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Medical Examiners Warn That Controversial Lung Float Test Could Be Dangerous
https://www.propublica.org/article/lung-float-test-stillbirth-pregnancy-medical-examinersThe nation’s largest organization for medical examiners has issued a warning about a controversial, centuries-old forensic test that has contributed to cases in which pregnant women have been charged with murder.
The premise behind the lung float test is simple: If a baby was born alive and then died, air from its first breaths would cause its lungs to float in a jar with water. If the baby was stillborn, the lack of air in the lungs would cause them to sink. But the many critics of the test have long labeled it junk science and drawn parallels between the test and witch trials, where women were deemed witches based on whether they floated or sank.
The National Association of Medical Examiners addressed the lung float test as part of a larger position paper released in October on investigating perinatal deaths, including stillbirths. A panel of 11 experts said the test has “known pitfalls” and is of “questionable value” and “without clearly defined error rates.”
“Those who use the lung float should be wary of accepting the results when it conforms to their summation of the findings and rejecting the result if it conflicts; a ‘test’ used in such fashion inevitably becomes more dangerous than useful,” the authors wrote.
The paper follows a 2023 investigation by ProPublica into the use of the lung float test in cases where women were charged with murder despite their claims that they had a stillbirth. ProPublica found that the test was deeply flawed, lacked the basic standardization of trusted forensic disciplines and did not have full support from any of the country’s 12 largest medical examiners’ offices.
The test is typically used where someone gives birth outside of a hospital or without medical supervision. But the paper cautioned that the distinction between a liveborn and stillborn infant can be very difficult to discern. Other than food in the stomach, the authors wrote, there is no diagnostic tool or finding that can “stand alone as the sole determinant of whether an infant was liveborn or stillborn.”
The premise behind the lung float test is simple: If a baby was born alive and then died, air from its first breaths would cause its lungs to float in a jar with water. If the baby was stillborn, the lack of air in the lungs would cause them to sink. But the many critics of the test have long labeled it junk science and drawn parallels between the test and witch trials, where women were deemed witches based on whether they floated or sank.
The National Association of Medical Examiners addressed the lung float test as part of a larger position paper released in October on investigating perinatal deaths, including stillbirths. A panel of 11 experts said the test has “known pitfalls” and is of “questionable value” and “without clearly defined error rates.”
“Those who use the lung float should be wary of accepting the results when it conforms to their summation of the findings and rejecting the result if it conflicts; a ‘test’ used in such fashion inevitably becomes more dangerous than useful,” the authors wrote.
The paper follows a 2023 investigation by ProPublica into the use of the lung float test in cases where women were charged with murder despite their claims that they had a stillbirth. ProPublica found that the test was deeply flawed, lacked the basic standardization of trusted forensic disciplines and did not have full support from any of the country’s 12 largest medical examiners’ offices.
The test is typically used where someone gives birth outside of a hospital or without medical supervision. But the paper cautioned that the distinction between a liveborn and stillborn infant can be very difficult to discern. Other than food in the stomach, the authors wrote, there is no diagnostic tool or finding that can “stand alone as the sole determinant of whether an infant was liveborn or stillborn.”
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