Criminalization of Drinking While Pregnant in UK?

A council on northwest England plans to bring legal action to establish liability for criminal damages by women who drink while pregnant, with resultant damage to their newborns. A tribunal in 2011 had ruled that a child had sustained personal injury "directly attributable to a crime of violence," and so was eligible for a payment from its mother. The holding came in spite of the fact that the mother had never been criminally convicted. The court simply held that, regardless of the lack of prosecution or conviction in her case, she had in fact committed the crime of maliciously administering poison so as to inflict grievous bodily harm, a crime under section 23 of the Offences Against the Person Act 1861. The upper tribunal of the Administrative Appeals Chamber reversed the holding, however. (The opinion can be downloaded here.) The Appeals Chamber agreed that there had been “administration of a poison or other destructive or noxious thing, so as thereby to inflict grievous bodily harm,” but found that the fetus who was damaged by the mother's drinking was not a "person" in legal terms at the time of her injury. The case now goes to the Court of Appeal.

It's important to recognize that the case at bar would set precedent for cases quite unlike it in the future. In the case at bar, adoptive parents of a child damaged by fetal alcohol syndrome are seeking payments from the child's biological mother--payments due them pursuant to criminal law. But if drinking-while-pregnant is criminal, the ordinary case of prosecution in the future may look rather different. It will involve not payment of damages by a biological mother to a third-party adoptive parent, but imprisonment of a new mother shortly after her child's birth.

Criminalization of drinking-while-pregnant seems like a terrible idea. It is obviously true that drinking while pregnant can damage one's fetus. It is also obviously true that the majority of women who drink while pregnant do not thereby damage their fetuses. The relevant studies seem to show no genuinely "safe" level of drinking during pregnancy, but also show that significant drinking during pregnancy often results in no harm to the fetus. In these circumstances--and given the addictive nature of alcohol--can it really be true that criminalization of drinking-while-pregnant is really the best, or even a reasonably good, method of reducing harm to fetuses from maternal drinking?

Criminalization will make it difficult for pregnant women to speak to their physicians or nurses about their drinking habits. Threat of criminal prosecution for drinking could be used as a lever against pregnant women by abusive men. Criminalization will subject visibly-pregnant women not only to prosecution, but also to public abuse and accusations from strangers, even though the actual danger to fetuses from moderate later-term drinking is minimal.

Women should be informed of the dangers to their fetuses of drinking. Alcoholic pregnant women should be offered help. The state's money is better spent on public service announcements and counseling sessions than on prosecutions and jail-cells. I'm guessing that no one who knows that drinking during pregnancy might damage her child, but who drinks anyway, does so with malicious intent, or does so without regard to the dangers to her child. People who don't know the damage they may be causing, or who simply cannot stop their drinking due to addiction, need help rather than punishment.

IVF Babies at Enhanced Risk. But Why, and So What?

This Australian study in PLOS One shows significant risk of health problems in babies born from assisted conception as opposed to spontaneous conceptions. Compared to spontaneously-conceived singletons, singletons from assisted conception were almost twice as likely to be stillborn, more than twice as likely to be pre-term, almost three times as likely to have very low birth weight, and twice as likely to die within the first four weeks after birth. Outcomes varied by type of assisted conception. Very low and low birth weight, very preterm and preterm birth, and neonatal death were "markedly" more common in births from IVF and, to a lesser degree, in births from ICSI. Use of frozen embryos elminated the risks of ICSI, but not of IVF. But frozen embryos also had increased risk of macrosomia.

The study mentions, but doesn't linger on, data showing that kids spontaneously born of parents with untreated infertility problems also have adverse outcomes compared to kids of non-infertile parents. Compared to spontaneously conceived children of women with no infertility problems, spontaneously conceived children of women with infertility problems were nine times more likely to have very low birth weight, seven times more likely to be very pre-term, and almost seven times more likely to die within the first 28 days of birth. Some experts say that this may mean that the problems experienced by children of assisted reproduction may be more due to parental infertility than to infertility treatment.

Let us leave aside the possibility that many or most IVF-related risks are really just infertility-related risks. The sort of data discussed in this study always brings to my mind some variations on the "non-identity" problem invented by Derek Parfit. Suppose a child of IVF is born with low birthweight, and experiences lifelong significant complications which were foreseeable by the parents when they decided to used IVF. Has that child any complaint against the parents? One possible answer is, "No, because the condition of the possibility of that particular child's ever existing at all was his or her parents' use of the IVF which caused both his or her existence and his or her low birthweight. Only a child whose life was so wretched as to literally not be worth living could complain about his or her parents' use of IVF." The argument in this form seems sound but it also troubles me, because (for example) one can easily imagine the circumstances in which one might accurately say to a slave, "You have no right to complain about being born a slave, because without the institution of slavery, you would never have been born at all."

If IVF is risky, and a child of IVF is born with a disability, and the child would not have been born without IVF, what sort of complaint can one mount, from the child's point of view, about the disability?