Abstract

KIE: This report by the American Medical Association's Board of Trustees discusses legal and policy concerns of legal intervention when a pregnant woman's behavior (refusal of recommended treatment, abuse of alcohol or drugs, etc.) endangers her fetus. Among the topics addressed are the moral and legal responsibilities of the pregnant woman toward the fetus, and the ethical obligations of the physician in instances of treatment refusal; the adverse consequences of seeking court-ordered interventions; and alternative responses -- legal, medical, and educational -- to harmful behavior by the pregnant woman. The Board of Trustees concludes that judicial intervention rarely is appropriate when a pregnant woman makes an informed refusal of treatment. The report ends with six recommendations for formulating AMA policy on how physicians should respond when a pregnant patient's refusal of treatment or noncompliance with her physician's recommendations could affect the well-being of the fetus.