? Do we want to create a new status crime?

    So no, you really can’t be perfectly pro-choice — or even have anywhere near a consistent view of the criminal law — and still support these prosecutions.

  20. Unfortunately, with the way HIPAA works, as long as the identities of the women receiving the abortions are concealed, what Kansas is doing is “legal.” Awful, but legal.

    I thought that the issue was dropped now that Phill Kline is no longer AG. Also, the DA for the district where the clinic was told him to butt out.

  21. First, correct treatment can reduce the risk of a pregnant woman transmitted HIV to her child significantly – from about 20-40% to 2%. On public health issues, we regularly override parental choices – vaccines are one example.

    Second, we often force people to take certain steps when their children are involved that we don’t force on adults. One reason not to forcibly test men or women who are not pregnant – their partners can “screen”. Their sexual partners can say, “no thanks”, I want to know if you’re hiv positive. And if the person lies, they can and should be criminally prosecuted.

    I’m generally pro-choice, but I personally find this law relatively understandable. Much more so than prosecution for drug use. Also, if this law were accompanied by prosecution, that would be completely different. And, my support would go way up if the law was accompanied by a requirement that people receive hiv treatment. What I don’t get is anyone who votes for this law but opposes sex education.

    And, that’s partially because I’m generally much more favorable towards government intervention when a health crisis is involved. I think it was ok for the government to shut down the San Francisco Bath Houses in the ’80s (I don’t think its ok that they otherwise ignored the hiv crisis). It’s ok that the government required everyone to get a smallpox vaccine back in the day. And so on.

    Just to provide some medical information (I can’t vouch for the specific source, but the stats are consistent with what I’ve read multiple times):
    http://www.avert.org/pregnancy.htm
    An HIV positive woman can transmit the virus to her baby during pregnancy, labour and delivery, and through breastfeeding. If she takes no preventive drugs and breastfeeds then the chance of her baby becoming infected is around 20-45%.
    Can this risk be reduced?
    Modern drugs are highly effective at preventing HIV transmission during pregnancy, labour and delivery. When combined with other interventions, including formula feeding, a complete course of treatment can cut the risk of transmission to below 2%. Even where resources are limited, a single dose of medicine given to mother and baby can cut the risk in half.

  22. On public health issues, we regularly override parental choices – vaccines are one example.

    Right — parental choice. Pregnant women are individuals. Fetuses are not. Once that fetus is born we can talk about overriding parental choice. Before that, it’s her body.

    Second, we often force people to take certain steps when their children are involved that we don’t force on adults. One reason not to forcibly test men or women who are not pregnant – their partners can “screen”. Their sexual partners can say, “no thanks”, I want to know if you’re hiv positive. And if the person lies, they can and should be criminally prosecuted.

    Right, but again, we aren’t talking about children, we’re talking about a pregnant woman.

    And I thoroughly disagree about criminally prosecuting someone for lying about their HIV status, but that’s another thread.

  23. So, it seems you think the individual’s interest in bodily autonomy and privacy is so great, it can never be infringed upon, no matter the harm done to other people or society as a whole?

    Do you think that Thalidomide babies have a suit against the pharmaceutical manufacturers, or just the women who took the drug? It’s obviously very different, because the pharmaceutical companies have no bodily autonomy at stake. But I do think it goes to the question of whether fetuses have any cognizable legal rights.

    Also, this law seems to require 2 things – (1) the doctor ask the woman to have an HIV test and (2) the doctor record a “no” answer. That seems like a very minor infringement on privacy interests. And recording the “no” answer may play multiple roles in this process. Among other things, forcing the doctor to record an answer may ensure that he actually asks, which may help ensure that doctors don’t refuse to ask for undesirable reasons.

  24. Dianne—HIV does not automatically qualify you for Medicaid, but it helps. As far as NY, at least, anything to do with HIV is under such tight security that any HIPAA breach would basically get you fired and banned from the helping profession, so people don’t throw that info around like confetti.

    would people be more cool with this if the man had to get tested too? personally, i used to be very ACLU about these matters until i had to work with so many foster care kids. obviously, a fetus is not a person, but if you chose not to abort and carry it to term, it does become a human life who is worth protecting. i think mothers’ rights are important to consider, esp. when you see what men can get away with, but you would be astounded at what people can do to their children under the legal system as is, with no consequences to anyone but the child. many of these laws are based in humanitarian social service ideals.

  25. Do you think that Thalidomide babies have a suit against the pharmaceutical manufacturers, or just the women who took the drug?

    As I understand it, the parents are the ones who have the legal standing to sue, because they are suing for their own pain and suffering, not that of the fetus or child (though, obviously, that comes into play in the court case). Where it becomes problematic is when the state is allowed to stand in that parental role to the fetus and sue the pregnant mother over the welfare of the fetus or child.

  26. I should say with my comments above, it’s kind of hard to say what the parents of Thalidomide babies actually did because all of the cases were in Europe and (I think) Japan, and their court systems are different than ours. The drug wasn’t approved in the U.S. until the early 1990s, and that was only because they found it can shrink certain kinds of tumors.

  27. Do you think that Thalidomide babies have a suit against the pharmaceutical manufacturers, or just the women who took the drug? It’s obviously very different, because the pharmaceutical companies have no bodily autonomy at stake. But I do think it goes to the question of whether fetuses have any cognizable legal rights.

    Thalidomide babies would be suing for their own injuries, so they would be going after the pharmaceutical companies.

    Which is a whole different ball of wax than an autonomous adult being forced to take a test that other, non-pregnant, autonomous adults are not forced to take.

  28. But I do think it goes to the question of whether fetuses have any cognizable legal rights. – MDtoMN

    Fetuses don’t have any cognizable legal rights but kids/adults do. And if your neglect leads to an individual’s harm — and you coulda/shoulda/woulda done something different, than you are still civily and possibly even criminally liable for your actions. That’s the way the law works. So even if you are doing something legal, on your own property … but harm results, you might be liable. A woman’s body is her own and nobody else’s. But if what she does to what’s her own harms people, even if a few years hence and even if what she’s doing is perfectly legal, she can still be liable just as we hold others liable for doing similar things.

    To get back to MDtoMN’s question: that Thalidomide babies have a suit against the pharma manufacturers doesn’t imply that they had rights as fetuses, but they do have rights as babies/kids/adults. And even if the harm happened before they were born, the harm still affects them now that they are born and the companies were neglegent in their role in causing that harm. So the companies could be liable for the harm to babies/kids/adults, even if the harm happened before then.

    Trying someone who took drugs while pregnant with distributing drugs to a minor doesn’t work for anyone even remotely pro-choice. Trying someone who miscarried due to drug use … same thing. But if the baby died afterwards — then, if the woman in question was criminally negligent in her behavior (of course, if she couldn’t check into treatment ’cause she was pregnant or whatever, she ought not to be considered criminally neglegent) which would likely affect a birthed human, then she is neglegent, whether or not that behavior occurred before or after the baby was born. You can be pro-choice (i.e. in favor of abortion rights accross the board) and still feel that women who make the choice to keep their fetuses have certain responsibilities.

    Now, we pro-choicers might get concerned about where this slippery-slope leads (cf. Jill’s comment), the sexism that too often lets guys off the hook even when we do neglegent things, or who defines what is a good faith effort (c.f. Ethyl’s comment) — concerns which I share, which is why I would be leary about such prosecutions. What’s odd is that so-called pro-lifers are not concerned about the “perverse incentives” (something conservatives usually worry about) of these sorts of regulations: what does that say about how much conservatives really believe their rhetoric about “perverse incentives” and/or how much the anti-abortion crowd really cares about taking constructive action to reduce abortions?

  29. Or the right to use someone else’s body without their consent to sustain your own existence.

    As others have pointed out, this frames the issue of choice in a nutshell. This point has been raised before, and it wouldn’t apply to the crunchy conservative set anyway as they are consistent about this sort of thing, but should government have the ability to compel you to breast-feed? If government has no business compelling a woman to use her body to feed a baby, what business does it have compelling women to remain pregnant?

  30. Sorry, I wasn’t clear:

    “Do you think that Thalidomide babies have a suit against the pharmaceutical manufacturers, or just the women who took the drug?”

    Is meant to mean:

    “Who do you think has a suit against the pharmaceutical companies? The Thalidomide babies? Or the women who took the drugs? Or Both?” (my answer is both).

    What I meant to get at – we recognize that an action taken today may give way to legal liability for harms that occur in the future – even if the person who will suffer that future harm is not an individual today.

    So, when a pregnant woman does not get an HIV test or treatment today, we are not concerned about the fetus today – we’re concerned about the harm that will occur to an individual in the future as a result of the action taken today. Which is very different from, say, an abortion, where no future individual will be harmed by the choice made today.

    Further, I thought the GA Law does not force pregnant women to get HIV tests. It forces doctors to ask the woman to get a test, and it forces doctors to record the either the test results or that the woman did not want to get a test.

  31. Yeah, my legally cognizable rights thing wasn’t what I really meant to get at. I was mixing up the causation issue and the cognizable rights. A kid has cognizable rights, a fetus doesn’t, but actions taken before the kid is a kid may harm her, so she may have a right of action.

    Now, personally I don’t think tort or criminal prosecution is the way to address these issues. But I am comfortable with some degree of regulation and incentivizing to protect those kids’ interests.

  32. Trying someone who took drugs while pregnant with distributing drugs to a minor doesn’t work for anyone even remotely pro-choice. Trying someone who miscarried due to drug use … same thing. But if the baby died afterwards — then, if the woman in question was criminally negligent in her behavior (of course, if she couldn’t check into treatment ‘cause she was pregnant or whatever, she ought not to be considered criminally neglegent) which would likely affect a birthed human, then she is neglegent, whether or not that behavior occurred before or after the baby was born. You can be pro-choice (i.e. in favor of abortion rights accross the board) and still feel that women who make the choice to keep their fetuses have certain responsibilities.

    Criminally negligent… how? What exactly would her crime be? Child abuse? Negligent homicide? How do you square finding a pregnant drug-user guilty of child abuse and still support a pregnant woman’s right to terminate a pregnancy?

    I’m still not seeing the crime here. It can’t be criminally negligent homicide by child abuse if there is no child to abuse. Criminal negligence generally requires a blatant disregard for human life — is it really fair to argue that a pregnant drug addict has that necessary component? Further, there’s the notice issue — child abuse and negligence statutes have been held to apply specifically to born people, and so extending them to fetuses would not give pregnant women the required notice that their actions are criminal.

    Here’s what it comes down to: Pregnancy is a status. It is a status that only women hold. Do we really want to go down the road of saying that certain legal actions become illegal and grounds for prosecution if the person performing those actions is a pregnant woman? Because that’s what these cases are: Prosecutions that could never be made if the person in question were not female.

  33. Oh, and I’ll also point out that, despite the fact that white women and black women use drugs during pregnancy at comparable rates, black women account for 90% of the women prosecuted for using drugs while pregnant. These cases are very much about going after those in society who are already low down on the social ladder.

  34. So, it seems you think the individual’s interest in bodily autonomy and privacy is so great, it can never be infringed upon, no matter the harm done to other people or society as a whole?

    No. But I do think that the status of being pregnant should not allow someone to be criminalized for otherwise legal behaviors.

  35. “Who do you think has a suit against the pharmaceutical companies? The Thalidomide babies? Or the women who took the drugs? Or Both?” (my answer is both).

    What I meant to get at – we recognize that an action taken today may give way to legal liability for harms that occur in the future – even if the person who will suffer that future harm is not an individual today.

    Well, neither the pharmaceutical companies nor the pregnant women were criminalized for taking Thalidomide, as far as I know. The pharma companies were sued in civil court, which is a whole different issue and uses different standards than criminal court does. People may have greater leverage in civil court to argue that they deserve damages for harm done to them in utero. My argument, WRT pregnant drug addicts, is one based on the criminal law.

    So while we may recognize civil liability, we rarely recognize criminal liability. Now, that’s changing with the Unborn Victims of Violence Act and similar state laws, but I would argue that even those are generally inapplicable to legal actions that a pregnant woman takes.

  36. “Who do you think has a suit against the pharmaceutical companies? The Thalidomide babies? Or the women who took the drugs? Or Both?” (my answer is both).

    What I meant to get at – we recognize that an action taken today may give way to legal liability for harms that occur in the future – even if the person who will suffer that future harm is not an individual today.

    Are you familiar with the legal concept of ripeness? Meaning, essentially, that you can’t bring a claim until it’s ripe — that is, until all the elements that trigger the claim are in place. So, for instance, people exposed to asbestos can’t bring a claim for damages unless and until they actually get sick. Because not everyone who is exposed gets sick, and there’s no cause of action for fear of developing an illness you might never get. IOW, the claim isn’t ripe.

    The claims of a fetus are not yet ripe because the fetus has not yet been born alive (so is not yet a person who can assert claims) and has not yet developed a condition for which a claim can be asserted. So, in the case of HIV testing in which the concern is that the mother, who may or may not be infected, might transmit the virus to the child, who might become infected, until that child is actually born alive and tests positive, that child just doesn’t have a ripe claim against anyone. While the fetus is in utero, all claims and all potential outcomes are still potential.

    There’s also a rather large question about whether the mother’s refusal to submit to testing is a proximate cause of the injury, too, but that’s a whole ‘nother legal concept.

  37. Now, we pro-choicers might get concerned about where this slippery-slope leads (cf. Jill’s comment), the sexism that too often lets guys off the hook even when we do neglegent things, or who defines what is a good faith effort (c.f. Ethyl’s comment) — concerns which I share, which is why I would be leary about such prosecutions. What’s odd is that so-called pro-lifers are not concerned about the “perverse incentives” (something conservatives usually worry about) of these sorts of regulations: what does that say about how much conservatives really believe their rhetoric about “perverse incentives” and/or how much the anti-abortion crowd really cares about taking constructive action to reduce abortions?

    Well, right. And by prosecuting drug-addicted pregnant women, we place huge disincentives in their way of getting proper pre-natal care — and lack of pregnancy care is known to have even worse effects on babies than drug use does. If a woman thinks her doctor is going to report her to the police, she isn’t going to go to her doctor. If she knows she’ll be prosecuted after she gives birth, she has a huge incentive to terminate her pregnancy. And yet it is conservative “pro-lifers” who often argue in favor of these laws…

  38. What frustrates me is the whole punative approach to the well being of the pregnant woman and the fetus – other than WIC (which still seems punative) why not mandate the OB offer/refer free *anonymous* testing to pregnant women? Or how about improved (free) access to prenatal care – no questions asked? Maternity leave for actually *caring* for the newborn?
    But again, I feel that it really *isn’t* about the well being of the fetus as much as it is about controlling and punishing women who are not pregnant under “approved” circumstances.

  39. “First, correct treatment can reduce the risk of a pregnant woman transmitted HIV to her child significantly – from about 20-40% to 2%. On public health issues, we regularly override parental choices – vaccines are one example.”

    Aside from everything that’s already been pointed out, 20-30 babies a year born HIV+ in a state that contains Atlanta is not a public fucking health crisis. This is particularly true given the fact that HIV+ != dead. They’d save ten or twenty times that number of babies every year without standing at the edge of a very slippery slope indeed simply by expanding contraception and prenatal care programs’ availability to the poor. If the price tag the article quotes is accurate, it would also be far cheaper.

  40. Yes, I understand ripeness. But we regularly let the government ban conduct which causes legal harms in the future. I can’t bring a case for asbestiosis until I get it. But, the government can ban asbestos beforehand. And I think that’s a good thing. It was mostly meant as an argument that we regularly recognize that just because an action today may cause a legally recognizable harm in the future. Mostly, I meant to point out that one can think a woman has every right to abort the fetus today but still think she doesn’t have complete freedom to carry on her pregnancy in exactly X way.

    Also, treatment costs an estimated $600,000 per baby, according to the public health agency. So, reducing that 25-30 to 1 or 2 would be a huge benefit. Aside from the fact that for those 22-25 kids, having HIV will be a defining disability for the rest of their lives.

    Finally, these women are not prosecuted or punished for not taking the test. They just have to answer one way or the other. Now, personally, I think the default in organ donation should be “donate”. A person should have to consciously opt out rather than be presumed to want to deny another person the chance to live. Similarly, a pregnant person should have to consciously refuse rather than be presumed to be more worried about being tested for HIV than about the health impact on their kids. It’s about the default rule, and as long as people can deviate, I don’t see why the default should be a presumption that the person doesn’t care about health impacts to other people.

  41. The proposal offers to give AZT to the women who plan to carry to term for free?

    If not, I cannot see how it protects fetuses (much less children) from anything.

    Read Blake Scott’s book Risky Rhetoric: AIDS and the Cultural Practices of HIV Testing for an explanation of how testing does not equal treatment.

    The knowledge of serostatus does not always (or even usually) help people get treatment.

  42. Finally, these women are not prosecuted or punished for not taking the test.

    Their refusal is noted in their medical records.

  43. As far as I know, this is already done in NY. With all of my pregnancies, I had to sign a waiver if I refused an HIV test. If I refused, it was mandatory that they test the newborn, and I was advised that the rapid test used for newborns had a higher rate of false positives, so I had the test done each time. It was not only noted in my records (when the nurses read me the results it was right out of my chart), my HIV staus was noted on my children’s medical records. I know this because when I requested my son’s autopsy report, I had to sign a second release b/c there was HIV related information contained within. I was curious as to how that was possible and they said it would contain information relating to my status. Sure enough, the report identified him as belonging to a 24 year old female with one previous live birth who was HIV negative. I was angry as hell, but they said they were following the laws and regulations.

  44. Uhh…I don’t think this is new. In many states this is already in place, and in fact, some states used to REQUIRE testing of all pg women (no opt-outs), at the risk of child protection being called, but I think that was before HIPAA. At my first appointment in New Jersey, I was asked if I wanted the test, put my answer on a consent form, and the form was sent to the lab along with my answer and later placed in a file. Also, with HIPAA I’m not sure you can just subpoena medical records without the patient’s consent. This has been in practice for years and I have never heard of anyone being denied custody of their child because “refused an HIV test during pregnancy.” If it has happened, it hasn’t made the news.

  45. I am in FL, and this is already being done here as far as I know and was done during my last pg in CA, as well. HIV testing refusal is noted in my chart, and I had to initial a form refusing it.

    I wasn’t threatened with testing for the baby or anything, but the test was part of the “blood panel” that supposedly “all prenatal clinics do” on new patients. I simply opted out of HIV and a few other tests, initialed my form and moved on. Since I’m white and married, I assume I got less pressure than some of the other patients at the clinic. I also refused the other STD testing that they “offer” to new patients, and that refusal is noted in my records as well.

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