Ethical Issues Related to Substance Abuse in Pregnancy ...

• Animal models suggest neurologic effects with low to moderate exposure• Tip of the iceberg – alcohol related neurodevelopmental disorder~incident of 10/1000 live births~absent facial features~structural brain abnormalities with confirmed maternal alcohol exposureBarriers to Adequate Counseling• Concern about labeling, difficulties in making a causal attribution to prenatalalcohol• Lack of consensus in the literature, skeptic physicians• Lack of awareness and knowledge among clinicians• Are physicians missing an important diagnosis with important implications forprevention?Important Research Questions• Does the pattern of alcohol consumption matter?• Threshold level of alcohol consumption?• Timing of consumption during pregnancy matter?• Other predictive factors• One or several phenotypes? Associations with other psychiatric disorders?Prevention of Alcohol Induced Fetal Damage• 2000, AAP Committee on Substance Abuse published the followingrecommendations:~abstinence is recommended for pregnant women and for those planningpregnancy~high quality educational programs should be developed for all levels ofsociety regarding the deleterious effects of alcohol on the unborn child.~health care professionals should increase their own awareness of FASand ARND and their prevention~AAP supports federal legislation requiring inclusion of health andsafety messages in all alcohol advertising~parents of affected children should receive appropriate support servicesfor themselves and their childrenNeonatal Alcohol Withdrawal is often overlooked, but importantIs There an Answer?• Abstinence• Discuss risk during pregnancyDaystar – New York State’s First and Only Day and Respite Program for MedicallyFragile InfantsPresenter: Natalie AndersonTo learn more about Daystar: www.daystarsj.orgFounded by the Sisters of St. Joseph in 1988 as a foster home for medically fragileinfants, Daystar fills an unmet need to provide safe, quality care for this population –a need that continues today as medical advances save the lives of children who in thepast would not have survived.In 2001, doctors in the neo-natal intensive care unit at the Golisano Children’s Hospitalat Strong urged Daystar to expand it services to provide medical daycare – first for twobabies, and following an expansion of our current home, for 10 babies per day. As alicensed Group Family Day Care under the NYS Office of Children and Family Services(OCFS), we can serve no more than 10 babies at a time.