We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
Published online by Cambridge University Press: 18 July 2014
The relationship between scientific knowledge and legal discourse is raised once again by a recent decision of the Supreme Court of Canada, a case involving a young Aboriginal woman who was pregnant and ordered by the court to remain in a drug treatment program at a health center until the baby was born. Her glue-sniffing habit was deemed dangerous to the normal development of the fetus. The Court held that her solvent-dependency did not justify the original court action, but both the Court and the various interveners disregarded the current state of our knowledge on the fetal syndromes. There is thus a continuing disconnect between the scientific understanding of fetal risk and the development of Constitutional law around women's reproductive rights. This paper reviews the case and follows it through the appellate process; we examine the research literature on fetal syndromes tracking the changes over time. Finally we comment on the interventions by the Winnipeg Child and Family Services, the Women's Health Rights Coalition, by The Canadian Civil Liberties Association, and both The Canadian Abortion Rights Action League and the Women's Legal Education and Action Fund.
La relation entre connaissance scientifique et discours juridique est interrogée de nouveau par une décision récente de la Cour suprême du Canada, une affaire concernant une jeune femme autochtone, enceinte, à laquelle la cour avait ordonné de suivre un programme de traitement pour toxicomanes dans un centre de santé jusqu'à la naissance du bébé. Son habitude d'inhaler des vapeurs de colle fut considérée dangereuse pour le développement du fétus. La Cour suprême décida que sa dépendance de solvants ne justifiait pas l'action de la cour inférieure, mais tant la Cour que les différents intervenants ne tenaient ainsi compte de l'etat des connaissances sur les syndromes du fétus. Le clivage entre la compréhension scientifique du risque pour le fétus et le développement du droit constitutionnel dans le domaine des droits reproductifs des femmes persiste done. Cet article analyse le cas en le suivant lors de la procédure d'appel; nous étudions la documentation scientifique consacrée aux syndromes du fétus pour en dégager les changements dans le temps. Enfin, nous interpréterons les interventions des Winnipeg Child and Family Services, de la Women's Health Rights Coalition, de la Canadian Civil Liberties Association, de la Canadian Abortion Rights Action League et du Women's Legal Education and Action Fund.
1. Winnipeg Child and Family Services (Northwest Area) v. D.F.G., [1997] 3 S.C.R. 925 [hereinafter D.F.G.].
2. If “the injunction is granted,” he said, “Ms. G. will be restrained from causing very serious mental and physical damage to herself.” And elsewhere in the text, ”(i]n the present case, counsel for the Agency and the pleadings seek protection for Ms. G., rather than for her child to be born.”
3. Szasz, T., Ideology and Insanity (Garden City: Anchor, 1970)Google Scholar.
4. Winnipeg Child and Family Services (Northwest Area) v. D.F.G., [1996] (Man. C.A.) at para.26. “An extension of child protection law to those yet unborn involves moral choices and a balancing of a mother's rights against those of her future child. The making of those choices and the delicate balancing task would more appropriately be undertaken by a body directly answerable to society.”
5. Winnipeg Child and Family Services (Northwest Area) v. D.F.G. [1996] M.J. No.398 Suit No. AH 96-30-02891. (Man. C. A.) September 12, 1996.
6. Chisholm, P., “A sad Manitoba case reopens the debate” Maclean's (19 August 1996) at 18–19Google Scholar.
7. The Globe and Mail (24 June 1997) 17. [Emphasis in the original.]Google Scholar
8. Sellick, E., Maclean's (19 August 1996) 17Google Scholar.
9. “Fetal protection misguided, MDs say.” The Globe and Mail (24 June 1997).
10. (14 September 1996) D6.
11. (31 December 1996) A12.
12. (23 June 1997) A12.
13. (3 November 197) A14.
14. As early as 1982, E. W. Keyserlingk, Coordinator of the Protection of Life Project of the Law Reform Commission of Canada declared that “there should be no contest at all between a mother's desire to smoke, drink or consume drugs excessively, and the unborn's right to be (legally) protected against the serious risk of resulting disability to it.” (1982) 3 Health L. in Can. 40.
15. Inciardi, J. A., ed., The Drug Legalization Debate. Studies in Crime, Law and Justice. (Newbury Park: Sage, 1991)Google Scholar. Glue is, of course, not an illicit substance, and glue-sniffing, whatever its social consequences, is not a criminal act.
16. Winnipeg Child and Family Services (Northwest Area) v. D.F.G. Supreme Court of Canada Reports. File 25508.
17. “In view of my conclusion that the common law of tort and parens patriae provide no support for the order at issue, the question of the constitutionality of the order and the procedures which gave rise to it did not arise.”
18. Mr. Justice Major and the late Justice Sopinka dissented questioning both the principle of whether the Court could or should act, as well as arguing that the older doctrine of “live birth” had been made obsolete by new technology (fetal monitoring, imaging) that allowed us to recognize the fetus as a person. The court, in their opinion, missed an opportunity to go beyond the abortion decision.
19. F. C. De Coste, “Winnipeg Child and Family Services (Northwest Area) v. D.F.G. The Impossibility of Fetal Rights and the Obligations of Judicial Governance” (1998) 36 Alta L. R. 725.
20. A recent issue of the Alberta Law Review included an extensive discussion of the case, but almost all of the articles discussed it as “fetal rights.” (1998) 36 Alta L. R.
21. R. v. Morgentaler, [1988] S.C.R. 30.
22. In 1991, Abel and Sokol, using conservative estimates (leaving out data on Aboriginal communities) suggested that for the U.S. “The annual cost of treating this disorder … $74.6 million.” E. L. Abel & R. J. Sokol, “A Revised Conservative Estimate of the Incidence of FAS and its Economic Impact” (1991) 15 Alcoholism: Clinical and Experimental Research 514.
23. January 1992.
24. Murray, T., “Prenatal Drug Exposure: Ethical Issues” The Future of Children (1991)Google Scholar. (Center for the Future of Children David and Lucile Packard Foundation.) Murray uses the phrase “not-yet-born child” rather than fetus, and argues that the woman's ethical obligation to the not-yet-born child is the equivalent of the father's obligation to the born child. See also “Legal Interventions During Pregnancy” (1990) 20 JAMA 2663Google Scholar.
25. Bepko, C., ed., Feminism and Addiction (New York: Haworth Press, 1991)Google Scholar.
26. Goldsmith, S., “Prosecution to Enhance Treatment” (1990) 19:4Children Today at 13–16, 36Google ScholarPubMed. Goldsmith was chairman of the Drug Abuse of Babies Project of the National District Attorneys Association and maintains that women are in denial. “The only way they may seek treatment,” he said, “is when the alternative is criminal punishment” at 15. He proposed a new concept: “the prosecution/medical model.” See also Little, R. E. & Ervin, C. H., “Alcohol Use and Reproduction” in Wilsnack, S.C. & Beckman, L. J., eds., Alcohol Problems in Women (New York: Gilford Press, 1984) at 155Google Scholar.
27. Inciardi, J. A., ed., The Drug Legalization Debate. Studies in Crime, Law and Justice, vol. 7 (Newbury: Sage, 1991)Google Scholar.
28. Bruner, M., “The Imperfect Womb” (1997) Doctor's Review 132Google Scholar. “Today, pregnant women talk to their swollen bellies, read them bedtime stories, and play them tapes of Bach and Beethoven.” at 137.
29. Montagu, A., Life Before Birth (London: Longmans 1964)Google Scholar. Montagu's own concerns were about the use of X-ray and smoking.
30. Montagu, A., Life Before Birth (New York: New American Library, 1977) at 105Google Scholar.
31. Stotland, N. Logan, Social Change and Women's Reproductive Health Care (New York: Praeger, 1988)Google Scholar.
32. Whether there was a prejudice about the dubious morals of women who were chronically intoxicated, the stereotype cannot be discounted and may have helped to put the acceptance of FAS on a fast track.
33. Little, R. E. & Ervin, C. H., “Alcohol Use and Reproduction” in Wilsnack, S. C. & Beckman, L. J., eds., Alcohol Problems in Women (New York: Gilford Press, 1984) 155Google Scholar.
34. Little, R., Graham, J. M. Jr. & Samson, H., “Fetal Alcohol Effects in Humans and Animals” in Stimmel, B., ed., The Effects of Maternal Alcohol and Drug Abuse on the Newborn (New York: Haworth Press, 1982)Google Scholar.
35. Sokol, R. J. & Clarren, S. K., “Guidelines for Use of Terminology Describing the Impact of Prenatal Alcohol on the Offspring” (1989) 13: 4Alcoholism: Clinical and Experimental Research 597CrossRefGoogle ScholarPubMed.
36. Richardson, G. A., Day, N. L & McGauhey, P. J., “The Impact of Prenatal Marijuana and Cocaine Use on the Infant and Child” (1993) 36: 3Clinical Obstetric and Gynecology at 302CrossRefGoogle ScholarPubMed.
37. Norton-Hawk, M. A., “Frequency of Prenatal Drug Abuse: Assessment, Obstacles, and Policy Implications” (1997) 27: 3Journal of Drug Issues at 447CrossRefGoogle Scholar.
38. Zuckerman., B., “Marijuana and Cigarette Smoking During Pregnancy: Neonatal Effects” in Chasnoff, I. J., ed., Drugs, Alcohol, Pregnancy and Parenting (Dordrecht: Kluwer Academic Publishers, 1988) 127Google Scholar.
39. Mayes, L. C. et al. , “The Problem of Prenatal Cocaine Exposure” (1992) 267:3JAMA at 406CrossRefGoogle ScholarPubMed
40. Ibid. Populations not well defined and generalizable to the larger population; identification of women based on self-report without urine assays; labeling and isolating infants and young children because of their prenatal experience.
41. Koren, G. et al. , “Bias against the null hypothesis: the reproductive hazards of cocaine” (1989) 16 The Lancet at 1440CrossRefGoogle Scholar.
42. Rovner, S., “Hospital fails to identify alcohol-affected newborns” The [Washington] Post Health Magazine (6 November 1990) at 5Google Scholar.
43. Bone, M. W., Capital Crime. Black Infant Mortality in America (Newbury Park: Sage, 1989)Google Scholar.
44. Travis, C. Brown, Women and Health Psychology (Hillsdale, New Jersey: Lawrence Erlbaum, 1988)Google Scholar.
45. Zuckerman, B. & Hingson, R., “Alcohol Consumption During Pregnancy: A Critical Review” (1986) 28 Developmental Medicine and Child Neurology at 649CrossRefGoogle ScholarPubMed.
46. Johnsen, D., “A New Threat to Pregnant Women's Autonomy” (1987) Hastings Center Report 33 at 36Google Scholar.
47. Plant, M., Women Drinking, and Pregnancy (London: Tavistock, 1985)Google Scholar.
48. Lester, B. M., Freier, K. & LaGasse, L., “Prenatal Cocaine Exposure and Child Outcome: What Do We Really Know?” in Lewis, M. & Bendersky, M., eds., Mothers, Babies, and Cocaine: The Role of Toxins in Development (Hillsdale, New Jersey: Lawrence Erlbaum Associates, 1995) 19Google Scholar.
49. Bingol, N. et al. “The Influence of Socio-economic Factors on the Occurrence of Fetal Alcohol Syndrome” (1987) 6:4Advances in Alcohol & Substance Abuse at 105–18CrossRefGoogle Scholar.
50. Love Canal was a chemical disposal site near Niagara Falls, New York. It demonstrated the possible harms to pregnant women or even couples contemplating a pregnancy as well as to young children of buried toxic wastes which can leach out into the water supply and atmosphere. See Levine, A., Love Canal: Science, Politics and People (Lexington, Mass.Lexington Books, 1982)Google Scholar.
51. See for example: Hall, R. E., Nine Months Reading. A Medical Guide for Pregnant Women (New York: Doubleday, 1983)Google Scholar. Hotchner, T., Pregnancy and Childbirth (New York: Avon, 1979)Google Scholar. Korte, D. & Scaer, R., A Good Birth, A Safe Birth (New York: Bantam, 1984)Google Scholar. Eisenberg, A., Murkoff, H. E. & Hathaway, S., What to Expect when You're Expecting (New York: Workman Publishing, 1996)Google Scholar. Chamberlain, D., The Mind of your Newborn Baby (Berkeley: North Atlantic Books, 1998)Google Scholar. Stone, J., Edelman, K. & Murray, M., Pregnancy for Dummies (IDG Books. Worldwide Inc., 1999)Google Scholar.
52. “FAS information service proposed” Notes from the Clearinghouse. Canadian Centre on Substance Abuse (1993) IV:5 Action News. Some of the programs described were intended for young people and used native healing methods.
53. Some examples of labels: “If you're pregnant, don't drink;”; “Pregnant Before You Drink, Think.”; “If you drink, your unborn baby does too.”
54. Rosett, H. L & Weiner, L., Alcohol and the Fetus (New York: Oxford, 1984)Google Scholar.
55. Little, R. E. & Ervin, C. A., “Alcohol Use and Reproduction” in Wilsnack, S. C. & Beckman, L. J., eds., Alcohol Problems in Women (New York: Guilford Press, 1984) at 182Google Scholar.
56. Crack is made from cocaine powder—“it is processed from cocaine hydrochloride by using amonia or baking soda and water and heating it to remove the hydrochloride. The result is a pebble-sized crystalline form of cocaine base” that is smoked. Inciardi, J. A., Surratt, H. L. & Saum, C. A., Cocaine-Exposed Infants (Thousand Oaks, CA: Sage, 1997) at 8Google Scholar.
57. Sarick, L., “CAS alarmed at rise in parents using crack” The Globe and Mail (23 September 1992) A16Google Scholar.
58. Platiel, R., “Hospitals encounter ‘cocaine moms’” The Globe and Mail (18 February 1992) A9Google Scholar.
59. Humphries, D., Crack Mothers. Pregnancy, Drugs, and the Media (Columbus, Ohio: Ohio State University Press, 1999)Google Scholar. Gomez, L.E., Misconceiving Mothers. Legislators, Prosecutors, and the Politics of Prenatal Drug Exposure (Philadelphia: Temple University Press, 1997)Google Scholar. Both of these books provide a chilling analysis about how the problem of “Crack” has been socially constructed through the media and the courts. See also, Inciardi, J. A., Lockwood, D. & Pottieger, A. E., Woman and Crack-Cocaine (New York: Macmillan, 1993)Google Scholar.
60. Roland, E. H. & Volpe, J. J., “Effect of Maternal Cocaine Use on the Fetus and Newborn: Review of the Literature” (1989) 15 Pediatric Neuroscience at 88–94CrossRefGoogle ScholarPubMed.
61. Stimmel, B., “Editorial” in Stimmel, B., ed., The Effects of Maternal Alcohol and Drug Abuse in the Newborn (New York: Hay worth Press, 1982)Google Scholar.
62. The factum of the Appellant made this case, that addiction cases are not deterred by coercive measures from seeking medical help. “The reality is that the group of women who will be affected by this remedy already under-utilize the health care system.”
63. Nielsen, A. L. & Scarpitti, F. R., “Changing the Behavior of Substance Abusers: Factors influencing the Effectiveness of Therapeutic Communities” (1997) 27:2Journal of Drug Issues 279CrossRefGoogle Scholar.
64. Bepko, C., Feminism and Addiction (Binghamton, New York: Haworth Press, 1991)Google Scholar.
65. Para. 43.
66. D.F.G., supra note 1. In the factum presented by the Women's Health Coalition, Dr.Chudley is cited as saying that the results of his research do not support the existence of a fetal solvent syndrome at para. 17.
67. Ibid. (Appellant's factum)
68. Ibid. (Factum of the intervener Women's Health Coalition. Public Interest Law Centre).
69. Canadian Charter of Rights and Freedoms, Part 1 of the Constitution Act, 1982, being Schedule B to the Canada Act 1982 (U.K.), 1982, c. 11 [hereinafter Charter].
70. D.F.G., supra note 2 (Factum of the intervener Canadian Civil Liberties Association).
71. Ibid. at para. 10.
72. D.F.G., supra note 2 (Factum of the interveners Women's Legal Education and Action Fund and Canadian Abortion Rights Action League).
73. Ibid. Canadian Abortion Rights Action League at para. 26.
74. Ibid. at para. 9.
75. Philip, M. et al. , “Epidemiology of Fetal Alcohol Syndrome Among American Indians of the Southwest,” (1983) 30:4Social Biology at 3774Google Scholar. See also Robinson, G. et al. , “Clinical profile and prevalence of fetal alcohol syndrome in an isolated community in British Columbia” (1987) 137 CMAJ 203Google Scholar.
