An arrest in Utah yesterday of 28 year old Melissa Rowland who allegedly
committed murder by refusing a recommended C-section represents a shocking
abuse of state authority and a dangerous disregard for medical ethics.
In this case prosecutors claim that a woman pregnant with twins rejected
advice of her physicians to have a cesarean section. Prosecutors assert
that the stillbirth of one of the twins was caused by her refusal to
undergo this surgery. According to the law, however, pregnant women, like
other Americans have the right to decide whether or not to undergo surgery.
The American Medical Association and the American College of Obstetricians
and Gynecologists as well other leading medical groups similarly conclude
that the final decision must be the woman’s.
These legal and medical –ethical principles make sense for both women and
children. Doctors are not infallible and their advice is just that,
advice. Recently a woman went to a hospital in Pennsylvania ready to
deliver her seventh child. For reasons that remain far from clear, the
hospital decided she needed a c-section and when she refused they went to
court. They asked for and won an order giving the hospital custody of the
fetus before during and after delivery and the right to take custody of the
pregnant woman and forcer to have the cesarean surgery. She and her husband
fled the hospital and delivered a perfectly health baby without
surgery. Similar cases abound. In Georgia doctors got a court order
claiming that without a c-section the baby had a 99% chance of dying and
the woman a 50% chance of dying. The court granted the order, she fled and
delivered a healthy baby vaginally. Neither women nor children are
protected by a system that makes women flee from hospitals or subjects them
to unnecessary surgery.
Angela Carder was not as lucky. Critically ill with a recurrence of cancer
and 25 weeks pregnant, she, her family and attending physicians agreed to
focus on prolonging her young life for as long as possible. The Hospital
however sought a court order forcing her to have a c-section. Despite
testimony that the surgery could kill her, the court concluded that the
fetus had a right to life and ordered her to be cut open against her
will. The surgery was performed: the fetus died within two hours and
Angela died within two days with the c-section listed as a contributing
factor. No one suggested arresting the doctor or hospital officials for
murder, in that case arguably a double homicide.
Ayesha Madyun survived. She was forced to have a c-section based on the
claim that she had been in labor too long and that her baby was at risk of
dying from an infection. Her request to be allowed to wait longer before
having the surgery so she could try natural delivery was portrayed to the
court as an irrational religious objection to surgery. The court granted
the order and after Ms. Madyun had been forcibly cut open they found that
there was in fact no infection.
The ability to get a court order or threaten pregnant women with arrest has
many negative consequences beyond denying pregnant women rights and
performing unnecessary surgery that poses health risks to both the pregnant
woman and fetus. In another Illinois case, doctors sought a court order
for a forced c-section claiming the pregnant woman and her husband held
irrational religious beliefs opposing all surgery. The doctors ran to the
court instead of spending time with the patient. The court refused the
order, the baby was delivered naturally, and it turned out that if the
doctors had spent the time communicating with the patient and her family
rather than judging them and rushing to court, they would have learned that
it was misunderstanding not an absolute objection to surgery that made it
appear that this couple was refusing a recommended (but unnecessary)
c-section.
Today both the law and medicine agree that coerced medical interventions on
pregnant women are an abuse of medical and state authority and that while
pregnant women do not always make the right decision, in America,
it is the
person on whom the surgery is to be performed who gets to decide. In spite
of this, Utah prosecutors apparently think that a pregnant woman who
exercises her constitutional and common-law right to refuse medical advice
can be arrested for murder. This is not only a clear misuse of the law, it
is dangerous to children and fundamentally dehumanizing to pregnant women
and their families.
Lynn M. Paltrow
Executive Director
National Advocates for Pregnant Women
www.advocatesforpregnantwomen.org
