In this commentary, I will consider the implications of the argument made by Christopher Stratman (2020) in ‘Ectogestation and the Problem of Abortion’. Clearly, the possibility of ectogestation will have some effect on the ethical debate on abortion. However, I have become increasingly sceptical that the possibility of ectogestation will transform the problem of abortion. Here, I outline some of my reasons to justify this scepticism. First, that virtually everything we already know about unintended pregnancies, abortion (...) and adoption does not prima facie support the assumption that a large shift to ectogestation would occur. Moreover, if ectogestation does not lead to significant restrictions to abortion then there is unlikely to be any radical transformation of the practice of abortion. Second, abortion is already associated with stigma and so the presence of ectogestation would need to create additional stigma to modify behaviour. Finally, I argue that ectogestation shifts the debate away from the fetus to the human subject of the artificial womb—the gestateling. Therefore, creating a new category of killing—gestaticide—and this would only reorient the debate rather than end it. (shrink)

Bioethics scholarship considering the possibility of gestating an embryo to full term in an artificial womb (ectogenesis) often overstates the capacities of current technologies and underestimates the barriers to the development of full ectogenesis. Moreover, this debate causes harm by (1) neglecting more immediate problems in the development of artificial wombs, (2) treating abortion as a “problem with a technological solution,” bolstering anti-abortion rhetoric, and (3) presuming the stability of women’s reproductive rights. The ectogenesis conversation must consider anticipated (...) uses of the technology (neonatal intensive care) and acknowledge the immediate context (recognizing abortion as essential healthcare and existing reproductive inequities). (shrink)

Don Marquis has put forward a non-religious argument against abortion based on what he claims is a morally relevant similarity between killing adult human beings and killing fetuses. He asserts that killing adults is wrong because it deprives them of their valuable futures. He points out that a fetus’s future includes everything that is in an adult’s future, given that fetuses naturally develop into adults. Thus, according to Marquis, killing a fetus deprives it of the same sort of valuable (...) future that an adult is deprived of in being killed and this makes abortion seriously wrong. Commentators have raised a number of objections to Marquis’s argument, to which he has satisfactorily responded. In this paper, difficulties with Marquis’s argument that have not been considered by previous commentators are pointed out. A main thesis of this paper is that Marquis does not adequately defend his argument against several important objections that he himself has raised. These new considerations support the view that Marquis’s argument is unsuccessful. (shrink)

Recent animal research suggests that it may soon be possible to support the human fetus in an artificial uterine environment for part of a pregnancy. A technique of extending gestation in this way (“ectogestation”) could be offered to parents of extremely premature infants (EPIs) to improve outcomes for their child. The use of artificial uteruses for ectogestation could generate ethical questions because of the technology’s potential impact on the point of “viability”—loosely defined as the stage of pregnancy beyond which the (...) fetus may survive external to the womb. Several medical decisions during the perinatal period are based on the gestation at which infants are considered viable, for example decisions about newborn resuscitation and abortion, and ectogestation has the potential to impact on these. Despite these possible implications, there is little existing evidence or analysis of how this technology would affect medical practice. In this paper, we combine empirical data with ethical analysis. We report a survey of 91 practicing Australian obstetricians and neonatologists; we aimed to assess their conceptual understanding of “viability,” and what ethical consequences they envisage arising from improved survival of EPIs. We also assess what the ethical implications of extending gestation should be for newborn and obstetric care. We analyze the concept of viability and argue that while ectogestation might have implications for the permissibility of neonatal life‐prolonging treatment at extremely early gestation, it should not necessarily have implications for abortion policy. We compare our ethical findings with the results of the survey. (shrink)

In this article, I explicate Kant’s position on the wide right to abortion. That is, I explore the extent to which, according to Kant’s practical philosophy, abortion is punishable, even if it involves an unjust infringement of the right to life. By focusing on the state’s right to punish, rather than the right to life or the onset of personhood, I use Kant to expose a novel range of issues and questions about the legal status of abortion (...) (and criminal punishment more generally). The article is divided into four sections. In the first, I lay the groundwork for Kant’s theory of rights and briefly canvass some of the literature on Kantian approaches to abortion. In the second, I look at Kant’s discussion of equivocal rights. In the third, I turn to Kant’s discussions of capital punishment and suicide. In the fourth, I examine Kant on honor killings, and I use his position on infanticide in order to extrapolate and explain his ideas about the right to punish in the context of abortion. (shrink)

Currently, the preferred accommodation for conscientious objection to abortion in medicine is to allow the objector to refuse to accede to the patient’s request so long as the objector refers the patient to a physician who performs abortions. The referral part of this arrangement is controversial, however. Pro-life advocates claim that referrals make objectors complicit in the performance of acts that they, the objectors, find morally offensive. I argue that the referral requirement is justifiable, although not in the way (...) that people usually assume that it is. (shrink)

The debate regarding the role of conscientious objection in healthcare has been protracted, with increasing demands for curbs on conscientious objection. There is a growing body of evidence that indicates that in some cases, high rates of conscientious objection can affect access to legal medical services such as abortion—a major concern of critics of conscientious objection. Moreover, few solutions have been put forward that aim to satisfy both this concern and that of defenders of conscientious objection—being expected to participate (...) in the provision of services that compromise their moral integrity. Here we attempt to bring some resolution to the debate by proposing a pragmatic, long-term solution offering what we believe to be an acceptable compromise—a quota system for medical trainees in specialties where a conscientious objection can be exercised, and is known to cause conflict. We envisage two main objectives of the quota system we propose. First, as a means to introduce conscientious objection into countries where this is not presently permitted. Second, to minimise or eliminate the effects of high rates of conscientious objection in countries such as Italy, where access to legal abortion provision can be negatively affected. (shrink)

In a previous paper, I had argued that Strong’s counterexamples to Marquis’s argument against abortion—according to which terminating fetuses is wrong because it deprives them of a valuable future—fail either because they have no bearing on Marquis’s argument or because they make unacceptable claims about what constitutes a valuable future. In this paper I respond to Strong’s criticism of my argument according to which I fail to acknowledge that Marquis uses "future like ours" and "valuable future" interchangeably. I show (...) that my argument does not rely on not acknowledging that "future like ours" and "valuable future" are interchangeable; and that, rather, it is exactly by replacing "future like ours" with "valuable future" that I construct my argument against Strong. I conclude with some remarks on how Marquis’s concept of "future like ours" should be interpreted. (shrink)

Abortion is one of the most divisive topics in healthcare. Proponents and opponents hold strong views. Some health workers who oppose abortion assert a right of conscientious objection to it, a position itself that others find unethical. Even if allowance for objection should be made, it is not clear how far it should extend. Can conscientious objection be given as a reason not to refer when a woman requests her doctor to do so? This paper explores the idea (...) of the general practitioner (GP) who declines to make a direct referral for abortion, asking the woman to see another GP instead. The purpose is to defend the claim that an appeal to conscientious objection in this way can be reasonable and ethical. (shrink)

This article analyzes the comparative history of the law and practice of abortion and assisted reproduction in the United States to consider the interplay between medical paternalism and legal paternalism. It supplements existing critiques of paternalism as harmful to women's equality with the medical perspective, as revealed through the writings of Alan F. Guttmacher, to consider when legal regulation might be warranted.

Scholars have offered various critiques of Alberto Giubilini and Francesca Minerva's controversial article, ‘After-birth abortion: Why should the baby live?’ My book The Ethics of Abortion: Women's Rights, Human Life, and the Question of Justice presents four such critiques. First, Giubilini and Minerva argue from the deeply controversial to the even more controversial. Second, they presuppose a false view of personal identity called body-self dualism. Third, their view cannot secure human equality. And fourth, their account of harm cannot (...) account for harm found in some cases of murder. In the article, ‘Pro-life arguments against infanticide and why they are not convincing’, J. Räsänen examines and finds wanting these four critiques. This essay responds to Räsänen's defense of infanticide and argues that his responses to the four objections fail. (shrink)

In his ‘The Identity Objection to the future‐like‐ours argument’ (Bioethics, 2019, 33: 287–293), Brill argues that Marquis's 'future of value' account of the wrong of abortion is still vulnerable to the identity objection—the claim that the foetus and the later person are not numerically identical, so the later person's valuable experiences are not the foetus's future experiences—even if it is conceded that the future organism, as well as the person, has experiences. This is because the organism has these experiences (...) in a different way from the person. The person has them directly, and the organism has them only derivatively. This implies, he maintains, that the organism cannot be deprived of those experiences in a way that is wrong. Only the person can be deprived in this morally relevant way. But, I argue, if the organism genuinely has those experiences, it is not at all clear why its being deprived of them would be permissible. I argue that the reason why Brill can claim that having those experiences derivatively makes this moral difference is because the sense in which the organism has experiences is not a genuine sense. But that is a problem for this theory of personal identity, not for Marquis's account of the wrong of abortion. I also argue that supposing that one cannot morally harm the human organism has various implausible implications, which cast doubt on the idea that having experiences derivatively means that the organism is not morally harmed by being deprived of them. (shrink)

Conscientious objection to participating in induced abortion is not present in the Finnish health care system or legislation unlike in many other European countries.

I argue against responsibility arguments that offer a defence of abortion even on the assumption that the fetus is a person. I focus on argumentation originally offered by Judith Jarvis Thomson and then later defended by David Boonin. I offer thought experiments meant to show that, under certain conditions, one bears moral responsibility for creating a fetus. I then offer a positive argument for when one is morally responsible for the creation of a fetus. This argument relies on the (...) presence of other forms of sex that reasonably approximate the goods of penile-vaginal intercourse. Given the presence of these options, sexual partners who engage in penile-vaginal intercourse bear moral responsibility for the creation of the fetus. While I do not think this argument settles the abortion debate – there still may be other ways to successfully defend abortion – it does explain why responsibility arguments like those offered by Thomson fail. (shrink)

An overview of the philosophical and bioethics literature on conscientious refusals by health care professionals to provide abortion and contraceptive services.

Access to abortion care has been hugely affected by the COVID-19 pandemic. This has prompted several governments to permit the use of telemedicine for fully remote care pathways, thereby ensuring pregnant people are still able to access services. One such government is that of England, where these new care pathways have been publicly scrutinised. Those opposed to telemedical early medical abortion care have raised myriad concerns, though they largely centre on matters of patient safeguarding. It is argued that (...) healthcare professionals cannot adequately carry out their safeguarding duties if the patient is not in the room with them. These concerns lack empirical support. Emerging evidence suggests that safeguarding processes may, in fact, be more effective within telemedical abortion care pathways. In this article, we address two specific safeguarding concerns: (1) that a remote consultation prevents a healthcare professional from identifying instances of abuse, and (2) that healthcare professionals cannot reliably confirm the absence of coercion during a remote consultation. We demonstrate that such concerns are misplaced, and that safeguarding may actually be improved in telemedical care pathways as victims of abuse may find it easier to engage with services. It is inevitable that some individuals will fall through the net, but this is unavoidable even with in-person care and thus does not constitute a strong critique of the use of telemedicine in abortion care. These safeguarding concerns set aside, then, we argue that the current approval that enables telemedical early medical abortion should be afforded permanence. (shrink)

The overturn of Roe v. Wade has resulted in fewer rights and resources for people seeking abortion care, particularly in the South. The Hyde Amendment has historically restricted abortion access for those enrolled in Medicaid. We argue here that its guarantees of minimum abortion coverage should be leveraged to offset harms where possible.

This paper critically analyses conscientious objection to abortion in the context of the new regulation of pregnancy termination in Chile. It argues that adequate regulation should not be blind: The bioethical requirements that seek to balance the interests involved must consider the legal regulation of the interests at stake, the context in which they are implemented, and, fundamentally, the effectiveness of the solutions adopted. Attention should be paid to the risks involved in the political use of conscientious objection to (...) prevent the implementation of women’s reproductive rights. In describing the process of the entrenchment and expansion of conscientious objection to abortion in Chile, we show how this process has overprotected conscience and how the risks of undermining the effectiveness of the new abortion legislation hinder the enjoyment of rights entrenched by the law. (shrink)

Philosophy to the rescue -- What is the soul? -- Life begins at conception. So what? -- Abnormal human development -- Responsibility -- The potentiality argument -- The golden rule argument against abortion -- Rights of the pregnant woman -- Consequences -- Virtue ethics and conclusion.

I argue here that Beth Singer's analysis of rights as operative social norms allows us to make sense of the personal and political complexities of the abortion debate. In particular, I argue that it is only by means of Singer's analysis that we, as feminists, can reconcile our conviction that Carol Gilligan's celebration of empathy and partiality gestures toward something definitive of our moral experience with the need to avail ourselves of the politically efficacious language of rights.

This paper provides an overview of the development and the sociopolitical background of legislation pertaining to abortion in Finland from the nineteenth century to the current day. The first Abortion Act came to force in 1950. Before that, abortions were handled under criminal law. The 1950 law was restrictive and allowed abortions in very limited circumstances only. Its main aim was to reduce the number of abortions and especially illegal abortions. It was not very successful in reaching these (...) goals, but, significantly, it moved abortions from the realm of the criminal law to the hands of medical professionals. The birth of the welfare state and the prenatal attitudes of 1930s and 1940s Europe played their part in shaping the law. By late 1960s, with the rise of the women’s rights movement and other changes in society, there was pressure to change the outdated law. The new 1970 Abortion Act was broader and allowed abortions for limited social reasons too but left very limited, if any, room for a woman’s right to choose. After a citizen’s initiative in 2020, the year 2023 will see a significant amendment to the 1970 law; during the first 12 weeks of pregnancy, an abortion can be performed on the woman’s request alone. However, there is still a long way to go in terms of women’s rights and abortion laws in Finland. (shrink)

It is now a common opinion in Western countries that a child's impairment would probably place an unexpected burden on her parents, a burden that the parents have not committed themselves to dealing with. Therefore, selective abortion is in general a morally justified option for the parents. I argue that this view is based on biased information about the quality of life of individuals with impairments and their families. Also, a conscious decision to procreate should bring about conscious assent (...) to assuming obligations as a parent. This implies a duty of caring for any kind of child. Consequently, if the child's condition is not such that it would make its life not worth living, and if the parents live in an environment where they are able to provide their child and themselves an adequate well-being, they do not have a morally sufficient reason to terminate the pregnancy on the grounds of fetal abnormality. (shrink)

The paper investigates the significance of the question of the fetus's status as a person for resolving the moral issues of abortion. It considers and evaluates several proposed solutions to this question. It also attempts to explain how different questions about the permissibility of abortion are appropriate to discussions at different levels of decision-making: the pregnant woman, the health professional, and the social policy level. The author's own conclusions to all these questions are offered along with other popular (...) views. (shrink)

In Brazil, induced abortion in adolescents has been frequent in less-advantaged socioeconomic classes, and the vulnerability of these adolescents has not been addressed. Given this context, the present study sought to investigate the relationship between the practice of abortion and vulnerability in adolescents. This was a descriptive cross-sectional study of 201 adolescents who completed a structured questionnaire that allowed the analysis of variables with respect to intent to abort. The profile of the pregnant adolescents in the sample studied (...) was the following: average age, 16.1 years; stable partner; mulatas; did not use condoms during sexual relations; precocious with respect to their first sexual relations; and did not plan the pregnancy. According to the classification of the World Health Organization, 81.59% of the subjects‘ abortions were known to be induced. Twenty-one were vulnerable to induced abortion; of these, 13 reported forced sexual intercourse, of whom 8 reported that they had suffered associated violence. These results indicate that sexual violence and unwanted pregnancy subject adolescents to a context of greater vulnerability to induced abortion. Thus, it is suggested that this relationship should be considered from the perspective of bioethics and human rights, but always respecting the cultural values of the society in which the adolescents live, as well as their human dignity. (shrink)

I argue that David Boonin has failed in his attempt to undermine Donald Marquis's future-like-ours argument against abortion. I show that the ethical principle advanced by Boonin in his critique to that argument is unable, contrary to what he claims, to account for the wrongness of infanticide. Then I argue that Boonin's critique misrepresents Marquis's argument. Although there is a way to restate his critique in order to avoid the misrepresentation, the success of such restatement is precluded by the (...) wrongness of infanticide. (shrink)

In “Abortion and Ownership” John Martin Fischer argues that in Judith Jarvis Thomson’s violinist case you have a moral obligation not to unplug yourself from the violinist. Fischer comes to this conclusion by comparing the case with Joel Feinberg’s cabin case, in which he contends a stranger is justified in using your cabin to stay alive. I argue that the relevant difference between these cases is that while the stranger’s right to life trumps your right to property in the (...) cabin case, the violinist’s right to life does not trump your right to liberty in the violinist case. (shrink)