孕期药物使用的惩罚措施如何影响治疗与研究：对研究人员观点的质性考察
How penalizing substance use in pregnancy affects treatment and research: a qualitative examination of researchers' perspectives.
作者信息
Shah Seema K, Perez-Cardona Leishla, Helner Khrystyna, Massey Suena H, Premkumar Ashish, Edwards Renee, Norton Elizabeth S, Rogers Cynthia E, Miller Emily S, Smyser Christopher D, Davis Matthew M, Wakschlag Lauren S
机构信息
Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Department of Pediatrics, Northwestern Feinberg School of Medicine, Chicago, IL, USA.
出版信息
J Law Biosci. 2023 Jul 9;10(2):lsad019. doi: 10.1093/jlb/lsad019. eCollection 2023 Jul-Dec.
INTRODUCTION
Laws regulating substance use in pregnancy are changing and may have unintended consequences on scientific efforts to address the opioid epidemic. Yet, how these laws affect care and research is poorly understood.
METHODS
We conducted semi-structured qualitative interviews using purposive and snowball sampling of researchers who have engaged pregnant people experiencing substance use. We explored views on laws governing substance use in pregnancy and legal reform possibilities. Interviews were double coded. Data were examined using thematic analysis.
RESULTS
We interviewed 22 researchers (response rate: 71 per cent) and identified four themes: (i) harms of punitive laws, (ii) negative legal impacts on research, (iii) proposals for legal reform, and (iv) activism over time.
DISCUSSION
Researchers view laws penalizing substance use during pregnancy as failing to treat addiction as a disease and harming pregnant people and families. Respondents routinely made scientific compromises to protect participants. While some have successfully advocated for legal reform, ongoing advocacy is needed.
CONCLUSION
Adverse impacts from criminalizing substance use during pregnancy extend to research on this common and stigmatized problem. Rather than penalizing substance use in pregnancy, laws should approach addiction as a medical issue and support scientific efforts to improve outcomes for affected families.
引言
规范孕期药物使用的法律正在发生变化，可能会对解决阿片类药物流行问题的科学努力产生意想不到的后果。然而，这些法律如何影响医疗和研究，目前还知之甚少。
方法
我们采用目的抽样和滚雪球抽样的方法，对接触过有药物使用问题孕妇的研究人员进行了半结构化定性访谈。我们探讨了对孕期药物使用相关法律的看法以及法律改革的可能性。访谈采用双重编码。数据采用主题分析法进行分析。
结果
我们采访了22名研究人员（回复率：71%），确定了四个主题：（i）惩罚性法律的危害，（ii）法律对研究的负面影响，（iii）法律改革建议，以及（iv）长期的激进主义。
讨论
研究人员认为，惩罚孕期药物使用的法律未能将成瘾视为一种疾病，对孕妇和家庭造成了伤害。受访者经常为保护参与者而做出科学上的妥协。虽然有些人成功地倡导了法律改革，但仍需要持续的倡导。
结论
将孕期药物使用定罪的负面影响延伸到了对这个常见且受污名化问题的研究上。法律不应惩罚孕期药物使用，而应将成瘾视为一个医学问题，并支持为改善受影响家庭的结局而进行的科学努力。
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