{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:36:53Z","timestamp":1782513413902,"version":"3.54.5"},"reference-count":16,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Ethics"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:p>The publication of the latest contribution to the alcohol-in-pregnancy debate, and the now customary flurry of media attention it generated, have precipitated the renewal of a series of ongoing debates about safe levels of consumption and responsible prenatal conduct. The University College London (UCL) study\u2019s finding that low levels of alcohol did not contribute to adverse behavioural outcomes\u2014and may indeed have made a positive contribution in some cases\u2014is unlikely to be the last word on the subject. Proving a negative correlation is notoriously difficult (technically, impossible), and other studies have offered alternative claims. The author is not an epidemiologist, and the purpose of this article is not to evaluate the competing empirical claims. However, the question of what information and advice healthcare practitioners ought to present to pregnant women, or prospectively or potentially pregnant women, in a situation of uncertainty is one to which healthcare ethicists may have a contribution to make. In this article, it is argued that the total abstinence policy advocated by the UK\u2019s Department of Health, and even more stridently by the British Medical Association, sits uneasily with recent data and is far from ethically unproblematic. In particular, the \u201cprecautionary\u201d approach advocated by these bodies displays both scant regard for the autonomy of pregnant and prospectively pregnant women and a confused grasp of the principles of beneficence and non-maleficence.<\/jats:p>","DOI":"10.1136\/jme.2008.028662","type":"journal-article","created":{"date-parts":[[2009,4,30]],"date-time":"2009-04-30T17:23:58Z","timestamp":1241112238000},"page":"300-303","source":"Crossref","is-referenced-by-count":42,"title":["\u201cYou can\u2019t<i>handle<\/i>the truth\u201d; medical paternalism and prenatal alcohol use"],"prefix":"10.1136","volume":"35","author":[{"given":"C","family":"Gavaghan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2009,4,30]]},"reference":[{"key":"2024052300531132000_35.5.300.1","unstructured":"Department of Health. How much is too much when you\u2019re having a baby? 1 October 2006. http:\/\/www.dh.gov.uk\/en\/publicationsandstatistics\/publications\/publicationspolicyandguidance\/dh_4139674 (accessed 11 Mar 2009)."},{"key":"2024052300531132000_35.5.300.2","unstructured":"Department of Health. Updated alcohol advice for pregnant women. 25 May 2007 http:\/\/nds.coi.gov.uk\/environment\/fullDetail.asp?ReleaseID\u200a=\u200a287152&NewsAreaID\u200a=\u200a2&NavigatedFromDepartment\u200a=\u200aTrue (accessed 11 Mar 2009)."},{"key":"2024052300531132000_35.5.300.3","unstructured":"British Medical Association. Fetal alcohol spectrum disorders: a guide for healthcare professionals. June 2007. http:\/\/www.bma.org.uk\/health_promotion_ethics\/alcohol\/Fetalalcohol.jsp (accessed 11 Mar 2009)."},{"key":"2024052300531132000_35.5.300.4","unstructured":"National Institute for Health and Clinical Excellence (NICE). Antenatal care: routine care for the healthy pregnant woman. March 2008: paragraph 1.3.9.2. http:\/\/www.nice.org.uk\/nicemedia\/pdf\/CG062NICEguideline.pdf (accessed 11 Mar 2009)."},{"key":"2024052300531132000_35.5.300.5","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyn230"},{"key":"2024052300531132000_35.5.300.6","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2006.054213"},{"key":"2024052300531132000_35.5.300.7","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e31816fea3d"},{"key":"2024052300531132000_35.5.300.8","unstructured":"BBC News Online. Light drinking \u201cno risk to baby\u201d. 31 October 2008. http:\/\/news.bbc.co.uk\/1\/hi\/health\/7699579.stm (accessed 11 Mar 2009)."},{"key":"2024052300531132000_35.5.300.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.330.7488.375"},{"key":"2024052300531132000_35.5.300.10","unstructured":"Brazier M Cave E . Information is a prerequisite of meaningful choice. In: Brazier M Cave E , ed. Medicine, patients and the law. 4th edn. London: Penguin Books, 2007:117."},{"key":"2024052300531132000_35.5.300.11","unstructured":"General Medical Council. Consent: patients and doctors making decisions together. 2008: part 1, paragraph 3. http:\/\/www.gmc-uk.org\/news\/articles\/Consent_guidance.pdf (accessed 11 Mar 2009)."},{"key":"2024052300531132000_35.5.300.12","unstructured":"British Medical Association. Consent tool kit. London: BMA, July 2008:10."},{"key":"2024052300531132000_35.5.300.13","first-page":"8","article-title":"Is it all right for women to drink small amounts of alcohol in pregnancy?","volume":"1","author":"O\u2019Brien","year":"2008","journal-title":"Student BMJ"},{"key":"2024052300531132000_35.5.300.14","doi-asserted-by":"crossref","unstructured":"Grant ECG . No safe dose of alcohol for the fetus [electronic response to Mukherjee RAS et al. Low level alcohol consumption and the fetus]. BMJ 2005. http:\/\/www.bmj.com\/cgi\/eletters\/330\/7488\/375#97081 (accessed 11 Mar 2009).","DOI":"10.1136\/bmj.330.7488.375"},{"key":"2024052300531132000_35.5.300.15","unstructured":"US Department of Health and Human Services, Office of the Surgeon General. US surgeon general releases advisory on alcohol use in pregnancy [press release]. 21 February 2005. http:\/\/www.surgeongeneral.gov\/pressreleases\/sg02222005.html (accessed 11 Mar 2009)."},{"key":"2024052300531132000_35.5.300.16","unstructured":"Johnson K . Hey, I\u2019m pregnant, not stupid. Times Online 25 June 2007. http:\/\/www.timesonline.co.uk\/tol\/life_and_style\/health\/features\/article1975770.ece (accessed 11 Mar 2009)."}],"container-title":["Journal of Medical Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jme.2008.028662","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T09:42:25Z","timestamp":1716457345000},"score":1,"resource":{"primary":{"URL":"https:\/\/jme.bmj.com\/lookup\/doi\/10.1136\/jme.2008.028662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,4,30]]},"references-count":16,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2009,4,30]]},"published-print":{"date-parts":[[2009,5]]}},"alternative-id":["10.1136\/jme.2008.028662"],"URL":"https:\/\/doi.org\/10.1136\/jme.2008.028662","relation":{},"ISSN":["0306-6800","1473-4257"],"issn-type":[{"value":"0306-6800","type":"print"},{"value":"1473-4257","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,4,30]]}}}