Reproductive Rights

Conservative and liberal approaches to the problem of abortion are oversimplified and deeply flawed. Accepting that the moral status of the conceptus changes during gestation, the author advances a more nuanced perspective. Through applying a form of rules in practice utilitarianism within the context of overall population policy, he provides a compelling ethical and legal framework for regulating contraception and abortion practices.

Anne Donchin attended graduate school while raising four children, received her doctorate from the University of Texas in 1970, taught for 18 years in Texas and New York, then joined the philosophy department at Indiana University–Purdue University Indianapolis in 1982. Here she developed a Women’s Studies program, specialized and in numerous ways pioneered in feminist bioethics, and won two prestigious grants. She co-edited two books, published some forty articles, and co-founded and co-ordinated The International Network on Feminist Approaches to Bioethics. (...) Before and after retiring she served on the editorial boards of an encyclopedia, several international bioethics collections and nine prestigious journals. Her publications have influenced many scholars here and abroad. At the time of her death she was at work on a book: Procreation, Power and Personal Autonomy: Feminist Reflections, which is now available on IUPUIScholarWorks. Laura Purdy has generously edited, organized, and, where possible, updated the manuscript. (shrink)

When an abortion is performed, someone dies. Are we killing an innocent human person? Widespread disagreement exists. However, it’s not necessary to establish personhood in order to establish the wrongness of abortion: a substantial chance of personhood is enough. We defend The Don’t Risk Homicide Argument: abortions are wrong after 10 weeks gestation because they substantially and unjustifiably risk homicide, the unjust killing of an innocent person. Why 10 weeks? Because the cumulative evidence establishes a substantial chance (a more than (...) 1 in 5 chance) that preborn humans are persons around this stage of development. We submit evidence from our bad track record, widespread disagreement about personhood (after 10 weeks gestation), problems with theories of personhood, the similarity between preborn humans and newborn babies, gestational age miscalculations, and the common intuitive responses of women to their pregnancies and miscarriages. Our argument is cogent because it bypasses the stalemate over preborn personhood and rests on common ground rather than contentious metaphysics. It also strongly suggests that society must do more to protect preborn humans. We discuss its practical implications for fetal pain relief, social policy, and abortion law. (shrink)

This paper reconsiders Tommie Shelby's (2016) analysis of procreation in poor black communities. I identify three conceptual frames within which Shelby situates his analysis—feminization, choice-as-control, and moralization. I argue that these frames should be rejected on conceptual, empirical, and moral grounds. As I show, this framing engenders a flawed understanding of poor black women's procreative lives. I propose an alternative framework for reconceiving the relationship between poverty and procreative justice, one oriented around reproductive flourishing instead of reproductive responsibility. More generally, (...) the paper develops a methodological challenge for nonideal moral and political philosophy, especially concerning the obligations of the oppressed. Specifically, I argue that in the absence of descriptive and conceptual accountability, the "moral gaze" of the philosopher risks preserving, rather than destabilizing, oppressive ideologies. (shrink)

Surrogacy involves a private agreement whereby a woman who gestates a child attempts to surrender her (putative) moral right to become the parent of that child such that another person (or persons), of the woman’s choice, can acquire it. Since people lack the normative power to privately transfer custody, attempts to do so are illegitimate, and the law should reflect this fact.

The ethics of abortion considers whether abortion is immoral. Pro-choice philosophers think that it is not immoral, while pro-life philosophers think that it is. The axiology of abortion considers whether world would be better if the pro-choice or pro-life position is right. While much attention has been given to the ethics of abortion, there has been no attention given to the axiology of abortion. In this article, I seek to change that. I consider various arguments for thinking our world would (...) be better if the pro-choice position or the pro-life position is correct, ultimately concluding that it would be better if the pro-choice position is right. This is unfortunate, however, since there is no good reason to think the pro-choice position is correct. (shrink)

In cases in which we must choose between either (i) preventing a woman from remaining unwillingly pregnant or (ii) preventing a fetus from being killed, we should prevent the fetus from being killed. But this suggests that in typical cases abortion is wrong: typical abortions involve preventing a woman from remaining unwillingly pregnant over preventing a fetus from being killed. So abortion is typically wrong—and this holds whether or not fetuses are persons.

Uterus transplantation (UTx) is an experimental surgery likely to face the issue of organ shortage. In my article, I explore how this issue might be addressed by changing the prevailing practices around live uterus donor recruitment. Currently, women with children – often the mothers of recipients – tend to be overrepresented as donors. Yet, other potentially eligible groups who may have an interest in providing their uterus – such as transgender men, or cisgender women who do not wish to gestate (...) or to have children – tend to be excluded as potential donors. Moving forward, I recommend that donor inclusion criteria for UTx be broadened to be more inclusive of these latter groups. (shrink)

Is moral or other regret for abortion an indicator that abortion may not be morally or prudentially choice worthy? This paper examines the work of Kate Greasley in this area, who offers an explanation of any asymmetry in openness to regret between women who have abortions and women who give birth. The latter, not unlike Derek Parfit’s 14-year-old who conceives deliberately, may feel duty-bound not to regret their decision (in their case, to continue their pregnancy) and to affirm the life (...) of their child. In response to Greasley, testimonial evidence of one group cannot be dismissed simply because regret may be less available to another group of decision-makers. Moreover, if moral regret for childbearing is uncommon, this is not because mothers have a moral duty, as Greasley argues, not to regret even a morally mistaken choice to conceive. On the contrary, one must separate the evaluation of choices and of the results of these choices, whether positive or negative. Regret, while not infallible, can elucidate values at stake in choices, and testimonial evidence in the form of regret should be taken more seriously in regard to certain kinds of choice. (shrink)

The reproductive rights of women have been a central topic in feminist bioethics. The focus has been predominantly on the right not to reproduce, and so not to be subject to pronatalist social forces that make motherhood compulsory for women. That is the case despite many women and other members of marginalized groups experiencing anti-natalism, or in other words, social pressure to avoid biological reproduction. For these groups, the right to reproduce is as important, if not more important, than the (...) right not to reproduce. This chapter concentrates on the right to reproduce and considers what form it should take in feminist bioethics. The main claim of the chapter is that feminists should ground the right in the need to protect marginalized groups from anti-natalism. (shrink)

Gender-based forms of administrative violence, such as reproductive violence, are the result of systems designed to enact population-level harms through the production and forcible imposition of colonial systems of gender. Settler statecraft has long relied on the strategic promotion of sexual and reproductive violence. Patterns of reproductive violence adapt and change to align with the enduring goals and evolving needs of settler colonial occupation, dispossession, and containment. The U.S. Supreme Court’s recent decision to end the constitutional right to abortion in (...) Dobbs v Jackson is but one instance of this larger pattern. We analyze reproductive and obstetric violence and the structural trauma they produce through the lenses of i) historical continuity and ii) the global architectures of neoliberal settler capitalism in order to connect reproductive rights rollbacks in the U.S. with the expansion of reproductive violence across a world connected by colonial globalization. (shrink)

The past few years has seen a resurgence in the public interest in space flight and travel. Spurred mainly by the likes of technology billionaires like Elon Musk and Jeff Bezos, the topic poses both unique scientific as well as ethical challenges. This paper looks at the concept of generation ships, conceptual behemoth ships whose goal is to bring a group of human settlers to distant exoplanets. These ships are designed to host multiple generations of people who will be born, (...) live, and die on these ships long before it reaches its destination. This paper takes reproductive ethics as its lens to look at how genetic enhancement interventions can and should be used not only to ensure that future generations of offspring on the ships, and eventual exoplanet colonies, live a minimally good life but that their births are contingent on them living genuinely good and fulfilling lives. The paper makes the further claim that if such a thesis holds, it also does so for human enhancement on Earth. (shrink)

Procreative obligations are often discussed by evaluating only the consequences of reproductive actions or omissions; less attention is paid to the moral role of intentions and attitudes. In this paper, I assess whether intentions and attitudes can contribute to defining our moral obligations with regard to assisted reproductive technologies already available, such as preimplantation genetic diagnosis (PGD), and those that may be available in future, such as reproductive genome editing and ectogenesis, in a way compatible with person‐affecting constraints. I propose (...) the parent–child relationship argument, which is based on the moral distinction between creating and parenting a child. Hence, I first argue that intentions and attitudes can play a role in defining our moral obligations in reproductive decisions involving PGD. Second, I maintain that if we accept this and recognize reproductive genome editing and ectogenesis as person‐affecting procedures, we should be committed to arguing that prospective parents may have moral reasons to prefer reproduction via such techniques than via sexual intercourse. In both cases, I observe an extension of our procreative responsibility beyond what is proposed by the consequentialist person‐affecting morality. (shrink)

Despite having essential health needs regarding sexual and reproductive health services (SRHS), young people (e.g., adolescents) in many countries show low use of such services. The World Health Organization advocates fostering young people’s autonomy to access health services to address this global health problem. However, there are gaps in the literature to understand how young people’s autonomy can be fostered to access SRHS. In 2019–2020, we conducted semi-structured interviews with 45 young people aged 14–23 years old in Colombia to explore (...) how they might wish to have their autonomy fostered in accessing SRHS. Research in different cultural contexts has shown that young people generally do not wish to discuss sex with their parents. By contrast, most of our participants expressed a strong wish for the ability to talk openly with their parents about their sexual and reproductive health. One of the main complaints of these young people was that their parents lacked the necessary knowledge to help them make informed decisions related to their sexual and reproductive health (e.g., choosing a contraceptive option). As a potential solution, participants were enthusiastic about initiatives that could provide parents with comprehensive sex education to assist young people in making informed choices for their sexual and reproductive health, including how to access SRHS. (shrink)

Ableist attitudes and structures regarding disability are increasingly recognized across all sectors of healthcare delivery. After Dobbs, novel questions arose in the USA concerning how to protect reproductive autonomy while avoiding discrimination against and devaluation of disabled persons. As a case study, we examine the Louisiana’s Department of Public Health August 1st Emergency Declaration, “List of Conditions that shall deem an Unborn Child ‘Medically Futile.’” We raise a number of medical, ethical, and public health concerns that lead us to argue (...) the declaration should be rescinded. The ethically objectionable declaration provides valuable lessons concerning how to uphold both reproductive and disability justice in a post-Dobbs landscape. (shrink)

In this article, I critique the commonly accepted distinction between commercial and altruistic surrogacy arrangements. The moral legitimacy of surrogacy, I claim, does not hinge on whether it is paid (‘commercial’) or unpaid (‘altruistic’); rather, it is best determined by appraisal of virtue-abiding conditions constitutive of the surrogacy arrangement. I begin my article by problematising the prevailing commercial/altruistic distinction; next, I demonstrate that an assessment of the virtue-abiding or non-virtue-abiding features of a surrogacy is crucial to navigating questions about the (...) moral legitimacy of surrogacy; in the final part, I reject other moral heuristics that might be proposed as alternatives to the commercial/altruistic dichotomy, and reiterate that a virtue-ethical framework is the most suitable way forward. (shrink)

Human reproductive cloning aims to produce duplicates, i.e., people who are phenotypically and genetically identical to those already in existence. This might appear to actually threaten human dignity, because it calls into question our much-vaunted, precious uniqueness. This is precisely what this book sets out to explore: Whether, in what sense, and to what extent human reproductive cloning can threaten human uniqueness and dignity, particularly by either promoting or violating certain human rights or moral rights.

Objective Our study sought to (1) describe the practices and preferences of Colombian adolescents in accessing sexual and reproductive health services: accompanied versus alone; (2) compare actual practices with stated preferences; and (3) determine age and gender differences regarding the practice and these stated preferences. -/- Methods 812 participants aged 11–24 years old answered a survey in two Profamilia clinics in the cities of Medellin and Cali in Colombia. A cross-sectional analysis was performed to compare participants’ answers based on the (...) variables of gender and age. -/- Results A quarter of participants visited the clinic alone (25.4%). Females were more likely to go alone in comparison to males (26.3% vs 14.1%; p = 0.031), and older participants went alone more often than younger participants (p < 0.001). Most participants – 72.7% (95 %CI: 69.3–75.9) – expressed a preference in being accompanied to the clinic, and more than 90% had their preferences met. The preferences of older participants were, however, less likely to be met than those of younger participants (p < 0.001), notably, because they predominantly wanted to be accompanied. -/- Conclusion Contemporary public health and bioethics literature advocates in favor of developing health services that better meet the preferences of adolescents. The present research highlights an apparent blind spot related to the role that others (e.g., parents, friends, partners) can or should play in accompanying adolescent patients when they access sexual and reproductive health services. Respecting adolescents’ preferences, and hence their autonomy, is not simply a matter of ensuring freedom from constraints (e.g., their right and ability to go alone). Rather, it should also consider the liberty to choose whether to be accompanied when accessing SHRS and by whom. (shrink)

It is often assumed that if the fetus is a person, then abortion should be illegal. Thomson1 laid the groundwork to challenge this assumption, and Boonin2 has recently argued that it is false: he argues that abortion should be legal even if the fetus is a person. In this article, I explain both Thomson’s and Boonin’s reason for thinking that abortion should be legal even if the fetus is a person. After this, I show that Thomson’s and Boonin’s argument for (...) legalised abortion fail; they have not given us good reason for thinking abortion should be legal.1 Finally, I argue that—if we play Boonin’s game—abortion should be illegal. When discussing the ethics and politics of abortion, whether the fetus is a person is usually central.3 4.2 However, Thomson1 long ago challenged this view. She argued that abortion is permissible even if the fetus is a person. To do so, she asks us to consider a case in which you are non-consensually taken to a hospital and hooked up to a famous violinist. The violinist, if he is to survive, needs to filter his blood through your body. After 9 months, he will be fine and you can unplug yourself and go on your way. If you unplug yourself prior to this, however, he will die. Is it permissible to unplug yourself? Thomson thinks the answer is ‘yes’. And this, she thinks, shows that abortion is permissible even if the fetus is a person. While the majority of her article focuses on the ethics of abortion, it is clear that she also aims to show that abortion should be legal if the fetus is a person; she would no doubt reject the view that the state is right to coerce you into …. (shrink)

After the US Supreme Court’s reversal of Roe v. Wade, a number of states have immediately banned abortion. Pro-choice activists are responding by promoting medication abortions – a do-it-yourself form of abortion. Women can take pills at home to induce an abortion in the first few weeks of pregnancy. -/- The Biden Administration [1] has backed the abortion pill, too. Attorney-General Merrick B. Garland and Health and Human Services Secretary Xavier Becerra both issued statements endorsing it. -/- “We stand ready (...) to work with other arms of the federal government that seek to use their lawful authorities to protect and preserve access to reproductive care,” said the Attorney-General. “In particular, the F.D.A. has approved the use of the medication mifepristone. States may not ban mifepristone based on disagreement with the F.D.A.’s expert judgment about its safety and efficacy.” -/- As the New York Times [1] has noted, this sets the scene for legal battles. The obvious one is: will anti-abortion states prosecute medication abortions? -/- But – based on experience in the United Kingdom - the use of the abortion pill could give pro-life doctors headaches as well. -/- In the past year, UK has witnessed the saga of two Catholic doctors who have been brought in front of the professional regulator, the General Medical Council, after accusations of professional misconduct. Their crime? They had supplied abortion pill reversal (APR) treatment to women. Accusations of this misconduct have been brought forward by pro-choice organisations [2]. -/- The problem is that some women might panic when they discover that they are pregnant or are pressured to make a rash decision. They obtain abortion pills, often without seeing a doctor faceto- face, and soon after taking the first pill, they regret their decision. -/- Is it too late for them to save their pregnancy? Not necessarily. -/- A treatment developed in the US works about half the time. It involves the woman taking progesterone after the first abortion pill to counteract the abortifacient action of the drug. -/- Seventy-three women in the UK are reported to have taken a full APR course, of whom, 38 – more than half — successfully remained pregnant. Admittedly, the procedure is controversial [3], with pro-choice writers denouncing it as unproven, unscientific, and unethical. This has triggered some healthcare practitioners and scholars to analyse the commitments of the pro-choice movement to APR. In a recently published paper in The New Bioethics [4], two colleagues, Dominic Whitehouse and Steven Bow, and I argue that those espousing a pro-choice worldview should actually support abortion pill reversal and that the current evidence indicates that they should actually be doing it. -/- While some pro-choice activists might be happy simply to expand women’s reproductive choices, some might also want to ensure that these choices are safe and effective at achieving the desired outcome, which in principle includes maintaining a pregnancy. -/- We then review the scientific evidence with respect to the ability of APR to halt an abortion, look at the potential impact of APR on mental health, as well as its procedural safety. While highlighting that gold-standard evidence is lacking, we note that APR is associated with about two times higher rate of embryo survival compared to not completing the full early medical abortion course, that there is large agreement in the literature that women who are ambiguous about abortion are at risk of poorer mental health outcomes after abortion (and argue that women who request APR fall into this category), and highlight that there is no evidence that APR is more dangerous than abandoning an initiated early medical abortion. -/- The latter fact is important, as the results of the only randomised-controlled trial of APR have been at times misrepresented in the media [5.6], creating the impression that APR is not safe while most of the adverse effects occurred in the study group that did not receive APR. As our paper argues, with respect to APR the two UK doctors were “champions of women’s choice and should be congratulated, not condemned, by pro-choice advocates”. -/- While the cases against the two doctors have now been dropped (and there have even been accusations against a member of one of these pro-choice organisations that they pressurised a patient into complaining about one of the doctors and twisted the patient’s experience of the treatment [7]), we argue that it is important to set-up systems to facilitate the future provision of APR to protect both patients and healthcare staff. -/- Our conclusion is that, while being open to any change in evidence, those espousing a pro-choice outlook should “support calls for an APR framework that will protect women and the healthcare professionals caring for them” “and certainly not oppose” APR. -/- The debate over abortion pill reversal will be heading to the United States soon. It is quite possible that it will be denounced as dangerous misinformation. It’s not. But pro-life defenders should be prepared to defend their ground. -/- This article was first published by Mercatornet. (shrink)

Dear Editor, -/- We are pleased to report that we have recently published an article in a well-established bioethics journal where we briefly review the evidence surrounding abortion pill reversal (APR) and argue that those who identify with the pro-choice standpoint should support APR provision (indeed, the ex-CEO of BPAS, Ann Furedi, has agreed in principle with this conclusion of ours in one of her tweets). We also hope that our article will serve as a record in the peer-reviewed and (...) indexed literature of the struggles our fellow CMA UK members have gone through to support women who eventually decided to keep their pregnancies, and the tribulations they had to endure from their colleagues in the medical establishment. It is perhaps somewhat symbolic that our paper has been published in a special issue dedicated to the ‘feminist ethics of care’ as APR and the sacrifice of our colleagues shows what care for women should really look like.(1) -/- We have made sure to spread the word about this as well. One of us has given an interview to Irish pro-life group Protect Life (still to be published) and we have submitted a post to a pro-life collaborative that also awaits publication. Finally, we have also published a post about this paper and current developments in the USA in a well-established bioethics news site, which has been republished in various online outlets.(2) -/- We believe that this promotion of APR is vital, as recent statements from both the UK and the USA indicate that the pressure against APR might grow. The American College of Obstetricians and Gynecologists have published a post entitled ‘Facts Are Important: Medication Abortion "Reversal" Is Not Supported by Science’.(3) Similarly, the UK Royal College of Obstetricians and Gynaecologists, together with other bodies (including the British Society of Abortion Care Providers) have posted a position statement stating that there is no reputable evidence for using progesterone in APR.(4) One truly wonders why these organisations are pushing this narrative despite the weight of the evidence available being in favour of APR and their organisations’ professed support for women’s choice. (shrink)

On 24 July 2022, the landmark decision Roe v. Wade (1973), that secured a right to abortion for decades, was overruled by the US Supreme Court. The Court decision in Dobbs v. Jackson Women’s Health Organisation severely restricts access to legal abortion care in the USA, since it will give the states the power to ban abortion. It has been claimed that overruling Roe will have disproportionate impacts on women of color and that restricting access to abortion contributes to or (...) amounts to structural racism. In this paper, we consider whether restricting abortion access as a consequence of overruling Roe could be understood as discrimination against women of color (and women in general). We argue that banning abortion is indirectly discriminatory against women of color and directly (but neither indirectly, nor structurally) discriminatory against women in general. (shrink)

Ellie Anderson had always known that she wanted to have children. Her mother, Louise, was aware of this wish. Ellie was designated male at birth, but according to news sources, identified as a girl from the age of three. She was hoping to undergo gender reassignment surgery at 18, but died unexpectedly at only 16, leaving Louise grappling not only with the grief of losing her daughter, but with a complex legal problem. Ellie had had her sperm frozen before starting (...) hormone treatment, specifically so that she would retain the chance of becoming a parent after her gender reassignment. Ellie had considered what might happen to the sperm if she died and was adamant that her children should be brought into the world. She made her mother promise to ensure that this would happen. But according to UK law, Ellie’s mother has no legal right to retain her sperm, or to use it to fulfil Ellie’s wishes. In this paper, we raise several key ethical questions on this case, namely: does a refusal to bring Ellie’s children into the world wrong her posthumously? Is Ellie’s mother morally entitled to use her daughter’s sperm as Ellie wished? Should the fact that Ellie was a minor at the time of her death or the fact that she was transgendered undermine her wish to have children? Can Ellie become a parent posthumously? We consider how these complex ethical questions could be approached. (shrink)

Recent publications debate the value of inconsistency arguments. Here, I argue that 'Cause of Death Arguments' - inconsistency arguments that claim miscarriage causes death far more often than induced abortion - are unsound or invalid. 'Miscarriage' ambiguously refers both to intrauterine death, an outcome that does not itself cause death, and preterm delivery, which only sometimes causes death. The referential ambiguity also obscures actions people do take to prevent 'miscarriage.' When using the most plausible versions of each premise, these arguments (...) equivocate. Thus, they cannot prove anything. However, missing the equivocation also causes those responding to Cause of Death Arguments to make unconvincing arguments; they inadvertently make or grant false claims themselves. To avoid such mistakes and expose the merely rhetorical power of Cause of Death Arguments, philosophers should replace 'miscarriage' with disambiguated terms. Doing so should lead people across the abortion debate to finally abandon the Cause of Death Argument. (shrink)

The introduction of pre-exposure prophylaxis (PrEP) for HIV has triggered critical analysis within the social sciences. For example, some have signalled how PrEP may lead to a renewed medicalisation of gay and other homosexually-active men’s sexuality. This chapter challenges some of those accounts. Adopting a public health ethics perspective, it argues that gay men should be understood as agentic in their use of PrEP, as opposed to being the passive victims of medicalisation, and that greater attention should be paid to (...) questions of pleasure in PrEP use. Applying a reproductive justice framework, the chapter argues that the worldwide inaccessibility of PrEP constitutes a more serious ethical issue than the potential problem of the medicalisation of gay men’s sexuality. (shrink)

This paper raises three concerns regarding self-ownership rhetoric to describe autonomy within healthcare in general and reproductive justice in specific. First, private property and the notion of “ownership” embedded in “self-ownership,” rely on and replicate historical injustices related to the initial acquisition of property. Second, not all individuals are recognized as selves with equal access to self-ownership. Third, self-ownership only justifies negative liberties. To fully protect healthcare access and reproductive care in specific, we must also be able to make claims (...) on others to respect, protect, and fulfill our positive rights. As much as nondomination remains an urgent demand for reproductive rights, it does not go far enough to ensure reproductive justice. (shrink)

Recent years have seen a surge of interest in the question of whether humans should reproduce. Some say human life is too punishing and cruel to impose upon an innocent. Others hold that such harms do not undermine the great and possibly unique value of human life. Tracing these outlooks historically in the debate has barely begun. What might philosophers have said, or what did they say, about human life itself and its value to merit reproduction? This article looks to (...) Kant, who wrote much on whether, by reproducing, humans do wrong or right morally. It assesses two main arguments: one examining whether perfect or imperfect duties condone reproduction, the other whether Kant’s teleological or, in the opposite sense, his eschatological outlooks can salvage reproduction. These two arguments are essential for building the entire argument. This article finds that, although Kant’s arguments against reproducing are strong, some of his writing seems to support reproduction as a good. Yet, must we must assume an author, even one who strove for systematicity, must be consistent over his entire oeuvre on every issue, especially if not handled directly in a single work? The article concludes that Kant does not sufficiently, systematically support anti-natalism as more moral than pro-natalism. It is best for the current debate to grapple with the very dilemma that daunted Kant. (shrink)

The development of new methods in the field of prenatal testing leads to an expansion of information that needs to be provided to expectant mothers. The aim of this research is to explore opinions and attitudes of gynecologists in Germany, Poland and Russia towards access to prenatal testing and diagnostics in these countries. Semi-structured interviews were conducted with n = 18 gynecologists in Germany, Poland and Russia. The interviews were analyzed using the methods of content analysis and thematic analysis. Visible (...) in all three countries is a connection of prenatal medicine with the politically and socially contentious issue of pregnancy termination. Respondents in Poland and Russia concentrated on the topic of inadequate resources. Quality of information for expectant mothers is an important point in all three countries. Only in Germany was the issue of language barriers in communication raised. With regard to non-invasive prenatal testing (NIPT) respondents in Germany focused on the ethical issues of routinization of testing; in Poland and Russia they concentrated on fair access to NIPT. Challenges in all three countries arise from structural factors such as imprecise and prohibitive regulations, lack of resources or organization of healthcare services. These should be addressed on a political and medico-ethical level. (shrink)

Conscientious objection in healthcare has come under heavy criticism on two grounds recently, particularly regarding abortion provision. First, critics claim conscientious objection involves a refusal to provide a legal and beneficial procedure requested by a patient, denying them access to healthcare. Second, they argue the exercise of conscientious objection is based on unverifiable personal beliefs. These characteristics, it is claimed, disqualify conscientious objection in healthcare. Here, we defend conscientious objection in the context of abortion provision. We show that abortion has (...) a dubitable claim to be medically beneficial, is rarely clinically indicated, and that conscientious objections should be accepted in these circumstances. We also show that reliance on personal beliefs is difficult to avoid if any form of objection is to be permitted, even if it is based on criteria such as the principles and values of the profession or the scope of professional practice. (shrink)

Many accounts of the morality of abortion assume that early fetuses must all have or lack moral status in virtue of developmental features that they share. Our actual attitudes toward early fetuses don’t reflect this all-or-nothing assumption: early fetuses can elicit feelings of joy, love, indifference, or distress. If we start with the assumption that our attitudes toward fetuses reflect a real difference in their moral status, then we need an account of fetal moral status that can explain that difference. (...) I argue that we can have or lack relational obligations to early fetuses in light of our own activities or choices, independent of the fetus’s own features or properties. Those relational obligations make the early fetus morally considerable to the persons who stand in a moral relation to it. Pregnant persons (and other participants in the procreative process) can come to have relational obligations to an early fetus just in virtue of their own decision to create a person, either by intentionally getting pregnant or by deciding to continue a pregnancy. That decision not only makes it appropriate for them to care about the fetus, but it also generates obligations to the fetus that they didn’t have before that decision. (shrink)

Reproduction has entered a new ice age: the ability to cryopreserve reproductive cells, tissue and embryos are fundamentally changing our understanding of what it means to be a reproductive citizen. This book explores the ways in which opinions of desirable reproductive futures are feared or are being welcomed by advances in freezing technologies, with the authors situating their discussions of cryo-fertility primarily within the Scandinavian region, asking: * How does cryopreservation help mobilize particular understandings of reproductive time, reproductive rights and (...) reproductive autonomy? * What values are embedded within Scandinavian laws that seek to regulate cryotechnologies? * How do men and women who freeze their gamets imagine the preservation of their material? -/- These questions demand a collaborative approach. The authors empirically cut across the areas of bioethics/law, practices/experiences and culture/commerce in order to pin down often comples and far-reaching answers. (shrink)

Disputes between separated couples over whether frozen embryos can be used in an attempt to create a child create a moral dilemma for public policy. When a couple create embryos intending to parent any resulting children, New Zealand’s current policy requires the consent of both people at every stage of the ART process. New Zealand’s Advisory Committee on Assisted Reproductive Technology has proposed a policy change that would give ex-partners involved in an embryo dispute twelve months to come to an (...) agreement before the embryos are destroyed. New Zealand’s current policy and the proposed policy both favour the person who wishes to avoid procreation. Two alternative policy approaches that do not favour procreative avoidance are considered. Using pre-fertilisation contracts to determine the decision reached in embryo disputes allows the couple’s wishes at the time the embryos are created to determine what happens to the embryos if they separate. However, pre-fertilisation contracts are agreements about healthcare and personal relationships, and changing circumstances can make enforcing such agreements unjust. Finally, it is argued that New Zealand’s Family Court system should be used to reach decisions that balance the interests of those involved in the dispute. (shrink)

Reseña del II Simposio de Ética Aplicada: la moralidad del aborto, evento organizado por el grupo de investigación Sentido y Referencia (Lima, Perú, 2018).

The ethics of biological procreation has received a great deal of attention in recent years. Yet, as I show in this paper, much of what has come to be called procreative ethics is conducted in a strangely abstract, impersonal mode, one which stands little chance of speaking to the practical perspectives of any prospective parent. In short, the field appears to be flirting with a strange sort of practical irrelevance, wherein its verdicts are answers to questions that no-one is asking. (...) I go on to articulate a theory of what I call existential grounding, a notion which explains the role that prospective children play in the lives of many would-be parents. Procreative ethicists who want their work to have real practical relevance must, I claim, start to engage with this markedly first-personal kind of practical consideration. (shrink)

Embryo screening technologies offer important benefits to individuals who use them and society. These techniques can expand the reproductive options of many prospective parents and can contribute to reducing the burdens of disease and disability. Nonetheless, embryo screening techniques present individuals and societies with important ethical challenges. Here, I explore some of them. In particular, I discuss the costs for prospective parents of increased reproductive choices, as well as concerns about sanctioning problematic social norms, increasing social injustice, limiting the ways (...) societies can tackle diseases and disabilities, and promoting the commodification of children. (shrink)

Many environmental philosophers have argued that there is an obligation for individuals to reduce their individual carbon footprints. However, few of them have addressed whether this obligation would entail a corresponding duty to limit one’s family size. In this paper, I examine several reasons that one might view procreative acts as an exception to a more general duty to reduce one’s individual greenhouse gas emissions. I conclude that none of these reasons are convincing. Thus, if there is an obligation to (...) reduce one’s unnecessary greenhouse gas emissions, then people should also limit the size of their families when they have the means to do so. (shrink)

Much of the discussion surrounding the ethics of abortion has centered around the notion of personhood. This is because many philosophers hold that the morality of abortion is contingent on whether the fetus is a person - though, of course, some famous philosophers have rejected this thesis (e.g. Judith Thomson and Don Marquis). In this article, I construct a novel argument for the immorality of abortion based on the notion of impairment. This argument does not assume that the fetus is (...) a person - indeed, I concede (for the sake of argument) that the fetus is not a person - and hence the morality of abortion is not contingent on whether the fetus is a person. I finish by answering a plethora of objections to my argument, concluding that none of them are successful. (shrink)

This book introduces readers to the many arguments and controversies concerning abortion. While it argues for ethical and legal positions on the issues, it focuses on how to think about the issues, not just what to think about them. It is an ideal resource to improve your understanding of what people think, why they think that and whether their (and your) arguments are good or bad, and why. It's ideal for classroom use, discussion groups, organizational learning, and personal reading. -/- (...) From the Preface -/- To many people, abortion is an issue for which discussions and debates are frustrating and fruitless: it seems like no progress will ever be made towards any understanding, much less resolution or even compromise. -/- Judgments like these, however, are premature because some basic techniques from critical thinking, such as carefully defining words and testing definitions, stating the full structure of arguments so each step of the reasoning can be examined, and comparing the strengths and weaknesses of different explanations can help us make progress towards these goals. -/- When emotions run high, we sometimes need to step back and use a passion for calm, cool, critical thinking. This helps us better understand the positions and arguments of people who see things differently from us, as well as our own positions and arguments. And we can use critical thinking skills help to try to figure out which positions are best, in terms of being supported by good arguments: after all, we might have much to learn from other people, sometimes that our own views should change, for the better. -/- Here we use basic critical thinking skills to argue that abortion is typically not morally wrong. We begin with less morally-controversial claims: adults, children and babies are wrong to kill and wrong to kill, fundamentally, because they, we, are conscious, aware and have feelings. We argue that since early fetuses entirely lack these characteristics, they are not inherently wrong to kill and so most abortions are not morally wrong, since most abortions are done early in pregnancy, before consciousness and feeling develop in the fetus. -/- Furthermore, since the right to life is not the right to someone else’s body, fetuses might not have the right to the pregnant woman’s body—which she has the right to—and so she has the right to not allow the fetus use of her body. This further justifies abortion, at least, until technology allows for the removal of fetuses to other wombs. Since morally permissible actions should be legal, abortions should be legal: it is an injustice to criminalizing actions that are not wrong. -/- In the course of arguing for these claims, we: 1. discuss how to best define abortion; 2. dismiss many common “question-begging” arguments that merely assume their conclusions, instead of giving genuine reasons for them; 3. refute some often-heard “everyday arguments” about abortion, on all sides; explain why the most influential philosophical arguments against abortion are unsuccessful; 4. provide some positive arguments that at least early abortions are not wrong; 5. briefly discuss the ethics and legality of later abortions, and more. -/- This essay is not a “how to win an argument” piece or a tract or any kind of apologetics. It is not designed to help anyone “win” debates: everybody “wins” on this issue when we calmly and respectfully engage arguments with care, charity, honesty and humility. This book is merely a reasoned, systematic introduction to the issues that we hope models these skills and virtues. Its discussion should not be taken as absolute “proof” of anything: much more needs to be understood and carefully discussed—always. (shrink)

This is a critical response to "Defending Eugenics", published in MBR in 2018.

Ectogenesis, or the use of an artificial womb to allow a foetus to develop, will likely become a reality within a few decades, and could significantly affect the abortion debate. We first examine the implications for Judith Jarvis Thomson’s violinist analogy, which argues for a woman’s right to withdraw life support from the foetus and so terminate her pregnancy, even if the foetus is granted full moral status. We show that on Thomson’s reasoning, there is no right to the death (...) of the foetus, and abortion is not permissible if ectogenesis is available, provided it is safe and inexpensive. This raises the question of whether there are persuasive reasons for the right to the death of the foetus that could be exercised in the context of ectogenesis. Eric Mathison and Jeremy Davis have examined several arguments for this right, doubting that it exists, while Joona Räsänen has recently criticized their reasoning. We respond to Räsänen’s analysis, concluding that his arguments are unsuccessful, and that there is no right to the death of the foetus in these circumstances. (shrink)

Lawrence Nelson (2018) criticizes conscientious objection (CO) to abortion statutes as far as they permit health care providers to escape criminal liability for what would otherwise be the legally wrongful taking of a pregnant woman’s life by refusing treatment (i.e. abortion). His key argument refers to the U.S. Supreme Court judgment (Roe v. Wade 1973) that does not treat the unborn as constitutional persons under the Fourteenth Amendment. Therefore, Nelson claims that within the U.S. legal system any vital interests of (...) pregnant women must always take precedence over fetuses’ interests. While agreeing with the main thesis of the article, we believe that the author’s argument neither vindicates his claim, nor explains why those who believe that fetuses are equally protectable human beings do not have the right to refuse to perform an abortion in lifethreatening emergency circumstances (AE). Therefore, the main aim of our commentary is to outline, by referring to our earlier works on conscientious objection in health care (Z_ uradzki 2016) and cultural exemptions (Ciszewski 2016), a better and universalizable argumentative path that would lead to the same conclusion. (shrink)

Is the wish to be biologically related to your children legitimate? Here, I respond to an argument in support of a negative answer to this question according to which a preference towards having children one is biologically related to is analogous to a preference towards associating with members of one’s own race. I reject this analogy, mainly on the grounds that only the latter constitutes discrimination; still, I conclude that indeed a preference towards children one is biologically related to is (...) morally illegitimate because, in the context of parental love, biological considerations are normatively irrelevant. (shrink)

Travis Rieder's Toward a Small Family Ethic confronts the effects of population growth and addresses what individual procreative obligations might follow from it. In this review, I summarize the main arguments that Rieder deploys to defend his position that those with large ecological footprints morally ought to follow a small family ethic. I express sympathy with some of his claims and praise the book's accessibility, but its short length inevitably means that some important issues are omitted or given only superficial (...) treatment. I highlight a few of those issues at the end of the review. (shrink)

Joona Räsänen, in his article ‘Ectogenesis, abortion and a right to the death of the fetus’, has argued for the view that parents have a right to the death of the fetus. In this article, I will explicate the three arguments Räsänen defends, and show that two of them have false or unmotivated premises and hence fail, and that the support he offers for his third argument is inconsistent with other views he expresses in his article. Therefore, I conclude that (...) there is no right to the death of the fetus—or, if there is one, Räsänen has not shown it. (shrink)

This paper discusses the importance of informed medical consent through a case study examines the implications this case had for the medical rights of EU citizens. I start by describing a case of a Slovakian national of Roma origin against the Government of Slovakia, which appeared at the European Court of Human Rights in 2007-2012. The twenty-year old woman, who had been sterilized at a Slovakian hospital during the birth of her second child, claimed that the procedure took place without (...) her full and informed consent, and argued that the doctors’ decision was connected to the society’s long-standing negative attitude towards Roma people. After presenting the background of the case and the legal proceedings, I discuss the relevant national and European law in order to explain the positions of both sides and the rulings of the courts. I conclude by putting the case in a wider context of racial discrimination in the EU and providing a policy analysis regarding both the Slovakian and the European policies toward the Roma minority. (shrink)

English-speaking research on morally right decisions in a healthcare context over the past three decades has been dominated by two major perspectives, namely, the Four Principles, of which the principle of respect for autonomy has been most salient, and the ethic of care, often presented as a rival to not only a focus on autonomy but also a reliance on principles more generally. In my contribution, I present a novel ethic applicable to bioethics, particularly as it concerns human procreation, that (...) I argue is a promising alternative to these two approaches. According to this new moral theory, an act is right just insofar as it treats people’s capacity to commune with respect, where communing is a matter of identifying with others and exhibiting solidarity with them. This ethic is inspired by relational ideals of communion and harmony from the African philosophical tradition, but is shown to be attractive to a broad, indeed global, audience, with regard to its implications for the morality of reproduction. (shrink)