An Incautious Tale of Biomedical Ethics, Abortion Politics and Political Expediency Mary Faith Marshall On November 6, 1998, Medical University of South Carolina President James B. Edwards, DMD, wrote a letter to “MUSC Family and Friends” announcing his forthcoming retirement after 17 years at the helm. In his letter he quoted Warren Bennis (author of Leaders on Leadership): In the postbeaurocratic world, the laurel will go the leader who encourages healthy dissent, and values those followers brave enough to say “no.” The successful leader will have not the loudest voice, but the readiest ear. And his or her real genius may well be, not in personal achievement, but in unleashing other people’s talent. Edwards closed: “While sometimes missing the mark, I and my administrative team have attempted to follow the above philosophy.” Grammatical infelicities aside, this was absolute bushwa. During my first month at MUSC (September, 1993) I learned about the Interagency Policy on Management of Substance Abuse During Pregnancy in a plenary session of a colleague’s ethic class. The presentation was made by the university’s general counsel, who stated, “we’ve written these women off . . . we want to save the babies.” There was laughter, but no dissent from the students or faculty filling the auditorium. The policy had, by then, resulted in the arrest of 39 MUSC obstetrics patients—“these women”—who used illegal drugs while pregnant and who had somehow “failed” treatment for substance abuse. The policy conditioned freedom from arrest on compliance with mandatory prenatal and substance abuse treatment. Of the patients arrested, all but one were African–American. The program was a joint venture between the obstetrics department of MUSC, the local prosecutor, and the Charleston police department. In October, 1993, Ferguson et al vs the City of Charleston et al was filed in federal district court on behalf of 11 women arrested under the Interagency Policy. It was, unfortunately, often referred to by the defendants and the media as “the Cocaine Baby trial.” The case ultimately made its way to the U.S. Supreme Court. An early sign of things to come: Edwards had asked me my position on abortion during an initial meet and greet shortly after I arrived at MUSC. Abortion politics were, after all, what the case of Ferguson et al v the City of Charleston et al was all about . . . making the fetus a person under auspices of the state’s child protection statute. South Carolina was the first state to do so. It was basically a fuck you—Edwards’ refusal in 1998 to put my promotion before the Board of Trustees because, as he stated in a letter to me, of my “testimony in the ‘Cocaine Baby’ trial.” He knew it couldn’t hold, so did the university’s general counsel—I’d been subpoenaed to testify in federal district court. My promotion had made its way through the university to the penultimate step. I’d received a congratulatory letter from Ian Taylor, my department chairman. But it took over a year, $19K [End Page 28] out of my pocket, $5K out of the AAUP’s (thanks to Jordan Kurland, AAUP Associate General Secretary, and former UVA President Robert M. O’Neill, then Chair of the AAUP Committee on Academic Freedom and Tenure), and a threatened lawsuit to make it right. After I was promoted the school of medicine “riffed” the bioethics program for reasons of “financial exigency.” I’ve only written about this once, (in a Festschrift for John Fletcher), because it feels self–serving. Having your promotion withheld and your program eliminated seem meaningless compared with spending ten or more years in jail, losing your newborn and other children to the vagaries of the foster care system, and public vilification as a derelict and wanton anti–mother for committing the “crime” of substance use disorder while pregnant. “I’m afraid you should have stayed at home today . . .” an observation made, (as we were filing out of Federal District Court, 12/9/96) by Melvin Berlinsky, the MUSC Trustee monitoring the Ferguson proceedings. I had testified that day under subpoena. The attorneys for the plaintiffs (the patients) and the defendants (MUSC, the Charleston city police department...