Rights, Duties and the Body : Law and Ethics of the Maternal-Fetal Conflict

If a pregnant woman refuses medical treatment needed by the fetus - for instance for religious reasons - or conducts some aspect of her life in a way which risks fetal harm, there may arise an instance of "maternal-fetal conflict". This is an unfortunate term, since pregant women are generally renowned for their self-sacrificing behaviour, but it may well reflect the reality of certain maternal choices and actions. Should a pregnant woman have the legal right to refuse medical treatment needed by the fetus, or should she owe it a legal duty of care which precludes her acting in ways which may harm it? Does the debate hinge simply upon the appropriateness, or otherwise, of legally compelling presumed moral obligations, or is it more complex than this? Indeed, what are a pregnant woman't moral obligations towards her fetus? In England and in some US states, courts have held that a pregnant woman has the right to refuse medical treatment needed by the fetus. In similar fashion, the idea of a general maternal legal duty of care toward the fetus has been rejected, most recently in Canada. The cases, however, leave the impression of an uncomfortable split between the ethics and the law, as if the problem were entirely one of not legally enforcing presumed moral duties. The effect is both puzzling and polarising: puzzling in that the cases leave unanswered - as largely they must - the huge question of a pregnant woman's moral rights and duties; polarising in that the cases leave troubling tensions about a pregnant woman's rights in the face of fetal harm or death. The tendency is to deny these by ever more strongly asserting a woman's rights. In turn this encourages a reaction in favour of fetal rights, one which is unlikely to attend to a woman's interests and difficulties in pregnancy. This could have serious legal repercussions for various instances of maternal-fetal conflict, including in those US states or other jurisdictions which have yet to address these issues. It