The New Jersey Supreme Court unanimously ruled Monday that the state’s civil child abuse statute cannot be used to charge patients who receive medically prescribed methadone treatment while pregnant.
The ruling came in the case of New Jersey Division of Child Protection & Permanency v. Y.N and overturns a lower court finding that a mother may be charged with civil child abuse and neglect because her newborn exhibited transitory and treatable side effects of methadone treatment that the woman received during pregnancy.
“Absent exceptional circumstances, a finding of abuse or neglect cannot be sustained based solely on a newborn’s enduring methadone withdrawal following a mother’s timely participation in a bona fide treatment program prescribed by a licensed healthcare professional to whom she has made full disclosure,” the court wrote in its ruling.
The case involved a woman identified by the court as Y.N. who, at a routine doctor’s appointment for a hand injury, learned that she was four months pregnant. During that four-month period, Y.N. had taken Percocet for injuries from a car accident and had become dependent on the medication.
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Hospital personnel advised her that she could not stop taking Percocet abruptly without endangering her pregnancy and recommended that she enter a methadone maintenance treatment program.
Y.N. followed health-care workers’ advice and entered such a program about a month before she gave birth to a healthy baby boy who was successfully treated for symptoms of neonatal abstinence syndrome (NAS), which is a group of side effects that may result from methadone treatment and other medications.
As a result of the NAS diagnosis, Y.N. was reported to the Division of Child Protection and Permanency, and was determined to have abused her child because she agreed with her physician’s recommendation and followed the prescribed course of methadone treatment while pregnant.
Y.N. appealed that decision, but a New Jersey appeals court affirmed the abuse and neglect ruling. Monday’s decision by the state supreme court reverses that finding.
“We hold that, absent exceptional circumstances, a finding of abuse or neglect cannot be sustained based solely on a newborn’s enduring methadone withdrawal following a mother’s timely participation in a bona fide treatment program prescribed by a licensed healthcare professional to whom she has made full disclosure,” the court wrote.
A woman who becomes addicted to lawfully prescribed medication and then learns she is pregnant is confronted with a choice–either to seek treatment that will improve the outcome for her newborn or to continue on the path of her addiction. The reasoning of the Appellate Division creates a perverse disincentive for a pregnant woman to seek medical help and enter a bona fide detoxification treatment program that will address her and her baby’s health needs.
The decision rejects fear-based speculation of drug harm to infants and instead listens to experts in maternal, fetal, and addiction treatment as to the best manner to address the issues of drug use during pregnancy and potential fetal harm.
Those experts agree that punitive approaches designed to punish drug-using patients like the one used in Y.N.’s case, and in play in places like Wisconsin and Tennessee end up causing more harm to pregnant patients and their families. National Advocates for Pregnant Women, with Lawrence S. Lustberg of Gibbons P.C., filed an amicus curiae (friend of the court) brief on behalf of 76 organizations and experts in maternal, fetal, and child health, addiction treatment, and health advocacy urging the New Jersey Supreme Court to rule as it did Monday.
Lynn Paltrow, executive director of National Advocates for Pregnant Women and co-counsel for the amici said, “This is an important victory, making clear that methadone treatment for pregnant women is health care, not harm.”
Attorneys for the State of New Jersey had urged the New Jersey Supreme Court to affirm the abuse and neglect finding based on Y.N. following a methadone treatment program. Had the court done so, it would have opened to door to more parents like Y.N. being prosecuted for following health-care workers’ advice.
As advocates noted while the New Jersey Supreme Court was considering Y.N.’s case, the case placed the state in the dubious position of both looking to prosecute vulnerable women at the same time it advertised its maternal chemical dependency programs, including methadone treatment programs, as ways to support children and families.
Monday’s decision is the latest from the New Jersey Supreme Court to confirm that state officials cannot charge pregnant people with abuse and neglect solely on evidence of prenatal drug exposure without evidence of actual harm to the child.
In February 2013 the court also rejected an abuse and neglect finding in a case involving an otherwise healthy baby who had traces of cocaine metabolites in a stool sample taken shortly after birth.