This essay will focus on the moral issues relating to surrogacy in the global context, and will critique the liberal arguments that have been offered in support of it. Liberal arguments hold sway concerning reproductive arrangements made between commissioning couples from wealthy nations and the surrogates from socioeconomically weak backgrounds that they hire to do their reproductive labor. My argument in this paper is motivated by a concern for controlling harms by putting the practice of globalized commercial surrogacy into the (...) context of care ethics. As I will argue, the unstable situations into which children of global surrogacy arrangements are born is symbolic of the crisis of care that the practice raises. Using the Baby Manji case as my touch point, I will suggest that liberalism cannot address the harms experienced by Manji and children like her who are created through the global practice of assisted reproductive technology. I will argue that, if commissioning couples consider their proposed surrogacy contracts from a care ethics point of view, they will begin to think relationally about their actions, considering the practice from an ethical lens, not just an economic or contractual one. (shrink)

This paper treats the political and ethical issues associated with the new caretaking technologies. Given the number of feminists who have raised serious concerns about the future of care work in the United States, and who have been critical of the degree to which society “free rides” on women's caretaking labor, I consider whether technology may provide a solution to this problem. Certainly, if we can create machines and robots to take on particular tasks, we may lighten the care burden (...) that women currently face, much of which is heavy and repetitious, and which results in injury and care “burnout” for many female caretakers. Yet, in some contexts, I argue that high-tech robotic care may undermine social relationships, cutting individuals off from the possibility of social connectedness with others. (shrink)

Robinson argues that by certain threshold criteria, pregnant women qualify for a higher moral status by reason of their pregnancies. While her intention is to make this a status upgrade for women, we worry that it may result in a status downgrade for women as a class, by presupposing and reinforcing women’s value in relation to their reproductive labour. Historically, central to feminist analysis is resistance to reductive accounts of women in relation to their reproductivity. For example, de Beauvoir addressed (...) men’s transcendence and contrasted it with women’s immanence, a status distinction possible because women are mired in expectations that they will marry, produce children and remain in the domestic realm; and for her part, Firestone argued that biological reproduction underlies women’s inferiority to men and that ‘The reproduction of the species by one sex for the benefit of both (should) be replaced by…artificial reproduction’1 2 Her concern was to liberate women from expectations of biological reproduction so their productive value in society is not reduced to their reproductive contributions. A formidable body of analysis in this same vein cautions against collapsing the value of women into their pregnancies, so much so that some commentators even distinguish ‘mothering’ from gestation.3 Robinson’s argument that pregnant women qualify at a higher threshold of personhood emphasises …. (shrink)

Ethics, Aging and Society...is the first major work in ten years to critically address issues and methodologies in aging and ethics...This well-organized volume begins theoretically and offers new ways of thinking about ethics that can handle the complexities and realities of aging in particular social contexts."--Choice This new research-based book, by experts in the field of ethics, is excellent and much-needed...I challenge you to consider reading this book and seeing all the ways in which you might be forced to rethink (...) things that most of us take as given for ethics and aging. I know you will not be disappointed and I guarantee you will end up thinking long and hard about personal and professional decisions you may have made as well as your assumptions about aging in America."--CFLE Network Newsletter This is a book that should be required reading for all involved in the ethical provision of services to the aging on any level, as well as for policy makers and administrators in positions of influence over the lives of older patients."--PsycCRITIQUES...the authors' application of feminist ethics to frail elders rings true to both my clinical experience working with frail elders, and my research experience trying to understand their quality of life concerns...there were true gems of ideas [in this book] that illuminated the limitations of the dominant paradigm of autonomy in bioethics. [The authors] make a compelling critique of end-of-life care."--GeriPal: A Geriatrics and Palliative Care Blog This book presents second generation issues in ethics, aging, and society by presenting critical outcomes that arise when ethics is applied to the practical concerns that occur in day-to-day elder care. The first volume in over 10 years to address ethics and gerontology, it is unparalleled in its comprehensiveness and integration of well-developed philosophical arguments with empirical research, humanistic scholarship, and insights gained from practical experience. This book challenges the tried and true approaches to ethical issues in aging and opens avenues for creative problem-solving. The authors' diverse backgrounds bring the advantages of both interdisciplinary scholarship and practical experience to this comprehensive textbook. It is an essential resource for those interested in, and working with, older people, from upper-level undergraduate students and graduate-division students, to gerontology practitioners in training. Key Features: Presents the first major work in over 10 years to integrate the disciplines of ethics and aging Includes case studies derived from day-to-day practice Addresses individual/clinical ethics in health and long-term care and ethical issues raised by public policy, cultural norms and social attitudes Examines such critical issues as Alzheimer's disease, long-term care, ageism, public policy, anti-aging medicine, elder abuse, and natural disasters Explores new directions in ethical and social philosophy as they pertain to gerontology and care. (shrink)

Are women's requests for aid in dying honored more often than men's, or less? Feminist arguments can support conclusions either that gendered perceptions of women as self‐sacrificing predispose physicians to accede to women's requests to die — or that cultural understandings of women as not fully rational agents lead physicians to reject their requests as irrational.

In this paper, I will argue that there is a deep connection between home-based care, technology, and the self. Providing the means for persons to receive care at home is not merely a kindness that respects their preference to be at home: it is an important means of extending their selfhood and respecting the unique selves that they are. Home-based technologies like telemedicine and robotic care may certainly be useful tools in providing care for persons at home, but they also (...) have important implications for sustaining selfhood in ways that are of value to individuals and those who care for them. I will argue, by appealing to Hilde Lindemann’s notion of “holding” persons’ identities in place, that technological interventions are not only useful tools for improving and sustaining health and good care at home, but that they may also help to extend our personal identities and relational capacities in ways that are practically and ethically good. Because of these important goods, I will claim that there is a prima facie moral duty to do this “holding” work and that it is best done by family members and loved ones who are well suited to the job because of their history and relationship with the individual that needs to be “held” in place. (shrink)

Nonfeminist accounts of post-menopausal IVF reject the practice on four main grounds: I) scarcity of resources; 2) fairness; 3) the “inappropriateness” of post-menopausal motherhood; and 4) concerns for orphaned children. I argue that these grounds are insufficient for denying post-menopausal women IVF access. I then suggest that a feminist evaluation of the practice is more compelling; ultimately, however, we have no strong grounds for a policy denying post-menopausal women access to this technology.

This paper applies a relational and familial ethic to address concerns relating to nursing home deaths and advance care planning during Covid‐19 and beyond. The deaths of our elderly in nursing homes during this pandemic have been made more complicated by the restriction of visitors even at the end of life, a time when families would normally be present. While we must be vigilant about preventing unnecessary deaths caused by coronavirus outbreaks in nursing homes, some deaths of our elders are (...) inevitable. Thus, it is essential that advanced care planning occurs in a way that upholds the familial and relational aspects of elders’ lives that often matter to them the most. We invoke concepts from feminist ethicists like Hilde Lindemann and Eva Kittay and introduce Avery Weisman and Thomas Hackett’s concept of “appropriate death” to suggest better ways of planning for those deaths of our elderly that cannot be avoided. Our hope is to allow for deaths that are as meaningful as possible for both the elderly and the family members who survive them. (shrink)

Some commentators maintain that gestational surrogates are not ‘mothers’ in a way capable of grounding a claim to motherhood. These commentators find that the practices that constitute motherhood do not extend to gestational surrogates. We argue that gestational surrogates should be construed as mothers of the children they bear, even if they fully intend to surrender those children at birth to the care of others. These women stand in a certain relationship to the expected children: they live in changed moral (...) circumstances by reason of their pregnancy, and they engage in the practices said to define motherhood in the post‐birth context. By contrast, ovum donors and embryo donors are not similarly ‘mothers’ because they do not find themselves involved in these circumstances. Not all women involved in three‐parent in vitro fertilization qualify as mothers either. Given this analysis of mothering, we note that transmen who gestate children are engaged in mothering activity even if they otherwise function as a father to those children. By itself, this defence of the maternity of gestational surrogates does not confer moral title to the children they bear; gestation would not by itself override the contractual arrangements gestational surrogates have made regarding the disposition of their children. This interpretation of gestational surrogates as mothers does, however, undercut cultural understandings of these women as mere ‘vessels’, devoid of entitlement to respect as persons and parents. We also consider the meaning of mothering for ‘brain‐dead’ women kept alive to give birth and for the prospect of extracorporeal gestation. (shrink)

This paper will consider ethical issues arising from medical tort litigation. I will argue that deep changes are required to ensure fairness in litigation and in order to hold morally responsible those corporations that take unnecessary risks with consumers’ lives.

The law ordinarily recognises the woman who gives birth as the mother of a child, but in certain jurisdictions, it will recognise the commissioning couple as the legal parents of a child born to a commercial surrogate. Some commissioning parents have, however, effectively abandoned the children they commission, and in such cases, commercial surrogates may find themselves facing unexpected maternal responsibility for children they had fully intended to give up. Any assumption that commercial surrogates ought to assume maternal responsibility for (...) abandoned children runs contrary to the moral suppositions that typically govern contract surrogacy, in particular, assumptions that gestational carriers are not ‘mothers’ in any morally significant sense. In general, commercial gestational surrogates are almost entirely conceptualised as ‘vessels’. In a moral sense, it is deeply inconsistent to expect commercial surrogates to assume maternal responsibility simply because commissioning parents abandon children for one reason or another. We identify several instances of child abandonment and discuss their implications with regard to the moral conceptualisation of commercial gestational surrogates. We conclude that if gestational surrogates are to remain conceptualised as mere vessels, they should not be expected to assume responsibility for children abandoned by commissioning parents, not even the limited responsibility of giving them up for adoption or surrendering them to the state. (shrink)

Radical feminists have argued for both the radical potential of assisted reproductive technology (ART) and its oppressive and damaging effects for women. This paper will address the question of what constitutes a radical feminist position on ART; I will argue that the very debate over whether ART liberates or oppresses women is misguided, and that instead the issue should be understood dialectically. Reproductive technologies are neither inherently liberating nor entirely oppressive: we can only understand the potential and effects by considering (...) how they are actually taken up within a culture. The internal contradictions, tensions, and inconsistencies within ART and the way it is addressed within the law points to a dialectic that resists a simple reductivist understanding. (shrink)

This essay addresses feminist approaches to medical aid in dying (MAID), considering whether it is a practice that should be supported for women and other marginalized groups. Some feminists have raised rights and justice-based arguments in support of MAID; others have taken a care-based approach to suggest that the practice violates relationships of care and only worsens distrust between marginalized groups and the medical establishment. I argue that we need to adopt both justice and care approaches to develop a robust (...) feminist account of MAID. I defend a woman’s right to choose death in cases of terminal illness or suffering but argue that relational concerns of care, trust, and trustworthiness must be addressed at the same time to ensure that MAID is justly practiced and accessible to all those who want it. (shrink)

In this paper, I argue that thestatus of those who take care of persons withdisabilities, and persons with disabilities,are inextricably linked. That is, devaluingthe status of one necessarily devalues that ofthe other. Persons with disabilities and thosewho help care for them must form an alliance toadvance their common interests. This alliancecan gain insight and inspiration from feministthought insofar as caretaking is literallylinked to problems of the representation ofcaretaking as ``women's work,'' and morephilosophically, by borrowing from the toolboxof feminist social, political, (...) and economicanalyses. (shrink)

Abstractabstract:Birth certificates typically designate parents as "mothers" or "fathers," although some US states offer nongendered designations. The authors argue that gendered characterizations offer scant legal or moral value and that states should move to degender parental status on birth certificates but retain that information in registrations of birth. Registrations of birth identify the person giving birth to a child, when, and where, and they report demographic and health information useful for civic and public health purposes. Birth certificates typically report a (...) child's name, sex, date and location of birth, and parentage so far as known. As documents establishing parents' standing in relation to children and vice versa, as well as age and presumptive citizenship, birth certificates add no legal or moral value by gendering parents. Gendering parents on birth certificates obliges the state to rely on exclusionary criteria of "mother" and "father." By contrast, degendering parental status withdraws the need for such criteria and confers benefits on people with transgender and nonbinary identities, as well as undercutting any problematic presumption that parents have responsibilities to their children qua mother or qua father. (shrink)

I consider how a feminist account might address the practice of surrogacy in Japan, both domestically and in the transnational context. Japanese culture emphasizes traditional values, family heritage, and the value of reproduction. Japan offers an interesting case study, since surrogacy is currently under review, and the government is in the process of determining its stance on the practice. I will advocate for legal changes to how surrogacy is treated, suggesting that Japan should eliminate the koseki, or the Family Registration (...) Act, which stipulates that only birth parents may register children as their natural children. A principle of respect for women should be explicitly adopted in setting regulations or guidelines surrounding this practice; additionally, attempts should be made to address citizens’ reproductive needs domestically, thus reducing the global demand for these arrangements. (shrink)

Our 2021 article, "Dying Well in Nursing Homes During COVID-19 and Beyond: The Need for a Relational and Familial Ethic," addresses the response to the COVID-19 pandemic within nursing homes and the impact it had on the lives of residents, care providers, and families. We acknowledge that, at the height of the pandemic, when infection and death rates were soaring in these facilities, extreme "lockdown" measures may have been justified; but these measures resulted in significant relational costs. The collateral damage (...) caused by these lockdown measures included extreme isolation, loss of community, and experiences of confusion, depression, and mental decline for the elderly residents that... (shrink)

Some authors have advanced a contractual model to protect patient autonomy within the therapeutic relationship. Such a conception of the physician–patient relationship is intended to serve both parties by respecting patients' choices and preserving physician integrity. I critique this contractual view and offer an alternative, feminist contextualized approach to autonomy within the therapeutic relationship. This approach places the physician-patient relationship within a larger social context, and indicates the many social inequalities that render insupportable the notion of physicians and patients as (...) contracting equals. (shrink)

Birth certificates typically designate parents as ‘mothers’ or ‘fathers’ although some U.S. states offer non-gendered designations. We argue that gendered characterizations offer scant legal or moral value and that states should move to degender parental status on birth certificates but retain that information in registrations of birth. Registrations of birth identify the person giving birth to a child, when and where, and they report demographic and health information useful for civic and public health purposes. Birth certificates typically report a child’s (...) name, sex, date and location of birth, and parentage so far as known. As documents establishing parents’ standing in relation to children and vice versa, as well as age and presumptive citizenship, birth certificates add no legal or moral value by gendering parents. Degendering parents on birth certificates interferes with no social roles or identities. Gendering parents on birth certificates obliges the state to rely on exclusionary criteria of ‘mother’ and ‘father.’ By contrast, degendering parental status withdraws the need for such criteria and confers benefits on people with transgender and non-binary identities, as well as undercutting any problematic presumption that parents have responsibilities to their children qua mother or qua father. (shrink)

Bioethics in a Changing World is an introductory textbook for individuals who are new to the study of bioethics.This interdisciplinary field, which encompasses philosophy, religion, sociology, gerontology, psychiatry, biomedical science, law, and nursing (to name a few), has been rapidly growing and developing over the last half-century.In order to get a handle on what "doing" bioethics entails, it is helpful to start with the basic philosophical foundations of bioethical theory and then consider a variety of trenchant issues that arise from (...) the practice of medicine and the provision of health care services within an age of technology. In constructing this textbook, the central aim has been to guide readers in developing a clear sense of how theory and practice are linked in the dynamic field of bioethics.Though new problems and issues in bioethics are constantly arising, it is important to focus on the persistence of foundational questions that applyto new contexts. (shrink)

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)

This paper considers the issues surrounding women’s bare-breastedness and breastfeeding in public. I argue that women should have equal freedoms with men to bare their breasts in public, but not for the reasons commonly cited Proponents of “the public breast” tend to focus on the similarities between women’s and men’s breasts; I argue that the sameness versus difference debate is unhelpful in resolving this question. As I argue, women’s breasts differ from men’s in significant ways, and by dismissing these differences (...) we dismiss the possibility of women’s authentic breasted experience. Instead, I suggest that women share an equal interest with men in defining their sexuality: When women are denied the right to go topless or breastfeed in public, they are denied their own understandings of their breasts. (shrink)

Carolyn McLeod's book is timely and important, especially when one considers the state of conscientious objection in a country like the United States. During his presidency, Donald Trump announced an expanded "conscience rule" for healthcare workers according to which they would have the protected right to morally and religiously oppose a variety of procedures, including abortion, sterilization, assisted suicide, and other medical procedures. In 2019, a number of states, local governments, and healthcare organizations brought lawsuits against the proposed rule, leading (...) a federal judge to reject it. New York Attorney General Letitia James said the state of New York sued in part because the... (shrink)

This book analyzes practices in the home health care industry and concludes that they are highly exploitative of both workers and patients. Under the existing system, underpaid workers are expected to perform tasks for which they are inadequately trained, in unreasonably short periods of time. This situation harms workers and puts home health care patients at risk. To the extent that the majority of patients and workers in home health care are women, I turn to feminist ethics for an alternative (...) approach. Through an understanding of individuals as social beings with obligations to others, and of home health care as a public good, I explain how to develop the social benefits of good home health care and increase the role of government in providing financial support and regulatory oversight. (shrink)

In this thesis I argue that the received view of autonomy is insufficient for both biomedical ethics and feminist theory. I begin with an examination of the received view of autonomy; I then indicate the way in which this view of autonomy has been applied to health care ethics. A feminist relational approach to autonomy is explored: I argue that such an approach has many strengths in that it gives us a more accurate picture of the self-in-relationships and that it (...) recognizes many social and structural conditions that may impede an individual's attempts to be autonomous. ;This feminist relational approach to autonomy, once defined, is applied to the medical/social practices of cosmetic surgery and contract motherhood. I do this to show the practical implications of this contextual approach to autonomy. (shrink)