 Most commentators on the ethics of managing pregnant drug abusers have rejected a punitive or coercive approach (Capron 1998, Steinbock 1992, deVille et al. 1998, Terplan, Kennedy-Hendricks, and Chisolm 2015). The Center for Reproductive Rights published a brief in 2000 summarizing common arguments against punishing pregnant drug abusers. They point out that punishing the mother does not particularly protect the well-being of children. It is also unlikely to have a deterrent effect, since drug use among addicts is rarely a voluntary choice based on a rational assessment of the risks and potential benefits of drug use. Indeed, most pregnant addicts are not ‘choosing’ their own pleasure over their children's well-being, as they would generally prefer not to be drug abusers, for their own sake as well as their child's. In addition to creating barriers to effective prenatal care, punitive and coercive approaches to drug use during pregnancy may inappropriately diminish women's agency and misconstrue the interests of pregnant women who use drugs (Olsen, Banwell, and Madden 2014). Threatening pregnant drug users with punishment does not serve to protect children from their “unfit” mothers, and may deter women from getting prenatal care and especially drug treatment, thereby further harming their children (Terplan, Kennedy-Henricks and Chisolm 2015). Furthermore, a punitive approach individualizes the problem of drug use during pregnancy and ignores social determinants of drug addiction. Some argue that punitive measures against pregnant women addicted to drugs are inherently unjust when taken in a system that fails to meet the basic health needs of marginalized women and children (Flavin and Paltrow 2010). Poor and minority pregnant women are disproportionately tested for drugs and threatened with punishment, even though they use drugs at rates no higher than their white, middle-class counterparts, and hence a punitive approach is likely to be unjustly applied (see also Hans 1999). Iris Young argues, “[b]ecause punishing the pregnant addict does next to nothing to prevent the birth of babies harmed by the chronic drug use of their mothers, punishment seems only to have the function of marking the women as deviant, publicly reaffirming their exclusion from the class of upstanding citizens” (Young 1994, 39).