Reproductive Rights

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)

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)

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

Consensus statement by UK teachers of medical ethics and law.

This chapter considers ethical issues involved in genetic testing and screening for susceptibility to various forms of cancer.

Review of book by Cynthia Daniels, At Women's Expense: State Power and the Politics of Fetal Rights.

Reproductive ageing has effects on individual and public health, now and in generations to come. This volume of presentations from a conference at the Royal College of Obstetricians and Gynaecologists brings together a diverse but timely set of contributions.. in ny chapter I specifically examine the responsibilities of the College to women outside normal reproductive age.

The results of a recent survey of Nigerian women might give pause to opponents of female genital mutilation (FGM). One could well argue that if these Nigerian women themselves favour FGM, then it is ironically paternalistic to oppose it. Should Western feminists actually support FGM if it is what women in the South want? I argue in this commentary that such an argument rests on shaky statistical, psychological, medical, political and philosophical grounds. We should go on opposing female genital mutilation (...) with all our power. (shrink)

Whilst India has been debating how to regulate 'surrogacy' the UK has undergone a major consultation on increasing the amount of 'expenses'paid to egg 'donors', while France has recently finished debating its entire package of bioethics regulation and the role of its Biomedicine Agency. Although it is often claimed that there is no alternative to the neo-liberal, market-based approach in regulating (or not) reproductive medicine--the ideology prevalent in both India and the UK--advocates of that position ignore the alternative model offered (...) by France's tighter regulation, as well as its overarching concern with protecting the vulnerable and ensuring social justice. Whilst the concepts underpinning the French model of regulation also have their provenance in Western political philosophy and not in the developed world, they embody a very different attitude and suggest that there is indeed an alternative to letting the market decide. However, even in France that alternative is highly contested. (shrink)

A ‘should’ question normally signals work for an ethicist but this ethicist’s task is complicated by the normative dimension of all the chapters in this volume. Each author was asked to come up with three recommendations from their own subject area – ’should’ statements deriving from the ‘is’ analysis that they present. If those prescriptions cover the relevant topics, what more is there for an ethicist to do? I have had a personal interest in obstetricians’ relationship with ‘older women’ since (...) being classified as an ‘elderly primigravida’ at the superannuated age of 26 years. Apart from that, however, what original contribution can I make? The convenors of the 56th RCOG Study Group gave me plentiful suggestions – perhaps a little too plentiful: How should the RCOG approach its constituencies, medical ethics, regulation and its relationship to government and the rest of the medical profession, i.e. the NHS and the market, vested interests, individuals or consumers, families, the unborn, doctors, drug companies, surrogacy, the unborn, trafficking, global adoption, law, research? I have to admit this was just too much for me. Instead, I want to argue for what may seem a self-evidently simple point. The RCOG describes its mission as ‘setting standards to improve women’s health’ – presumably all women. In the 6 years that I have served on the RCOG Ethics Committee, however, we have almost always been concerned with that minority of the female population who are of reproductive age. (shrink)

Does advocating women's reproductive rights require us to believe that women own property in their bodies? In this chapter I conclude that it does not. Although the concept of owning our own bodies — ‘whose body is it anyway?’ — has polemical and political utility, it is incoherent in philosophy and law. Rather than conflate the entirely plausible concept of women’s reproductive rights and the implausible notion of property in the body, we should keep them separate, so that the weakness (...) of the second concept does not contaminate the purity of the first. (shrink)

In this article I evaluate a resurrected French resistance movement--to biotechnological commodification. The official French view that ‘the body is the person’ has been dismissed as a ‘taboo’ by the French political scientist Dominique Memmi . Yet France has indeed resisted the models of globalised commodification adopted in US bioechnology, as, for example, when the government blocked a research collaboration between the American firm Millennium Pharmaceuticals and a leading genomics laboratory, le Centre d’Etude du Polymorphisme Humain, on the grounds the (...) ‘French DNA’ should not be given away. -/- This example, however, itself suggests why the ‘new French Resistance’ is not altogether liberating. The absolutist conception of all bodies as belonging to the French state—indeed, as constituting the body politic —is so potentially invasive that a counter-ideology of inviolability of the body is maintained assiduously. This inviolability is defended particularly strongly against commercialisation, but only at the moment when tissue is taken from the individual subject, who is not to be paid or compensated-- although commercial enterprises who subsequently use the tissue are not similarly constrained. -/- . (shrink)

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

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

Eugenics is commonly thought of as having endured as science and social movement only until 1945. With the advance of both reproductive and enhancement technologies, however, concern has arisen that eugenics has resurfaced in new forms. In particular, the eugenic potential of the Human Genome Project led to talk of the rise of ‘newgenics’ and of a backdoor to eugenics. This article focuses on such concerns deriving from the practice of prenatal screening and technologies that increase our ability to generate (...) information about the kinds of children we are likely to have. Given individual preferences and social norms concerning what traits are intergenerationally desirable, how should we act and what practices and policies should we endorse or scrutinise? This article will concentrate on key components of eugenic thinking present today and emphasise continuities between the eugenic past and new- genic present in the subhumanisation of people with cognitive or intellectual disabilities. (shrink)

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

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

I take issue with the view that libertarian theory does not imply any particular stand on abortion. Liberty is the absence of interference with people’s wills—interests, wishes, and desires. Only entities that have such are eligible for the direct rights of libertarian theory. Foetuses do not; and if aborted, there is then no future person whose rights are violated. Hence the “liberal” view of abortion: women (especially) may decide whether to bear the children they have conceived. Birth is a good (...) dividing line between the freedom to abort and the point at which society is permitted to take an interest. Once born, children detach from their mothers; no invasion of their bodies is necessary to separate them. Yet some ways of bringing them up can have a negative impact on society. There is a thus legitimate interest in protecting ourselves from the results of truly bad parenting. (shrink)

With the recent report of a live birth after use of Mitochondrial replacement therapy, sometimes called ‘Three-parent IVF’, the clinical application of the technique is fast becoming a reality. While the United Kingdom allows the procedure under regulatory scrutiny, it remains effectively outlawed in many other countries. We argue that such prohibitions may violate individuals’ procreative rights, grounded in individuals’ interest in genetic affinity. The interest in genetic affinity was recently endorsed by Singapore’s highest court, reflecting an emphasis on the (...) importance of biological ties found across the globe. We apply that reasoning to make the case for a right to ‘Three-parent IVF’. (shrink)

Sarah Conly's One Child is a substantive treatment of the extent to which procreative freedom is curtailed by rising global population and the environmental problems to which it contributes. This review provides an overview of the book's content and closes with a few critical remarks. The book is highly recommended for those interested in the intersection between environmental ethics and the ethics of procreation.

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)

This paper analyzes the underlying tendencies and attitudes toward reproductive medicine borrowing the Nietzschean concepts of nihilism: “death of God” with secularization; “will to power” with reproductive liberty and technological power; and the race of “supermen” with transhumanism. Medical science has advanced in leaps and bounds. In some way, technical innovations have given us unprecedented power to manipulate the way we reproduce. The indiscriminant use of medical technology is backed by a warped notion of human freedom. With secularization in the (...) West, freedom has taken on greater significance in society, but with a heavy emphasis on individual choices and rights. As technology joins forces with sexual liberty, it is not difficult to understand why the public accepts the latest novelty from the reproductive industry. As a result, many find Catholic teaching behind the times and incomprehensible, if not downright anti-scientific. In fact, this coupling of reproductive liberty (will) with reproductive technology (power) echoes the famous dictum “will to power” Nietzsche predicted would characterize post-modern societies. When liberty becomes absolute and technology unchecked, transhumanism is the logical outcome. As a response to these nihilistic tendencies, the paper will end with a critique drawing from theological insights. (shrink)

Many instances of parental enhancement are objectionable on egalitarian grounds because they unnecessarily amplify one kind of asymmetry of power between parents and children. Because children have full moral status, we ought to seek egalitarian relationships with them. Such relationships are compatible with asymmetries of power only to the extent to which the asymmetry is necessary for (1) advancing the child's level of advantage up to what justice requires or (2) instilling in the child morally required features. This is a (...) ground to oppose parental enhancements whose purpose is either to merely satisfy parents' preferences or to confer on the child advantages above and beyond what the child is owed by justice. (shrink)

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)

The book discusses the development of reproductive medicine from the perspective of the parent-child relationship. -/- A könyv a reprodukciós medicina fejlődését vizsgálja a szülői felelősség szempontjából.

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

This paper is my last word, in the present journal, in the debate I have been having with Walter Block on the subject of evictionism as an alleged libertarian “third way,” capable of transcending the familiar “pro-life” and “pro-choice” dichotomy. In this debate, I myself defended what might be regarded as a qualified “pro-life” position, while Block consistently argued that the mother is morally allowed to expel the fetus from her womb provided that no non-lethal methods of its eviction are (...) available. While my position articulated in this paper contains an element of what Block might consider a concession on my part—i.e., an explicit declaration that abstaining from lethal evictions of fetuses conceived as a result of rape is a libertarian duty, but only an imperfect one—I continue to regard the unqualified support of evictionism as indefensible on libertarian grounds. (shrink)

Since the Supreme Court upheld the partial birth abortion ban in 2007, more U.S. abortion providers have begun performing intraamniotic digoxin injections prior to uterine dilation and evacuations. These injections can cause medical harm to abortion patients. Our objective is to perform an in-depth bioethical analysis of this procedure, which is performed mainly for the provider’s legal benefit despite potential medical consequences for the patient.

Cass Sunstein and Richard Thaler's proposal that social and legal institutions should steer individuals toward some options and away from others-a stance they dub "libertarian paternalism"-has provoked much high-level discussion in both academic and policy settings. Sunstein and Thaler believe that steering, or "nudging," individuals is easier to justify than the bans or mandates that traditional paternalism involves. -/- This Article considers the connection between libertarian paternalism and the regulation of reproductive choice. I first discuss the use of nudges to (...) discourage women from exercising their right to choose an abortion, or from becoming or remaining pregnant. I then argue that reproductive choice cases illustrate the limitations of libertarian paternalism. Where choices are politicized or intimate, as reproductive choices often are, nudges become not much easier to justify than traditional mandates or prohibitions. Even beyond the context of reproductive choice, it is not obvious how much easier nudges are to justify than bans or mandates. -/- Part I of this Article briefly introduces Sunstein and Thaler's libertarian paternalism. Part II then turns to the context of reproductive choice. Part II.A reviews restrictions on the right to choose an abortion-particularly post-Casey regulations such as waiting periods, requirements that women receive certain types of information, and requirements that women undergo ultrasound-that pitch themselves as steering choice without entirely closing off the right to choose an abortion. This distinction between nudges and prohibitions echoes Sunstein and Thaler's proposals, but works to subordinate women's choices to the judgment of (often male) experts and administrators-hence my term "libertarian patriarchalism." Part II.B reviews efforts to nudge women-particularly teenagers, HIV-positive women, and others thought to be unsuitable mothers-to avoid pregnancy. -/- Part III considers the normative implications of nudging reproductive decisions. In Part III.A, I argue that the political nature of reproductive choices presents a problem for nudges. I do so by considering a parallel with voting rights. Empirical research shows that voters are more likely to choose the candidate listed first on the ballot. Yet we do not empower the administrator in charge of ballot design to choose a default rule that nudges individuals toward the candidate he sincerely believes would promote choosers' welfare. Given the political nature of reproductive choices, a policymaker's attempting to nudge reproductive decisionmaking in the direction he prefers-or indeed in any direction-fails to show adequate respect for the chooser's agency. In Part III.B, I offer an argument that targets the use of nudges in the context of pregnancy. Finally, in Part III.C, I argue that nudges do not merely add choices to an existing menu, but change the substantive choices available to individuals and thereby impose more-than-trivial costs on them. I conclude by exploring the implications of my arguments for nudges more generally. (shrink)

In proportion to the increased emphasis placed on abortion in partisan political debate since the early 2000s, there has been a noticeable upsurge in cultural representations of abortion. This article charts ways in which that increase manifests in contemporary survival-horror. This article contends that numerous contemporary survival-horror films foreground pregnancy. These representations of pregnancy reify the pressures that moralistic, partisan political campaigning places on individuals who consider terminating a pregnancy. These films contribute to public discourse by engaging with abortion as (...) an individual, emotional matter, rather than treating abortion as a matter of political principle or a political “means to an end.” This article not only charts a relationship between popular culture and its surrounding political context, but also posits that survival-horror—a genre that has been disparaged by critics and largely ignored by scholars—makes an important contribution to sexual-political discourse. These films use horror to articulate the things we cannot say about abortion. (shrink)

In this article Judith Jarvis Thomson's Good Samaritan Argument in defense of abortion in the case of rape is defended from two objections: the Kill vs. Let Die Objection, and the Intend to Kill vs. Merely Foresee Death Objection. The article concludes that these defenses do not defend Thomson from further objections from Peter Singer and David Oderberg.

In my previous paper I argued that if in vitro fertilization (IVF) is legal and practiced there is no moral ground to object to legalization of preimplantation genetic diagnosis (PGD). My opponent raises an objection that my paper “fails to address the ethical argumentation of one key opponent of IVF – the Catholic Church”. In this reply I show that her/his thesis that embryos created during IVF are in ‘ethical limbo’ and “fall outside the moral universe of Christian ethics” does (...) not undermine my argumentation and masks the serious problem Catholics have with the moral status of early embryos. (shrink)