Moral and social issues regarding pregnant women who use and abuse drugs.

Pregnant women who abuse drugs, such as alcohol, cocaine, and marihuana may face a variety of legal and social responses, including involuntary commitment, forced treatment, and criminal sanctions. These programs are intended to remedy apparent maternal-fetal conflicts but paradoxically may encourage some women to avoid beneficial medical and social services or to seek abortion. Although pregnant women have ethical duties to give due consideration to their offspring, these moral obligations fail to justify coercive and punitive programs regarding substance abuse. Coercive fetal protection policies may undermine pregnant women's trust and cooperation, violate their autonomy, weaken our civil liberties, and raise a host of ethical problems relating to race, gender, and class prejudice. Education and drug treatment programs, rather than punitive and coercive measures, may better help pregnant women fulfill their moral duties to refrain from abusing substances.