Reproductive Ethics, Misc

In the future, full ectogestation – in which artificial placenta technology would be used to carry out the entirety of gestation – could be an alternative to human pregnancy. This article analyzes some underexplored objections to ectogestation which relate to the possibility for new and continuing forms of social oppression. In particular, we examine whether ectogestation could be linked to an unwarranted de-valuing of certain aspects of female reproductive embodiment, or exacerbate objectionable kinds of scrutiny over the reproductive choices of (...) gestating persons. Without discounting the potential benefits of full ectogestation, we conclude that the socially oppressive potential of ectogestation, on top of other concerns, warrants further critical ethical reflection. (shrink)

Some responses to analogies between abortion and infanticide appeal to Judith Jarvis Thomson's argument for the permissibility of abortion. I argue that these responses fail because a parallel argument can be constructed for the permissibility of infanticide. However, an argument on the grounds of a right to choose to become a parent can maintain that abortion is permissible but infanticide is not by recognizing the normative significance and nature of parenthood. -/- Certaines réponses aux analogies entre l'avortement et l'infanticide font (...) appel à l'argument de Judith Jarvis Thomson en faveur de la licéité morale de l'avortement pour désamorcer ces analogies. Je soutiens que ces réponses échouent parce qu'un argument parallèle peut être construit en faveur de la licéité de l'infanticide. Cependant, un argument reposant sur le droit de choisir de devenir parent permet de soutenir que l'avortement est autorisé mais que l'infanticide ne l'est pas en reconnaissant le sens et la nature normatifs de la parentalité. (shrink)

I consider cases of multifetal pregnancy in which one fetus with a fatal birth defect poses a risk to the survival of another healthy fetus to show that the substance view anti-abortion position leads to a contradiction. In cases of complicated multifetal pregnancy, if intervention by selective abortion to terminate the defective fetus is not performed, both fetuses will die due to the conditions created by the defective fetus’s fatal birth defect. Because abortion is wrong on the anti-abortion position, and (...) a moderate anti-abortion position cannot make an exception for selective abortion in cases of complicated multifetal pregnancy if it operates on the substance view, choosing selective abortion must be wrong, so one must let both fetuses die. However, the substance view anti-abortion position must take letting both fetuses die to be wrong, otherwise it will undermine itself as an anti-abortion position. Further, the substance view provides grounds for why letting fetuses die would be wrong anyway. Thus, the substance view anti-abortion position must take both having an abortion and not having an abortion to be wrong, which is a contradiction. Therefore, cases of complicated multifetal pregnancy show that the substance view anti-abortion position is false. (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)

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. And so abortion is typically wrong—and this holds whether or not fetuses are persons.

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)

This special issue of the Journal of Medicine and Philosophy focuses on unintended intrauterine death (UID) and preterm delivery (both phenomena that are commonly—and unhelpfully—referred to as “miscarriage,” “spontaneous abortion,” and “early pregnancy loss”). In this essay, I do two things. First, I outline contributors’ arguments. Most contributors directly respond to “inconsistency arguments,” which purport to show that abortion opponents are unjustified in their comparative treatment of abortion and UID. Contributors to this issue show that such arguments often rely on (...) a grossly oversimplified picture of abortion opponents’ views. Furthermore, contributions in this issue weigh in on issues regarding UID with theoretical import and therapeutic implication beyond the inconsistency argument debate. These papers can be mined for principles that better inform us about anembryonic pregnancies (i.e., nonviable pregnancies in which a gestational sac exists but no embryonic pole can be seen via transvaginal ultrasound), UID-prevention research, the law concerning UID (especially post-Dobbs), policies for handling embryonic remains, and moral psychology as it relates to UID, emotion, and empathy. In each case, conceptual philosophical analysis might bring about therapeutic benefits for those affected by UID. Philosophers, therefore, are in position not only to provide clarity—careful analysis and discussion of UID and related phenomena—but are also in position to genuinely help people affected by UID. (shrink)

The question of how disability affects wellbeing has occupied a number of philosophers in recent years. However, this literature has proceeded without a careful examination of the fairly vast empirical research on the topic. In this paper, I review the scholarly literature and discuss some philosophically-relevant aspects of it. On average, those with disabilities have a significantly lower level of wellbeing than those without disabilities. Furthermore, there is strong evidence that this reduction in wellbeing is not due entirely to ableist (...) factors. Hence, I argue that it shows that the Mere Difference View of disability is most likely false. However, the literature indeed shows that disabled people typically live good lives. Thus, despite its rejection of the Mere Difference View, it still upholds a disability-affirmative view. These findings allow for a measured critique of some of Peter Singer’s writings on disability. (shrink)

We explain libertarian thought about family and children, including controversial issues in need of serious attention. To begin our discussion of marriage, we distinguish between procedural and substantive contractarian approaches to marriage, each endorsed by various libertarians. Advocates of both approaches agree that it is a contract that makes a marriage, not a license, but disagree about whether there are moral limits to the substance of the contract with only advocates of the substantive approach accepting such. Either approach, though, offers (...) advantages over the current licensing system, so we discuss paths from that to a contractarian system. We also discuss the concept of marriage itself, the ages of consent for marriage, sexual activity, and reproduction, as well as how marriages can be dissolved, and coercion that sometimes occurs in marriage. We then turn to children. We first discuss reproductive freedom and then discuss the moral relationship between children and parents, especially considering stewardship, propertarian, and best interests approaches (we also touch on anti-natalism). One of the biggest issues facing parents is how to properly raise and educate children; we discuss this in depth and consider the sort of schooling that should be offered in a free society. Since children lack the requisite ability to consent, they cannot choose their education; how to respond to this is of the utmost importance for libertarians. As we note, the same issue of consent looms large for many forms medical treatment of children. (shrink)

Controversially, psychologist and public intellectual Jordan Peterson advises “enforced monogamy” for societies with high percentages of “incels.” As Peterson’s proposal resonates in manosphere circles, this chapter reconstructs and briefly evaluates the argument for it. Premised on the moral importance of civilizational sustainability, advocates argue that both polygamous and socially monogamous but sexually liberal mating patterns result in unsustainable proportions of unattached young men. Given the premises, monogamous societies are probably justified in maintaining their anti-polygamist social and legal norms. The case (...) for imposing stricter sexual norms on socially monogamous but sexually liberal societies is weaker, however, as male involuntary celibacy in those places isn’t as directly caused by male intrasexual competition, and since less intrusive social interventions are more likely to ameliorate “the incel problem.”. (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)

In this discussion note on Michal Pruski and Richard C. Playford’s “Artificial Wombs, Thomson and Abortion – What Might Change?,” I consider whether the prospect of ectogenesis technology would make abortion impermissible. I argue that a Thomson-style defense may not become inapplicable due to the right to life being conceived as a negative right. Further, if Thomson-style defenses do become inapplicable, those who claim that ectogenesis would be an obligatory alternative to abortion cannot do so without first showing that fetuses (...) have a right to life, something that Thomson assumed rather than argued for. I also include a discussion on ethical problems concerning what to do about children born from artificial wombs put there by those who looked to terminate their pregnancies because they sought to avoid parenthood. (shrink)

Could it be that if a fetus is not a person abortion is still immoral? One affirmative answer comes in the form of ‘The Impairment Argument’, which utilizes ‘The Impairment Principle’ to argue that abortion is immoral even if fetuses lack personhood. I argue ‘The Impairment Argument’ fails. It is not adequately defended from objections, and abortion is, in fact, a counterexample to the impairment principle. Furthermore, it explains neither what the wrong-making features of abortion are nor what features of (...) fetuses ground their supposed moral significance. By presupposing the fetus lacks personhood and providing no alternate account of the basis of fetuses’ moral significance, there is nothing to constitute abortion’s wrongness. Attempts to modify it fail for the same reasons. Thus, the impairment argument fails to show abortion is immoral. (shrink)

Some opponents of abortion claim that fetuses are persons from the moment of conception. Following Berg (2017), let us call these individuals “Personhood-At-Conception” (or PAC), opponents of abortion. Berg argues that if fetuses are persons from the moment of conception, then miscarriage kills far more people than abortion. As such, PAC opponents of abortion face the following dilemma: They must “immediately” and “substantially” shift their attention, resources, etc., toward preventing miscarriage or they must admit that they do not actually believe (...) that fetuses are persons from the moment of conception (or, at least, they must recognize that they are not acting in ways that are consistent with this belief). In this essay, I show that Berg’s argument fails at each step. Specifically, after outlining her argument (in section 1), I consider the central claim of Berg’s style of argument: That “miscarriage…is much deadlier than abortion.” In section 2, I argue that this claim is false (when taken literally) and misleading otherwise. In section 3, I show that Berg’s style of argument is identical in structure to a criticism that is sometimes levied against the recent “Black Lives Matter” movement. In the latter context, the argument has been vehemently rejected. I argue that Berg’s style of argument should be rejected for the same reasons. Finally, in section 4, I show that Berg’s suggestion that opponents of abortion should divert “substantial” amounts of money and attention to miscarriage prevention faces two problems. First, these claims are made without any evidence regarding the actual priorities and spending habits of PAC opponents of abortion. If we are told “not enough is being done,” one wonders: What is being done and how much counts as “enough”? Berg gives no answer to either question. Second, even if it is true that opponents of abortion do not pay substantial attention to miscarriage prevention, Berg fails to notice that this may be for good reason. I conclude that PAC opponents of abortion do not face the dilemma that Berg presents. (shrink)

Rob Lovering has developed an interesting new critique of views that regard embryos as equally valuable as other human beings: the moral argument for frozen human embryo adoption. The argument is aimed at those who believe that the death of a frozen embryo is a very bad thing, and Lovering concludes that some who hold this view ought to prevent one of these deaths by adopting and gestating a frozen embryo. Contra Lovering, we show that there are far more effective (...) strategies for preserving the lives of frozen embryos than adoption. Moreover, we point out that those who regard the deaths of frozen embryos as a very bad thing will generally regard the deaths of all embryos as a very bad thing, whether they are discarded embryos, aborted embryos or embryos that spontaneously abort. This entails these other embryos must be taken into account when considering moral obligations, as well as other human lives at risk from preventable causes. (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)

Opponents of abortion are often described as ‘inconsistent’ (hypocrites) in terms of their beliefs, actions and/or priorities. They are alleged to do too little to combat spontaneous abortion, they should be adopting cryopreserved embryos with greater frequency and so on. These types of arguments—which we call ‘inconsistency arguments’—conform to a common pattern. Each specifies what consistent opponents of abortion would do (or believe), asserts that they fail to act (or believe) accordingly and concludes that they are inconsistent. Here, we show (...) that inconsistency arguments fail en masse. In short, inconsistency arguments typically face four problems. First, they usually fail to account for diversity among opponents of abortion. Second, they rely on inferences about consistency based on isolated beliefs shared by some opponents of abortion (and these inferences often do not survive once we consider other beliefs opponents of abortion tend to hold). Third, inconsistency arguments usually ignore the diverse ways in which opponents of abortion might act on their beliefs. Fourth, inconsistency arguments criticise groups of people without threatening their beliefs (eg, that abortion is immoral). Setting these problems aside, even supposing inconsistency arguments are successful, they hardly matter. In fact, in the two best-case scenarios—where inconsistency arguments succeed—they either encourage millions of people to make the world a (much) worse place (from the critic’s perspective) or promote epistemically and morally irresponsible practices. We conclude that a more valuable discussion would be had by focusing on the arguments made by opponents of abortion rather than opponents themselves. (shrink)

Transhumanism is a movement that seeks to transcend certain limitations inherent in the human condition as we know it. But does it justify overriding the dignity of current human beings in order to satisfy the desire to increase human potential and improve human beings as such, in order to obtain other human beings? Does it justify disregarding the dignity of women in order to obtain new human beings through fertilization? To answer these questions, we have made a sweep over the (...) ideas of transhumanism that drive this type of techniques, to later understand the vision that women have in the use of in vitro fertilization, the hidden discrimination under these procedures and the clarification of the true emancipation and restoration of women's rights in relation to the use of in vitro fertilization. -/- El transhumanismo es un movimiento que busca trascender ciertos límites inherentes a la condición humana como la conocemos. Sin embargo, ¿justifica dejar de lado la dignidad de los seres humanos actuales por cumplir el deseo de aumentar el potencial humano y mejorar al ser humano como tal para obtener otros seres humanos?, ¿justifica pasar por encima de la dignidad de una mujer para obtener nuevos seres humanos a través de la fertilización in vitro? Para responder a estas preguntas hemos hecho un barrido sobre las ideas del transhumanismo que impulsa este tipo de técnicas, para luego comprender la visión que se tiene de la mujer en el uso de la fertilización in vitro, la discriminación oculta bajo estos procedimientos y la aclaración de la verdadera emancipación y restablecimiento de los derechos de la mujer en relación con el uso de la fertilización in vitro. (shrink)

It has recently been argued that reproductive genetic manipulation technologies like mitochondrial replacement and germline CRISPR modifications cannot be said to save anyone’s life because, counterfactually, no one would suffer more or die sooner absent the intervention. The present article argues that, on the contrary, reproductive genetic manipulations may be life-saving (and, from this, have therapeutic value) under an appropriate population health perspective. As such, popular reports of reproductive genetic manipulations potentially saving lives or preventing disease are not necessarily mistaken, (...) though such terminology still requires further empirical validation. (shrink)

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)

In this paper, I will present the empirical version of the slippery slope argument (SSA) in the field of genome editing. According to the SSA, if we adopt germline manipulation of embryos we will eventually end up performing or allowing something morally reprehensible, such as new coercive eugenics. I will investigate the actual possibility of sliding towards eugenics: thus, I will examine enhancement and eugenics both in the classical and liberal versions, through the lens of SSA. In the first part, (...) I will discuss the classical eugenics from a historical perspective and conclude that classical eugenics is morally deplorable; but by currently accepting genome editing I argue that it is not possible to ‘slip’ into classical eugenics. Then, I will analyze liberal eugenics: I will consider Habermas’ and Sandel’s objections to liberal eugenics and genetic human enhancement. Subsequently, I will reply to these arguments affirming that, although it is not possible to refuse any form of genetic enhancement, liberal eugenics would not consider the principles of justice, non-maleficence, and non-instrumentalization; hence, it should be considered not morally acceptable. In addition, I will support the thesis according to which the possibility of relapsing into liberal eugenics is more likely than relapsing into classical eugenics. Then, I will present a strategy that, while avoiding falling into the undesirable scenarios related to SSA, still accepts some application of germline genome editing of embryos and gametes. In such a way, I will show that even if we accept the plausibility of a certain slip into an undesirable scenario, SSA does not offer conclusive reasons to forbid any use of germline genome editing technique in both therapeutic and enhancement fields. (shrink)

The dominant framework for addressing procreative ethics has revolved around the notion of harm, largely due to Derek Parfit’s famous non-identity problem. Focusing exclusively on the question of harm treats what procreators owe their offspring as akin to what they would owe strangers (if they owe them anything at all). Procreators, however, usually expect (and are expected) to parent the persons they create, so we cannot understand what procreators owe their offspring without also appealing to their role as prospective parents. (...) I argue that prospective parents can wrong their future children just by failing to act well in their role as parents, whether or not their offspring are ultimately harmed or benefitted by their creation. Their obligations as prospective parents bear on the motivations behind their reproductive choices, including the choice to select for some genetic trait in their offspring. Even when procreators’ motivations aren’t malicious, or purely selfish, they can still fail to recognize and act for the end of the parental role. Procreators can wrong their offspring by selecting for some genetic trait, then, when doing so would violate their obligations as prospective parents, or when their motivation for doing so is antithetical to the end of the parental role. (shrink)

Recently, I argued that human subjects in artificial wombs (AWs) “share the same moral status as newborns” and so, deserve the same treatment and protections as newborns. This thesis rests on two claims: (A) “Subjects of partial ectogenesis—those that develop in utero for at time before being transferred to AWs—are newborns,” and (B) “Subjects of complete ectogenesis—those who develop in AWs entirely—share the same moral status as newborns.” In response, Elizabeth Chloe Romanis argued that the subject in an AW is (...) “a unique human entity…rather than a fetus or a newborn.” She provides four lines of response to my essay. First, she argues that I have “misconstrued” what birth is. Once we correct that error, it becomes clear that subjects of partial ectogenesis have not been born. Second, she argues that my claims imply that non-implanted embryos (existing in vivo) “would also be ‘born.’” But that is absurd. Third, she claims I fail to “meaningfully respond” to distinctions she draws between subjects of ectogenesis and neonates. Finally, she criticizes my essay for focusing on subjects of AWs rather than focusing on pregnant persons (who should be at the “centre” of debates over AWs). I respond to each of these charges. In doing so, I reaffirm that (contra Romanis) some subjects of ectogenesis are newborns and all subjects of ectogenesis—even those that have not been born—share the same moral status as newborns. (shrink)

In recent years, multifetal pregnancy reduction (MFPR) has increasingly been the subject of debate in Norway, and the intensity reached a tentative maximum when Legislation Department delivered the interpretative statement § 2 - Interpretation of the Abortion Act in 2016 in response to the Ministry of Health (2014) requesting the Legislation Department to consider whether the Law on abortion allows for MFPR of healthy fetuses in multiple pregnancies. The Legislation Department concluded that current abortion laws allow MFPR within the framework (...) the law otherwise stipulates. The debate has not subsided, and during autumn 2018, it was further intensified in connection with the Christian Democrat "crossroads" and signals from the Conservatives to consider removing §2.3c and to forbid MFPR. -/- Many of the arguments in the MFPR debate appear seemingly similar to arguments pending in the general abortion debate, and an analysis of what sets MFPR apart from other abortions is wanting. The aim of this article is, therefore, to examine whether there is a moral distinction between abortion and MFPR of healthy fetuses. We will cover the typical arguments of the Norwegian debate, and highlight them with scholarly articles from the literature. The most important arguments against MFPR that we have identified we have dubbed the harm argument, slippery-slope argument, intent argument, grief argument, psychological long-term effects for the woman and sorting argument. We conclude that counter-arguments do not measure up in terms of detecting a morally relevant difference between MFPR of healthy fetuses and abortions. Our conclusion is therefore that—despite what several debaters seem to think—there is no morally relevant difference between the two. Therefore, when we allow abortion, we should also allow MFPR. (shrink)

In the United States, roughly 1 out of 4 births takes place at a hospital certified as Baby-Friendly. This paper offers a multi-disciplinary perspective on the Baby-Friendly Hospital Initiative (BFHI), including empirical, normative, and historical perspectives. Our analysis is novel in that we trace how medical practices of “quality improvement,” which initially appear to have little to do with breastfeeding, may have shaped the BFHI. Ultimately, we demonstrate that a rich understanding of the BFHI can be obtained by tracing how (...) norms of gender/motherhood interact with, and are supplemented by, other normative, historical, and institutional realities. We conclude with suggestions for practical revisions to the BFHI. (shrink)

In this paper I look at the much-discussed case of disabled parents seeking to conceive disabled children. I argue that the permissibility of selecting for disability does not depend on the precise impact the disability will have on the child’s wellbeing. I then turn to an alternative analysis, which argues that the permissibility of selecting for disability depends on the impact that disability will have on the child’s future opportunities. Nearly all bioethicists who have approached the issue in this way (...) have argued that disabilities like deafness unacceptably constrain a child’s opportunities. I argue, however, that this conclusion is premature for several reasons. Most importantly, we don’t have a good way of comparing opportunity sets. Thus, we can’t conclude that deaf children will grow up to have a constrained set of opportunities relative to hearing children. I conclude by suggesting that bioethicists and philosophers of disability need to spend more time thinking carefully about the relationship between disability and opportunity. (shrink)

A new reprogenetic technology, mitochondrial replacement, is making its appearance and, unsurprisingly given its promise to wash off our earthly stains --or at least the scourges of sexual reproduction--, John Harris finds only reasons to celebrate this new scientific feat.1 In fact, he finds mitochondrial replacement techniques (MRTs) so “unreservedly welcome” that he believes those who reject them suffer from “a large degree of desperation and not a little callousness.”2 Believing myself to be neither desperate nor callous, but finding myself (...) also no closer at all – not even after reading his article—to following Harris in welcoming these technologies wholeheartedly, it seems appropriate to respond. (shrink)

In this article, I address what kinds of claims are of the right kind to ground conscientious refusals. Specifically, I investigate what conceptions of moral responsibility and moral wrongness can be permissibly presumed by conscientious objectors. I argue that we must permit HCPs to come to their own subjective conclusions about what they take to be morally wrong and what they take themselves to be morally responsible for. However, these subjective assessments of wrongness and responsibility must be constrained in several (...) important ways: they cannot involve empirical falsehoods, objectionably discriminatory attitudes, or unreasonable normative beliefs. I argue that the sources of these constraints are the basic epistemic, relational, and normative competencies needed to function as a minimally decent health-care professional. Finally, I consider practical implications for my framework, and argue that it shows us that the objection raised by the plaintiffs in Zubik v. Burwell is of the wrong sort. (shrink)

This paper comes out of a panel honoring the work of Anne Donchin (1940-2014), which took place at the 2016 Congress of the International Network on Feminist Approaches to Bioethics (FAB) in Edinburgh. My general aim is to highlight the contributions Anne made to feminist bioethics, and to feminist reproductive ethics in particular. My more specific aim, however, is to have a kind of conversation with Anne, through her work, about whether reproductive justice could demand insurance coverage for in vitro (...) fertilization. I quote liberally from Anne’s work for this purpose, but also to shower the reader with her words, reminding those of us who knew her well what a wonderful colleague she was. (shrink)

Sterilisation requests made by young, childfree adults are frequently denied by doctors, despite sterilisation being legally available to individuals over the age of 18. A commonly given reason for denied requests is that the patient will later regret their decision. In this paper I examine whether the possibility of future regret is a good reason for denying a sterilisation request. I argue that it is not and hence that decision-competent adults who have no desire to have children should have their (...) requests approved. It is a condition of being recognised as autonomous that a person ought to be permitted to make decisions that they might later regret, provided that their decision is justified at the time that it is made. There is also evidence to suggest that sterilisation requests made by men are more likely to be approved than requests made by women, even when age and number of children are factored in. This may indicate that attitudes toward sterilisation are influenced by gender discourses that define women in terms of reproduction and mothering. If this is the case, then it is unjustified and should be addressed. There is no good reason to judge people’s sterilisation requests differently in virtue of their gender. (shrink)

Browne 1 (this issue ) argues that what may appear to be a benevolent practice-disclosing the sex of a fetus to expecting parents who wish to know-is in fact an epistemically problematic and, as a result, ethically questionable medical practice. Browne worries that not only will the disclosure of fetal sex encourage sex-selective abortions (an issue we will not take up here), but also that it will convey a misleading and pernicious message about the relationship between sex and gender. More (...) specifically, she contends that the practice of disclosure is problematic because (1) it purports to establish the gender of the developing baby based on information about the baby's sex, whereas this is not a warranted inference because while sex is determined by biological factors, gender is determined by social factors and (2) it conflates (biological) sex with (social) gender or encourages such conflation or reduction and thereby promotes 'essentialistic' thinking about gender that is closely linked to sexism and social injustice. If (1) is true, then disclosing fetal sex amounts to misinforming or misleading prospective parents-and since misinforming patients is wrong, the act of disclosing is also wrong. However, beyond the wrongs of misinforming patients, the practice also perpetuates the harms associated with a rigidly gendered society through endorsing the message in (2), thus lending the authority of the medical profession to the gender-essentialist ideas that have underpinned, and continue to drive, sexism and social injustice. This analysis leads Browne to recommend that clinicians be prohibited from informing parents about the sex of their developing fetus. -/- We agree with Browne that gender essentialism-the notion that 'femaleness' and 'maleness' carve out distinct natural classes with innate, immutable properties-is not only a false metaphysical thesis, but also a pernicious idea insofar as the sexist attitudes it fosters motivate policies that systematically violate the human rights of women, as well as those of the LGBTQ community. However, we do not think that the disclosure of fetal sex misinforms prospective parents about the gender of their baby, nor do we believe that such disclosure presupposes or promotes gender essentialism properly understood. (shrink)

Religion has a considerable influence over the public’s attitudes towards science and technologies. The objective of the paper is to understand the ethical and religious problems concerning the use of embryo for research in assisting conception for infertile couples from the perspective of Catholic Christians. This paper seeks to explain our preliminary reflections on how religious communities particularly the Catholic Christian communities respond to and assess the ethics of reproductive technologies and embryo research. Christianity as a whole lacks a unified (...) and definitive statement on when an embryo becomes a person, although fundamentalist Christians tend to be opposed to embryo experimentation. Roman Catholics tend to believe that the embryo should be treated as human life from the moment of conception or fertilisation. As opposed to this preconception I have tried to point out that a foetus is a clump of cells and lacks individuality as a conscientious human being and thus can be used for research for therapeutic reason. The paper concluded that the Church accepts techniques on embryo that respect their life. So they would allow procedures that are akin with healing and improvement of life without involving undue risks. The Church feels children should arise out of act of love between man and his wife in co-operation with God. In this regard, it may be pointed out though the creation of a child through a conjugal act in a wed lock is the preferred method since it is the most natural, least expensive one. But that does not mean, it should be the only acceptable means to conception. To state a child born using ARTs would be less perfect compared to a child born through conjugal act of husband and wife is absurd one to be mentioned. (shrink)

The use of modern medical technologies and interventions involves ethical and legal dilemmas which are yet to be solved. For the religious Jews the answer lies in Halakhah. The objective of this paper is to unscramble the difficult conundrum possessed by the halakhalic standing concerning the use of human embryonic cell for research. It also aims to take contemporary ethical issues arising from the use of technologies and medical advances made in human reproduction and study them from an abstract philosophical (...) perspective. Instead of providing any Jewish practical ruling the paper have tried to incite, stimulate and encourage philosophical thoughts about the issue through the intensive understanding of traditional Jewish thoughts. In this paper, an objective as well as a deep-rooted study has been adopted about the use of human embryos for research and the Jewish adoption of assisted reproductive technologies through the prism of the knowledge of Halakhah, Torah and Talmud. The paper finds that the embryo research sits at the crossroads of many halakhalic issues. Judaism adopts the belief that God has created man in his own image. The Jews not being dogmatic decipher “the image” of the creator as the ability to discern and reason. It follows that Judaism does not subscribe to the notion that tampering with nature is prohibited. To the Jews the mitzvah for procreation is so great that they are open to reason and adopt newer medical advancement in procreation. The Jewish laws are not only for engagement in intellectual exercise or academic pursuit but subscribe to a higher order of moral conduct. The Jewish approach is not situational but also casuistic in resolving conflicting medical issues. (shrink)

According to the Donohue-Levitt hypothesis, the legalization of abor- tion in the United States in the 1970s explains some of the decrease in crime in the 1990s. In this paper, I challenge this hypothesis. First, I argue against the intermediate mechanisms whereby abortion in the 1970s is supposed to cause a decrease in crime in the 1990s. Second, I argue against the correlations that sup- port this causal relationship.

The Deaf culture in the United States is a unique culture that is not widely understood. To members of the Deaf community in the United States, deafness is not viewed as a disease or pathology to be treated or cured; instead it is seen as a difference in human experience. Members of this community do not hide their deafness; instead they take great pride in their Deaf identity. The Deaf culture in the United States is very communitarian not individualistic. Mary (...) Beth and Dominic are a married couple in their late 20s who are genetically deaf. They are active members in the Deaf community and work as advocates for individuals who are deaf, family members of Deaf people and sign language interpreters who identify with the Deaf culture. Mary Beth and Dominic approach the fertility clinic with a request that they only want a child with the genetic gene for deafness. They would want the embryos that do not have the gene to be destroyed. This would entail creating a child who would have the gene for deafness. Medically and ethically, should the fertility clinic agree to the couple’s request? The authors argue that the couple's request should be denied and provide reasons for it from the perspectives of foundational and clinical ethics. (shrink)

I review this report of an old medical congress on reproductive medicine. Much has happened in the 17 years since its publication but the most urgent task of preventing further population growth has largely failed on a global scale. I try to bring it up to date and briefly discuss the inexorable disaster coming as the world population passes 11 billion in the 22nd century. -/- Those wishing a comprehensive up to date framework for human behavior from the modern two (...) systems view may consult my book ‘The Logical Structure of Philosophy, Psychology, Mind and Language in Ludwig Wittgenstein and John Searle’ 2nd ed (2019). Those interested in more of my writings may see ‘Talking Monkeys--Philosophy, Psychology, Science, Religion and Politics on a Doomed Planet--Articles and Reviews 2006-2019 3rd ed (2019), The Logical Structure of Human Behavior (2019), and Suicidal Utopian Delusions in the 21st Century 4th ed (2019). (shrink)

Mitochondrial DNA (mtDNA) diseases are a group of neuromuscular diseases that often cause suffering and premature death. New mitochondrial replacement techniques (MRTs) may offer women with mtDNA diseases the opportunity to have healthy offspring to whom they are genetically related. MRTs will likely be ready to license for clinical use in the near future and a discussion of the ethics of the clinical introduction ofMRTs is needed. This paper begins by evaluating three concerns about the safety of MRTs for clinical (...) use on humans: (1) Is it ethical to use MRTs if safe alternatives exist? (2) Would persons with three genetic contributors be at risk of suffering? and (3) Can society trust that MRTs will be made available for humans only once adequate safety testing has taken place, and that MRTs will only be licensed for clinical use in a way that minimises risks? It is then argued that the ethics debate about MRTs should be reoriented towards recommendingways to reduce the possible risks of MRT use on humans. Two recommendations are made: (1) licensed clinical access to MRTs should only be granted to prospective parents if they intend to tell their children about their MRT conception by adulthood; and (2) sex selection should be used in conjunction with the clinical use ofMRTs, in order to reduce transgenerational health risks. (shrink)

Jurgen Habermas has argued that carrying out pre-natal germline enhancements would be inimical to the future child's autonomy. In this article, I suggest that many of the objections that have been made against Habermas' arguments by liberals in the enhancement debate misconstrue his claims. To explain why, I begin by explaining how Habermas' view of personal autonomy confers particular importance to the agent's embodiment and social environment. In view of this, I explain that it is possible to draw two arguments (...) against germline enhancements from Habermas' thought. I call these arguments ‘the argument from negative freedom’ and ‘the argument from natality’. Although I argue that many of the common liberal objections to Habermas are not applicable when his arguments are properly understood, I go on to suggest ways in which supporters of enhancement might appropriately respond to Habermas' arguments. (shrink)

La FIV puede llevar aparejada la acumulación de embriones humanos excedentes. Aunque la ley prevé varios posibles destinos, las clínicas de reproducción asistida, que con frecuencia han de decidir qué hacer con ellos, buscan criterios para hacerlo de la forma más razonable posible. Este trabajo pretende aportar razones jurídicas y éticas que ayuden a esa decisión.

This article discusses an anomaly in the English law of reproductive liability: that is, an inconsistency between the law’s approach to wrongful life claims and its approach to cases of negligent selection of gametes or embryos in infertility treatments (the selection cases). The article begins with an account of the legal position, which brings into view the relevant inconsistency: while the law treats wrongful life claims as non- actionable, it recognises a cause of action in the selection cases, although the (...) selection cases bear a relevant resemblance to wrongful life claims. The article then considers arguments that may be invoked in an attempt to reconcile the above two strands of the law. Three of these counterarguments consist in attempts to distinguish the selection cases from wrongful life claims. It is argued that these attempts fail to reveal a valid basis for treating these situations differently. A fourth possible counterargument levels against the present analysis a charge of reductio ad absurdum. It is shown that this argument suffers from a fundamental flaw caused by confusion between different senses of the term “identity”. Finally, the article discusses possible changes to the legal position that could rectify the problem. It argues that one of these changes, which focuses on legal redress for violation of personal autonomy, is particularly apt to resolve the problem at hand, but also highlights the need for further inquiry into the broader implications of introducing this form of redress into the law of torts. (shrink)

The process of adopting a child is “not for the faint of heart.” This is what we were told the first time we, as a couple, began this process. Part of the challenge lies in fulfilling the licensing requirements for adoption, which, beyond the usual home study, can include mandatory participation in parenting classes. The question naturally arises for many people who are subjected to these requirements whether they are morally justified. We tackle this question in this paper. In our (...) view, while strong reasons exist in favour of licensing adoptive parents, these reasons support the licensing not only of adoptive parents, but of all or some subset of so-called “natural” parents as well. We therefore conclude that the status quo with respect to parental licensing, according to which only adoptive parents need to be licensed, is morally unjustified. (shrink)

South African law currently forbids those seeking to arrange a surrogate motherhood agreement from creating a child that will not be genetically related to at least one of them. For a surrogacy contract to be legally valid, there must be a ‘genetic link’ between the child created through a surrogate and the parents who will raise it. Currently, this law is being challenged in the High Court of South Africa, and in this article I critically explore salient ethical facets of (...) the dispute. I argue that the law is unjust and should be revised. (shrink)

Recent breakthroughs in stem cell differentiation and reprogramming suggest that functional human gametes could soon be created in vitro. While the ethical debate on the uses of in vitro generated gametes (IVG) was originally constrained by the fact that they could be derived only from embryonic stem cell lines, the advent of somatic cell reprogramming, with the possibility to easily derive human induced pluripotent stem cells from any individual, affords now a major leap in the feasibility of IVG derivation and (...) in the scope of their potential applications. In this paper we develop an ethical framework, rooted in recent scientific evidence, to support a robust experimental pipeline that could enable the first-in-human use of IVG. We then apply this framework to the following objectives: (1) a clarification of the genetic parenting options afforded by IVG, along with their ethical underpinnings; (2) a defence of the use of IVG to remedy infertility, broadening their scope to same-sex couples; (3) an assessment of the most far-reaching implications of IVG for multiplex parenting. These include, first, the liberation of parenting roles from the constraints of biological generations in vivo, allowing multiple individuals to engage in genetic parenting together, thus blurring the distinction between biological and social generations. Second, we discuss the conflation of IVG with sequencing technology and its implications for the possibility that prospective parents may choose among a hitherto unprecedented number of potential children. In view of these perspectives, we argue that, contrary to the exhausted paradigm according to which society lags behind science, IVG may represent instead a salient and most visible instance where biotechnological ingenuity could be used in pursuit of social experimentation. (shrink)

In a recent paper, Giubilini and Minerva argue for the moral permissibility of what they call ‘after-birth abortion’, or infanticide. Here I suggest that they actually employ a confusion of two distinct arguments: one relying on the purportedly identical moral status of a fetus and a newborn, and the second giving an independent argument for the denial of moral personhood to infants (independent of whatever one might say about fetuses). After distinguishing these arguments, I suggest that neither one is capable (...) of supporting Giubilini and Minerva's conclusion. The first argument is at best neutral between permitting infanticide and prohibiting abortion, and may in fact more strongly support the latter. The second argument, I suggest, contains an ambiguity in its key premise, and can be shown to fail on either resolution of that ambiguity. Hence, I conclude that Giubilini and Minerva have not demonstrated the permissibility of infanticide, or even great moral similarity between abortion and infanticide. (shrink)

David DeGrazia tentatively defends what he calls the Interests Model of moral status (see page 135).1 On this model all sentient beings have the same moral status, though some are owed more than others in virtue of having more or stronger interests. The proponent of this model can accept, say, that one should normally save the life of a human in preference to that of a dog. But she denies that we should save the human because he has higher moral (...) status. Instead, the human should be saved because he has more at stake—he may, for example, have a stronger interest in continued existence. In defending the Interests Model, DeGrazia cuts against the grain of recent theorising on moral status, which has instead favoured what he calls the Respect Model. (shrink)

Those who oppose human embryonic stem cell research argue for a clear position on the metaphysical and moral status of human embryos. This position does not differ whether the embryo is present inside its mother’s reproductive tract or in a cryopreservation tank. It is worth examining, however, whether an embryo in “suspended animation” has the same status as one actively developing in utero. I will explore this question from the perspective of Thomas Aquinas’s metaphysical account of human nature. I conclude (...) that a cryopreserved human embryo counts, both metaphysically and morally, as a person; and thus the utilization of such embryos for inherently destructive research purposes is impermissible. (shrink)

Benatar’s central argument for antinatalism develops an asymmetry between the pain and pleasure in a potential life. I am going to present an alternative route to the antinatalist conclusion. I argue that duties require victims and that as a result there is no duty to create the pleasures contained within a prospective life but a duty not to create any of its sufferings. My argument can supplement Benatar’s, but it also enjoys some advantages: it achieves a better fit with our (...) intuitions; it does not require us to acknowledge that life is a harm, or that a world devoid of life is a good thing; and it is easy to see why it does not have any pro-mortalist implications. (shrink)