"Controversial Lung Float Test Faces Scrutiny: Medical Experts Warn of Flawed Science in Criminal Cases"
Medical Examiners Warn Against Controversial Lung Float Test in Perinatal Death Investigations
In a significant move, the National Association of Medical Examiners (NAME) has issued a cautionary statement regarding the lung float test, a forensic method that has been used for centuries to determine whether a newborn was born alive or stillborn. This warning comes amid growing concerns about the test’s reliability and its implications in legal cases, particularly those involving pregnant women charged with murder.
The Lung Float Test: A Historical Overview
The lung float test operates on a straightforward premise: if a baby takes its first breaths, air fills the lungs, causing them to float in water. Conversely, if the baby is stillborn, the lungs will sink. However, critics have long denounced this method as "junk science," drawing parallels to historical witch trials where women were judged based on whether they floated or sank.
In an October position paper, NAME’s panel of 11 experts highlighted the test’s "known pitfalls" and described it as being of "questionable value" with "no clearly defined error rates." The authors emphasized that reliance on the test could lead to dangerous outcomes, particularly when results are selectively accepted based on preconceived conclusions.
Investigative Findings
This position paper follows a 2023 investigation by ProPublica, which scrutinized the use of the lung float test in cases where women were prosecuted for murder despite claiming their infants were stillborn. The investigation revealed that the test lacks standardization and does not have the backing of any of the 12 largest medical examiners’ offices in the United States.
The test is often employed in situations where births occur outside of medical facilities, making it even more critical to accurately determine whether a live birth occurred. The NAME paper cautioned that distinguishing between liveborn and stillborn infants is complex, with no single diagnostic tool capable of definitively making this determination.
Legal Implications and High Stakes
The ramifications of misclassifying a birth can be severe, leading to criminal charges against mothers. The authors of the NAME paper stressed the necessity for a high degree of certainty in such determinations. They recommended that in the absence of "clear and convincing evidence of live birth," the default classification should be fetal death (stillbirth).
Dr. Reade Quinton, president of NAME and an associate professor at the Mayo Clinic, noted that this is the first time in the organization’s nearly 60-year history that it has addressed the lung float test in a formal position paper. The paper is set to be published in the American Journal of Forensic Medicine and Pathology next year.
Ongoing Research and Expert Opinions
In response to ProPublica’s findings, a group of medical and legal experts has convened to evaluate the lung float test’s validity in court settings. Dr. Odey Ukpo, chief medical examiner in Los Angeles County, stated that his office does not use the lung float test due to its unreliability. He emphasized the importance of adhering to evidence-based medicine, a sentiment echoed in the NAME position paper.
Despite the growing criticism, some medical examiners express concern about the potential backlash for not utilizing the lung float test, as it is often included in forensic pathology training. However, the NAME paper clarifies that there is "no reason to mandate its performance," highlighting the lack of data and the variability in how the test is conducted.
Contextual Relevance
The findings of the NAME paper are particularly pertinent in light of recent legal trends surrounding pregnancy loss. Following the U.S. Supreme Court’s decision to overturn Roe v. Wade, a report from the nonprofit Pregnancy Justice revealed that over 400 individuals were charged with pregnancy-related crimes in the two years following the ruling, including 31 cases involving pregnancy loss. This trend has raised alarms about the criminalization of miscarriage and stillbirth, framing these personal medical experiences as suspicious events.
Case Studies Highlighting the Test’s Flaws
ProPublica’s investigation detailed several troubling cases, including that of Moira Akers, a Maryland mother sentenced to 30 years in prison after prosecutors cited the lung float test as evidence against her. Akers maintained that her baby was stillborn, but the prosecutor argued otherwise based on the test results. In February, the Maryland Supreme Court granted her a new trial, although it did not address the lung float test’s validity.
Another case involved Latice Fisher, who delivered her baby in a toilet. The medical examiner’s use of the lung float test yielded inconclusive results, leading to an indictment for second-degree murder. After further investigation, the district attorney dismissed the charges, underscoring the test’s shortcomings.
Conclusion
The NAME’s position paper serves as a critical call to action for medical examiners, legal professionals, and policymakers. As the landscape surrounding pregnancy loss and maternal health continues to evolve, the need for reliable, evidence-based practices in forensic medicine has never been more urgent. The ongoing discussions and research surrounding the lung float test highlight the complexities of perinatal death investigations and the potential consequences of flawed forensic methodologies.