The nation’s largest organization for medical examiners has cautioned against relying on the lung float test, a centuries-old forensic method that has played a role in criminal charges against pregnant women following pregnancy loss.
Concerns Over a Controversial Test
The lung float test attempts to determine if a baby was born alive before dying, based on whether the lungs float in water – indicating air from breathing – or sink. However, the National Association of Medical Examiners (NAME) has identified “known pitfalls” and deemed the test of “questionable value” due to a lack of clearly defined error rates.
The concerns stem from a recent position paper released in October, and follow a 2023 investigation by ProPublica that revealed the test lacks standardization and is not universally supported by medical examiners.
The Challenge of Determining Live Birth
The NAME paper emphasizes the difficulty in definitively determining whether an infant was liveborn or stillborn, noting that, aside from the presence of food in the stomach, no single finding can conclusively prove live birth. The authors wrote that if evidence doesn’t provide “clear and convincing evidence of live birth, it is recommended to default to a designation of fetal death (stillbirth).”
Dr. Reade Quinton, president of NAME, stated the association hopes the paper will “provide guidance on how to address these complex cases.” A study group is also currently examining the test’s use in court, and Dr. Odey Ukpo, chief medical examiner in Los Angeles County, confirmed his department does not use the test due to its “unreliable and inaccurate” nature.
Growing Concerns About Criminalizing Pregnancy Loss
The renewed scrutiny of the lung float test comes amid increasing concerns about the criminalization of pregnancy loss, particularly following the U.S. Supreme Court’s decision regarding abortion rights. A September report by Pregnancy Justice found that over 400 people were charged with pregnancy-related crimes in the two years following that decision, including 31 cases involving pregnancy loss.
Cases like those of Moira Akers, sentenced to 30 years in prison based in part on lung float test results, and Latice Fisher, initially charged with murder after delivering her baby in a toilet, highlight the potential for the test to contribute to unjust prosecutions. Fisher’s charges were later dismissed after her attorneys raised concerns about the test’s validity.
Frequently Asked Questions
What is the lung float test?
The lung float test is a forensic method used to try and determine if a baby was born alive before dying, based on whether the lungs float or sink in water.
Why is the National Association of Medical Examiners questioning the test?
The NAME has identified “known pitfalls” and deems the test of “questionable value” due to a lack of clearly defined error rates and the difficulty in accurately interpreting results.
What are the implications of this warning?
The warning suggests that the test should not be used as the sole determinant of whether an infant was liveborn or stillborn, especially when criminal charges are being considered. The NAME recommends defaulting to a designation of fetal death if clear evidence of live birth is lacking.
As forensic science evolves and legal landscapes shift, how will medical examiners balance the pursuit of accuracy with the potential consequences for individuals facing serious criminal charges?
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