HOMICIDE AND DRUG HABITS: PREGNANT WOMEN BEWARE

A recent homicide case sets the stage for new laws to protect the
unborn and hold drug-addicted moms accountable. But there is much work
still to be done before taxpayers will stop being forced to pay for
preventable medical services. Regina McKnight of Horry County is a
24-year-old mother of three whose crack cocaine habit resulted in the
death of her unborn child. In May, she was convicted of homicide and
sentenced to 12 years in prison. McKnight is the first woman convicted
of murder under these circumstances, although other addicted mothers
of stillborn children have pleaded guilty to involuntary
manslaughter.

The McKnight case raises a number of questions. Is the fetus a person
deserving protection? Should women be prosecuted for harmful health
habits that endanger their unborn children? Should abusers be coerced
into treatment?

Drug-addicted newborns are generally premature and often require
hundreds of thousands of dollars worth of health care in just the
first year. If they survive, they frequently suffer developmental problems.

Not surprisingly, many jurisdictions are turning to coercion, proven
to be the most effective tool to get addicts into treatment. Perhaps
the best example of a coercion-based program is drug courts, which
give convicted abusers the choice of jail or a sentence structured by
the judge that usually includes treatment, a job-training program and
frequent drug tests to ensure abstinence.

But the linchpin for drug courts or, for that matter, most treatment
programs, is addict motivation. The addict must really want help, and
the program must be comprehensive and long term.

Unfortunately, the United States has only a quarter of the treatment
programs needed, and many of these aren't comprehensive. The best
programs, which are often expensive and privately run, are not
available to homeless abusers like McKnight.

And while McKnight's case involves an illegal drug, there are,
perhaps, millions of pregnant women who drink alcohol or smoke
cigarettes. These behaviors by their mothers endanger the unborn
children and create health problems that impose huge health costs on
the public.

For years, S.C. officials have tried to solve the problem of
drug-addicted mothers who give birth to very sick babies. And many
states have considered tough laws to punish mothers who, like
McKnight, demonstrate poor judgment. No state, however, has passed
such a law because the medical community contends that punitive
approaches to health problems during pregnancy are counterproductive.
Regrettably, doctors have offered no viable alternatives to the status
quo.

An unborn child in South Carolina is a protected person under a 1997
state Supreme Court ruling involving a woman who tested positive for
cocaine after giving birth and pleaded guilty to violating child-abuse
laws.

In a strange twist of logic, had McKnight chosen to kill her baby
intentionally by having it legally aborted, she would have escaped
prosecution. The U.S. Supreme Court's tragic Roe vs. Wade decision
established a fundamental constitutional right to abortion but lets
states decide at what stage abortion is no longer legal.

McKnight did right to choose life over abortion. But she is being
punished, and justifiably so, for living a lifestyle that resulted in
the death of her unborn child.

It is not too much of a stretch to reason that, just as a mother is
responsible for the care of her child after it is born, she is
responsible for its care while it remains helpless within the womb.
While it would be a tragedy if the threat of prosecution for substance
abuse drove more women to abort their babies, it would be equally
tragic if no mechanism is found to facilitate treatment for
drug-addicted pregnant women who seek help. Those who refuse to seek
treatment and bear damaged children as a result certainly merit punishment.

In the future, all who are concerned about life before and after birth
will have to wrestle with these sticky issues. State legislatures
ought to establish a prenatal standard of care that involves drug
testing and extends protection to the unborn, mandates effective drug
treatment for drug-abusing moms, saves the taxpayer from high public
assistance medical costs-and does this without violating individual
liberties.