Fetal Alcohol Syndrome: The Origins of a Moral Panic

Abstract

Since its discovery almost 30 years ago, the fetal alcohol syndrome (FAS) has been characterized in the USA, as a major threat to public health. In part because FAS resonated with broader social concerns in the 1970s and 1980s about alcohol's deleterious effect on American society and about a perceived increase in child abuse and neglect, it quickly achieved prominence as a social problem. In this paper, we demonstrate that, as concern about this social problem escalated beyond the level warranted by the existing evidence, FAS took on the status of a moral panic. Through examples taken from both the biomedical literature and the media about drinking during pregnancy, we illustrate the evolution of this development, and we describe its implications, particularly how it has contributed to a vapid public policy response.

Ethical challenges in FASD prevention: Scientific uncertainty, stigma, and respect for women’s autonomy

“…1 However, this message of abstinence faces some criticism, as 1) it can be unrealistic for some; 2) it ignores the uncertainties discussed above; and 3) it can present an obstacle to informed choice for women as it fails to acknowledge the complexity of the evidence about the effects of prenatal alcohol exposure. 5 Recently, the Centers for Disease Control and Prevention (CDC) endorsed a stronger public health message that extended the need for alcohol abstinence to all women who could become pregnant (i.e., sexually active women not using birth control). 13 This message was heavily criticized by many, especially in the media.…”

“…Prevention messaging thus risks perpetuating stigma and promoting the idea that women who give birth to children with FASD are irresponsible and careless mothers who are at fault. 5,[18][19][20] The risk of perpetuating stigma is heightened when prevention messaging neglects both the factors that may lead a woman to drink while pregnant (e.g., social pressures, being unaware of or not wanting to reveal the pregnancy, coping strategies) 21 and other factors that can modulate the susceptibility to the development of an FASD (e.g., nutrition, smoking, and socio-economic effects).…”

“…Moreover, it has been argued that prevention efforts have led to a "moral panic". 5 Recently, the Canadian Medical Association highlighted the importance of FASD prevention but also the need to avoid stigma within prevention. 6,7 Indeed, FASD prevention strategies face significant ethical challenges.…”

Workshop Scribbles, Policy Work and Impact: Anthropological Sensibilities in Praxis at an FASD Workshop

“…This interdisciplinary field of research is replicated when discussing the fields of workers involved in FASD client management: health, social work, justice and education specialists. As a life-long condition, FASD not only impacts the lives of those living with the condition but also impacts on the lives of women in terms of prevention practices and protocols (Armstrong 2003;Drabble et al 2011) that can get swept up in the moral panic of alcohol consumption (Armstrong and Abel 2000) -all of which can have racialised and gendered components.…”

A Bio-Social and Ethical Framework for Understanding Fetal Alcohol Spectrum Disorders

“…Theorists of mothering, and scholars interested in the process of 'mother-blame', note that mothers, especially those from marginalised social groups, can be held solely responsible for actions that may affect their offspring, ignoring the social determinants of the mothers' behaviour and their children's outcomes [44,48,49]. Ultimately, the effects of these social pressures on women's preparedness to disclose alcohol consumption during pregnancy may pose a major barrier to diagnosis and, in fact, place their fetuses at increased risk of FASD.…”