Hospital accused of experiments on pregnant women

BMJ 1994; 308 doi: (Published 29 January 1994) Cite this as: BMJ 1994;308:291
  1. J Roberts

    A major American medical centre has been accused of violating the rights of its pregnant patients. The Medical University of South Carolina was accused last week of testing pregnant patients for drug use without their consent, collecting confidential information and turning it over to police, and conducting illegal experiments on humans.

    The programme of drug testing began in 1989 to try to stop women from using drugs such as cocaine and heroin during pregnancy. Local government and hospital officials hoped that the threat of prison would make addicts seek treatment. Since the programme began in 1989 more than 40 women have been arrested, and at least three women have been sent to prison for using drugs during pregnancy. Some women were arrested within a day of giving birth, says the Center for Reproductive Law and Policy, the group in New York that filed the complaint with the National Institutes of Health, which monitors experimentation on humans.

    A spokesperson for the medical centre said that the project was “treatment,” not experimentation. But some members of staff did compare outcomes before and after the programme began, and they published their data in the state's medical journal in 1990.

    The complaint alleges that women were not told that when they sought prenatal care they were giving up their rights to confidentiality or that their medical records would be passed to police. The hospital said that all patients must sign a “standard” consent from that states: “I further consent to the testing of drugs, if deemed advisable by my physician.” A hospital official told the press, “These cases are a burden to their families and the state. All we are trying to do is something positive for the growing problem here in South Carolina and around the country.”

    According to the article in the state medical journal, women were tested for drug misuse if, on admission for delivery, they had had little or no prenatal care, were in early labour, or had a history of drug misuse. Those in whom results were positive were told that they would be arrested if they did not seek treatment. The hospital says the programme has been a success because the number of women in whom results of tests for drugs have been positive has “diminished markedly” since 1989.

    Federal rules require that all research on humans must be reviewed by institutional review boards and that patients' informed consent for such research must be obtained. In addition, patients have a right to refuse to participate in research and still receive medical treatment.

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