Tuesday, March 16, 2004

NAPW Commentary on Murder Arrest of Pregnant Woman Who Refused a C-Section

NAPW Commentary on Murder Arrest of Pregnant Woman Who Refused a C-Section

An arrest in Utah yesterday of 28 year old Melissa Rowland who allegedly committed murder by refusing a recommended C-section represents a shocking abuse of state authority and a dangerous disregard for medical ethics.

In this case prosecutors claim that a woman pregnant with twins rejected advice of her physicians to have a cesarean section. Prosecutors assert that the stillbirth of one of the twins was caused by her refusal to undergo this surgery. According to the law, however, pregnant women, like other Americans have the right to decide whether or not to undergo surgery. The American Medical Association and the American College of Obstetricians and Gynecologists as well other leading medical groups similarly conclude that the final decision must be the woman’s.

These legal and medical –ethical principles make sense for both women and children. Doctors are not infallible and their advice is just that, advice. Recently a woman went to a hospital in Pennsylvania ready to deliver her seventh child. For reasons that remain far from clear, the hospital decided she needed a c-section and when she refused they went to court. They asked for and won an order giving the hospital custody of the fetus before during and after delivery and the right to take custody of the pregnant woman and forcer to have the cesarean surgery. She and her husband fled the hospital and delivered a perfectly health baby without surgery. Similar cases abound. In Georgia doctors got a court order claiming that without a c-section the baby had a 99% chance of dying and the woman a 50% chance of dying. The court granted the order, she fled and delivered a healthy baby vaginally. Neither women nor children are protected by a system that makes women flee from hospitals or subjects them to unnecessary surgery.

Angela Carder was not as lucky. Critically ill with a recurrence of cancer and 25 weeks pregnant, she, her family and attending physicians agreed to focus on prolonging her young life for as long as possible. The Hospital however sought a court order forcing her to have a c-section. Despite testimony that the surgery could kill her, the court concluded that the fetus had a right to life and ordered her to be cut open against her will. The surgery was performed: the fetus died within two hours and Angela died within two days with the c-section listed as a contributing factor. No one suggested arresting the doctor or hospital officials for murder, in that case arguably a double homicide.

Ayesha Madyun survived. She was forced to have a c-section based on the claim that she had been in labor too long and that her baby was at risk of dying from an infection. Her request to be allowed to wait longer before having the surgery so she could try natural delivery was portrayed to the court as an irrational religious objection to surgery. The court granted the order and after Ms. Madyun had been forcibly cut open they found that there was in fact no infection.

The ability to get a court order or threaten pregnant women with arrest has many negative consequences beyond denying pregnant women rights and performing unnecessary surgery that poses health risks to both the pregnant woman and fetus. In another Illinois case, doctors sought a court order for a forced c-section claiming the pregnant woman and her husband held irrational religious beliefs opposing all surgery. The doctors ran to the court instead of spending time with the patient. The court refused the order, the baby was delivered naturally, and it turned out that if the doctors had spent the time communicating with the patient and her family rather than judging them and rushing to court, they would have learned that it was misunderstanding not an absolute objection to surgery that made it appear that this couple was refusing a recommended (but unnecessary) c-section.

Today both the law and medicine agree that coerced medical interventions on pregnant women are an abuse of medical and state authority and that while pregnant women do not always make the right decision, in America, it is the person on whom the surgery is to be performed who gets to decide. In spite of this, Utah prosecutors apparently think that a pregnant woman who exercises her constitutional and common-law right to refuse medical advice can be arrested for murder. This is not only a clear misuse of the law, it is dangerous to children and fundamentally dehumanizing to pregnant women and their families.





Lynn M. Paltrow
Executive Director
National Advocates for Pregnant Women
www.advocatesforpregnantwomen.org

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