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 paper, we identify some key features of what makes something a disease, and consider whether these apply to pregnancy. We argue that there are some compelling grounds for regarding pregnancy as a disease. Like a disease, pregnancy affects the health of the pregnant person, causing a range of symptoms from discomfort to death. Like a disease, pregnancy can be treated medically. Like a disease, pregnancy is caused by a pathogen, an external organism invading (...) the host’s body. Like a disease, the risk of getting pregnant can be reduced by using prophylactic measures. We address the question of whether the ‘normality’ of pregnancy, its current necessity for human survival, or the value often attached to it are reasons to reject the view that pregnancy is a disease. We point out that applying theories of disease to the case of pregnancy, can in many cases illuminate inconsistencies and problems within these theories. Finally, we show that it is difficult to find one theory of disease that captures all paradigm cases of diseases, while convincingly excluding pregnancy. We conclude that there are both normative and pragmatic reasons to consider pregnancy a disease. (shrink)

Elselijn Kingma argues that, in cases of mammalian placental pregnancy, the foster (roughly, the post-implantation embryo/foetus) is part of the gravida (the pregnant organism). But she does not consider the possibility of proper overlap. I show that this generates a number of serious problems for her argument and trace the oversight to a quite general issue within the literature on biological individuality. Doing so provides an opportunity to pull apart and clarify the relations between some importantly distinct questions concerning (...) organismality and organismic parthood, and to identify the implications that this has for those who want to draw on this literature when making metaphysical or mereological arguments. (shrink)

This article aims to explore the philosophical meaning of pregnancy and maternity in the writ-ings of R. Soloveitchik and Emmanuel Lévinas. They both make a phenomenological enquiry into these phenomena, by looking on the biological aspect and the emotional aspects. R. Solove-itchik suggests a spiritual interpretation concerning the meaning of pregnancy, which is both biological and spiritual. He attempts to differentiate between the natural parenthood and the spiritual parenthood. Lévinas gives us the philosophical observation through the phenomenolog-ical research (...) of pregnancy, motherhood and parenthood. For him, this inquiry may be revealed as an ethical occurrence that demand responsibility. Perhaps this is one of the unique dimensions of modern Jewish philosophy, looking towards the religious texts with modern philosophical method and modern philosophy theories. Reading carefully the biblical story of Genesis on the notion of birth and maternity, raises textual questions and cultural questions. For Lévinas and R. Soloveitchik these questions can open the door to new philosophical inquiry. (shrink)

In “The Pregnancy Rescue Case: why abortion is immoral”, Hendricks presents The Pregnancy Rescue Case. In this reply I argue that even if it would be better (i.e. less bad) for the abortion to be prevented in The Pregnancy Rescue Case, that does not mean that typical abortions are impermissible. I also argue that there is a possible explanation, consistent with the pro-choice view and empirically testable, as to why people would think it better for the abortion (...) to be prevented in The Pregnancy Rescue Case. (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. So abortion is typically wrong—and this holds whether or not fetuses are persons.

Fetal reduction is the practice of reducing the number of fetuses in a multiple pregnancy, such as quadruplets, to a twin or singleton pregnancy. Use of assisted reproductive technologies increases the likelihood of multiple pregnancies, and many fetal reductions are done after in vitro fertilisation and embryo transfer, either because of social or health-related reasons. In this paper, I apply Joe Horton’s all or nothing problem to the ethics of fetal reduction in the case of a twin (...) class='Hi'>pregnancy. I argue that in the case of a twin pregnancy, there are two intuitively plausible claims: abortion is morally permissible, and it is morally wrong to abort just one of the fetuses. But since we should choose morally permissible acts rather than impermissible ones, the two claims lead to another highly implausible claim: the woman ought to abort both fetuses rather than only one. Yet, this does not seem right. A plausible moral theory cannot advocate such a pro-death view. Or can it? I suggest ways to solve this problem and draw implications for each solution. There are no data in this work. (shrink)

Clinical evidence has shown that physical exercise during pregnancy may alter brain devel- opment and improve cognitive function of offspring. However, the mechanisms through which maternal exercise might promote such effects are not well understood. The present study examined levels of brain-derived neurotrophic factor (BDNF) and absolute cell num- bers in the hippocampal formation and cerebral cortex of rat pups born from mothers exer- cised during pregnancy. Additionally, we evaluated the cognitive abilities of adult offspring in different behavioral (...) paradigms (exploratory activity and habituation in open field tests, spatial memory in a water maze test, and aversive memory in a step-down inhibitory avoid- ance task). Results showed that maternal exercise during pregnancy increased BDNF lev- els and absolute numbers of neuronal and non-neuronal cells in the hippocampal formation of offspring. No differences in BDNF levels or cell numbers were detected in the cerebral cortex. It was also observed that offspring from exercised mothers exhibited better cognitive performance in nonassociative (habituation) and associative (spatial learning) mnemonic tasks than did offspring from sedentary mothers. Our findings indicate that maternal exer- cise during pregnancy enhances offspring cognitive function (habituation behavior and spa- tial learning) and increases BDNF levels and cell numbers in the hippocampal formation of offspring. (shrink)

L.A. Paul argues that interesting issues for rational choice theory are raised by epistemically transformative experiences: experiences which provide access to knowledge that could not be known without the experience. Consideration of the epistemic effects of pregnancy has important implications for our understanding of epistemically transformative experiences and for debate about the ethics of abortion and applied ethics more generally. Pregnancy is epistemically transformative both in Paul’s narrow sense and in a wider sense: those who have not been (...) pregnant face significant barriers to acquiring the knowledge made accessible through pregnancy. This knowledge is crucial for engaging with the ethics of abortion. The epistemically transformativeWIDE nature of pregnancy may require us to use new methods to try to partially grasp what pregnancy is like such as for example, significant engagement with narrative literature. Because pregnancy is also epistemically transformative in a narrow sense, we need to work out how to engage in ethical reasoning when relevant knowledge is not fully accessible to all. This argument has implications beyond the debate about abortion. Philosophers in many areas of applied ethics will need to work out how to respond appropriately to epistemically transformative experiences. (shrink)

Ectopic pregnancy is defined as the fertilized ovum implants in a location outside the endometrial cavity, remains to be an important cause of maternal morbidity and mortality worldwide and is a health problem with incidence ranges between 0.25% and 2% of all pregnancies. In our study, in Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Obstetrics and Gynecology from 2011 to 2013, 96 cases with diagnosis of ectopic pregnancy managed by the adapted RCOG’s Guide were (...) analyzed retrospectively. The data were analyzed as follows: age, the history of operation, smoking, the presence of intrauterine device, blood groups, hemoglobin, platelets, values of B-hCG, the diagnostic interval, intra-abdominal free fluid and/or acute abdomen, the method of treatment and the success of treatment. (shrink)

In this paper I take up (what I call) the pregnancy loss objection to defenses of abortion that deny fetal moral status. Though versions of this objection have been put forth by others—particularly Lindsey Porter’s in a 2015 paper—I argue that the existing versions of the objection are unsuccessful in various ways: failing to explain the ground of moral considerability that would apply to embryos/fetuses in very early pregnancy, lack of clarity about what it means to take grief (...) after miscarriage seriously, and implausible implications regarding pre-embryo and infertility cases. I go on to offer a more plausible version of the objection, which I apply only to mid-pregnancy and fetuses, by drawing on personal narratives of later pregnancy loss and abortion and emphasizing practices that indicate the relevant kind of mourning. I then take up the question of how experience of the sort I have in mind can function as evidence, by situating my version of the objection in a pragmatist ethical view. Finally I consider and respond to some worries about the very idea of taking experience of pregnancy loss to be evidence regarding fetal moral status. (shrink)

Many ethics instructors turn to peculiar examples and cases to highlight ethical concerns about autonomy and collective goods. While these efforts are respectable, they lamentably reinforce the valorization of independence and the opposition of individuality to collectivity that are too prevalent in ethics today. Attending to the event of pregnancy would help overcome these troubles. By concentrating on pregnancy, we can better appreciate the dependence that is integral to the human experience, the discrete value of each individual, the (...) possible noncompetition between individual and society, and the importance of appreciating the sources of our existence. Religious ethicists would do well to think more about pregnancy, a condition which is sui generis and yet also illustrative of the fundamental interdependence of human beings. (shrink)

Birth mothers usually have a moral right to parent their newborns in virtue of a mutual attachment formed, during gestation, between the gestational mother and the fetus. The attachment is formed, in part, thanks to the burdens of pregnancy, and it serves the interest of the newborn; the gestational mother, too, has a powerful interest in the protection of this attachment. Given its justification, the right to parent one's gestated baby cannot be transferred at will to other people who (...) would wish to function as social parents of the child in question. This indicates that surrogacy contracts are illegitimate, and therefore should be void. (shrink)

A 2017 Nature report was widely touted as hailing the arrival of the artificial womb. But the scientists involved claim their technology is merely an improvement in neonatal care. This raises an under-considered question: what differentiates neonatal incubation from artificial womb technology? Considering the nature of gestation—or metaphysics of pregnancy—(a) identifies more profound differences between fetuses and neonates/babies than their location (in or outside the maternal body) alone: fetuses and neonates have different physiological and physical characteristics; (b) characterizes birth (...) as a physiological, mereological and topological transformation as well as a (morally relevant) change of location; and (c) delivers a clear distinction between neonatal incubation and ectogestation: the former supports neonatal physiology; the latter preserves fetal physiology. This allows a detailed conceptual classification of ectogenetive and ectogestative technologies according to which the 2017 system is not just improved neonatal incubation, but genuine ectogestation. But it is not an artificial womb, which is a term that is better put to rest. The analysis reveals that any ethical discussion involving ectogestation must always involve considerations of possible risks to the mother as well as her autonomy and rights. It also adds a third and potentially important dimension to debates in reproductive ethics: the physiological transition from fetus/gestateling to baby/neonate. (shrink)

This study examines the ethical and legal issues faced by girls/women requesting abortions who were victims of rape, aspects which have received little attention to date. This is a retrospective study using an approach and legal issues relating to incidents of unwanted pregnancy resulting from rape as reported in Turkish newspapers from 2010 to 2018. A total of 95 articles were discovered and categorized. These were then evaluated for content and analyzed in terms of the ethical issues related to (...) the cases. Of the articles,14 involved rape-related pregnancy cases. The six cases chosen for analysis in this study were carefully selected from newspaper reports between 2010-2018. The victims who requested abortions were between 9 and 26 weeks pregnant and aged 14-26 years old. Turkish courts approved only two of the victims' requests. The cases in this study were evaluated by the authorities solely on legal grounds. The stress experienced by victims of rape is exacerbated by compulsory pregnancy; the fact that these victims were not allowed to terminate their pregnancies resulted in their further punishment. Requests for abortions should be assessed not only in terms of legality but also based on medical and especially ethical issues. (shrink)

In this paper, I respond to criticisms toward my account of the difference in moral status between fetuses and newborns. I show my critics have not adequately argued for their view that pregnant women participate in a parent-child relationship. While an important counterexample is raised against my account, this counterexample had already been dealt with in my original paper. Because the criticisms against my account lack argumentative support, they do not pose a problem for my account. I conclude the raised (...) criticisms do not amount to a strong philosophical case against my account. (shrink)

Ectogenesis, or “artificial womb technology,” has been heralded by some, such as prominent feminist Shulamith Firestone, as a way to liberate women. In this chapter, we challenge this view by offering an alternative analysis of the technology as relying upon and perpetuating a problematic model of pregnancy which, rather than liberating women, serves to devalue them. We look to metaphysics as the abstract study of reality to elucidate how the entities in a pregnancy are related to one another. (...) We consider two models of the metaphysics of pregnancy: (1) the Parthood Model, whereby the fetus is a part of what/who gestates it; and (2) and the Fetal Container Model, whereby the gestator is a container for the fetus. We suggest that under the assumption of the Fetal Container Model, we are more likely to think that any container will suffice for gestation, even an artificial one. In contrast, under the assumption of the Parthood Model, we are less likely to treat the gestator as interchangeable or replaceable, given the parthood relationship between gestator and fetus. This chapter argues that ectogenesis is conceptually linked to the Fetal Container Model and advocates a more cautious approach in promoting ectogenesis as a tool for women’s liberation. (shrink)

An important strand in the debate on abortion focuses on the moral status of fetuses. Knowledge of the moral value of fetuses is needed to assess fetuses’ moral status. As Errol Lord argues, acquaintance plays a key role in moral and aesthetic knowledge. Many pregnant persons have acquaintance with their fetus that provides privileged access to knowledge about that fetus’ moral value. This knowledge is (a) very difficult to acquire without being pregnant and (b) relevant for assessing the moral status (...) of fetuses. This has implications for public debate on abortion and the research methods of philosophers working on abortion. (shrink)

Issues surrounding pregnancy loss are rarely addressed in Christian philosophy. Yet a modest estimate based on the empirical and medical literature places the rate of pregnancy loss between fertilization and term at somewhere between 40–60%. If miscarriage really is as common as the research gives us to believe, then it would seem a pressing topic for a Christian philosophy of the future to address. This paper attempts to begin this work by showing how thinking more closely about (...) class='Hi'>pregnancy loss understood as a grievable event can have a profound impact on the way we think about particular theoretical debates in Christian philosophy and provide opportunities for the discipline to put its skills to use in the development of helpful conceptual and hermeneutical resources for those grieving such losses. However, this will require seeking out and taking seriously the testimony of those who have undergone pregnancy loss, as well as getting clearer on how best to conceptualize pregnancy and its loss in the first place. (shrink)

This article explores the Nuffield Council on Bioethics’ recent report about non-invasive prenatal testing. Given that such testing is likely to become the norm, it is important to question whether there should be some ethical parameters regarding its use. The article engages with the viewpoints of Jeff McMahan, Julian Savulescu, Stephen Wilkinson and other commentators on prenatal ethics. The authors argue that there are a variety of moral considerations that legitimately play a significant role with regard to (prospective) parental decision-making (...) in the context of NIPT, for example, views on the morality of abortion and understandings of the impact of disability on quality of life. The variable nature of such considerations, both singularly and combined, suggests that any approach to NIPT should be sensitive to and understanding of similarly variable parental assessments and decisions. The implications of the approach developed for current and future policies in this area are explored, along with the impact of such arguments on ideas about procreative beneficence. (shrink)

Iris Marion Young’s classic paper on the phenomenology of pregnancy chronicles the alienating tendencies of technology-ridden maternal care, as the mother’s subjective knowledge of the pregnancy gets overridden by the objective knowledge provided by medical personnel and technological apparatuses. Following Fredrik Svenaeus, the authors argue that maternal care is not necessarily alienating by looking specifically at the proper attention paid by sonographers in maternal care when performing ultrasound examinations. Using Martin Heidegger’s philosophy as a theoretical lens, the authors (...) argue that sonographers who cultivate technical mastery, build patient rapport, explain the process and significance of the ultrasound, and understand the patient’s world are able to provide excellent patient care. The authors utilize Hans-Georg Gadamer’s hermeneutics to show how sonographers can frame the ultrasound in a way that acknowledges both the subjective knowledge of the mother and the objective data obtained by the sonographer through the use of technology. Ultimately, the authors argue that the common practice of framing the ultrasound as the chance to “meet the baby” is inappropriate, as it exacerbates the tendency to regard objective knowledge as the only legitimate knowledge in medical contexts. They recommend a more balanced approach that elicits a fusion of horizons between the patient’s subjective knowledge and the objective data that is obtained by the sonographer via the ultrasound, thus respecting and bolstering patient autonomy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:“An Equivocal Couple Overwhelmed by Life”A Phenomenological Analysis of PregnancySara HeinämaaTwo conceptions of human generativity prevail in contemporary feminist philosophy. First, several contributors argue that the experience of pregnancy, when analyzed by phenomenological tools, undermines several distinctions that are central to Western philosophy, most importantly the subject-object distinction and the self-other and own-alien distinctions. This line of argument was already outlined by Iris Marion Young in her influential (...) essay “Pregnant Embodiment: Subjectivity and Alienation” (1984). The other dominant argument is related to the first one, and it states that organic birth is the event that establishes the first experiential separation between the self and the other. On this understanding, the mother-fetus relation would not involve any relations between two corporeal selves; all such relations would be postnatal. This notion has been defended, for example, by Christine Schües (1997; 2000) and Johanna Oksala (2003).1On the other hand, classical phenomenology is dominated by the idea that the rigorous first-person methodology that is essential to phenomenology dictates that the sense of birth must be studied primarily by reflection on the structures of our own recollection or memory. Consequently, the primary sense of human birth would be that of an unattainable limit. This is argued on the basis of the existential fact that we all are born but cannot recall our own birth, or else on the basis of the transcendental fact that the structure [End Page 31] of retention ties each living present to an earlier one and implies that the transcendental ego cannot be subject to generation.2 From this perspective, all analyses and reflections of the experiences of labor, gestation, and pregnancy would be secondary since the sense of birth that these experiences involve is the nativity of another human being and not the nativity of the reflecting self.This paper challenges both the feminist and the classical phenomenological approach. I maintain that careful phenomenological analyses of the experience of pregnancy undermine both notions. Such analyses show, on the one hand, that pregnancy does not imply a nondistinction or self-other fusion but on the contrary involves a specific self-other divide. At the same time, they demonstrate that the sense of birth is more complex than the classical recollection-paradigm suggests and that it includes more components than the signification of an unattainable limit. A proper phenomenology of birth must take into account not only the universal fact that we all are born, but also the equally universal fact that each of us is born from another human being, that is, some other human subject.3 This other human being who “gave” us birth or “from whose flesh we were born” provides us with a unique perspective on our own past, beyond the limits of our own recollection. Her perspective is incomparable to any other external perspective; rather than simply giving us an additional third-person viewpoint on our own organic birth, this one person is able to open a second-person perspective on our pre- and postnatal life and the transition between them—all of which is beyond our own recollection.My argument proceeds by the following steps:First, I develop a fresh discourse on the experience of pregnancy, by studying a set of remarks to be found in Julia Kristeva’s postphenomenological discourse on maternity, on the one hand, and in Simone de Beauvoir’s existential-phenomenological discourse on feminine embodiment, on the other hand. I use these remarks as leading clues for a novel phenomenological study of the experience of pregnancy.4 Contra Young’s influential account mentioned above, I argue that gestation, as experienced by women who live it in the first person, includes a separation between two sensory-motor beings in a nesting relation: the pregnant self and the embryonic other. The alternative account that I provide hinges on my analysis of the experience of fetal movements and the role of touch-sensations and kinesthetic sensations in such experiences. Ultimately, I argue that pregnancy does not erode the self-other boundary or the own-alien boundary but reestablishes both divisions.Second, I compare my account of the experience of pregnancy to Merleau... (shrink)

Basic understandings of subjectivity are derived from the principles of masculine embodiment such as temporal stability and singularity. But pregnancy challenges such understandings because it represents a sort of splitting of the body. In the pregnant situation, a subject may experience herself as both herself and an other, as well as neither herself nor an other. This is logically untenable—an impossibility. If our discourse depends on singular, fixed referents, then what paradigms of identity are available to the pregnant subject? (...) What could be the pregnant subject's ontology? -/- Eric Bapteste and John Dupré offer the idea that organisms are processual beings. In their view, the ecological interrelationships between the objects of biology are defining, and render them dynamic processes, rather than stable things. Does Bapteste and Dupré’s processual ontological account accommodate pregnant organisms, including pregnant people? -/- Here, I analyze the processual account and determine whether it can accommodate the phenomenon of pregnancy. I find that a processual ontology captures a great deal about pregnant embodiment and is a significant improvement over Cartesian and anti-metaphysical accounts. However, in order to accommodate pregnancy, what we still need from an ontology is the inclusion of subjectivity. (shrink)

Many accounts of the morality of abortion assume that early fetuses must all have or lack moral status in virtue of developmental features that they share. Our actual attitudes toward early fetuses don’t reflect this all-or-nothing assumption: early fetuses can elicit feelings of joy, love, indifference, or distress. If we start with the assumption that our attitudes toward fetuses reflect a real difference in their moral status, then we need an account of fetal moral status that can explain that difference. (...) I argue that we can have or lack relational obligations to early fetuses in light of our own activities or choices, independent of the fetus’s own features or properties. Those relational obligations make the early fetus morally considerable to the persons who stand in a moral relation to it. Pregnant persons (and other participants in the procreative process) can come to have relational obligations to an early fetus just in virtue of their own decision to create a person, either by intentionally getting pregnant or by deciding to continue a pregnancy. That decision not only makes it appropriate for them to care about the fetus, but it also generates obligations to the fetus that they didn’t have before that decision. (shrink)

INTRODUCTION[|] Feminism was born as an ethical opposition to the women's oppression by patriarchal society in almost every aspects of life. Termination of an unwanted pregnancy is one such aspect of life where this oppression is felt most intensively both in the past and still today. The aim of this study is to analyze how the feminist theorists and their supporters percieve the issue of termination of pregnancy and with which arguments they defend or object it. [¤]METHODS[|]The texts (...) and books which were used in this study are accessed via my own personal library, Library of Marmara University Faculty of Medicine, Prof.Dr Orhan Oğuz Central Library of Marmara University and the remote access service to the databases of Marmara University Library which is offered by the library's itself.[¤]RESULTS[|]-[¤]DISCUSSION AND CONCLUSION[|] The study, in accordance with the neutral stance of the previous revisionary texts written on the termination of pregnancy, doesn't support any specific thought or side regarding feminist ethical approach to the termination of pregnancy. But the study shows that feminism has been in this world not more than 250 years and in the academic field not more than 50 years as a serious philosophical idea which gained supporters and a constructive stance by going beyond it's critical nature. Ergo, feminist views should be voiced more, should be taken more seriously and it's intellectual content should be improved whenever possible in the philosophical, medical, legal, etc. texts written on the termination of pregnancy.[¤]. (shrink)

This chapter discusses how phenomenologies of pregnancy challenge traditional philosophical accounts of a subject that is seen as autonomous, rational, genderless, unified, and independent from other subjects. Pregnancy defies simple incorporation into such universal accounts since the pregnant woman and her unborn child are incapable of being subsumed into traditional theories of the subject. Phenomenological descriptions of the experience of pregnancy lead one to question if philosophy needs to reject the subject altogether as central, or rather to (...) revise traditional descriptions of the subject. The chapter examines both options and argues for the later. The exploration of pregnancy in feminist theory upholds the value of working from the subject’s lived experience, but indicates that it is possible without viewing the subject as a disembodied universal agent. Finally, it discusses how phenomenologies of pregnancy are attuned to discussing difference thereby aiding philosophies that take into account the political, historical, and cultural conditioning that shape experience and theory. (shrink)

This Ideas and Opinions article revisits an argument from Judith Jarvis Thomson in her essay “A Defense of Abortion” that abortion can be an ethical choice even if we assume that fetuses have full moral personhood and moral rights. The authors examine the implications of laws that require a pregnant person to care for another with their body and what other impositions states may also require of citizens to care for others.

Vulnerability is a notion discussed in feminist philosophy as a basis for a morality that widens our sense of those whose deaths are grievable. Vulnerability and grievability also factor in reproductive ethics. This essay employs recognition theory to analyze critically how these notions are mobilized in conservative Christian anti-abortion writings and in feminist philosophy. This analysis exposes weaknesses and misrecognition in both sets of discourses. In response, I offer theological arguments for recognizing fetal value without implying a right to life (...) and for acknowledging how human finitude and the precarity of pregnancy render gestational hospitality a discretionary, not obligatory, moral act. (shrink)

Shared decision-making involves health professionals and patients/clients working together to achieve true person-centred health care. However, this goal is infrequently realized, and most barriers are unknown. Discussion between philosophers, clinicians, and researchers can assist in confronting the epistemic and moral basis of health care, with benefits to all. The aim of this paper is to describe what shared decision-making is, discuss its necessary conditions, and develop a definition that can be used in practice to support excellence in maternity care. Discussion (...) between the authors, with backgrounds in philosophy, clinical maternity care, health care management, and maternity care research, assisted the team to confront established norms in maternity care and challenge the epistemic and moral basis of decision-making for caesarean section. The team concluded that shared decision-making must start in pregnancy and continue throughout labour and birth, with equality in discourse facilitated by the clinician. Clinicians have a duty of care for the adequacy of women's knowledge, which can only be fulfilled when relevant knowledge is offered freely and when personal beliefs and biases that may impinge on decision-making (defeaters) are disclosed. Informed consent is not shared decision-making. Key barriers include existing cultural norms of “the doctor knows best” and “patient acquiescence” that prevent defeaters being acknowledged and discussed and can lead to legal challenges, overuse of medical intervention and, in some areas, obstetric violence. Shared decision-making in maternity care can thus be defined as an enquiry by clinician and expectant woman aimed at deciding upon a course of care or none, which takes the form of a dialogue within which the clinician fulfils their duty of care to the client's knowledge by making available their complete knowledge (based on all types of evidence) and expertise, including an exposition of any relevant and recognized potential defeaters. Research to develop measurement tools is required. (shrink)

This study presents a reconsideration of Levinas’s concept of the feminine. This reconsideration facilitated by a philosophically informed analysis of Levinas’s Talmudic readings on that subject. The innovation of this research is based on the methodology which combined the two corpuses of Levinas’ writings as important parts of his thought. Two main phenomena are derived from Levinas’ Talmudic readings and arouse main principles of his ethics. In the hearth of the discussion on Eros stated the differentiation of feminine and masculine (...) in Levinas’ thought, and its implication of gender and Ethics of otherness. In the center of Levinas’ terminology of maternity stated his phenomenology of pregnancy, and its ethical implication on responsibility to the other. The extreme responsibility committed to the subject since there is a immanent conflict between parents and their child. The characters of Leivnas’ discussion which described here are obligating the reconsideration of the philosophical question: are Levinas’ concepts of the feminine exclusive to the women? -/- The subjects of Levinas’s exploration of the feminine, in this view, emerge from his Talmudic readings, but his phenomenological analysis of those very subjects goes beyond what can be found in those readings. Analyzing the meaning of the difference between the sexes—the topic of one of the Talmudic readings—leads Levinas to a wider phenomenological treatment of the status of woman that does not bypass the feminine voice. Delving into the Talmudic concept of rodef (persecutor) as applied to the relationship of fetus and mother leads Levinas to a phenomenological analysis of the concept of maternity and readiness to accept responsibility (even suffering) for the Other. Those two discussions lead us to a rereading of Levinas’s essay “Phenomenology of Eros” and enable us to rebut the charge that in that essay Levinas presents only a masculine voice. Levinas’s concept of “responsibility” will be seen to resemble the feminist psychologist Carol Gilligan’s concept of “care.” We must then reconsider whether Levinas’s concept of the feminine is exclusively the domain of women. -/- . (shrink)

Feminist bioethicists of a variety of persuasions discuss the 2013 case of Marlise Munoz, a pregnant woman whose medical care was in dispute after she became brain dead.

In this essay, I draw on Kant’s legal philosophy in order to defend the right to voluntary motherhood by way of abortion at any stage of pregnancy as an essential feature of women’s basic rights. By developing the distinction between innate and acquired right in Kant’s legal philosophy, I argue that the viability standard in US law (as established in Planned Parenthood v. Casey) misunderstands the nature of embodied right. Our body is the site of innate right; it is (...) the means through which we can set and pursue ends in the world. The law, therefore, cannot adjudicate the relationship between the will and the body: it cannot require us to allow our bodies to be used against our will. By comparing unwanted pregnancy to sexual assault, I problematize the notion that consent to pregnancy, like consent to sex, can ever be conclusive. I examine Kant’s own account of unwanted pregnancy, in which he describes mother and child finding themselves “in a state of nature” in order to rethink the status of the fetus in law, and I argue that we should understand the fetus’s right to life as provisional, rather than as enforceable by law. (shrink)

This paper explores the role of moral uncertainty in explaining the morally disruptive character of new technologies. We argue that existing accounts of technomoral change do not fully explain its disruptiveness. This explanatory gap can be bridged by examining the epistemic dimensions of technomoral change, focusing on moral uncertainty and inquiry. To develop this account, we examine three historical cases: the introduction of the early pregnancy test, the contraception pill, and brain death. The resulting account highlights what we call (...) “differential disruption” and provides a resource for fields such as technology assessment, ethics of technology, and responsible innovation. (shrink)

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)

Feminist social theory and female body experience are the twin themes of Iris Marion Young's twelve outstanding essays written over the past decade and brought together here. Her contributions to social theory raise critical questions about women and citizenship, the relations of capitalism and women's oppression, and the differences between a feminist theory that emphasizes women's difference and one that assumes a gender-neutral humanity. Loosely following a phenomenological method of description, Young's essays on female embodiment discuss female movement, pregnancy, (...) clothing, and the breasted body. In an introduction that situates her work in the context of shifts in feminist theory and politics over the past decade, Young emphasizes the rootedness of her theorizing in a dedicated and seasoned political activism. (shrink)

I defend the right to an abortion at any stage of pregnancy by drawing on a Kantian account of consent and innate right. I examine how pregnant women are positioned in moral and legal debates about abortion, and develop a Kanitan account of bodily autonomy in order to pregnant women’s epistemic authority over the experience of pregnancy. Second, I show how Kant's distinction between innate and private right offers an excellent legal framework for embodied rights, including abortion and (...) sexual consent, and I draw on the legal definition of sexual consent in order to show how abortion discourse undermines women's innate right. I then explore Kant’s treatment of the infanticidal mother, and draw out the parallels between this case and contemporary abortion rights in order to develop a distinctly Kantian framework of reproductive rights in non-ideal conditions. Finally, I explore the implications of this non-ideal approach for contemporary abortion discourse, arguing that debates about the legality of abortion should more broadly engage the barbaric conditions of reproductive injustice. (shrink)

This article addresses the ethics of betel nut use in Taiwan. It first presents scientific facts about the betel quid and its consumption and the generally accepted negative health consequences associated with its use: oral and esophageal cancer, coronary artery disease, metabolic diseases, and adverse effects in pregnancy. It then analyzes the cultural background and economic factors contributing to its popularity in Asia. The governmental and institutional attempts to curb betel nut cultivation, distribution, and sales are also described. Finally, (...) the article analyzes the bioethical implications of this often-ignored subject from the perspectives of human dignity, the good of health, vulnerable groups, cultural diversity, informed consent, and ethical blind spots. (shrink)

This article investigates some of the constraining factors experienced by 16 school-going mothers in the Okalongo circuit, Namibia. This was a qualitative phenomenological study, conducted through in-depth individual interviews, focus group discussions, and reflective journals with 16 school-going mothers between the ages of 17 and 20, purposively selected from three different public rural schools. This qualitative, phenomenological study analyses, through feminist and intersectionality theory, the lived experiences of these young mothers as they encounter the traditional, patriarchal attitudes and practices of (...) the Ovambadja community because these girls fell pregnant before their formal, cultural initiation. The article documents, through the voices of the young women themselves, the numerous constraints they experienced and overcame in their determination to complete their schooling. The findings show that, aside from the deeply held destructive patriarchal beliefs that significantly constrain and harm the mother-learners, the Namibian Learners Pregnancy Policy, which is intended to protect and ensure pregnant learners and motherlearners complete their schooling, is not being properly or effectively implemented. The study recommends an increase in efforts at the national level in Namibia to raise awareness among members of parliament, school administrators and principals, and all policymakers to develop better monitoring systems that will improve policy implementation in schools. (shrink)

In Western societies many immigrants live in difficult social and working conditions. Together with other factors, this state of affairs represents a risk for the well being of their children. This article will consider the principle risk factors for child psychopathology and/or distress, with a distinction between temporary and permanent factors and with a peculiar attention to the interplay between risk and protective factors. Risk factors can be ordered in cultural, social, familiar/parental and individual factors. Some of these are general (...) risk factors, applying to child and adolescent psychopathology and distress independently from the status of immigrants’ offspring. Other factors are specific of migration, some of them being related to: a) different ways of immigrated families to situate themselves within the host society ; b) cultural/familiar attitudes in child’s nurture and education; c) the family role of women as well as factors specific of the pregnancy period in immigrants; d) the ability of the school system to enhance and support children’s abilities to integrate within the new society; e) the political/bureaucratic facilitation/impediment to the regularization of VISA, with the consequent effect on the sense of identity/rejection within/from the host society. In conclusion, the programs for monitoring immigrants’ living and health conditions should also include: the assessment of parental skills, the dynamic indicators of risk and protection indexes, the assessment of living conditions and social school environment, with a careful attention to those early signs of discomfort that might precede possible later onset of psychopathology and/or social distress. (shrink)

In Western societies many immigrants live in difficult social and working conditions. Together with other factors, this state of affairs represents a risk for the well being of their children. This article will consider the principle risk factors for child psychopathology and/or distress, with a distinction between temporary and permanent factors and with a peculiar attention to the interplay between risk and protective factors. Risk factors can be ordered in cultural, social, familiar/parental and individual factors. Some of these are general (...) risk factors, applying to child and adolescent psychopathology and distress independently from the status of immigrants’ offspring. Other factors are specific of migration, some of them being related to: a) different ways of immigrated families to situate themselves within the host society ; b) cultural/familiar attitudes in child’s nurture and education; c) the family role of women as well as factors specific of the pregnancy period in immigrants; d) the ability of the school system to enhance and support children’s abilities to integrate within the new society; e) the political/bureaucratic facilitation/impediment to the regularization of VISA, with the consequent effect on the sense of identity/rejection within/from the host society. In conclusion, the programs for monitoring immigrants’ living and health conditions should also include: the assessment of parental skills, the dynamic indicators of risk and protection indexes, the assessment of living conditions and social school environment, with a careful attention to those early signs of discomfort that might precede possible later onset of psychopathology and/or social distress. (shrink)

Results: We analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92–0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00–1.28) to report difficulty refilling medications. Only 2% (...) of CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19. (shrink)

The development of new methods in the field of prenatal testing leads to an expansion of information that needs to be provided to expectant mothers. The aim of this research is to explore opinions and attitudes of gynecologists in Germany, Poland and Russia towards access to prenatal testing and diagnostics in these countries. Semi-structured interviews were conducted with n = 18 gynecologists in Germany, Poland and Russia. The interviews were analyzed using the methods of content analysis and thematic analysis. Visible (...) in all three countries is a connection of prenatal medicine with the politically and socially contentious issue of pregnancy termination. Respondents in Poland and Russia concentrated on the topic of inadequate resources. Quality of information for expectant mothers is an important point in all three countries. Only in Germany was the issue of language barriers in communication raised. With regard to non-invasive prenatal testing (NIPT) respondents in Germany focused on the ethical issues of routinization of testing; in Poland and Russia they concentrated on fair access to NIPT. Challenges in all three countries arise from structural factors such as imprecise and prohibitive regulations, lack of resources or organization of healthcare services. These should be addressed on a political and medico-ethical level. (shrink)

The question of whether or not one should procreate is rarely cast as a personal choice in philosophical discourse; rather, it is presented as an ethical choice made against a backdrop of aggregate concerns. But justifications concerning procreation in popular culture regularly engage with the role that identity plays in making procreative decisions; specifically, how one’s decision will affect who they are and who they might be in the future. Women in particular cite the personally transformative aspects of becoming a (...) parent — personal circumstances, including socioeconomic status, age, health, and relationship status — as the most important considerations for the decision they make regarding possible parenthood, and not the more aggregate concerns that an ethics of procreation prioritizes. I highlight women because when women undergo a transformative experience related to parenthood, they do so in contexts where the social, economic, and emotional effects related to pregnancy and motherhood are extensive and impose greater effects on women than men. These harmful material effects threaten a woman’s economic stability, career development, social relationships, and emotional health. Because of this, I argue that an ethics of procreation must engage with the ways in which women’s identities are transformed through procreative decisions. (shrink)

The study focused on exploring and understanding the challenges junior high school teachers in the Division of Rizal faced during the full implementation of in-person classes and identifying the coping mechanisms they employed to adapt to this new educational landscape. Forty participants were purposefully selected from various public secondary school clusters in the division of Rizal. A qualitative phenomenological design was employed, and the information collected through Google Forms was imported into Microsoft Excel and Microsoft Word. After importing the data, (...) it was coded through and looked for patterns in the meaning of the data to find themes. It was analyzed using QDA Miner Lite to make a user-friendly, accessible, and simple-to-use software for qualitative data analysis. QDA Miner Lite allowed for a quicker and more accurate breakdown of documents, enabling organization, coding, annotation, retrieval, and analysis of document and image collections. The study revealed these categories and themes: Experiences in Teaching in In-Person Classes. Teachers' experiences during the full implementation of in-person classes were categorized into five themes: Comparison to distance learning modalities, Student- centered Focus, Positive emotional experiences, Challenging Emotional experiences, and Adaptations. Comparison of Teaching Experiences. The comparison and contrast of teaching experiences between distance learning and in-person learning revealed six themes: Assessment and Progress Monitoring, Stress and Fulfillment, Effectiveness and Limitations, Technology and Connectivity, preparation and Communication, and Learning Environment and Engagement. Identified Challenges in In- Person Classes. The study identified nine challenges faced by teachers and schools during the full implementation of in-person classes. These challenges encompassed issues related to Classroom Infrastructure and Facilities, Learning Gaps and Academic Challenges, Behavioral Issues and Student Discipline, Safety, and Security, Teacher Workload and Teaching Loads, Student Engagement and Parent Involvement, Gender-Responsive Policy and Early Pregnancy, Professional Development, and Learning Materials. Coping Mechanisms for Challenges. The coping mechanisms employed by teachers in response to the identified challenges included Collaborative Support and Professional Development, Resilience, and Positivity, Student-Centered Strategies Interventions, Adaptability, and Flexibility, Emphasizing Physical and Mental Health, Effective Communication Involvement of Stakeholders, Innovative Teaching Approaches, and Reminding Purpose and Passion. The study provides valuable insights into teachers' experiences and challenges in fully implementing in-person classes. The identified coping mechanisms offer potential strategies to support educators in navigating the complexities of teaching in this environment. Educational institutions and policymakers can use these insights to develop supportive and enriching learning environments for teachers and students. By implementing targeted interventions and policies, stakeholders can optimize the teaching and learning experiences in the in-person learning setting and foster a positive and conducive educational environment. (shrink)

: This article critically examines the constitution of impairment in prenatal testing and screening practices and various discourses that surround these technologies. While technologies to test and screen prenatally are claimed to enhance women's capacity to be self-determining, make informed reproductive choices, and, in effect, wrest control of their bodies from a patriarchal medical establishment, I contend that this emerging relation between pregnant women and reproductive technologies is a new strategy of a form of power that began to emerge in (...) the late eighteenth century. Indeed, my argument is that the constitution of prenatal impairment, by and through these practices and procedures, is a widening form of modern government that increasingly limits the field of possible conduct in response to pregnancy. Hence, the government of impairment in utero is inextricably intertwined with the government of the maternal body. (shrink)

Infertility, the inability to get pregnant after twelve months or more regular unprotected sexual intercourse is a global phenomenon but among the Ikwerre people of Rivers State, the blame of infertility in the family is always shifted to the woman despite the discovery of modern diagnosis that reveals that men and women can be responsible for childlessness. This research brings to bear the fact that modernity has not affected the Ikwerre people on the blame game of infertility in families. Thus, (...) this paper looked at the problem of infertility using a structured questionnaire of 4-point Likert scale, analyzed the data with a descriptive statistics and simple percentage for the socio-demographic distribution of respondent while mean and standard deviations were used to analyze the research questions. It adopted the use of Fertility Awareness Methods Theory as a panacea to the blame of infertility and concludes that knowledge of the reproductive anatomy and physiology of couples as it relates to fertility will help them make informed decisions concerning childbearing. (keywords: Infertility, Blame, Marriage, Pregnancy). (shrink)

In the midst of current social change and public debates regarding provision of reproductive health education and services in the Philippines, the need exists to understand the realities of teenagers and young adults’ lives and the challenges they face in finding the way sexual and reproductive well-being. Although a few studies have focused on quantifying unintended pregnancy and abortion in the Philippines, few investigations using qualitative research methods have been conducted to more fully explore and situate these phenomena. Unsafe (...) abortion through the use of abortifacients has been practiced since time immemorial. An estimated 26 million pregnancies are terminated legally throughout the world, and 20 million are terminated illegally, with more than 78,000 deaths. The Philippines, with a steadily increasing population that is approaching 100 million, faces significant challenges in the area of reproductive health. -/- . (shrink)

This case study deals with failure to ejaculate intravaginally during sexual intercourse. The causative factors were thought to be unconscious in nature. The patient showed significant improvement after only one session, when these unconscious factors were interpreted to and accepted by the patient. We discuss briefly the application of psychodynamic theory in sex therapy and possible implementations in training settings.

Various tribes deny that males have a role in causing pregnancy. Edmund Leach thinks members don’t actually believe tribal dogma. I propose that there is a practical value in denying our biological knowledge.

Background and objectives: Bangladesh has the highest malnutrition rates in the world. The main objective of this study is to identify and determine the main factors for child malnutrition among children under the age 5 years in rural Bangladesh. -/- Material and methods: This research was conducted in rural areas at Meherpur district in Bangladesh. Convenience sampling method is used and 85 under 5 child information is collected through a structured questionnaire. The information’s of child’s are gathered from the mothers (...) of the child. Malnourished children is measured by using APLS method and WHO Child Growth Standard Median Index. Binary logistic regression model is used to find out the key factors of malnutrition. -/- Results: It is found that family income, maintain proper diet during pregnancy period, proper diet maintain for children have negative significant (p<0.05) effect on child malnutrition. -/- Conclusion: The magnitude of the child’s malnutrition still is of great concern in Bangladesh. Since, poverty, imbalanced diet during pregnancy period and imbalanced diet for under 5 children influences to malnutrition are significantly associated with high prevalence of malnutrition, so government and people should reduce these factor to reduce malnutrition in rural area of Bangladesh. (shrink)