Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic...
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Transcript of Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic...
![Page 1: Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic FASD Regional Training Center is a project of the UAA Center.](https://reader031.fdocuments.us/reader031/viewer/2022012922/5697bff21a28abf838cbb9a3/html5/thumbnails/1.jpg)
Fetal Alcohol Spectrum Disorders:Competency VII –
Ethical, Legal, and Policy Issues
The Arctic FASD Regional Training Center is a project of the UAA Center for Behavioral Health Research & Services.
Funding for this project is provided by CDC Cooperative Agreement #U84DD000886-01.
![Page 2: Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic FASD Regional Training Center is a project of the UAA Center.](https://reader031.fdocuments.us/reader031/viewer/2022012922/5697bff21a28abf838cbb9a3/html5/thumbnails/2.jpg)
• Ethical Issues
• Legal & Policy Issues
Road Map for Presentation
![Page 3: Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic FASD Regional Training Center is a project of the UAA Center.](https://reader031.fdocuments.us/reader031/viewer/2022012922/5697bff21a28abf838cbb9a3/html5/thumbnails/3.jpg)
ETHICAL ISSUES
![Page 4: Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic FASD Regional Training Center is a project of the UAA Center.](https://reader031.fdocuments.us/reader031/viewer/2022012922/5697bff21a28abf838cbb9a3/html5/thumbnails/4.jpg)
• Basic Principles
• Respect for Persons
• Confidentiality
Ethical Issues
![Page 5: Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic FASD Regional Training Center is a project of the UAA Center.](https://reader031.fdocuments.us/reader031/viewer/2022012922/5697bff21a28abf838cbb9a3/html5/thumbnails/5.jpg)
• Autonomy
• Beneficence
• Nonmaleficence
• Justice
Basic Principles
![Page 6: Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic FASD Regional Training Center is a project of the UAA Center.](https://reader031.fdocuments.us/reader031/viewer/2022012922/5697bff21a28abf838cbb9a3/html5/thumbnails/6.jpg)
• Encompasses all of the basic principles
• Asks care providers to honor each person’s dignity and interests
• Respect for individuals with FASD
Respect for Persons
![Page 7: Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic FASD Regional Training Center is a project of the UAA Center.](https://reader031.fdocuments.us/reader031/viewer/2022012922/5697bff21a28abf838cbb9a3/html5/thumbnails/7.jpg)
• Essential to the health provider-patient relationship
• Protection of privacy
• Acknowledge limitations
Confidentiality
![Page 8: Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic FASD Regional Training Center is a project of the UAA Center.](https://reader031.fdocuments.us/reader031/viewer/2022012922/5697bff21a28abf838cbb9a3/html5/thumbnails/8.jpg)
LEGAL AND POLICY ISSUES
![Page 9: Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic FASD Regional Training Center is a project of the UAA Center.](https://reader031.fdocuments.us/reader031/viewer/2022012922/5697bff21a28abf838cbb9a3/html5/thumbnails/9.jpg)
• Fetal rights and the maternal-fetal relationship
• Limitations of coercive and punitive approaches
• A public health approach
Legal and Policy Issues
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• Ethical perspective• Personhood
• Legal perspective• Federal law• State law
•Well-being
Fetal Rights and the Maternal-Fetal Relationship
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• Law enforcement measures• Examples from states
• Legal decisions• Whitner v. State of SC
(1997)• Ferguson v. City of
Charleston (2001)
Limitations of Coercive and Punitive Approaches
![Page 12: Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic FASD Regional Training Center is a project of the UAA Center.](https://reader031.fdocuments.us/reader031/viewer/2022012922/5697bff21a28abf838cbb9a3/html5/thumbnails/12.jpg)
• Autonomy and justice compromised
• Women may not have enough time to prepare their cases
• Courts may make their decisions too late to protect the fetus
• Does not optimize beneficence (benefit)
• Does not avoid undue harm (nonmalficence)
• Might contribute to mistrust of health care providers
Limitations of Coercive and Punitive Approaches
![Page 13: Fetal Alcohol Spectrum Disorders: Competency VII – Ethical, Legal, and Policy Issues The Arctic FASD Regional Training Center is a project of the UAA Center.](https://reader031.fdocuments.us/reader031/viewer/2022012922/5697bff21a28abf838cbb9a3/html5/thumbnails/13.jpg)
1. Coercive and punitive legal approaches to pregnant women who refuse medical advice fail to recognize that all competent adults are entitled to informed consent and bodily integrity.
2. Court-ordered interventions in cases of informed refusal, as well as punishment of pregnant women for their behavior that might put a fetus at risk, neglect the fact that medical knowledge and predictions of outcomes in obstetrics have limitations.
Six Objections to Coercive and Punitive Approaches
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3. Coercive and punitive policies treat medical problems such as addiction and psychiatric illness as if they were moral failings.
4. Coercive and punitive policies are potentially counterproductive in that they are likely to discourage prenatal care and successful treatment, adversely affect infant mortality rates, and undermine the physician-patient relationship.
Six Objections….
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5. Coercive and punitive policies directed toward pregnant women unjustly single out the most vulnerable women.
6. Coercive and punitive policies create the potential for criminalization of many types of otherwise legal maternal behavior.
Six Objections….
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• Education/prevention vs. punishment
• Drug and alcohol treatment
• Health provider screening
• Public health interventions for FASD
Public Health Approach
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• Ethical concerns related to FASD
• Legal and Policy Issues
In Closing….
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Arctic FASD Regional Training Centerwww.uaa.alaska.edu/arcticfasdrtc
The Arctic FASD Regional Training Center is a project of the UAA Center for Behavioral Health Research & Services.
Funding for this project is provided by CDC Cooperative Agreement #U84DD000886-01.