Deborah Mathieu's proposal for state intervention in the lives of pregnant substance abusers in order to prevent serious harm to their future children sparked a lively debate in this journal. The present discussion characterizes the three main arguments offered against her proposal as (a) the “uncertainty principle''—the inability to predict which fetuses will be affected, (b) the “father factor”—gender bias with respect to prenatal damage, and (c) “critical periods”—the vulnerability of the embryo/fetus at different times of pregnancy. Each of these arguments is examined in the specific context of fetal alcohol syndrome (FAS). Since the birth of a child with FAS is a virtual certainty if a woman has previously given birth to a child with FAS, since no father has ever sired a child with FAS unless his spouse is an alcoholic, and since the most damaging effects are those associated with exposure throughout and especially late in pregnancy, none of the arguments offered against Mathieu's proposal are relevant in this particularly narrow set of circumstances. While Mathieu's proposal seems pertinent in this situation, her proposal would be even more effective if modified as suggested here.
Health professionals' knowledge, practice and opinions about fetal alcohol syndrome and alcohol consumption in pregnancy
