[AMA Board of Trustees Report. Legal interventions during pregnancy: court- ordered medical treatments and legal penalties for potentially harmful behavior by pregnant women. JAMA. 1990; 264:2663–2670.]

The AMA Board of Trustees recommends adoption of the following statement:

1. Judicial intervention is inappropriate when a woman has made an informed refusal of a medical treatment designed to benefit her fetus. If an exceptional circumstance could be found in which a medical treatment poses an insignificant or no health risk to the woman, entails a minimal invasion of her bodily integrity, and would clearly prevent substantial and irreversible harm to her fetus, it might be appropriate for a physician to seek judicial intervention. However, the fundamental principle against compelled medical procedures should control in all cases that do not present such exceptional circumstances.

2. The physician’s duty is to provide appropriate information, such that the pregnant woman may make an informed and thoughtful decision, not to dictate the woman’s decision.

3. A physician should not be liable for honoring a pregnant woman’s informed refusal of medical treatment designed to benefit the fetus.

4. Criminal sanctions or civil liability for harmful behavior by the pregnant woman toward her fetus are inappropriate.

5. Pregnant substance abusers should be provided with rehabilitative treatment appropriate to their specific physiological and psychological needs.

6. To minimize the risk of legal action by a pregnant patient or an injured child or fetus, the physician should document medical recommendations made including the consequences of failure to comply with the physician’s recommendations.