Bowden Catherine
School of Law, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
Health Care Anal. 2019 Jun;27(2):128-145. doi: 10.1007/s10728-018-0364-z.
Smoking is frequently presented as being particularly problematic when the smoker is a pregnant woman because of the potential harm to the future child. This premise is used to justify targeting pregnant women with a unique approach to smoking cessation including policies such as the routine testing of all pregnant women for carbon monoxide at every antenatal appointment. This paper examines the evidence that such policies are justified by the aim of harm prevention and argues that targeting pregnant women in this way is likely to do more harm than good. Routine carbon monoxide testing is particularly problematic as it sends a message to pregnant women that they cannot be trusted either to truthfully answer questions as to whether or not they smoke, or to make decisions in the best interests of themselves and their future children in the way that non-pregnant individuals are. Further, if the aim is to reduce rates of prenatal harm, the evidence suggests that adopting a supportive and empowering approach to prenatal care is the most effective way to achieve this, something that the current policies aimed at pregnant women are in conflict with.
吸烟常常被视为一个特别棘手的问题，尤其是当吸烟者为孕妇时，因为这可能会对未出生的孩子造成潜在危害。基于这一前提，人们认为有必要采取独特的方法来帮助孕妇戒烟，包括在每次产前检查时对所有孕妇进行一氧化碳常规检测等政策。本文审视了这些政策以预防危害为目标是否合理的证据，并认为以这种方式针对孕妇可能弊大于利。常规一氧化碳检测尤其成问题，因为它向孕妇传递了一个信息，即她们要么无法被信任如实回答是否吸烟的问题，要么无法像非孕妇那样为自己和未来的孩子做出最符合自身利益的决定。此外，如果目标是降低产前伤害发生率，有证据表明，采取支持性和赋权性的产前护理方法是实现这一目标的最有效途径，而目前针对孕妇的政策与此相冲突。
