Legal interventions during pregnancy: court-ordered medical treatments and legal penalties for potentially harmful behavior by pregnant women

Article Abstract:

A report is presented from the Committee on Medicolegal Problems of the American Medical Association (AMA) concerning the legal aspects of situations where pregnant women act in ways that may be detrimental to their fetuses. With improvements in medicine, treating the fetus separately from the mother becomes increasingly possible. The state has a strong interest in fetal well-being, and in ensuring that the woman protects its health. Although the pregnant woman is morally responsible to attempt to preserve fetal health, she is not legally compelled to accept medical treatments for the fetus. Legal precedents and distinctions between the mother's moral and legal responsibilities are discussed. The physician should act in the interests of both mother and fetus; even when pressures seem to force decisions that favor one over the other, the physician should retain a commitment to both. Pregnant women, as do all adults, have the right to refuse treatment, even if their decisions seem harmful to the fetus in the eyes of the physician. When pregnant women refuse treatment, several negative consequences can result if the physician seeks court-ordered obstetrical interventions; these are described. Societal responses to harmful behavior by pregnant women, including substance abuse, are evaluated. Treatment and education of pregnant women are the best ways to prevent harmful behavior. Six recommendations by the AMA Board of Trustees are presented. They include: (1) judicial intervention is inappropriate if the woman has made an informed refusal of a treatment; (2) the physician should provide information to facilitate such an informed and thoughtful decision; (3) the physician should not be liable for honoring the woman's informed refusal of medical treatment; (4) criminal sanctions for harmful behavior by the woman toward the fetus are not appropriate; (5) pregnant substance abusers should undergo appropriate rehabilitative treatment; and (6) the physician should document treatment recommendations, including the consequences of failure to comply with them. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Fetus, Physicians, Medical professions, Ethical aspects, Pregnant women, Right to refuse treatment, Treatment refusal, Drug abuse in pregnancy

---

The future of psychiatry

Article Abstract:

The Council on Long Range Planning and Development of the American Medical Association has issued a series of reports concerning trends in medicine. The effects of these trends on psychiatry are evaluated in a report that includes input from the American Psychiatric Association. Sociodemographic, scientific and clinical, and educational and practice trends are covered. The demand for psychiatrists is likely to grow rapidly in the coming decade, and the supply of psychiatrists will not be adequate to meet this demand. New approaches to treatment are likely to include several kinds of service agencies, and to lead to shorter in-patient hospitalization stays. Severe and chronic mental illness will remain a major research and treatment focus for psychiatry, and innovative approaches will probably be tried more widely. The scientific rationales for psychiatric decisions will be enhanced by the use of new imaging and biological techniques. Diagnostic nomenclature will have to become increasingly accurate, and more knowledge concerning mental illness will be gained from subspecialization. The medical profession as a whole should act to ensure that indigent people can receive funds for psychiatric care and that the availability of community services be improved. Educational efforts need to be expanded and the stigma associated with mental illness should be removed. This latter goal requires the participation of physicians in other fields, as well as psychiatrists. Psychiatrists are ideally situated to act as patient advocates. They should be actively involved in developing mental health research programs and priorities. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Economic aspects, Supply and demand, Practice, Mental illness, Mental disorders, Psychiatrists, Psychiatry

---

Improving the Evaluation of Permanent Impairment

Article Abstract:

The editors of the fifth edition of the Guides to the Evaluation of Permanent Impairment discuss the changes this edition contains. Guides to the Evaluation of Permanent Impairment is produced by the American Medical Association and is the most commonly used document in the US for assessing a patient's disability. Many doctors have criticized previous editions and recommended changes to be incorporated into the fifth edition. Some changes were made but others are more complex. Feedback from doctors is always welcome and will increase the usefulness of the Guides.

Disability evaluation

Similar abstracts:

• Abstracts: Evaluation of multiple frequency bioelectrical impedance and Cole-Cole analysis for the assessment of body water volumes in healthy humans
• Abstracts: Moonlighting: a student's lot? Fighting to keep my baby: Nurse Penny Roberts has severe disabilities and faces having her newborn baby taken away from her
• Abstracts: Infection and immunity. Diseases and disorders that open a seam between the face and the self. Diabetes, clinical dentistry and changing paradigms
• Abstracts: Formation of a facial hematoma during endodontic therapy. The effect of diabetes mellitus on endodontic treatment outcome: data from an electronic patient record
• Abstracts: Precision and accuracy of clinical and radiological signs in premature infants at risk of patent ductus arteriosus

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.