Physicians who don’t inform pregnant women and their partners of fetal anomalies can be sued, the Iowa Supreme Court decided this month.
These “wrongful birth” cases involve pregnancies in which physicians or other medical professionals have access to test results, not disclosed to parents, indicating the child will face severe disabilities. For instance, in the case before the Iowa Court, parents Pamela and Jeremy Plowman say their prenatal doctors failed to inform them of abnormalities discovered during an ultrasound. Instead they were led to believe “everything was fine” with the pregnancy, and recommended follow-up testing was never completed.
Severe cognitive defects were diagnosed after their son was born. His medical condition requires lifelong oversight and intervention. Now six years old, their son does not speak or walk, and he is never expected to do so.
Key to the case, at least from a legal standpoint, is the parents’ statements that, had they been informed, they would have chosen to terminate the pregnancy.
The parents’ lawsuits seeking damages stemming from the cost of their son’s care, their own mental anguish and loss of income was initially dismissed on summary judgment by the lower court. The Supreme Court order includes instructions for the lower court to determine what costs can be submitted to a jury.
I must admit this case — as well as its initial dismissal — stunned me. How can it be ethical or legal for a doctor to withhold scientifically verifiable information from a patient? How can patients make informed decisions regarding their care if doctors or medical technicians aren’t being truthful?
And, yes, I understand this is marginally related to abortion — the only medical procedure where everyone but the patient is culturally empowered to render judgment. But are we really ready to give legal credence to medical lies of omission on the mere possibility of full disclosure leading to an abortion?
The Supreme Court’s 6-1 decision doesn’t get into specifics on if the medical team was aware of Pamela’s intentions regarding such a pregnancy. So we don’t know if the information was held back specifically to thwart an abortion, or just the consideration of one. But it shouldn’t matter.
Not all women who confront high-risk pregnancies, children with severe disabilities or fetal anomalies incompatible with life choose abortion. And those women also benefit from unfiltered facts about their pregnancies. It is information that helps them plan for labor and delivery, prepare older children or other family members, purchase necessary medical supplies and equipment and generally ready their homes and their lives.
We should all applaud this court decision, which places Iowa among a majority of states that acknowledge wrongful birth malpractice claims. It’s an especially important decision given the added pressures placed on obstetricians and gynecologists by a misguided Iowa Legislature.
People, including pregnant women, seeking medical care rely on accurate information to make informed decisions.
This column by Lynda Waddington originally published in The Gazette on June 24, 2017. Photo credit: Stephen Mally/The Gazette