Since the introduction of ultrasound technology in the 1960s as a tool to visibly articulate the interiors of the pregnant body, feminist scholars across disciplines have provided extensive critique regarding the visual culture of fetal imagery. Central to this discourse is the position that fetal images occupy- as products of a visualizing technology that at once penetrates and severs pregnant and fetal bodies. This visual excision, feminist scholars describe, has led not only to an erasure of the (...) female body from fetal images but also to an erasure of the pregnant body in social, political, and biomedical discourses. Vital to feminist scholarship is, thereby, an engagement with fetal images in ways that reinscribe the pregnant body onto fetal images and into political discourses pertaining to reproductive rights. In this paper, similar to the feminist aim, I am interested in engaging with fetal images as way to gain agency for pregnant women and their bodies. The critical question that I ask is: Can we conceive of medical technology in an embodied way -one that interacts organically, dynamically, and through multisensory dimensions with pregnant bodies? In attempting to answer this question, I turn to Bruno Latour and Gilles Deleuze’s articulations of how bodies and machines interact to produce visual fact. (shrink)
This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception about the nature of clinical research and the status of research subjects. Second, given that it is not clear who the research subject/s in MFS is/are, if clinical equipoise is to be used as (...) a criterion to test the ethical appropriateness of RCT, its meaning should be unambiguous. Third, because of the multidisciplinary character of MFS, it is not clear who should be in equipoise. As a result, we lack an adequate criterion for the ethical review of MFS protocols. In our account, which is based on Chervenak and McCullough's seminal work in the field of obstetric ethics, equipoise is abandoned. and RCT involving MFS can be ethically initiated when a multidisciplinary ethics review board (ERB), having an evidence-based assessment of the risks involved, is convinced that the value of answering the research hypothesis, for the sake of the health interests of future pregnant women carrying fetuses with certain congenital birth defects, justifies the actual risks research participants might suffer within a set limit of low/manageable. (shrink)
Discussions of reproductive responsibility generally draw heavily upon the principles of nonmaleficence and beneficence. However, these principles are typically only applied to women due to the incorrect belief that only women can cause fetal harm. The cultural perception that women are likely to cause fetal and child harm is reflected in numerous social norms, policies, and laws. Conversely, there is little public discussion of men and fetal and child harm, which implies that men do not (or cannot) (...) cause such harm. My goal in this paper is to begin to fill the void in the academic literature about men’s reproductive responsibility by highlighting the health-related, economic, and social harms men can cause to potential fetuses and children and then examining what it would mean to hold them responsible for preventing these harms. Applying the principles of nonmaleficence and beneficence to men, I conclude that men have a moral duty to use contraception if their behavior—past, current, or future—could harm the potential fetuses and children who result from their unprotected sexual behavior. (shrink)
When surgery is performed on pregnant women forthe sake of the fetus (MFS or maternal fetalsurgery), it is often discussed in terms of thefetus alone. This usage exemplifies whatphilosophers call the fallacy of abstraction: considering a concept as if it were separablefrom another concept whose meaning isessentially related to it. In light of theirpotential separability, research on pregnantwomen raises the possibility of conflictsbetween the interests of the woman and those ofthe fetus. Such research should meet therequirement of equipoise, i.e., a (...) state ofgenuine uncertainty about the risks andbenefits of alternative interventions ornoninterventions. While illustrating thefallacy of abstraction in discussions of MFS,we review the rationale for explicitacknowledgment of the essential tie betweenfetus and pregnant woman. Next we examinewhether it is possible to meet the requirementof equipoise in research on MFS, focusing on afetal condition called myelomeningocele. Weshow how issues related to equipoise innonpregnant populations appear also in debatesregarding MFS. We also examine evidence insupport of claims that the requirement ofequipoise has been satisfied with respect to``the fetal patient'' while considering risks andbenefits to gestating women only marginally ornot at all. After delineating challenges andpossibilities for equipoise in MFS research, weconclude with a suggestion for avoiding thefallacy of abstraction and achieving equipoiseso that research on MFS may be ethicallyconducted. (shrink)
Both the medical model and the social model of disability have substantial drawbacks for the project of creating better lives for people with disabilities; the first denies the value of difference and the effects of discrimination, and the second denies any place for prevention and cure. Using fictional and non-fictional parental narratives of Fetal Alcohol Syndrome, this article argues that a third model–a morphological model of disability–can best help us think about respectfully and effectively intervening in disability.
Infant facial characteristics may affect discriminative parental solicitude because they convey information about the health of the offspring. We examined the effect of Fetal Alcohol Syndrome (FAS) infant facial characteristics on hypothetical adoption preferences, ratings of attractiveness, and ratings of health. As expected, potential parents were more likely to adopt “normal” infants, and they rated the FAS infants as less attractive and less healthy. Cuteness/attractiveness was the best predictor of adoption likelihood.
In this commentary we discuss the possibility of subcortical consciousness and its implications for fetal anesthesia and analgesia. We review the neural development of structural and functional elements that may participate in conscious representation, with a particular focus on the experience of pain. (Published Online May 1 2007).
In early 2010, the Nebraska state legislature passed a new abortion restricting law asserting a new, compelling state interest in preventing fetal pain. In this article, we review existing constitutional abortion doctrine and note difficulties presented by persistent legal attention to a socially derived viability construct. We then offer a substantive biological, ethical, and legal critique of the new fetal pain rationale.
This essay concerns what people should do in conflict situations when a doubt of fact bears on settling whether an alternative under consideration is legitimate or not. Its principal audience are those who believe that abortion can be legitimate when not having an abortion gives rise to serious harms that can be avoided by having one, but who are concerned that fetuses might feel pain when being aborted, and who believe that causing unnecessary pain should be avoided when doing so (...) would not pose an undue burden. The essay remains neutral on the substantive questions of the moral status of the unborn and the morality of abortion. The question of fetal pain has taken center stage in the last few years in the .. (shrink)
Corporate fetal protection policies are designed to protect unborn children from exposure to harmful substances in the workplace. In recent years, a number of corporations have instituted fetal protection policies which excluded all fertile female employees from jobs which exposed them to hazardous substances. Critics argued that these policies discriminated against women, and several lawsuits were filed.The United States Supreme Court recently decided a case involving the fetal protection policy of Johnson Controls, Inc. This article will (...) analyze the impact of the Supreme Court decision from a legal and ethical perspective. Practical guidelines for policies which protect the unborn and comply with the law will also be addressed. (shrink)
Proceedings of a one day symposium for medical professionals with an interest in, or with a responsibility for, the development of ante-natal screening, fetal medicine and the provision of termination of pregnancy, held on 26 September 1996 at the Royal Society of Medicine, London. The objectives of the symposium were: to provide an occasion for the discussion of the clinical and ethical issues involved in screening for fetal abnormality and in providing the options of continuing the pregnancy or (...) abortion; to clarify good practice in respect of late abortion for fetal abnormality; to discuss the problems of providing a service sympathetic to women. (Author). (shrink)
This essay critiques feminist treatments of maternal-fetal "relationality" that unwittingly replicate features of Western individualism (for example, the Cartesian division between the asocial body and the social-cognitive person, or the conflation of social and biological birth). I argue for a more reflexive perspective on relationality that would acknowledge how we produce persons through our actions and rhetoric. Personhood and relationality can be better analyzed as dynamic, negotiated qualities realized through social practice.
Objective Standards of care regarding obstetric management of life-threatening anomalies are not defined. It is hypothesised that physicians' management of these pregnancies is variable and influenced by demographic factors. Design A questionnaire was mailed to members of the Society of Maternal–Fetal Medicine with valid US addresses assessing obstetric management of both ‘uniformly lethal’ (eg, anencephaly, renal agenesis) and ‘uniformly severe, commonly lethal’ (eg, trisomy 13 and 18) anomalies. Respondents were asked to answer as if not limited by state/institutional restrictions. (...) Fisher's exact or χ2 tests were used as appropriate and correction made for multiple comparisons in analyses that were not prespecified. Results The response rate was 36% (732/2038). Nearly 100% of respondents discuss termination for both uniformly and commonly lethal anomalies. In continuing pregnancies, with patient request for obstetric non-intervention 99% of providers would comply for either uniformly or commonly lethal anomalies. The majority ‘encourage’ such management, but some were non-directive or discouraged this management. In continuing pregnancies, with patient request for full obstetric intervention the majority of respondents was willing to comply for both uniformly (71%) and commonly (82%) lethal anomalies. While most practitioners ‘discouraged’ full intervention, some were non-directive or encouraged this management. Demographics and severity of anomaly influenced counselling. Conclusion Discrepancies exist regarding the management of life-threatening fetal anomalies. Patients may be offered different options based on practitioner demographics. The majority of physicians comply with patient wishes. Differences were noted when comparing the management of lethal with that of severe commonly lethal anomalies, suggesting that practitioners make a distinction when counselling patients. (shrink)
Chervenak and McCullough, authors of the most acknowledged ethical framework for maternal–fetal surgery, rely on the ‘ethical–obstetrical’ concept of the fetus as a patient in order to determine what is morally owed to fetuses by both physicians and the women who gestate them in the context of prenatal surgery. In this article, we reconstruct the argumentative structure of their framework and present an internal criticism. First, we analyse the justificatory arguments put forward by the authors regarding the moral status (...) of the fetus qua patient. Second, we discuss the internal coherence and consistency of the moral obligations those authors derive from that concept. We claim that some of the dilemmas their approach is purported to avoid, such as the debate about the independent moral status of the fetus, and the foundation of the moral obligations of pregnant women (towards the fetuses they gestate) are not, all things considered, avoided. Chervenak and McCullough construct the obligations of physicians as obligations towards entities with equal moral status. But, at the same time, they assume that the woman has an independent moral status while the moral status of the fetus is dependent on the decision of the woman to present it to a physician for care. According to the logic of their own argumentation, Chervenak and McCullough implicitly admit a different moral status of the woman and the fetus, which will lead to different ascription of duties of the physician than those they ascribed. (shrink)
Ethical controversy over transplantation of human fetal tissue has arisen because the source of tissue is induced abortions. Opposition to such transplants has been based on various arguments, including the following: rightful informed consent cannot be obtained for use of fetal tissue from induced abortions, and fetal tissue transplantation might result in an increase in the number of abortions. These arguments were not accepted by the National Institutes of Health (NIH) Human Fetal Tissue Transplantation Research Panel. (...) The majority opinion of the panel stated that abortion and fetal tissue use are entirely separate issues, and that tissue use is ethically acceptable because it can be morally insulated from the issue of abortion. In support of this view, panel members and others have replied to the arguments put forward by opponents of fetal tissue use. However, replies to the two arguments mentioned above have been unsatisfactory, and the shortcomings of those replies are identified herein. Examination of the arguments pro and con suggests that fetal tissue use cannot be completely insulated from the issue of abortion. Thus, in seeking an ethical justification for fetal tissue transplantation we must consider reasons other than those put forward by the NIH panel. In this paper it is argued that whatever wrong is involved in using fetal tissue from induced abortions must be balanced against the benefits for patients, and it is on this basis that fetal tissue transplantation can be ethically justified. (shrink)
The use of human fetal tissue for scientific research has enormous potential but is subject to government legislation. In the United Kingdom the Polkinghorne Committee's guidelines were accepted by the Department of Health in 1990. These guidelines set out to protect women undergoing termination of pregnancy from exploitation but in so doing may significantly restrict potential research. Although the committee took evidence from a wide variety of experts they did not seek the views of the general public. We asked (...) 108 women about to have a therapeutic abortion; 167 women who had had a pregnancy terminated in the past, and 419 women who had never had an abortion, their views on research using human fetal tissue. Regardless of their past experiences the women were overwhelmingly in favour of research using fetal tissue (94 per cent). They made little distinction between basic research and research with obvious clinical relevance and supported the concept of using transplanted fetal tissue for the treatment of adult disease such as Parkinsonism. Women about to undergo an abortion were significantly more likely (p < 0.001) to approve of all types of research including that aimed at improving methods of abortion and research using live fetuses in utero. (shrink)
In this essay, I provide evidence that a new generation of prochoice advocates wishes to move away from defending abortion rights via the view that fetal life has little or no value (for example, as Mary Anne Warren does in her “On the Moral and Legal Status of Abortion”) and toward a more complex view of abortion rights. This newer view simultaneously grants that fetuses are more than simply “clumps of cells,” that they are, to some extent, entities that (...) possess some degree of value, and also that women still have the right to decide whether they wish to continue a pregnancy (for example, as can be found in the writings of Rosalind Hursthouse, Judith Jarvis Thomson, and Margaret Olivia Little). Prima facie, this may sound like an impossible task—an instance of “having your cake and eating it too”—but I will show throughout my paper that, and how, such a task can indeed be accomplished. (shrink)
Advances in transplantation have extended the life and relieved the suffering of thousands of individuals. The prospect of being able to use tissues from embryos, as well as from anencephalic newborns, offers the promise of further relief of suffering. However, these possibilities raise significant moral and public policy issues. The question arises of the extent to which those who disapprove of abortion may make use of tissues derived from abortion in order to treat serious diseases. This essay argues that, with (...) proper safeguards, such tissue can be used without cooperating in abortion. That is, even those who oppose abortion can benefit from the use of tissue procured during abortion. Questions also arise regarding the probity of maintaining a pregnancy in order to produce an anencephalic newborn whose biological existence will be maintained so as better to secure organs once death is declared. It is argued that, since no harm can be done to a being that has neither a sense of self or the capacity to feel pain, and since women have a right to forego abortions, there is no legitimate ground for opposing women's seeking meaning in their pregnancy through maximizing the opportunity of others to use the organs of their anencephalic newborn once death has been declared. Finally, it is argued that, since the capacities for sentience, a minimal condition for personhood, are never realized by an anencephalic, the entity has never been alive as a person. Therefore, there should be no opposition in principle to aborting anencephalics nor, after proper declaration, to making their organs available as one would after whole-brain death, despite the continued functioning of the brain stem. Keywords: anencephalics, transplantation, fetal tissue, definition of death CiteULike Connotea Del.icio.us What's this? (shrink)
One common objection to fetal tissue transplantation (FTT) is that, if it were to become a standard form of treatment, it would encourage or entrench the practice of abortion. This claim is at least factually plausible, although it cannot be definitively established. However, even if true, it does not constitute a compelling ethical argument against FTT. The harm allegedly brought about by FTT, when assessed by widely accepted non-consequentialist criteria, has limited moral significance. Even if FTT would cause more (...) abortions to be performed, and abortion is taken to be a serious moral wrong, this is not sufficient in itself to make FTT wrong. (shrink)
Since 1994, when the first fetal imaging boutique appeared in Texas, many sites have been established around the country for parents to receive nonmedical fetal imaging using three- and four-dimensional ultrasound machines. These businesses boast the benefits they offer to parental-fetal bonding, but the medical community objects to the use of ultrasound machines for nonmedical purposes. In this article, I present the statements released by the medical community, highlighting the alarmist strategies used to paint boutique ultrasounds as (...) bad science and elevate the medical use of ultrasounds. Through a close reading of the statements, it is shown that the medical community's primary concern is not the health of the fetus or the woman but rather their place as the sole users of fetal ultrasounds. This detailed analysis reveals a medical community fearful that its authority is being usurped and is therefore responding with statements meant to denigrate boutique fetal ultrasounds. (shrink)
Medea killed her children to take away the smile from her husband's face, according to Euripides, an offence against nature and morality. What if Medea had still been carrying her two children, perhaps due to give birth within a week or so, and had done the same? If this would also have been morally reprehensible, would that be a judgment based on her motives or on her action? We argue that the act has multiple and holistic moral features and that, (...) in fact, there is no absolute principle, such as the right of the fetus to life, which governs our moral judgments about fetal-maternal conflicts. We suggest that they illustrate a pervasive feature of human moral discourse and can only be addressed by attending to a range of negotiable moral considerations which depend on particular features of each situation. (shrink)
Heuser, Eller and Byrne provide important descriptive ethics data about how physicians counsel women on the clinical management of pregnancies complicated by severe fetal anomalies. The authors present an account of what such counselling ought to be based on, the ethical concept of the fetus as a patient and the professional responsibility model of obstetric ethics. When there is certainty about the diagnosis and either a very high probability of either death as the outcome of the anomaly or survival (...) with severe and irreversible deficit of cognitive developmental capacity as a result of the anomaly diagnosed, the pregnant woman should be offered the alternatives of aggressive and non-aggressive obstetric management and induced abortion before viability. It is also ethically permissible to offer feticide followed by termination of pregnancy after viability in such cases. This ethically justified approach will reduce the variation in the actual practices of specialists in maternal–fetal medicine described by Heuser, Eller and Byrne. (shrink)
In 1989, in the wake of the first operations to transplant fetal tissue into the brains of sufferers from Parkinson's Disease, the UK Code of Practice governing the use of the fetus for research was overhauled by an eminent committee under the chairmanship of the Reverend Dr John Polkinghorne. The Polkinghorne Report has, however, attracted remarkably little comment or analysis. This paper is believed to be the first to subject it to sustained ethical and legal scrutiny. The author concludes (...) that, although the committee's recommendations meet the major objections to the Code of Practice, the report is nevertheless vulnerable to criticism in its treatment of at least three issues: the moral status of the fetus; paternal consent to fetal use, and the ethical inter-relation of fetal use and abortion. (shrink)
The procurement of fetal tissue for transplantation may promise great benefit to those suffering from various pathologies, e.g., neural disorders, diabetes, renal problems, and radiation sickness. However, debates about the use of fetal tissue have proceeded without much attention to ethical theory and application. Two broad moral questions are addressed here, the first formal, the second substantive: Is there a framework from other moral paradigms to assist in ethical debates about the transplantation of fetal tissue? Does the (...) use of fetal tissue entail cooperation in abortion? To answer these questions I develop a theoretical framework by combining the paradigm of just-war reasoning with canons governing the use of cadaverous tissue. The kinds of safeguards provided by this paradigm allow fetal tissue to be procured without the taint of association with abortion. Central to solving the problem of cooperation is the distinction between intending and foreseeing a moral misdeed. Fetal researchers may foresee fetal death in elective abortions without intending such deaths to occur. Thus, even those who object unequivocally to elective abortion may condone the procurement of fetal tissue, if sufficient reason exists. Keywords: fetal tissue, casuistry, prima facie duties, just-war tenets, complicity CiteULike Connotea Del.icio.us What's this? (shrink)
This essay examines three tendencies nurtured in the practices of reproductive technology – tendencies with profoundly disturbing implications for us as individuals and as social beings. They are: 1) the increasing subjectification of the fetus (that is, the increasing tendency to posit a fetal subject), 2) the increasing objectification of the gestating woman, leading to her representation as interchangeable object rather than unique subject, and 3) the increasing tendency to conceive of the fetus and the mother as social, medical, (...) and legal antagonists. Considering the construction of fetus, mother, and the fetal/maternal relation in earlier (Western) historical periods, a contemporary work of literature, a government report, and the popular press, I argue that as the fetus is increasingly being understood as a subject, the mother is increasingly being reduced to an antagonist, an obstacle to fetal health, and an object. The essay concludes by offering some tentative conclusions about the general process of fetal subjectification in the United States and Europe. (shrink)
Genetics holds the key to understanding normal human biology and possibly many of the major causes of human disease and impairment. Research into human developmental genetics seems, therefore, to be both necessary and justified. However, such research requires the use of embryonic and fetal tissue obtained from spontaneous abortions and elective termination of pregnancy. This paper examines the arguments in favour of using tissue from elective terminations and the evolution of regulatory frameworks for this research. The paper argues that (...) the recent statutory and regulatory reforms in the UK have not properly addressed the issue of ethically obtaining postimplantation human embryos for research. It is argued that the recent reforms have left the Polkinghorne guidelines untouched but that these are now unequal to the task. A practical suggestion for reform of the approach to the informing and consent of potential donors is offered. (shrink)
Heuser and colleagues' survey of obstetricians provides a valuable insight into the current management of severe fetal anomalies in the United States. Their survey reveals two striking features - that counselling for these anomalies is far from neutral, and that there is significant variability between clinicians in their approach to management. In this commentary I outline the reasons to be concerned about both of these. Directiveness in counselling arguably represents a form of paternalism, and the evident variability in practice (...) is likely the result of physician personal values. However, Heuser's survey may, by shining a light on practice, provide an important step towards a more consistent approach. (shrink)
This article presents an overview ofregulations, guidelines and societal debates ineight member states of the EC about a)embryonic and fetal tissue transplantation(EFTT), and b) the use of human embryonic stemcells (hES cells) for research into celltherapy, including `therapeutic' cloning. Thereappears to be a broad acceptance of EFTT inthese countries. In most countries guidance hasbeen developed. There is a `strong' consensusabout some of the central conditions for `goodclinical practice' regarding EFTT.International differences concern, amongstothers, some of the informed consent issuesinvolved, and (...) the questions whether anintermediary organisation is necessary, whetherthe methods of abortion may be influenced bythe possible use of EFT, and whether EFTTshould only be used for the experimentaltreatment of rare disorders. The potential useof hES cells for research into cell therapy hasgiven a new impetus to the debate about (human)embryo research. The therapeutic prospects withregard to the retrieval and research use of hEScells appear to function as a catalyst for theintroduction of less restrictive regulationsconcerning research with spare embryos, atleast in some European countries. It remains tobe seen whether the prospect of treatingpatients suffering from serious disorders withtransplants produced by therapeutic cloningwill decrease the societal and moral resistanceto allowing the generation of embryos for`instrumental' use. (shrink)
The history of the fetalalcohol syndrome (FAS) provides a microcosm in which to explore the larger ramifications of historical citations in biomedical publications. Though some historical references such as Biblical writings may hint at a rudimentary understanding of the relationship between maternal drinking and fetal development, no definitive case can be made for an understanding of FAS dating back hundreds of years. Authors who claim an impressive history for FAS misrepresent that history. The modern history of (...) FAS raises a question concerning citations of original discoveries. The first paper describing ethanol-induced damage to the fetus appeared in 1968 yet most researchers cite one of two papers from 1973. Both ancient citations and modern references to original discoveries pose difficult questions for the scientist. Both dilemmas may be solved by a better reading of the literature and a more judicious wording when writing about history. (shrink)
Several conceptual and methodological challenges must be solved in order to create knowledge that can be useful to pregnant women, their families, and any clinicians who serve them: (1) going beyond nominal and ordinal hypotheses and presenting estimates of conditional probabilities; (2) focusing on clearly defined outcomes; (3) modeling the relationship of fetal growth and length of gestation; (4) understanding the process of fetal growth even though most of our data is cross-sectional; (5) estimating the independent effects of (...) genetics, race, ethnicity, maternal risk behaviors, medical prenatal care, and socioeconomic status on fetal growth and length of gestation; and (6) estimating the independent effects of maternal pre-pregnancy weight, weight gain during pregnancy, and nutrition on fetal growth and length of gestation. (shrink)
Infertility affects 15 per cent of the world's couples. Research at Edinburgh University has been directed at transplanting fetal ovarian tissue into infertile women, thus enabling them to bear children. Fetal ovary transplantation (FOT) has generated substantial controversy; in fact, one ethicist deemed the procedure 'so grotesque as to be unbelievable' (1). Some have suggested that fetal eggs may harbour unknown chromosomal abnormalities: however, there is no evidence that these eggs possess a higher incidence of genetic anomaly (...) than ova found in a healthy adult female. There is also concern that fetal egg children will be psychologically harmed by the knowledge of their special conceptual status. It will be demonstrated that special conceptual status in and of itself does not determine developmental success. Rather, psychological well-being is dependent upon how the family and child cope with the unique challenges inherent in FOT. Lastly, though considering FOT a legitimate method of family building, given the global population crisis the wisdom of procreational rights will be challenged. Inherent to this challenge is a re-evaluation of the treatment of infertility as a significant disease necessitating remedy. (shrink)
In addition to the scientific and medical issues surrounding the use of fetal tissue transplants, the ethical implications should be considered. Two major ethical issues are relevant. The first of these is whether this experimental procedure can be justified on the basis of potential benefit to the patient. The second is whether the use of tissue obtained from intentionally aborted fetuses can be justified in the context of historical and existing guidelines for the protection of human subjects. The separation (...) of ethical decisions from medical practice and scientific research is necessary to prevent the exploitation of innocent human life. (shrink)
In the debate over fetal tissue use, an analogy is often drawn between removing organs from the body of a person who has been murdered to use for transplantation, and collecting tissue from an aborted fetus to use for the same purpose. The murder victim analogy is taken by its proponents to show that even if abortion is the moral equivalent of murder, there is still no good reason to refrain from using the fetal tissue, since as a (...) society we do not see any problem about using organs from murder victims. However, I argue that the analogy between murder victims and aborted fetuses does not hold -- the two situations are not the same in all morally relevant respects. Thus the murder victim analogy does not provide an argument in favour of fetal tissue transplant. In conclusion, I point to some of the potential pitfalls of using analogies in ethical argument. (shrink)
Khalafzai, Rida Usman Harms of alcohol consumption are not limited to the consumer. For women, it poses a significant threat to their unborn child. This article discusses one type of alcohol-related harm to the fetus: the fetal alcohol spectrum disorders (FASD).
Obstetric ultrasound is the well-recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from the clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non-medical fetal ultrasound (also known as ‘keepsake’ ultrasound) is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. Notwithstanding the guidelines and warnings regarding ultrasound safety issued by (...) governments and professional bodies, the absence of scientifically proven physical harm to fetuses from this procedure seems to provide these businesses with grounds for rapid expansion. However, this argument is too simplistic because current epidemiological evidence is not synchronous with advancing ultrasound technology. As non-medical fetal ultrasound has aroused very significant public attention, a thorough ethical analysis of this topic is essential. Using a multifaceted approach, we analyse the ethical perspective of non-medical fetal ultrasound in terms of the expectant mother, the fetus and health professionals. After applying four major theories of ethics and principles (the precautionary principle; theories of consequentialism and impartiality; duty-based theory; and rights-based theories), we conclude that obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence. Non-medical fetal ultrasound can be considered ethically unjustifiable. Nevertheless, the ethical analysis of this issue is time dependent owing to rapid advancements in ultrasound technology and the safety issue. The role of health professionals in ensuring that obstetric ultrasound is an ethically justifiable practice is also discussed. (shrink)
In this paper Iain McFadyen highlights a modern ethical dilemma. In each case the fetus was recognised to be in danger, but in both cases the advice given in the fetal interest was refused by the mothers. Both the mother and the physician were concerned for the fetus, but their differing actions and reasons pose the dilemma--who decides?
There are limitations of obstetric estimation of neonatal outcome in extremely premature newborns. Predicting outcomes, survival, and morbidity are often uncertain, such as in cases of extreme prematurity, certain fetal anomalies, intrauterine growth restriction, and intrauterine infection. Informed consent, truth telling, the maternal–fetal conflict, decision making, and the fetus as a patient are the most important issues of obstetric and neonatal ethics. Because the boundary between utility and futility is not clear, the best interest of the mother, the (...) fetus, and the newborn will be subject of discussion every time. Here, we report a case of obstetric patient to discuss. (shrink)
This essay considers the ways in which the various contexts – abortion, prenatal diagnosis, fetal research, and the use of fetuses in transplantation – shape the American debate on the moral standing of the fetus. This discussion gives rise to several philosophical debates on the status of the preimplantation embryo, particularly the debate over when the preimplantation embryo becomes individuated. How that question is resolved has critical ethical and policy implications.
Fetal surgery has been practised for some decades now. However, it remains a highly complex area, both medically and ethically. This paper shows how the routine use of ultrasound has been a catalyst for fetal surgery, in creating new needs and new incentives for intervention. Some of the needs met by fetal surgery are those of parents and clinicians who experience stress while waiting for the birth of a fetus with known anomalies. The paper suggests that the (...) role of technology and visualisation techniques in creating and meeting such new needs is ethically problematic. It then addresses the idea that fetal surgery should be restricted to interventions that are life-saving for the fetus, arguing that this restriction is unduly paternalistic. Fetal surgery poses challenges for an autonomy-based system of ethics. However, it is risky to circumvent these challenges by restricting the choices open to pregnant women, even when these choices appear excessively altruistic. (shrink)
Despite some clinical promise, using fetal transplants for degenerative and traumatic brain injury remains controversial and a number of issues need further attention. This response reexamines a number of questions. Issues addressed include: temporal factors relating to neural grafting, the role of behavioral experience in graft outcome, and the relationship of rebuilding of neural circuitry to functional recovery. Also discussed are organization and type of transplanted tissue, the of transplant viability, and whether transplants are really needed to obtain functional (...) recovery after brain damage. (shrink)
This essay explicates and evaluates the roles that fetal metaphysics and moral status play in Rosalind Hursthouse’s abortion ethics. It is motivated by Hursthouse’s puzzling claim in her widely anthologized paper Virtue Ethics and Abortion that fetal moral status and (by implication) its underlying metaphysics are in a way, fundamentally irrelevant to her position. The essay clarifies the roles that fetal ontology and moral status do in fact play in her abortion ethics. To this end, it presents (...) and then develops her fetal metaphysics of the potential and actual human being, which she merely adumbrates in her more extensive treatment of abortion ethics in her book Beginning Lives. The essay then evaluates her fetal ontology in light of relevant research on fetal neural and psychological development. It concludes that her implied view that the late-stage fetus is an actual human being is defensible. The essay then turns to the analysis of late-stage abortions in her paper and argues that it is importantly incomplete. (shrink)