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)
(2013). Offering Testicular Tissue Cryopreservation to Boys: The Increasing Importance of Biological Fatherhood. The American Journal of Bioethics: Vol. 13, No. 3, pp. 39-40. doi: 10.1080/15265161.2012.760678.
We report on the case of a 2-year-old female, the youngest person ever to undergo ovarian tissue cryopreservation (OTC). This patient was diagnosed with a rare form of sickle cell disease, which required a bone-marrow transplant, and late effects included high risk of future infertility or complete sterility. Ethical concerns are raised, as the patient's mother made the decision for OTC on the patient's behalf with the intention that this would secure the option of biological childbearing in the future. Based (...) on Beauchamp and Childress's principlism approach of respect for autonomy, nonmaleficence, beneficence, and justice, pursing OTC was ethically justified. (shrink)
Modern contraceptives—especially long-acting, reversible contraceptives, or LARCs—are typically seen as a boon for humanity and for women, the majority of their users, in particular. But the disparity between the number and types of female and male LARCs is problematic for at least two reasons: first, because it forces women to assume most of the financial and health-related responsibilities of contraception, and second, because men’s reproductive autonomy is diminished by it. In order to understand how to change our current contraceptive arrangement, (...) I want to look at some of the historical and contemporary factors that contribute to this disparity, especially gender norms that associate women with reproduction .. (shrink)
A dominant cultural narrative within Costa Rica describes Costa Ricans not only as different from their Central American neighbours, but it also exalts them as better: specifically, as more white, peaceful, egalitarian and democratic. This notion of Costa Rican exceptionalism played a key role in the creation of their health care system, which is based on the four core principles of equity, universality, solidarity and obligation. While the political justification and design of the current health care system does, in part, (...) realize this ideal, we argue that the narrative of Costa Rican exceptionalism prevents the full actualization of these principles by marginalizing and excluding disadvantaged groups, especially indigenous and black citizens and the substantial Nicaraguan minority. We offer three suggestions to mitigate the self-undermining effects of the dominant national narrative: 1) encouragement and development of counternarratives; 2) support of an emerging field of Costa Rican bioethics; and 3) decoupling health and national successes. (shrink)
One winter morning, the two of us—both postdoctoral fellows in medical humanities and bioethics—gathered with a handful of reproductive science graduate students in the lab to watch a demonstration on making alginate beads. Due to their three-dimensional nature, the beads are capable of holding ovarian follicles—the beads act as though they were a small ovary. The scientists in the lab have managed to mature the follicles maintained in the beads into eggs, fertilize these eggs, and produce the birth of live (...) mice. This research was begun in an effort to develop a means of gathering ovarian follicles from young human cancer patients before they commence cancer treatment that may result in their infertility, thus .. (shrink)
When one thinks about organ transplantation, the organs that usually come to mind are the heart, or possibly the kidney, the most commonly transplanted organ (UNOS 2008). Transplantations are generally regarded as necessary to the life of the person receiving the transplant or to physiologically improving that life: the transplant is seen as making the recipient “whole” once more (Lederer 2008). While many have commented on the various ethical issues brought forth by the clinical practice of organ transplantation, here we (...) are concerned with the idea of becoming whole from organ transplantation. The idea of wholeness that a transplant renders can extend beyond the physiological to the individual, the familial, and .. (shrink)
In this paper, we recommend expanding infertility insurance mandates to people who may become infertile because of cancer treatments. Such an expansion would ensure cancer patients can receive fertility preservation technology (FPT) prior to commencing treatment. We base our proposal for extending coverage to cancer patients on the infertility mandate in Massachusetts because it is one of the most inclusive. While we use Massachusetts as a model, our arguments and analysis of possible routes to coverage can be applied to all (...) states' seeking inclusive coverage for infertility treatment. Furthermore, our proposal can also be applied to people with other diseases who may be rendered infertile by treatment. (shrink)
Assuming a relational understanding of the self, I argue that empathy is necessary for individual and cultural recovery from rape. However, gender affects our ability to listen with empathy to rape survivors. For women, the existence of cultural memories discourages empathy either by engendering fear of their own future rape or by provoking sympathy rather than empathy. For men, the lack of cultural memories makes rape what Arendt calls an "unreality," thus diminishing the possibility for empathy. Although empathetic listeningpresents gender (...) specific challenges for both women and men, it should not be abandoned as a strategy for trauma recovery. I make two broad suggestions for promoting empathy. First, we need to teach empathy for victims and survivors. Second, we need to discredit problematic gender norms, which buttress rape culture and sexual violence. (shrink)
