Treatment refusal, noncompliance, and substance abuse in pregnancy: legal and ethical issues.

Prenatal caregivers often note that the behavior of pregnant patients creates the risk of fetal harm. Three such cases are reviewed, together with care providers' responses and relevant law. Pregnant womens' rights to disregard medical advice are increasingly being overridden in courtrooms and bedside hearings. To preserve the patient-provider relationship, and to avoid coercive actions that may have little legal basis, emphasis should be on helping the woman act in her own best interest and that of her fetus, rather than on the law or the courts as a means of directly or indirectly controlling her behavior.