Unintended Consequences of Policy Responses to Fetal Alcohol Spectrum Disorders: Civil Commitment and Community Sentiment in North Dakota

Abstract

Policymakers are political system elites that may respond to, or even help lead, community sentiment. For any specific policy question, community sentiment may include preferences expressed by the mass public or may be limited to the relevant community of experts and insiders. In 2003, the North Dakota state legislature unanimously added alcohol abuse during pregnancy to the existing laws against child abuse and neglect and allowed for involuntary civil commitment to treat women who violate the law. Alcohol use by pregnant women can be very costly to a state because of the risk of fetal alcohol spectrum disorders (FASD), and one strategy for alcohol control is to punish expectant mothers as criminals. This chapter presents a policy analysis of North Dakota’s approach to reducing prenatal alcohol use. Searches for community sentiment in media reports and in legislative history suggested that the policy subsystem of insider stakeholders was the impetus for this policy change. Stunted public discourse driven by unanimously positive, neutral, or uninformed sentiment leads to a variety of negative outcomes for mothers and society. The policy analysis highlights the negative effects of this law and suggests better alternatives.