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Expectant Mothers Who Misuse Alcohol And/or Illicit Drugs Should Be Subject to Mandatory Reporting Requirements for Child Abuse

Alcohol and substance abuse by a woman when she is pregnant is an issue for criminal justice and is a public health concern. There are multiple consequences on the health of the mother and that on the child as well. If this act done by the mother is criminalized than the woman may face some serious implications. Some of them are the danger of detention, punishment or even arrest. They may also be prosecuted or their child could be taken away from them (Stone, 2015, Corsi et al., 2019, Cook et al., 2017, Tarasoff et al., 2018, Burns, L., Coleman-Cowger & Breen, 2016, Lee & Boeri, 2017). There can be various implications on the fetus also. When the child is born, he/she may have less birth weight, is premature, can have physical deformities or malformations and could in addition develop neurological damage. Pregnancy can also be affected by the usage of alcohol or drugs. Miscarriages can happen to the pregnant woman or she may also deliver a stillborn (World Health Organization, 2020). Therefore, it is important to report about child abuse by the healthcare professional.

Consuming alcohol or taking illicit drugs like heroin, cocaine, marijuana and so on during pregnancy can direct towards various social and health problems for the child and as well as for mother. Being dependent on alcohol or drugs can very badly impact the normal functioning of a person as a parent or partner. This could also relatively affect the mental, emotional and physical development of the child. Healthcare professionals or workers who are functioning with the women who take alcohol or drugs should be aware of the complications and should acknowledge the complexity of the female’s mental, physical or social problems so that accurate support and advice could be given to her during the time period when she’s pregnant and after the delivery as well (World Health Organization, 2020). A healthcare professional needs to follow the principle of beneficence which states that healthcare researchers and providers should practice in a way which will do good to the patient and which will benefit him/her. Healthcare professional needs to make contributions which are positive and which is best for the patient or for the complete population’s welfare (World Health Organization, 2015). Therefore, the doctor or the nurse should prioritize the prevention which will reduce or stop the usage of drug or alcohol in the pregnant woman. They should in addition to this provide the woman with correct information about the dangers of consuming harmful substances while they are pregnant. They should also put forward preventive strategies to help the pregnant woman. They should support her and should promote a healthy social or home environment (World Health Organization, 2020). However, it is important to note that using drug and alcohol while being pregnant can severely harm the babies. These things can cause stillbirths, preterm birth or even miscarriages. Hence, it is necessary for the healthcare professional to report about the misconduct performed by the fetus mother so that no more harm can be done to the child that has already happened (World Health Organization, 2020).

Another ethical principle which should be kept in mind by the healthcare professional is non-maleficence. This ethical code states that healthcare professionals or providers should not do any harm to the patient either through intentionally or via their negligence. Healthcare practitioners should make sure that patients are provided with correct information and are referred to the treatment which will do no harm to them. The patients should be given knowledge about potential harm and risks they can face while receiving care. This principle also states that the healthcare professional should stop himself/herself from doing any harm to the patient. With that, they should be there for the patient and should prevent and protect them from the probable harm they can face. The harm does not only mean physical assault or abuse but also harm to their mental or social status (World Health Organization, 2015, Motloba, 2019). Therefore, while treating a pregnant woman who is facing drug abuse and alcohol-related problem, healthcare workers need to provide safe and comprehensive care. They should also safeguard the pregnant woman against stigmatization and discrimination. They should also stop the marginalization of the pregnant woman and should promote social, community and family support towards her. With that, healthcare professionals should also enhance her links with the services which would help in childcare, employment, housing and education (World Health Organization, 2020). Looking at the other side it is also important to look at the safety of the child. It is necessary for the healthcare provider that he understands that no harm should be made to the unborn child. Due to alcohol consumption, many implications can happen to the fetus. The child who will be born can have deformities in his/her body, can also have learning disabilities or lifelong behavioural problems. Hence, it is important for the healthcare professionals and other providers to report about the act which can lead to serious consequences on a child's health (World Health Organization, 2020).

The third principle which needs to be followed by healthcare professionals and workers is autonomy. According to World Health organization, autonomy can be refereed as when a person makes his/her own choice or decision on the basis of various factors which are internal and not on the basis of external ones. It can be simply put as acting and accepting personal decision. The autonomy of the patient is needed to be followed. In healthcare, doctors or nurses should operate under the formal consent given by the patient only. They should restrain themselves in doing what was not mentioned by the patient or was opposite to the patient decision or choice (World Health Organization, 2015). In the case of a pregnant woman who takes drugs and consumes alcohol, it is very necessary for the healthcare professional to respect her autonomy. The pregnant women should always be respected and they need to be completely given all the information and knowledge about the benefits and risks which are imposed on them and as well as for the fetus they carry. They should also be told about their options with treatment so that they can make their decisions about their own healthcare. With that, their decision should be respected by the healthcare professional and workers so that her autonomy can be protected (World Health Organization, 2020). However, in the case of an unborn child, it is very crucial for the healthcare provider to think about the child who could not make any informed decisions for himself/herself. If the correct decision is not made for them, then, they have to bear consequences which are will be with them all their life. Alcohol or drug abuse by the mother can physically or mentally harm them. For that reason, it is very essential for a health worker or provider to report about the mother's wrongdoing with the child (World Health Organization, 2020).

The fourth principle by which healthcare professional and workers should abide is justice. This principle morally guides them to distribute burdens and benefits among the society equally. Sometimes, it is considered very tough to provide healthcare to everyone equally. However, many other factors are considered while doing so. This ethical code also states that giving the patients the service that they deserve. They need to make decisions which will be fair to the patient and is actually for the patient wellbeing only. Healthcare professionals must be just and provide the patient with the utmost care with respect and honour (World Health Organization, 2015). In the case of a pregnant woman who is involved with alcohol and drug usage, the healthcare provider should be giving her holistic care which is appropriate for her. The care which should be given should be just and fair and no type of injustice be done with her. The woman should be provided with care which could deal with complexities of the substance that they used (World Health Organization, 2020). As for the child, the healthcare provider needs to do justice with him as well. They need to safeguard and protect the fetus from severe implications that might have been caused due to the intake of drugs or alcohol by the mother. Alcohol not only impacts the fetus in the womb but also in the future also. Children might suffer from Fetal Alcohol Spectrum Disorders (FASD). Hence, it is vital for the healthcare provider to be just and fair to the unborn child. That’s why it is important to report the incidents where a pregnant woman is involved in heavy drinking and drug abuse (World Health Organization, 2020).

In conclusion, it can be said that drinking alcohol and taking drugs while being pregnant can be very injurious to the health and wellbeing of the child and as well as the mother. This can cause social, mental and emotional disbalance for the mother and for her family as well. Furthermore, it could have serious implications on the unborn child. Miscarriages or preterm delivery might happen in some cases. Not only this, but the child could also be born with physical deformities or could have mental problems. He may also suffer from behavioural disorders or FASD just because of his/her mother's fault. Therefore, this makes reporting mandatory by the healthcare professional as there is child abuse involved that might harm him/her in various ways.

References for Ethical Principles and Mandatory Reporting

Burns, L., Coleman-Cowger, V. H., & Breen, C. (2016). Managing maternal substance use in the perinatal period: Current concerns and treatment approaches in the United States and Australia. Substance Abuse: Research and Treatment10, SART-S34558.

Cook, J. L., Green, C. R., de la Ronde, S., Dell, C. A., Graves, L., Ordean, A. & Wong, S. (2017). Epidemiology and effects of substance use in pregnancy. Journal of Obstetrics and Gynaecology Canada, 39(10), 906-915.

Corsi, D. J., Walsh, L., Weiss, D., Hsu, H., El-Chaar, D., Hawken, S. & Walker, M. (2019). Association between self-reported prenatal cannabis use and maternal, perinatal, and neonatal outcomes. Jama322(2), 145-152.

Lee, N., & Boeri, M. (2017). Managing stigma: Women drug users and recovery services. Fusio: the Bentley Undergraduate Research Journal1(2), 65.

Motloba, P. D. (2019). Non-maleficence-a disremembered moral obligation. South African Dental Journal74(1), 40-42.

Stone, R. (2015). Pregnant women and substance use: fear, stigma, and barriers to care. Health & Justice3(1), 2.

Tarasoff, L. A., Milligan, K., Le, T. L., Usher, A. M., & Urbanoski, K. (2018). Integrated treatment programs for pregnant and parenting women with problematic substance use: Service descriptions and client perceptions of care. Journal of Substance Abuse Treatment, 90, 9-18.

World Health Organization. (2015). Global health ethics key issues. Available at file:///C:/Users/acer/Downloads/9789240694033_eng.pdf

World Health Organization. (2020). Management of substance abuse. Available at https://www.who.int/substance_abuse/activities/pregnancy_substance_use/en/

World Health Organization. (2020). Protecting unborn babies from alcohol-related harm. Available at https://www.who.int/features/2014/aboriginal-babies-alcohol-harm/en/

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