Maternal-Fetal Rights and Substance Abuse: Gestation Without Representation.

In the field of forensic psychiatry we are accustomed to working with attorneys on a regular basis in a variety of circumstances. We take access to attorneys for granted. We should not take it for granted. A pregnant woman arrested for alleged addiction to opiates should have an attorney appointed to defend her before she undergoes forced treatment. This was not the case with Alicia Beltran. Ms. Beltran, in her second trimester of pregnancy, was arrested for refusing to follow the recommendations of her nurse practitioner. She had been advised to continue buprenorphine (Suboxone), even after tapering herself off of opiates when she learned she was pregnant. She was evaluated by an emergency room physician, who indicated that inpatient treatment was not necessary. Ms. Beltran was taken to court for a hearing, but she was not appointed an lawyer. Her fetus, on the other hand, already had an assistant district attorney and guardian ad litem appointed for representation. The judge ordered Ms. Beltran to substance abuse treatment in a halfway house for a substantial portion of her early pregnancy. The Cocaine Mom Act