The authors of “The Two Front War on Reproductive Rights” make a profoundly important observation—“Because zygotes, embryos and fetuses early in gestation are neither viable nor independent without...

Feminist bioethicists have long shed light on the indignities and injustice of reproductive intrusions, be they coerced gestation or forced interventions during pregnancy and birth. Writing about t...

The Dobbs v. Jackson Women’s Health Organization Supreme Court decision not only upended constitutional protections for abortion in the United States but also bolstered legislative and cultural int...

Perhaps I am wrong to take this article personally, but when the authors refer to Cassandras “voicing concern about a post-Roe degradation of pregnant persons’ right to chart their own medical cour...

In March of 2021, a woman named Ashley Caswell was arrested in Etowah County, Alabama after testing positive for methamphetamine (Levin 2023). Ms. Caswell was two months pregnant and was arrested f...

The loss of the federally protected constitutional right to an abortion is a threat to the already tenuous autonomy of pregnant people, and may augur future challenges to their right to refuse unwanted obstetric interventions. Even before Roe’s demise, pregnancy led to constraints on autonomy evidenced by clinician-led legal incursions against patients who refused obstetric interventions. In Dobbs v. Jackson Women’s Health Organization, the Supreme Court found that the right to liberty espoused in the Constitution does not extend to a (...) pregnant person’s right to an abortion. With Roe’s demise, the right to request specific types of care has been vitiated. The same argument underpinning that holding may now become ballast for attacks on the traditionally more robust right, the right to refuse. Here we discuss how the elevation of fetal and embryonic rights may lead to a cascade of medical intrusions and deprivations of liberty against pregnant persons, and offer an argument opposing these improprieties. (shrink)

The intrusive state has long viewed women as fetal containers. The Dobbs decision goes further, essentially causing women to vanish when fetuses are abstracted from their relationships to pregnant persons. The ways in which women are first controlled and then made invisible are clearly connected with the move from obedience to omission that has historically affected black Americans. When personal decisionmaking and participation in democracy are regarded as threats, those threatened restrict decisional freedom and political power, deepening structural injustices relating (...) to sex, race, and poverty. Fear of Dobbs has health effects on conditions unrelated to pregnancy and connects with erasures of human value that are not health-related. We reaffirm solidarity as a countering influence. Taking account of the richly relational context in which issues like abortion and political representation arise should lead to better, more meaningful policies, making so many people impossible to unsee. (shrink)

John Rawls has held up as a model of public reason the U.S. Supreme Court. I argue that the Dobbs Court is justifiably criticized for failing to respect public reason. First, the entire opinion is governed by an originalist ideological logic almost entirely incongruent with public reason in a liberal, pluralistic, democratic society. Second, Alito’s emphasis on “ordered liberty” seems completely at odds with the “disordered liberty” regarding abortion already evident among the states. Third, describing the embryo/fetus from conception until (...) birth as an “unborn human being” begs the question of the legal status of the embryo/fetus, as if an obiter dictum settled the matter. Fourth, Alito accuses the Roe court of failing to exercise judicial restraint, although Alito argued to overturn Roe in its entirety. In brief, the Dobbs opinion is an illiberal, disingenuous, ideological swamp that swallows up public reason and the reproductive rights of women. (shrink)

The U.S. Supreme Court’s Dobbs ruling triggered a global debate about access to abortion and the legislative models governing it. In the United States, there was a sudden reversal of federal guidance about pregnancy termination that is unprecedented in Western and high-income countries. The strong polarization on the issue of abortion and the difficulty of finding a point of compromise lead one to consider the experiences of countries that have had different paths. Italy stands as a candidate for being a (...) partially alternative model because it allows abortion up to 12 weeks, but without considering it a subjective right. The legislation in place since 1978 aims to balance the interests of the fetus and those of the woman. An issue often raised concerning Italian law is that of conscientious objection granted to doctors. Many gynecologists declare themselves objectors, and this makes access to abortion more difficult in some regions of Italy. After discussing this issue and envisaging different ways to deal with it, the article concludes by highlighting new dilemmas about a possible divorce between the law and medical ethics in different directions and offers some avenues to begin setting up a response. (shrink)

Just last week (October 4, 2022), the U.S. White House released a blueprint for an A.I. Bill of Rights, consisting of “five principles and associated practices to help guide the design, use, and de...

While experience often affords important knowledge and insight that is difficult to garner through observation or testimony alone, it also has the potential to generate conflicts of interest and unrepresentative perspectives. We call this tension the paradox of experience. In this paper, we first outline appeals to experience made in debates about access to unproven medical products and disability bioethics, as examples of how experience claims arise in bioethics and some of the challenges raised by these claims. We then motivate (...) the idea that experience can be an asset by appealing to themes in feminist and moral epistemology, distinguishing between epistemic and justice-based appeals. Next, we explain the concern that experience may be a liability by appealing to empirical work on cognitive biases and theoretical work about the problem of partial representation. We conclude with preliminary recommendations for addressing the paradox and offer several questions for future discussion. (shrink)

On 24 July 2022, the landmark decision Roe v. Wade (1973), that secured a right to abortion for decades, was overruled by the US Supreme Court. The Court decision in Dobbs v. Jackson Women’s Health Organisation severely restricts access to legal abortion care in the USA, since it will give the states the power to ban abortion. It has been claimed that overruling Roe will have disproportionate impacts on women of color and that restricting access to abortion contributes to or (...) amounts to structural racism. In this paper, we consider whether restricting abortion access as a consequence of overruling Roe could be understood as discrimination against women of color (and women in general). We argue that banning abortion is indirectly discriminatory against women of color and directly (but neither indirectly, nor structurally) discriminatory against women in general. (shrink)

Paltrow, Harris, and Marshall argue that the reversal of Roe will impact all pregnant persons, not only those who wish to terminate a pregnancy. I agree that these consequences ar...

Katie Watson (2022) writes that “If the Supreme Court shifts the question of legality in whole or in part to state legislatures, the ethics of abortion will become an even more intense subject of debate in public, academic, and clinical realms. Therefore, this is the moment for all bioethicists to strengthen our teaching, thinking, and writing in abortion ethics” (emphasis added). . . Persuading broader audiences that ethicists might be able to help advance pro-choice causes is thereby essential to implementing (...) Watson’s suggestion that bioethicists get more engaged. What good ethicists might do depends on others taking advantage of what they have to offer: that this would need to happen is my focus here. (shrink)

Philosophers of science deploy mathematical models to describe epistemic communities, or groups of people creating and sharing knowledge for individual and collective purposes. These models capture...

This issue of the American Journal of Bioethics shines a light on abortion, recognizing that reproductive freedom as understood for the past fifty years no longer exists in the United States. Some...

The target articles in this “Roe v. Wade” special issue of AJOB rightly point to multiple ethical harms of an imminent end to full federal protection for legal abortion in the United States, p...

In 1973, the Supreme Court of the United States issued Roe v. Wade, a historic and contentious decision that established abortion as a fundamental constitutional right. This ruling protected aborti...

The impending U.S. Supreme Court decision in Dobbs vs. Jackson Women’s Health Organization has appropriately engendered critical thought and speculation as to what a post-Roe America would look lik...

Paltrow, Harris and Marshall argue that understanding Roe v. Wade as a decision that only protects the right to terminate a pregnancy misconstrues its larger implications. The striking down of Roe...

Paltrow and colleagues focus on the deleterious consequences that could occur if Roe were overturned, including food and housing insecurity, loss of employment, bankruptcy, unjustified arres...

Public debates about abortion emphasize choice. Privately, when people face that decision, how much choice do they feel they have?We are part of a team who provide abortions at the oldest public ho...

The adamant and uniform pro-choice viewpoints expressed in each of the target articles demonstrates how mainstream bioethics has become a homogeneous and insular advocacy movement that seeks to ins...

In recent years, tremendous progress has been made toward recognizing the need for improved medical knowledge for pregnant people, a population group that has long been excluded from clinical trial...

Paltrow, Harris, and Marshall detail the ways in which overturning Roe v. Wade legally impacts all pregnant persons, leading to criminal prosecution, arrests, and racist implementation of policies...

In “The Ethics of Access: Reframing the Need for Abortion Care as a Health Disparity,” Watson considers the advantages of framing the need for abortion as an issue of health disparities. Dra...

In this open peer commentary, we concur with the three target articles’ analysis and positions on abortion in the special issue on Roe v. Wade as the exercise of reproductive liberty essential for the bioethical commitment to patient autonomy and self-determination. Our proposed OPC augments that analysis by explicating more fully the concept crucial to Roe of fetal personhood. We explain that the development and use of predictive reproductive technologies over the fifty years since Roe has changed the literal image, (...) and thereby the epistemological landscape, through which a prospective parent comes to know the fetus. The logic of Roe required a legal and ethical denial of fetal personhood to prioritize maternal autonomy over claims to fetal moral personhood. Our claim is that such a denial may be more complicated today. The fetal person genetic testing and reproductive imaging now presents to prospective parents has become an increasingly individualized, distinct medicalized picture of a developing person with which a parent can either identify or differentiate. In contrast, the fetal person of Roe was an abstract and vague figure stripped of most human particulars, a pregnancy rather than the specific individualized human entity reproductive technology now presents as a person to prospective parents. We discuss the implications of this shift and call for a more capacious analysis of reproductive ethics that works towards both reproductive and disability justice. (shrink)