The attitudes of Australian practitioners working in clinical genetics and obstetrical ultrasound were surveyed on whether termination of pregnancy (TOP) should be available for conditions ranging from mild to severe fetal abnormality and for non-medical reasons.These were compared for terminations at 13 weeks and 24 weeks. It was found that some practitioners would not facilitate TOP at 24 weeks even for lethal or major abnormalities, fewer practitioners support TOP at 24 weeks compared with 13 weeks for any condition, and the (...) difference in attitudes to TOP between 13 weeks and 24 weeks is most marked for pregnancies which are normal or involve a mild disorder. It is argued that a fetal abnormality criterion for late TOP is inconsistently applied, discriminatory and eugenic. Four possible moral justifications for current practice are examined, each of which would require significant changes to current practice. I argue in favour of a maternal interests criterion for any TOP. (shrink)

Obstetric ultrasound has become a significant tool in obstetric practice, however, it has been argued that its increasing use may have adverse implications for women’s reproductive freedom. This study aimed to explore Australian obstetricians’ experiences and views of the use of obstetric ultrasound both in relation to clinical management of complicated pregnancy, and in situations where maternal and fetal health interests conflict.

There has been increased interest in the potential of maternal immunisation to protect maternal, fetal, and infant health. Maternal tetanus vaccination is part of routine antenatal care and immunisation campaigns in many countries, and it has played an important part in the reduction of maternal and neonatal tetanus. Additional vaccines that have been recommended for routine maternal immunisation include those for influenza and pertussis, and other vaccines are being developed. Maternal immunisation is controversial since (...) regulators, professionals, and the public are often reluctant to accept pharmaceutical interventions during pregnancy. So far, little attention has been given to the ethics of vaccination during pregnancy. In this Personal View we argue that maternal immunisation should be offered in response to concrete, severe risks of disease for mother and child, and we explain how this requirement of serious risk can be used to guide ethical decision-making about maternal immunisation. (shrink)

The author analyzes the lessons for ethics consultants presented by McCrary and colleagues in their case, “Elective Delivery Before 39 Weeks’ Gestation: Reconciling Maternal, Fetal, and Family Interests in Challenging Circumstances.” Clinical ethics cases that involve different specialists representing the best interests of different parties in a case, such as this case involving neonatologists and perinatologists, are complex and time-consuming. The author concludes that ethics must insure the interests of the fetus and future person are not (...) subsumed to the interests of those with a voice, without deliberate reflection and strong ethical justification. (shrink)

A recent statement of consensus held that the principle of double effect would allow the induction of a previable fetus in order to eliminate a grave and present danger to the life of a mother suffering from peripartum cardiomyopathy. The author responds to this declaration, points out some limitations preventing it from being a vehicle for broader agreement, and offers an alternative, namely, medical induction of labor in cases of maternal–fetal vital conflict can be justified if the fetus has (...) at least a fair chance of survival. This support of induction in cases of periviability considers the interests of both fetus and mother and, unlike the earlier consensus statement, can be defended by those who hold that one’s moral intention includes both the ultimate and proximate ends, or the immediate consequences of one’s act. (shrink)

Objective: The aim of the current study was to investigate associations, unique and interactive, between mothers’ and children’s histories of childhood sexual abuse (CSA) and children’s psychiatric outcomes using an intergenerational perspective. Further, we were particularly interested in examining whether maternal reflective functioning about their own trauma (T-RF) was associated with lower likelihood of children’s abuse exposure (among children of CSA-exposed mothers). Method: One hundred and eleven children (Mage= 9.53 years; 43 sexual abuse victims) and their mothers (Mage= 37.99; (...) 63 sexual abuse victims) participated in this study. Mothers completed the Parent Development Interview (PDI), which yielded assessments of RF regarding their own experiences of abuse, and also reported on their children’s internalizing and externalizing symptoms. Results: Children of CSA-exposed mothers were more likely to have experienced CSA. A key result was that among CSA-exposed mothers, higher maternal T-RF regarding their own abuse was associated with lower likelihood of child CSA-exposure. Mothers’ and children’s CSA histories predicted children’s internalizing and externalizing symptoms, such that CSA exposure for mother or child was associated with greater symptomatology in children. Conclusions: The findings show that the presence of either maternal or child CSA is associated with more child psychological difficulties. Importantly in terms of identifying potential protective factors, maternal T-RF is associated with lower likelihood of CSA exposure in children of CSA-exposed mothers. We discuss these findings in the context of the need for treatments focusing on increasing Trauma - RF in mothers and children in the context of abuse to facilitate adaptation and reduce the intergenerational risk. (shrink)

On 20 October 2010, the European Parliament proposed to give all women in the European Union (EU) minimally 20 weeks fully paid maternity leave, and to introduce a legal right for all fathers to 2 weeks fully paid paternity leave. In many other countries, individuals and groups are advocating for longer maternity leave, longer paternity leave, and/or longer parental leave. In this paper, I argue for two principles that proposals of maternity/paternity/parental leave systems should respect: the ?principle of non-discrimination? and (...) the ?principle of balancing the interests of all affected parties?. The principle of non-discrimination requires that women should receive paid leave for the number of weeks that are needed as part of their pregnancy and to recover from childbirth, but that any additional weeks should be seen as birth leave rather than maternity leave, and be given on equal terms to men and women. The principle of balancing the interests of all parties suggests that it would be good for newborns, their parents, and for employers and society at large, that parents have enough time to spend with their children. To illustrate its practical relevance, I apply these principles to the current situation in the Netherlands and to the European Parliament's proposal to introduce a minimum of 20 weeks maternity leave and 2 weeks paternity leave. (shrink)

What are the implications of microchimerism in sociocultural and ethico-legal contexts, particularly as they relate to the destabilization of genetic origins? Conventional biomedicine and related law have been reluctant to acknowledge microchimerism—the existence of unassimilated traces of genetic material that result in some cells in the body coding differently from the dominant DNA—despite it becoming increasingly evident that microchimerism is ubiquitous in the human population. One exception is maternal–fetal microchimerism which has long been recognized, albeit with little consideration of (...) the nonmedical implications. Most immediate issues concern the ongoing biomedical debate around whether microchimerism is beneficial in terms of enhancing the body’s range of immunological responses, harmful in provoking autoimmune diseases, or simply neutral with respect to subsequent health. That controversy remains unresolved, but whichever way it develops, I want to extend consideration by insisting that changing biological concerns cannot be separated from sociocultural and ethico-legal effects. Once the diversity of DNA coding in a singular body has been established, relations of kinship, the identification of legal parenthood, and the operation of surrogacy laws are of direct interest. The overriding problematic asks whether our ethical and legal apparatus is able to address such newly emerging questions. (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)

We present the case of a 36-year-old woman who has experienced three lost pregnancies; during the most recent loss, a full term pregnancy, she almost died from complications of placental abruption. She is now completing the 34th week of gestation and is experiencing symptoms similar to those under which she lost the previous pregnancy. Despite a lack of specific medical indications, the patient and her husband firmly but politely request that the attending obstetrician/perinatologist perform an immediate cesarean section in order (...) to alleviate the couple’s anxiety about possibly never having a family. Discussing the case are an experienced perinatologist, a neonatologist, a regional perinatal center coordinator, and a clinical ethicist. (shrink)

The presence of fetal cells has been associated with both positive and negative effects on maternal health. These paradoxical effects may be due to the fact that maternal and offspring fitness interests are aligned in certain domains and conflicting in others, which may have led to the evolution of fetal microchimeric phenotypes that can manipulate maternal tissues. We use cooperation and conflict theory to generate testable predictions about domains in which fetal microchimerism may enhance maternal (...) health and those in which it may be detrimental. This framework suggests that fetal cells may function both to contribute to maternal somatic maintenance (e.g. wound healing) and to manipulate maternal physiology to enhance resource transmission to offspring (e.g. enhancing milk production). In this review, we use an evolutionary framework to make testable predictions about the role of fetal microchimerism in lactation, thyroid function, autoimmune disease, cancer and maternal emotional, and psychological health.Also watch the Video Abstract. (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)

We present the case of a 36-year-old woman who has experienced three lost pregnancies; during the most recent loss, a full term pregnancy, she almost died from complications of placental abruption. She is now completing the 34th week of gestation and is experiencing symptoms similar to those under which she lost the previous pregnancy. Despite a lack of specific medical indications, the patient and her husband firmly but politely request that the attending obstetrician/perinatologist perform an immediate cesarean section in order (...) to alleviate the couple’s anxiety about possibly never having a family. Discussing the case are an experienced perinatologist, a neonatologist, a regional perinatal center coordinator, and a clinical ethicist. (shrink)

In this chapter we argue that the four principles of medical ethics -- beneficence, non-maleficence, respect for autonomy and justice (Beauchamp & Childress, 2001; Gillon, 1985), a new Family Interest Principle (introduced below) and a consideration of ‘capacity’ provide a reasoned practice guide for work with mothers experiencing health problems, focussing here on mental health when a parent is a patient. Our concern is the relationship of the clinician with a parent and through the parent their child. Ethics of service (...) provision or services planning (e.g. Culyer, 2001; McLachlan, 2005; see also Newbigging and Paul, chapter xxx), or the provision of other services (e.g. education, child protection) although intensely relevant to this area are not addressed in this chapter nor will we deal with the complex aspects of medical ethics relating to the treatment of children (Baines, 2008). We use the term ‘parent’ to refer to any adult person who fulfils a substantive parental role with a child. Defining what counts as a family will in certain circumstances be contentious. There are diverse patterns of family arrangements that may be influenced by cultural, political economic and temporal factors. For the purposes of our discussion, we define a family in terms of its role in childrearing, as a group of at least one adult and at least one child, living together in long term relationships on an ongoing basis with vested interest in the well being of each of the family members. (shrink)

This article begins by wondering how the writer’s transformation into motherhood affects her practice of reading, writing and research: how maternities are made academic. Specifically, this article is interested in thinking through lactating breasts, as a particularly complex and potentially subversive ‘performance’ of maternity. In addition, this article reframes ‘maternal thinking’ through 1990s theories of embodiment and corporeality, and asks how embodied practices like breastfeeding might be theorized, as well as how ‘embodied theory’ might be practised. In looking at (...) various cultural texts about breasts and breastfeeding, the article is scripted into a series of connective and reflexive scenes around performance, space, language and knowledge, coming to rest in the imaginative project of an epistemology of breasts. It sets reflexive accounts of lived experience alongside theoretical reflections to create a dynamic and thoughtful reading of breasts, entwining personal and public discourses, maternal and academic writing, theorizing and cultural practices. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Maternal Imprint: The Contested Science of Maternal-Fetal Effects (2021) by Sarah RichardsonQuill KuklaQuill Kukla, review of Sarah Richardson's The Maternal Imprint: The Contested Science of Maternal-Fetal Effects (2021)I had been eagerly anticipating the release of Sarah Richardson's meticulously researched The Maternal Imprint: The Contested Science of Maternal-Fetal Effects (2021) for several years, and I was not disappointed. A leading feminist scholar (...) of the history and philosophy of science, Richardson traces the scientific history of the idea that pregnant people's bodies control the future health, character, and well-being of their offspring. She also explores how this science is translated into social messaging and shaped by social ideology. Richardson delves into the details of the methodology, motivations, results, and communication of the science of maternal influences. She reveals a history of shaky results, contested methods, and socially loaded messaging, unified by a sustained interest in framing maternal bodies as sites of risk and responsibility for birth outcomes.A central narrative of the book is that the perceived location and mechanism through which pregnant bodies control fetal development keeps shifting around; over time, scientists have located this maternal influence in the uterine environment, the cytoplasm, the methylation of DNA, maternal nutrition, and even in the emotions, thoughts, and imagination of the mother, among other locations.1 Each time a version of the maternal influence hypothesis re-emerges, targeting a different bodily location and mechanism, it comes along with similar social messaging: pregnant people are distinctively responsible for the 'quality' of their children; their bodies are distinctive sites of risk, in need of social management; and their influence can be understood and controlled independent of the context in which they live. Given how many times this scientific hypothesis and its accompanying social messaging has died and been reborn, it is hard not to conclude, with Richardson, that background ideology compels us to keep searching for new stories that take this same form. The idea that pregnant people's bodies are understood as decontextualized and heightened sites of risk and responsibility for birth outcomes, in need of systematic discipline (both self-discipline and social discipline) in order to ensure their production of proper offspring, is one that has been explored [End Page e-1] in quite a bit of depth within feminist theory and reproductive ethics over the last thirty years. To name just a few, Barbara Duden's Disembodying Women: Perspectives on Pregnancy and the Unborn (1993), Deborah Lupton's "Risk and the Ontology of Pregnant Embodiment" (1999), Lisa Mitchell's Baby's First Picture: Ultrasound and the Politics of Fetal Subjects (2001), and my own Mass Hysteria: Medicine, Culture, and Mothers' Bodies (2005) are all works firmly within this tradition. What is new about Richardson's book is not the development and exploration of this cultural narrative and imaginary, but rather her rigorous and skillful analysis of the science that has grown out of and undergirded it. Richardson is a masterful writer, who makes scientific details comprehensible and fascinating. Her historical and epistemological analyses of exactly what shaped the science at each stage, what each scientific iteration did and didn't manage to show, and how these different scientific movements were translated into public messaging, is sharp and compelling. Richardson shows us the inner workings of how scientific programs build momentum; how scientists make methodological decisions; and how results feed into ongoing research programs. From this book, we also develop a rich sense of just how much uncertainty is baked into the science of human development, and how both scientific and public excitement about a given research program are mostly independent of the success and security of the science that comes out of it. The book traces 150 years of the history of the science of maternal influences, culminating in the current focus on epigenetics—which, like various past maternal influence theories, has ignited our broader social imagination. Epigenetics, roughly, is the study of molecular changes outside our DNA that control how genes express themselves. Environmental stimuli (such as stress) can cause changes in methylation, and thereby influence the expression of the genome: "Epigenetic markers that help determine whether a... (shrink)

In recent years there has been an explosion of interest in Artificial Intelligence (AI) both in health care and academic philosophy. This has been due mainly to the rise of effective machine learning and deep learning algorithms, together with increases in data collection and processing power, which have made rapid progress in many areas. However, use of this technology has brought with it philosophical issues and practical problems, in particular, epistemic and ethical. In this paper the authors, with backgrounds in (...) philosophy, maternity care practice and clinical research, draw upon and extend a recent framework for shared decision-making (SDM) that identified a duty of care to the client's knowledge as a necessary condition for SDM. This duty entails the responsibility to acknowledge and overcome epistemic defeaters. This framework is applied to the use of AI in maternity care, in particular, the use of machine learning and deep learning technology to attempt to enhance electronic fetal monitoring (EFM). In doing so, various sub-kinds of epistemic defeater, namely, transparent, opaque, underdetermined, and inherited defeaters are taxonomized and discussed. The authors argue that, although effective current or future AI-enhanced EFM may impose an epistemic obligation on the part of clinicians to rely on such systems' predictions or diagnoses as input to SDM, such obligations may be overridden by inherited defeaters, caused by a form of algorithmic bias. The existence of inherited defeaters implies that the duty of care to the client's knowledge extends to any situation in which a clinician (or anyone else) is involved in producing training data for a system that will be used in SDM. Any future AI must be capable of assessing women individually, taking into account a wide range of factors including women's preferences, to provide a holistic range of evidence for clinical decision-making. (shrink)

Feminist analyses have made important contributions to the sociocultural experiences of pregnancy, birth and breastfeeding. This article draws upon recent theorizing within science studies to focus on the mattering of these processes. Specifically, the article expands upon Mauss's notion of the ‘gift’, which Diprose develops through the idea of ‘corporeal generosity’. I am interested in corporeal generosity insofar as it circumvents descriptions of relationships in terms of a closed economy in which resources are exchanged without excess or remainder. Corporeal generosity (...) refers to the often missed but nevertheless inescapable debt that a body owes to other bodies. At the same time, this embodied ‘gifting’ is both unpredictable and intrusive – there is as much possibility of threatening the integrity of bodies as there is of opening new possibilities. (shrink)

One of the most robust findings in psychopathology is the fact that specific phobias are more prevalent in women than in men. Although there are several theoretical accounts for biological and social contributions to this gender difference, empirical data are surprisingly limited. Interestingly, there is evidence that individuals with stereotypical feminine characteristics are more fearful than those with stereotypical masculine characteristics; this is beyond biological sex. Because gender role stereotypes are reinforced by parental behavior, we aimed to examine the relationship (...) of maternal gender stereotypes and children’s fear. Dyads of 38 mothers and their daughters were included. We assessed maternal implicit and explicit gender stereotypes as well as their daughters’ self-reported general fearfulness, specific fear of snakes, and approach behavior toward a living snake. First, mothers’ fear of snakes significantly correlated with their daughters’ fear of snakes. Second, mothers’ gender stereotypes significantly correlated with their daughters’ self-reported fear. Specifically, maternal implicit gender stereotypes were associated with daughters’ fear of snakes and fear ratings in response to the snake. Moreover, in children, self-reported fear correlated with avoidance of the fear-relevant animal. Together, these results provide first evidence for a potential role of parental gender stereotypes in the development and maintenance of fear in their offspring. (shrink)

The case, which occurred in a public hospital in Turkey in 2005, exhibits a striking dilemma between a mother’s and her fetus’ interests. For a number of reasons, the mother refused to cooperate with the midwives and obstetrician in the process of giving birth, and wanted to leave the hospital. The care providers evaluated the case as a matter of maternal autonomy and asked the mother to give her consent to be discharged from the hospital, which she did (...) despite the fact that her cervix was fully open. She left the hospital and gave birth shortly thereafter. Subsequently, the baby died two days later. In light of the contemporary ethical principles, the mother’s competency could be debatable due to the physical and psychological conditions the mother confronted. Furthermore, protection of the fetus’ life should have been taken into account by the caregivers when making a decision concerning discharging of the mother. (shrink)

This book explores feminine archetypes and mythological figures in African and European traditions with an underlying goal of describing the foundations of social status for women. The author provides a rich corpus of mythology and tales to illustrate aspects of female and mother-daughter relationships. Diop analyzes the symbolic aspects of maternity and femininity, describing the social meaning of the matrix, breasts, and breastfeeding. A retrospective of female characters in African literature brings an interesting approach to explore the figures of femininity (...) and maternity in society. After an extensive analysis of African mythology and tales, the author proposes a way to integrate them in the clinical psychotherapy as a projective material. The analysis of clinical cases offers an example of how this material can be used in therapy with women from African descent. (shrink)

This book examines the organization as embodied experience. An international range of contributors is assembled to deal explicitly with the 'maternal' aspects of organization. This challenging book will be of essential interest to all critical management theorists. With its innovative approach, it will also appeal to students, teachers, and all those looking for an approach to management that does justice to the complexity, ambivalence and chaos of the world of organizing.

In this paper, I argue that bioethics suffers from a masculinist approach-what I call “ethical androcentrism.” Despite the genesis of other legitimate approaches to ethics (such as feminist, narrative, and communicative ethics), this masculinist tradition persists. The first part of my paper concerns the problem of ethical androcentrism, and how it is manifest in our typical ways of “doing” bioethics (as teachers, ethicists, policymakers, and medical practitioners). After arguing that bioethics suffers from a masculinist ethic, I consider the case of (...) maternal substance addiction to show how this ethic negatively affects the treatment of pregnant addicts. I argue that by treating maternal substance addiction from an androcentric approach, we fail to serve both pregnant addicts and their fetuses; furthermore, we misrepresent the intentional state of pregnant substance addicts and label them “prenatal abusers.” If maternal substance addiction is to be ethically addressed -- and if pregnant substance addicts are to be effectively treated -- we cannot tacitly accept an androcentric ethic. (shrink)

Pregnancy presents some interesting challenges for the philosophy of embodied cognition. Mother and fetus are generally considered to be passive during pregnancy, both individually and in their relation. In this paper, we use the enactive operational concepts of autonomy, agency, individuation, and participation to examine the relation between mother and fetus in utero. Based on biological, physiological, and phenomenological research, we explore the emergence of agentive capacities in embryo and fetus, as well as how maternal agency changes as pregnancy (...) advances. We show that qualitatively different kinds of agency have their beginnings already in utero, and to what extent fetal and maternal movement modulate affectivity and individuation in pregnancy. We thus propose that mother and fetus are both agents who participate in pregnancy. Pregnancy then emerges as a relational developmental organization that anchors and holds its developing participants. We end the paper with reflections on ethical implications of this proposal, and suggestions for future research. (shrink)

The aim of this study is an analysis of the possible adaptive consequences of delivery of low birth weight infants. We attempt to reveal the cost and benefit components of bearing small children, estimate the chance of the infants’ survival, and calculate the mothers’ reproductive success. According to life-history theory, under certain circumstances mothers can enhance their lifetime fitness by lowering the rate of investment in an infant and/or enhancing the rate of subsequent births. We assume that living in a (...) risky environment and giving birth to a small infant may involve a shift from qualitative to quantitative production of offspring. Given high infant mortality rates, parents will have a reproductive interest in producing a relatively large number of children with a smaller amount of prenatal investment. This hypothesis was tested among 650 Gypsy and 717 non-Gypsy Hungarian mothers. Our study has revealed that 23.8% of the Gypsy mothers had low birth weight (<2,500 g) children, whose mortality rate is very high. These mothers also had more spontaneous abortions and stillbirths than those with normal weight children. As a possible response to these reproductive failures, they shortened birth spacing, gaining 2–4 years across their reproductive lifespan for having additional children. Because of the relatively short interbirth intervals, by the end of their fertility period, Gypsy mothers with one or two low birth weight infants have significantly more children than their ethnic Hungarian counterparts. They appear to compensate for handicaps associated with low birth weights by having a larger number of closely spaced children following the birth of one or more infants with a reduced probability of survival. The possible alternative explanations are discussed, and the long-term reproductive benefits are estimated for both ethnic groups. (shrink)

In Alabaster v. Barclays Bank plc and Secretary of State for Social Security (No. 2: [2005] E.W.C.A Civ. 508, [2005] I.R.L.R. 576.) Michelle Alabaster won a grand total of £204.53 (plus £65.86 interest) after eight years of litigation, which included two visits to the Court of Appeal and one to the European Court of Justice. This marathon resulted from the sex discrimination which Alabaster had alleged in relation to the calculation of her Statutory Maternity Pay (S.M.P.) whilst she was pregnant (...) 10 years earlier. The technicalities of the statutory schemes involved should not be allowed to disguise the important principle which finally emerges in the Court of Appeal and which underlines one of the longstanding criticisms of the equality legislation, namely the requirement that a woman must compare herself with a man in order to establish unlawful sex discrimination. (shrink)

News about the first baby born after a mitochondrial replacement technique (MRT; specifically maternal spindle transfer) broke on September 27, 2016 and, in a matter of hours, went global. Of special interest was the fact that the mitochondrial replacement procedure happened in Mexico. One of the scientists behind this world first was quoted as having said that he and his team went to Mexico to carry out the procedure because, in Mexico, there are no rules. In this paper, we (...) explore Mexico's rule of law in relation to mitochondrial replacement techniques and show that, in fact, certain instances of MRTs are prohibited at the federal level and others are prohibited at the state level. According to our interpretation of the law, the scientists behind this first successful MRT procedure broke federal regulations regarding assisted fertilization research. (shrink)

As members of the fetal surgery advisory board at a large tertiary care center, we read with great interest Hendriks’ et al. target article proposing a new ethical framework for fetal therap...

In the late 1720s, Daniel Turner and James Blondel engaged in a pamphlet dispute over the power of the maternal imagination. Turner accepted the long-standing belief that a pregnant woman's imagination could be transferred to her unborn child, imprinting the foetus with various marks and deformities. Blondel sought to refute this view on rational and anatomical grounds. Two issues repeatedly received these authors' attention: the identity of imagination, and its power in pregnant women; and the process of generation and (...) foetal development. In their discussions of these issues, differences between the authors' acceptance of general medical theories and philosophies became apparent. Blondel invoked Newtonian matter theory, experimental philosophy, and iatro-mechanism, while Turner adhered more to the authority of the Ancients and advocated a more direct role for the Creator as an alternative to mechanism in explaining natural phenomena. Additionally, the authors held differing views of what they regarded as experience. The widespread contemporary interest in their dispute suggests that Turner and Blondel raised the phenomenon of the maternal imagination from an issue of folk belief to a concern of eighteenth-century medicine. (shrink)

Philosophical inquiry into pregnancy, childbirth, and mothering is a growing area of interest to academic philosophers. This volume brings together a diverse group of philosophers to speak about topics in this reemerging area of philosophical inquiry, taking up new themes, such as maternal aesthetics, and pursuing old ones in new ways, such as investigating stepmothering as it might inform and ground an ethics of care. The theoretical foci of the book include feminist, existential, ethical, aesthetic, phenomenological, social and political (...) theories. These perspectives are then employed to consider many dimensions of pregnancy, childbirth, and mothering, which are of central importance to human existence, but are only rarely discussed in philosophical cannons. Topics include pregnancy and embodiment, breast-feeding, representations – or the lack thereof – of pregnant and birthing women, adoption, and post-partum motherhood. (shrink)

Much due criticism has been directed at Levinas's images of the feminine and “the Woman” in Time and the Other and Totality and Infinity, but less attention has been paid to the metaphor of maternity and the maternal body that Levinas employs in Otherwise Than Being. This metaphor should be of interest, however, because here we find an instance in which Levinas uses a female image without in any way seeming to exclude women from full ethical selfhood.In the first (...) three sections of this paper I explain how maternity functions in Otherwise Than Being. I argue that maternity is used as an image of the vulnerability or passive sensibility that characterizes the relation with the Other, as well as a metaphor for Levinas's account of ethical responsibility as substitution. In the final section of the paper, I defend the claim that Levinas's maternal metaphors are not disparaging to real, empirical women. I also discuss a remaining worry that feminists may have about the metaphor: namely, that it characterizes pregnancy and motherhood in ways that challenge some pro-choice assumptions. (shrink)

This book exploits the power of phenomenological methods to access and describe lived moral experiences of pain and suffering for patients, their families and the wider community. Creating new fields of communication for patients, their family members and health professionals in shared decision making processes, this book builds on knowledge about suffering to help and guide correct action in preventing and relieving chronic pain and improving systems of care. It offers a new phenomenology for understanding moral experience in serious illness (...) and suffering, and its implication for policy, practice and research. A series of applied chapters, looking at individual experiences of suffering and care experiences, present some areas of ethical inquiry, including: pain and suffering maternal care ethics evaluation and moral deliberation about treatment options decision-making and moral agency end-of-life experiences of care. Exploring how moral phenomenology could provide fruitful alternatives to traditional frameworks in bioethics, this is an important addition to the literature. It will be of interest to scholars and students of bioethics and phenomenological methods in the health and human services. (shrink)

Motherhood is no longer a clear-cut concept. Is it a mere biological fact, or does it require a volitional component? This question is answered differently throughout Europe. The French regime of accouchement sous X is more oriented towards the second option. Conversely, the English system identifies parturition as the exclusive determinant for defining legal motherhood. This debate has an impact on the resolution of another issue, namely whether an individual, preeminently a child, has a right to know about his/her origins. (...) The recognition of an absolute right of a woman to give birth anonymously evidently contravenes France’s obligation to protect the right to know one’s origins, as enshrined in the UNCRC as well as in the ECHR. Furthermore, despite its laudable purpose, the French regime has proved unable to prevent tragic events, such as infanticide, abandonment and abortion. But does English law offer a solution that is more respectful of children’s rights? To all appearances, it does, but not substantially. The denial of accouchement sous X should not be viewed as enhancing the overall protection of children’s rights in England. By providing abortion on demand, a woman’s right to renounce maternity is fully protected and, therefore, the legalization of anonymous birth would be superfluous. In light of the complexity of the issue whether a child has the right to know his/her origins, categorical positions are not appropriate, since they implicitly postulate hierarchies of rights. To the contrary, the acknowledgement of the competing rights as equally fundamental makes it possible to achieve a fair equilibrium between the interests of all parties involved. In this balancing exercise, the reconceptualization of identity as child-centered has the potential to overcome the culturally-constructed dichotomy of biological connections/social bonds and, therefore, to realize the best interests of every child. (shrink)

Fetuses and their mothers (and other adults) share many objective interests. These include interests in disjunctive ways of achieving human well-being, including the formation and success of good projects such as particular friendships. Pursuing such good projects is in the individual’s interests and is what growing up is all about. Some interests are time-sensitive, and determining which interests apply at what stages in life requires asking which benefits are in some sense appropriate to the individual (...) and still in his/her actual or possible or even hypothetical future. Human individuals not only have interests in unconditional benefits to them, including the welfare of existing family members, but in conditional benefits to them, including the welfare of possible future family members. Even if not all interests apply to the individual at every stage, if an adult-type benefit is still in the (long-term) future, the young individual including the fetus has a stake in that benefit, conditional as the benefit may sometimes be. Fulfilment is enhanced by pursuit and conscious enjoyment of ‘human goods’, but as with adults, the stake in these remains strong even if psychological links with the long-term future in which this happens are tenuous or non-existent. (shrink)

Suppose a woman chooses to carry a pregnancy to term. What duties should she be understood to have with respect to the fetus? If she is informed that a vaginal delivery will pose significant risks to its life or health, for example, is she obligated to submit to a caesarean section procedure on its behalf?

Approaches to supporting autonomy in medicine need to be able to support complex and sensitive decision-making, incorporating reflection on the patient's values and goals. This should involve deliberation in partnership between physician and patient, allowing the patient to take responsibility for her decision. Nowhere is this truer than in decisions around pregnancy and Caesarean section where maternal autonomy can seem to directly conflict with foetal interests. Medical and societal expectations and norms such as the expectations of a ‘mother’, (...) constraints of making decisions in an emergency, and the role of technology in viewing the foetus as a separate patient and surgery as a guarantor of results can all act to limit a woman's autonomy. In considering decisions about Caesarean section, maternal interests in bodily integrity can be dismissed as being less important than the foetus's own interests and the mother's duties to it, despite the inherent risks and impacts of such a major surgical procedure... (shrink)

Recently there has been a flurry of interest and activity, both scholarly and political, about the role and importance of fathers in child rearing. One manifestation of this interest is a movement that began in the United Kingdom, but is increasingly influential in the United States and Canada, asserting fathers’ rights in custody disputes following divorce. Advocates assert that fathers should have equal standing with mothers in such cases, and that current practice fails to grant them this standing. U ntil (...) the nineteenth century, most Western legal systems granted fathers property rights in their children and failed to grant mothers any rights at all. Thus, fathers were almost always able to claim custody successfully after divorce. In the latter part of the nineteenth century, the “Tender Years Doctrine” displaced this practice. This view holds that children, especially young children, have special need of maternal nurture, and that mothers are naturally more suited to the task of raising young children than fathers are. (shrink)

Kant's contribution to modern Protestant theology is as unmistakable as it is controversial. The authors of this volume are investigating a new perspective on the work of theology and the effects of Kant's philosophy of religion concentrated on biblical hermeneutics and dogmatic theology.

Cet article a pour objectif de montrer l’importance de la réception de la théologie politique de J.B. Metz auprès de certains théologiens soucieux de la dimension politique de la foi chrétienne. L’étude présente les réactions immédiates au projet théologique de Metz pour ensuite se focaliser sur des théologiens contemporains. Premièrement, on trouve J. Milbank, qui apprécie la pensée de Metz en la confrontant à son programme de Radical Orthodoxy. Deuxièmement, on rencontre H.-J. Gagey et J.-L. Souletie, qui évaluent la force (...) politique de la théologie de Metz. Enfin, on découvre la façon dont L. Boeve reprend de façon personnelle certains aspects de la pensée du théologien allemand. Pour terminer, l’article propose une réflexion synthétique et critique sur cette réception, avec le souci de montrer la pertinence de la théologie politique de Metz et sa capacité à stimuler la réflexion sur le rapport foi et société. (shrink)