March 12, 2004

Woman Charged with Murder for Refusing C-Section

[UPDATE: More from the Salt Lake Tribune here--with more from Leslie Francis--and here.]

Salt Lake Tribune:

Salt Lake County prosecutors on Thursday charged a West Jordan woman with criminal homicide in the death of her stillborn baby. Prosecutors claim the woman ignored repeated warnings in the last few weeks of pregnancy that the twins she was carrying could die or suffer brain damage unless she had an immediate Caesarean section.

(The woman denies that she refused a C-section.)

This case raises legal questions, which I'm not qualified to comment on. My department chair, Leslie Francis, is quoted in this accompanying article saying that this case is unprecented in Utah, and that doctors in these situations have difficult issues.

But politically I find this very troubling. A C-section is a very invasive procedure, and to declare that a woman must obtain one on pain of life imprisonment seems outrageous. The legal doctrine seems to be that a woman who becomes pregnant forfeits control over her own body. The contrast between this case and the Parker Jensen case, in which charges were reduced to a slap on the wrist against parents who refused to allow their 12-year-old son diagnosed with Ewing's sarcoma.

The Jensen case led to over two dozen bills in the Utah legislature to increase parental rights, though the most radical bills apparently did not pass. The thought seems to be that parents gain the right to decide whether their children will get medical treatment the moment the child leaves a woman's body.

Posted by Matt Weiner at March 12, 2004 12:48 PM

I also think that the c-section case is troubling, but (to play devil's advocate for a moment) there might be good reasons from a moral point of view that the woman ought to pursue a c-section. (I realize that you are primarily concerned in the political implications of such a precedent, but if our political views are informed by our moral commitments, (and I think that you would agree with me that they are), then it might be well worth looking to what moral commitments inform this decision--moral commitments that we might not be ready to reject even given this case.

First, what I would like to suggest is that I do not think that what underlies this decision is the view that "a woman who becomes pregnant forfeits control over her own body" as you claim. Instead, (and this argument is coming from an upcoming PhD from Rice University) we could suppose that a pregnant woman has certain moral obligations not only towards her fetus but also towards her future children. And the moral obligation is this. A woman who voluntarily chooses to become pregnant accepts responsibility for protecting her child's vulnerability to harm. And the thought here is that her voluntariliy choosing to conceive a child is sufficient for generating this obligation. (Certain exceptions apply, e.g. life of the mother becomes endangered by carrying the pregnancy to term, etc.) Now, if a woman who chooses to conceive a child is morally obligated to protect that child from harm, then it seems reasonable to say that included in the scope of this obligation is protecting the life of the fetus. Choosing a c-section over vaginal delivery is a case that seems to fall within the scope of this moral obligation. You might disagree with me, and insist on saying that this is a clear violation of a woman's bodily integrity, and that this case illustrates that a woman is expected to forfeit her bodily rights. My response to this would be that in this case, this is only incidentally so. It just so happens that this case required that she ought to concede to a c-section, but not because she is expected (from a moral point of view) to give up a right to her body, but because she is expected to fulfill her moral obligation to protect her child from harm.

A quick FYI--some stats on the risks of c-sections themselves might be relevant to what you think about this case, though if you are outraged by this case on reasons having to do with a woman's bodily autonomy, then I suspect these stats are irrelevant to your case. C-sections have been reported to have fewer complications than vaginal deliveries--but they have complications of their own that are somewhat more serious than the complications associated with vaginal delieveries. (See WebMD for more on this, as well as JAMA and The New England Journal.) C-sections (vs. vaginal deliveries) also present a (negligibly) higher risk that the woman will die from the procedure. And an interesting fun fact: having recognized that the requests for c-sections are climbing (both in the US and abroad) and that c-sections often present fewer delivery complications for women, in 1993 Britain passed a law that allows women to request what kind of delivery they want--though, for financial reasons vaginal deliveries are usually encouraged unless the life of the mother or fetus (or both) are at stake.

At any rate, my point: we might have good moral reasons to require a woman to choose a c-section, and these reasons are also internal to the woman herself if we affirm the moral commitment that women have to their future children--that they ought to protect them from harm.

Posted by: Linda Fiorentino at March 17, 2004 10:44 AM