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Whither the rights of pregnant women?

Samantha Burton’s legal battle to appeal a judge’s ruling that confined her to a hospital’s care and, ultimately, the cesarean birth of a her stillborn baby, continues to garner national media attention. The Washington Post reports:

And six months after the pregnancy ended, the dispute over the legal move to keep her in the hospital continues, raising questions about where a mother’s right to decide her own medical treatment ends and where the priority of protecting a fetus begins.

“The entire experience was horrible and I am still very upset about it,” Burton said through her lawyer. “I hope nobody else has to go through what I went through.”

Burton, who declined to be interviewed, is appealing the judge’s order. She isn’t asking for money but hopes to keep her case from setting a precedent for legal control over women with problem pregnancies. She also worries it could prevent women from seeking prenatal care.

At the heart of the matter are the rights of pregnant women to make their own informed medical decisions and refuse unwanted care.

American Civil Liberties Union lawyer Diana Kasdan said if the ruling stands it could lead to the state virtually taking over the lives of pregnant women, including telling them what they should or should not eat and drink and what medications they must take.

“It would be a horrible precedent,” Kasdan said.

And…

The judge ruled the best interests of the fetus overrode Burton’s privacy rights, but Abrams [Burton's lawyer] disputes that. He notes the Florida Constitution, unlike its federal counterpart, has an explicit and strong privacy right, which the state Supreme Court has said guarantees a competent person the right to “choose or refuse medical treatment.”

“If you apply the best interest of the child standard, the woman becomes nothing more than a fetal incubator owned by the state of Florida,” Abrams said.

Jacob M. Appel sums it up well on Huffington Post:

One of the most essential principles of modern medical care — possibly the fundamental underpinning — is that competent patients have the right to make their own medical decisions. Pregnant women have as much authority to control their course of care as does anybody else.

The Washington Post further reports:

There have been a few other cases nationwide that involve similar efforts by courts to intervene in pregnancies:

- In 1987, a Washington, D.C., judge ordered a woman who was dying of cancer to have a C-section, which she had refused, to save her fetus. The baby died within two hours of delivery and the mother died two days later. An appeals court later ruled the judge should not have ordered the C-section.

- In 2003, prosecutors in Salt Lake City charged an acknowledged cocaine addict who had a history of mental health problems with murder when she refused to have a C-section for two weeks before finally agreeing to the procedure. One of her twins died in the womb during the delay. Through a plea deal, the charge was later reduced to child endangerment.

- In 2004, a hospital in Wilkes-Barre, Pa., obtained a court order to force a woman to have a C-section because her seventh baby was oversized, but the order was too late. The mother, whose first six children each weighed nearly 12 pounds at birth, went to another hospital and delivered an 11-pound, 9-ounce girl naturally.

- Also in 2004, a judge in Rochester, N.Y., ordered a homeless woman not to get pregnant again without court approval after she lost custody of several neglected children.

Dr. Michael Grodin, a physician and professor of health law, bioethics and human rights at Boston University, said doctors should never resort to court orders.

“People have the absolute right to refuse treatment …,” Grodin said. “It’s unconscionable. … It’s an affront to women.”

And Appel adds this advice:

Pregnant women and those planning pregnancies should also take away a lesson from the Samantha Burton tragedy. Ask your obstetrician directly: Is there any circumstance under which you will refuse to let me make my own medical decisions or will prevent me from leaving the hospital? That is a question no woman should ever have to ask her doctor. Unfortunately, as long as rogue OBGYNs continue to impose their values upon unsuspecting patients, it is a prudent question to ask.

For more information on the legal rights of pregnant women, see here and here.