Cesarean delivery rates have been steadily increasing worldwide. In response, many countries have introduced target goals to reduce rates. But a focus on target goals fails to address practices embedded in standards of care that encourage, rather than discourage, cesarean sections. Obstetrical standards of care normalize use of technology, creating an imperative to use technology during labor and birth. A technological imperative is implicated in rising cesarean rates if physicians or patients fear refusing use of technology. Reproductive autonomy is at (...) stake since a technological imperative undermines patients’ ability to choose cesareans or refuse use of technology increasing the likelihood of cesareans. To address practices driven by a technological imperative I outline three physician obligations that are attached to respecting patient autonomy. These moral obligations show that a focus on respect for autonomy may prove not only an ideal ethical response but also an achievable practical response to lowering cesarean rates. (shrink)

The aim of this commentary is to critically examine Matti Häyry’s article ‘Just Better Utilitarianism’, where he argues that liberal utilitarianism can offer a basis for moral and political choices in bioethics and thus could be helpful in decision-making. This commentary, while generally sympathetic to Häyry’s perspective, argues that Häyry should expand on who belongs to our moral community because, to solve practical ethical issues, we need to determine who (and what) deserves our moral consideration. Challenging Häyry’s principle of actual (...) or prospective existence, this commentary suggests that – at least sometimes – the quality of life of those who will never come into existence matters. In a similar vein, this commentary aims to show that determining how to treat mindless humans such as fetuses might pose difficulties for liberal utilitarianism unless the issue of the boundaries of the moral community is addressed. (shrink)

My primary aim is to call into question an influential notion of paternal responsibility, namely, that fathers owe support to their children due to their causal responsibility for their existence. I argue that men who impregnate women unintentionally, and despite having taken preventative measures, do not owe child support to their children as a matter of justice; their children have no right against them to support. I argue for this on the basis of plausible principles of responsibility which have been (...) used to defend abortion rights. I then consider the morally relevant differences between men and women, arguing that while in some cases these differences may justify differential treatment, their import should not be overstated - in many cases, the burden of child support will be too great to impose justly on fathers. This conclusion is not as undesirable as it may seem: I suggest feminist considerations in favor of revising the notion of paternal responsibility and considering alternative arrangements of child support. (shrink)

Ectogenesis (artificial wombs) might soon become a reality. This paper will analyse how the development of such technologies will affect Judith Jarvis Thomson’s defence of abortion, and what the potential consequences of this will be for society. Thomson attempts to justify abortion by appealing to the mother’s right to bodily autonomy. We will argue that once these technologies have been developed, the right to abortion can no longer be justified by such appeals. As a result, when justifying abortion, Thomson-style arguments (...) will no longer work, and a very different strategy will have to be adopted by those wishing to justify its permissibility. Anticipating a consequent weaker position of the pro-choice view, we briefly consider some of the practical implications of ectogenesis for society: effects on parental dynamics, governmental expenditure, research, and gender equality. (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)

Despite the attempts to promote the inclusion of pregnant women into clinical research, this group is still widely excluded. An analysis of the “vulnerability of pregnant women” that questions deeply internalized stereotypes is necessary for finding the right balance in the protection of pregnant women as research participants. Criticism of the traditional account of vulnerability will lead to an alternative that focuses on situations rather than groups and on the obligations of responsible parties. The paper adds to the current general (...) discussion of vulnerability and at the same time addresses the specific problem of drug treatment during pregnancy. (shrink)

In this article I investigate the ways in which phenomenology could guide our views on the rights and/or wrongs of abortion. To my knowledge very few phenomenologists have directed their attention toward this issue, although quite a few have strived to better understand and articulate the strongly related themes of pregnancy and birth, most often in the context of feminist philosophy. After introducing the ethical and political contemporary debate concerning abortion, I introduce phenomenology in the context of medicine and the (...) way phenomenologists have understood the human body to be lived and experienced by its owner. I then turn to the issue of pregnancy and discuss how the embryo or foetus could appear for us, particularly from the perspective of the pregnant woman, and what such showing up may mean from an ethical perspective. The way medical technology has changed the experience of pregnancy—for the pregnant woman as well as for the father and/or other close ones—is discussed, particularly the implementation of early obstetric ultra-sound screening and blood tests for Down’s syndrome and other medical defects. I conclude the article by suggesting that phenomenology can help us to negotiate an upper time limit for legal abortion and, also, provide ways to determine what embryo–foetus defects to look for and in which cases these should be looked upon as good reasons for performing an abortion. (shrink)

Infertility can be an agonizing experience, especially for women. And, much of the agony has to do with luck: with how unlucky one is in being infertile, and in how much luck is involved in determining whether one can weather the storm of infertility and perhaps have a child in the end. We argue that bad luck associated with being infertile is often bad moral luck for women. The infertile woman often blames herself or is blamed by others for what (...) is happening to her, even when she cannot control or prevent what is happening to her. She has simply had bad luck. We focus on the self-blame of infertile women and show how it stems from pro-natalism that targets women. We also argue that overall for women, regret is a better moral response to infertility than self-blame. (shrink)

In the first part of this paper, I argue that the positions set out in traditional debates about abortion are focused on the status of the fetus to the extent that they ignore the value and meaning of pregnancy as something involving persons other than the fetus. -/- In the second part of the paper, I build on Hilde Lindemann’s ideas by arguing that recognition of the related activities of calling a fetus into personhood and creating an identity as a (...) parent allow us to make sense of a variety of reactions to pregnancy and pregnancy loss while recognizing that pregnancy can and does have meaning for many people in many cases. (shrink)

A threat to women is obscured when we treat “abortion-as-evacuation” as equivalent to “abortion-as-killing.” This holds only if evacuating a fetus kills it. As technology advances, the equivalence will fail. Any feminist account of abortion that relies on the equivalence leaves moral room for women to be required to give up their fetuses to others when it fails. So an account of the justification of abortion-as-killing is needed that does not depend on the equivalence.

This essay critiques feminist treatments of maternal-fetal "relationality" that unwittingly replicate features of Western individualism (for example, the Cartesian division between the asocial body and the social-cognitive person, or the conflation of social and biological birth). I argue for a more reflexive perspective on relationality that would acknowledge how we produce persons through our actions and rhetoric. Personhood and relationality can be better analyzed as dynamic, negotiated qualities realized through social practice.

A recent paper by Teresa Baron and Geoffrey Dierckxsens argues that puberty blockers and hormone therapy should be disallowed before adulthood on prudential and consent-related grounds. This response contends that their argument fails because it is predicated on unsupported premises and misinterpretations of the available evidence. There is no evidence that a large proportion of pubertal and postpubertal youths later discontinue medical transition. Meaningful assent is a viable and commonly accepted alternative to meaningful consent in paediatric bioethics. And finally, the (...) primary purpose of transition-related interventions is to actualise youths’ gendered self-image, not treat an underlying mental illness. (shrink)

The feminist literature against the commodification of embryos in human embryo research includes an argument to the effect that embryos are “intimately connected” to persons, or morally inalienable from them. We explore why embryos might be inalienable to persons and why feminists might find this view appealing. But, ultimately, as feminists, we reject this view because it is inconsistent with full respect for women's reproductive autonomy and with a feminist conception of persons as relational, embodied beings. Overall, feminists should avoid (...) claims about embryos’ being inalienable to persons in arguments for or against the commodification of human embryos. (shrink)

We must reconceive the ethical relationship between mothers and their newborn babies. The intertwinement of mother and baby does not disappear with birth but rather persists in the form of postpartum maternal tethering. Drawing upon three years of ethnographic fieldwork and training in the United States and China, I argue that dependencies associated with postpartum maternal tethering make it extremely difficult for postpartum mothers to act autonomously, even in the relational sense. Breaching this tether opens up new possibilities for thinking (...) about the bioethics of vulnerability, dependency, and care by denaturalizing and desanctifying the mother-baby relationship and diversifying newborn care. (shrink)

This paper presents a relational account of autonomy showing that a technological imperative impedes autonomy through undermining women’s capacity to resist use of technology in the context of labor and birth. A technological imperative encourages dependence on technology for reassurance whenever possible through creating a (i) separation of maternal and fetal interests; and (ii) perceived need to use technology whenever possible. In response I offer an account of how women might promote autonomy through cultivating self-trust and self-confidence. Autonomy is not (...) simply a matter of choosing freely and acting on our choices, it is also a matter of possessing the ability to resist social contexts undermining choice and action. An important implication of this view is that respecting autonomy requires more than simply respecting persons’ ability to make and act on choices. Respecting patient autonomy requires a recognition of patients’ need to resist factors impeding autonomy and support for that resistance. (shrink)

This paper explores early Australasian philosophy in some detail. Two approaches have dominated Western philosophy in Australia: idealism and materialism. Idealism was prevalent between the 1880s and the 1930s, but dissipated thereafter. Idealism in Australia often reflected Kantian themes, but it also reflected the revival of interest in Hegel through the work of ‘absolute idealists’ such as T. H. Green, F. H. Bradley, and Henry Jones. A number of the early New Zealand philosophers were also educated in the idealist tradition (...) and were influential in their communities, but produced relatively little. In Australia, materialism gained prominence through the work of John Anderson, who arrived in Australia in 1927, and continues to be influential. John Anderson had been a student of Henry Jones, who might therefore be said to have influenced both main strands of Australian philosophical thought. (shrink)

In a recent paper, Lee Kerckhove and Sara Waller (hereafter K & W) argue that the concept of personhood is irrelevant for the abortion debate.1 Surprisingly, this irrelevance is due merely to the fact that the predicate ‘being a person’ — hereafter ‘personhood’ — is inherently vague. This vagueness, they argue, reduces ‘personhood’ to incoherency and disqualifies the notion from being a useful moral concept. In other words, if ‘personhood’ isn’t a precise notion with well-defined boundaries, then it cannot be (...) of any use in the debate over the permissibility of abortion. This argument is mistaken. While it may be true that ‘personhood’ is irrelevant for the debate over abortion (a substantive issue not dealt with in this paper), it is not true that ‘personhood’ should be disqualified merely because it is vague. Section 2 of the paper is a quick survey in which I briefly review the importance of ‘personhood’ in some of the more recent literature concerning the moral status of abortion. Section 3 is a reconstruction of K & W’s argument against the relevancy of ‘personhood’ and a criticism showing why their argument fails. Section 4 approaches the use of a vague predicate in moral debate and explores the application of ‘personhood’ given three contemporary solutions to vagueness: degree theory, epistemicism and supervaluationism. (shrink)

ABSTRACT A brief discussion of how relational autonomy, phenomenological theories of embodiment and narrative approaches to clinical ethics can open up the space for more subtle feminist ethical reflection about genetic termination.

Many of the decisions mothers face are morally intense. They're experienced as highly morally significant, and they are also often very morally complex, meaning that there aren't black-and-white, obvious answers to questions about what one morally may or must do. For example, I suggest that breastfeeding is complex in this way, despite a good deal of cultural pressure in favour of trying to do it. Acknowledging many of the decisions of motherhood as complex or as ‘grey areas’ is accurate, and (...) also good for mums. But it also burdens mums with the responsibility of researching, discussing, thinking through, and ultimately making significant, complex moral decisions for themselves. I call this the moral load, taking inspiration from Emma's ‘mental load’. In the last section I consider what we could or should do to try to lessen the moral load as a burden on mums. (shrink)

The work of Iris Marion Young (1949–2006) comprises major contributions in the areas of feminist phenomenology, international justice, political theory, and ethical responses to differences. Many of Young's articles, such as ‘Throwing like a Girl’, ‘Pregnant Embodiment’, ‘Women Recovering our Clothes’, ‘Gender as Seriality’, and ‘House and home’, in addition to her books Justice and the Politics of Difference (1990) and Inclusion and Democracy (2000) are particularly significant. My paper shows how Young's earlier essays in feminist phenomenology concerning the lived (...) body can be linked to her later political thought, despite her own separation of these two strands in her work. Furthermore, I explore her legacy by examining how feminists have challenged her self-criticisms and have also developed Young's ideas in these fields, including her work on oppression and responsibility. (shrink)

Journal of Religious Ethics, Volume 49, Issue 2, Page 358-380, June 2021.

Philosophy and Literature is an internationally renowned refereed journal founded by Denis Dutton at the University of Canterbury, Christchurch. It is now published by the Johns Hopkins University Press. Since its inception in 1976, Philosophy and Literature has been concerned with the relation between literary and philosophical studies, publishing articles on the philosophical interpretation of literature as well as the literary treatment of philosophy. Philosophy and Literature has sometimes been regarded as iconoclastic, in the sense that it repudiates academic pretensions, (...) insidious jargon and institutional vogue. Dutton, who remains the editor, still writes a regular column. A distinctive feature of Philosophy and Literature was the annual Bad Writing Contest, held from 1995–98, which sought to identify (and publish) the ‘most stylistically lamentable passages’ of academic prose, often to great amusement. (shrink)

In “Where Is the Sin in Synecdoche?” (2005) Adrienne Asch and David Wasserman criticize the choice to use prenatal testing (PNT) to determine disability. Notwithstanding the multiple meanings, motives, and circumstances behind people’s reproductive choices, Asch and Wasserman argue that individual choices to reject impaired potential offspring should be the subject of moral scrutiny, since they are likely to be the result of synecdoche—“the uncritical reliance on a stigma-driven inference from a single feature to a whole future life” (181). Such (...) synecdochal choices, they argue, assume that in virtue of impairment, the future child in question would be “incapable of [the] intimacy and community” involved in family.. (shrink)

On 22 January 2019, New York state passed the Reproductive Health Act (RHA), which specifies three circumstances under which a healthcare provider may perform an abortion in New York: (1) the patient is within twenty-four weeks of pregnancy, (2) the fetus is non-viable, or (3) the abortion is necessary to protect the patient’s life or health. The first one, that of abortion being accessible within the first twenty-four weeks of pregnancy, is not unique to New York, as many other states (...) allow medical professionals to provide abortions during this time. The latter two have caused significant controversy because they detail certain circumstances in which abortions would be accessible after twenty-four weeks. This paper will focus on these latter two circumstances. I will first argue that any debate or discussion about (2) must go beyond the conventional debate about the ethics of abortion and incorporate, more appropriately, a discussion on euthanasia and the ethics of end-of-life care for nascent human life. In particular, it requires us to consider the morality of non-voluntary active euthanasia for non-viable fetuses, rather than just a discussion of the ethics of late term abortions. When it comes to (3), I will argue that assessing its moral permissibility actually raises some legitimate moral concerns, even from a reproductive rights perspective. On certain readings, it seems as if condition (3) would allow for the termination of a healthy fetus for reasons not related to the mother’s physical health or life. If this is the case, I argue, the right to an abortion would be construed as a right to fetal termination, rather than just fetal evacuation. However, I will argue that there are good reasons that pro-choice advocates should interpret the right to an abortion as a right to fetal evacuation instead of termination, and if this is the case, a woman should not be able to demand the death of a healthy fetus if ending the pregnancy safely via fetal evacuation would suffice. (shrink)

This essay suggests some links between concern about the decline of ‘the family’, or of ‘family values’, the use of reproductive technology, and the claim that some people have children for the ‘wrong reasons’. It is argued that where conceiving and bringing a child to term is a matter of choice, a person must have a reason or reasons for doing so and further, that those reasons are of moral significance. By appealing to Kant's Categorical Imperative: ‘Act in such a (...) way that you always treat humanity … never simply as a means, but always at the same time as an end’, a distinction is made between morally desirable and morally undesirable reasons, on the grounds of the extent to which the parent or parents will be able or likely to treat the child as an end in herself. In conclusion it is argued that whilst ‘the family’is vital to the health of children, and to the health of society, it is not so much the form that the family takes that is significant, but the extent to which it allows for the development and maintainance of a certain sort of relationship. (shrink)