Background: Oral health of women is often neglected during pregnancy. We need to address this issue in a developing country’s perspective, as oral healthcare is not an integral part of antenatal protocols. -/- Objective: To evaluate the oral health status of pregnant women using the Oral Hygiene Index-Simplified (OHI-S) Score as well as explore oral hygiene practice by them and conduct a mini-assessment of their knowledge of oral health. -/- Methods: This cross-sectional, descriptive study was conducted using (...) data by using a semi-structured questionnaire among 170 pregnant women attending an antenatal center in Dhaka city, Bangladesh, from March to August 2018. A pre-tested semi-structured questionnaire containing OHI-S index was used for data collection. Dental mirror and probe were used for oral hygiene assessment. -/- Results: The mean age of the participants was 24.22±5.07 years. 140(82.4%) were found to use toothbrushes as a tooth-cleaning aid and 146(85.9%) used toothpaste as a tooth cleaning material. Among them, 132(94.3%) were found to brush at least once a day. The predominant health problems identified by clinical examination among those pregnant women were gum bleeding, mild to severe periodontitis, halitosis (bad breath), and loose teeth. The majority did not know the safe period of dental treatment and the consequences of having poor oral health during pregnancy. The overall oral hygiene status of the maximum pregnant women was ‘Fair’ (50.6%) (OHI-S score 0-1.2), while 39.4% had ‘Poor’ oral hygiene status (OHI-S score 1.3-3.0) and only 10% had ‘Good’ oral hygiene status (OHI-S score 3.1-6.9). -/- Conclusion: Pregnant women in Bangladesh suffer from various oral health issues during pregnancy; however, they exhibit that they do not address this issue due to a lack of awareness and other factors. Hence, it is crucial to plan and implement effective oral health programs for pregnant women all over the country. (shrink)

The paper assessed the nutritional knowledge and cultural food beliefs on dietary practices of pregnant women in Epe Local Government Area, Lagos State, Nigeria. A descriptive research design was adopted for this study. The population of the study consisted of all registered pregnant women in seven (7) antenatal clinics in Epe Local Government Area of Lagos State. A sample size of 270 was drawn using proportionate sampling technique. The collected data were analyzed using frequency, percentage, and (...) the Chi-square test of association. The significance level was set at p < 0.05. The results showed a statistically significant relationship between knowledge of nutrition and dietary practices, χ2 (2) = 78.201, p<0.05. However, there was no statistically significant relationship between cultural food beliefs and dietary practices, χ2 (1) = 1.151, p>0.05. The finding also showed that cultural food beliefs do not influence the dietary practices of pregnant women. The study recommends that the government and health agencies should continuously train health workers on nutritional issues, particularly on how to enhance the nutritional knowledge of expectant pregnant women prior to conception. This will help potential mothers improve their dietary practices. (shrink)

Domestic violence is identified across the globe as a menace as it poses a threat to the mental health of its victims, the significant others of the victim and the security of a nation at large. In some cases, the victim of domestic violence is a pregnant woman and harm is caused not only to a woman but her fetus also and this calls for urgent psychological assessment and intervention. Although there is no doubt that psychological tests are effective (...) in the assessment of domestic violence, using the psychometric properties obtained from a different population may produce generate inaccurate findings. This paper therefore attempts the validation study of Women Abuse Screening Tool (WAST) using a sample of 379 pregnant women attending antenatal clinic at the State Specialist Hospital, Osogbo, Osun State, Nigeria. The study derived a Cronbach’s Alpha Reliability of 0.758, p <.05 and a Guttman split-half coefficient of 0.683, p <.05. Furthermore, concurrent validity of Women Abuse Screening Tool (WAST) and Ongoing Abuse Screen (OAS) was established as 0.29, p<.05. The norms of the instrument were given as 2.38 for tolerable level of domestic violence and 5.79 for severe and pathological level of domestic violence. Authors conclude that Women Abuse Screening Tool has acceptable psychometric properties to justify its usage for the assessment of level of domestic violence among pregnant women in Nigeria and other nations with similar socio-cultural backgrounds. (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.

BACKGROUND: -/- In its recent report 'Human Reproductive Technologies and the Law', the House of Commons' Select Committee on Science and Technology called for greater efforts to establish the potential demographic impact of sex selection across all sectors of UK society. Given the well-known preference for boys over girls among some communities, there is concern that a readily available service for social sex selection may upset the balance of the sexes. Of particular interest are the gender preferences and the demand (...) for sex selection among Pakistanis. METHODS: -/- We conducted a social survey on gender preferences and potential demand for preconception sex selection among 301 pregnant women in Karachi, Pakistan, using a self-report questionnaire consisting of 14 questions. RESULTS: -/- About 41.5% wish to have a family with an equal number of boys and girls; 3.3% would like to have only boys, 1.0% only girls, 27.6% more boys than girls and 4.3% more girls than boys, and 22.3% stated that they do not care about the sex composition of their family. Whereas 6.3% could imagine employing cytometric sperm separation for social sex selection, 76.1% could not and 17.6% were undecided. About 27.2% felt that social sex selection ought to be legal, 48.8% thought it ought to be illegal and 23.9% were undecided. CONCLUSIONS: -/- Although Pakistani women do show a statistically significant preference for boys over girls, the number of women willing to subject themselves to cytometric sperm separation appears to be too small to cause a severe imbalance of the sexes. However, further research among British citizens of Pakistani origin is needed to establish whether sex selection poses a serious threat to the sex ratio of UK communities. (shrink)

BACKGROUND Preconception sex selection for non-medical reasons is a controversial issue in bioethics. Little research has described preferences for preconception sex selection among Arab populations. This study describes the sex preference and interest in employing sex selection techniques among pregnant women in northern Jordan. -/- METHODS A self-reported questionnaire was administered to 600 pregnant women in Irbid, Jordan. χ2 test and binary logistic regression were used to examine the factors associated with interest in preconception sex selection. (...) -/- RESULTS In general, the interest in using sex selection was low. Women who preferred boys were more likely to be interested in sex selection, if paid for by the couple [odds ratio (OR) = 4.40, 95% confidence interval (CI): 1.75–11.11] or by health insurance (OR = 3.42, 95% CI: 1.94–6.06), or, if feasible, administered through oral medication (OR = 8.84, 95% CI: 5.05–15.63). Women with lower education were more likely to be interested in sex selection, if paid by health insurance (OR = 1.96, 95% CI: 1.10–3.45) and were more likely to believe that sex selection is legal (OR = 1.79, 95% CI: 1.06–2.86). Women who had no boys were more likely to be interested in sex selection, if paid by health insurance (OR = 1.94, 95% CI: 1.10–3.42) or, if feasible, through medication (OR = 3.03, 95% CI: 1.82–5.00). -/- CONCLUSIONS The majority of participants were not in favor of using preconception sex selection. Those with a preference to have boys, with lower education, and those with an imbalanced family were more likely to be interested in using sex selection technology. (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)

This commentary explores the notion of vulnerability applied to pregnant women in clinical research. The use of this notion, related to a semantic problem, raises an ethical issue and participates in the quasi-systematic exclusion of this sub-population from the research process.

Background: Oral health of women is often neglected during pregnancy. We need to address this issue in a developing country's perspective,as oral healthcare is not an integral part of antenatal protocols. Objective: To evaluate the oral health status of pregnant women using the Oral Hygiene Index-Simplified (OHI-S) Score as well as explore oral hygiene practice by them and conduct a mini-assessment of their knowledge of oral health. Methods: This cross-sectional, descriptive study was conducted using data by using (...) a semi-structured questionnaire among 170 pregnant women attending an antenatal center in Dhaka city, Bangladesh, from March to August 2018. A pre-tested semi-structured questionnaire containing the OHI-S index was used for data collection. Dental mirror and probe were used for oral hygiene assessment. Results: The mean age of the participants was 24.22±5.07 years. 140(82.4%) were found to use toothbrushes as a tooth-cleaning aid and 146(85.9%) used toothpaste as a tooth cleaning material. Among them, 132(94.3%) were found to brush at least once a day. The predominant health problems identified by clinical examination among those pregnant women were gum bleeding, mild to severe periodontitis, halitosis (bad breath), and loose teeth. The majority did not know the safe period of dental treatment and the consequences of having poor oral health during pregnancy. The overall oral hygiene status of the maximum number of pregnant women was 'Fair' (50.6%) (OHI-S score 0-1.2), while 39.4% had 'Poor' oral hygiene status (OHI-S score 1.3-3.0) and only 10% had 'Good' oral hygiene status (OHI-S score 3.1-6.9). Conclusion: Pregnant women in Bangladesh suffer from various oral health issues during pregnancy; however, they exhibit that they do not address this issue due to a lack of awareness and other factors. Hence, it is crucial to plan and implement effective oral health programs for pregnant women all over the country. (shrink)

Pregnant women and persons engaging in homosexual practices compose two groups that have been and still are amongst those most severely subjected to coercive restrictions regarding their own bodies. From an historical point of view, it is a recent and rare phenomenon that a woman’s right to abortion and a person’s right to engage in homosexual interactions are recognized. Although most Western liberal states currently do recognize these rights, they are under continuous assault from various political and religious (...) movements. Moreover, though liberal theories of justice typically defend women’s rights to abortion and people’s rights to homosexual activity, these theories often struggle to capture the fundamental ground for these rights. For example, it appears hard for the liberal to say why and when only the woman and not the embryo/fetus has rights and why the right to certain sexual practices is not on par with rights to other preferences. Contemporary liberal theories of justice, therefore, have a hard time identifying what distinguishes questions of abortion and sexual activities from other questions of right and thereby also have difficulty capturing the gravity of the wrongdoing involved in coercively restricting homosexual interactions and abortion as such. I argue that Kant’s theory of justice succeeds on both counts, because it can locate the fundamental ground for these rights in an understanding of the bodily integrity of the person. Just states will neither permit nor outlaw all abortions or sexual interactions, but rather will require all such laws to be reconcilable with the protection of each person’s right to freedom. (shrink)

Malaria is a life-threatening disease spread to humans by some types of mosquitoes. It is mostly found in tropical countries. It is preventable and curable. The infection is caused by a parasite and does not spread from person to person. Symptoms can be mild or life-threatening. Mild symptoms are fever, chills and headache. Severe symptoms include fatigue, confusion, seizures, and difficulty breathing. Infants, children under 5 years, pregnant women, travelers and people with HIV or AIDS are at higher (...) risk of severe infection. Discovering this disease is a good step for proper and correct treatment. Determining the treatment with high accuracy depends on the method used in the diagnosis. Correctly, expert systems can greatly help to avoid spreading this disease. The expert system diagnoses malaria disease correctly to facilitate doctors to find the correct treatment based on the appropriate diagnosis. Objectives: An expert system has been established based on CLIPS to diagnose malaria disease. (shrink)

We ask whether it is reasonable to delay or refuse to take COVID-19 vaccines that have been shown in clinical trials to be safe and effective against infectious diseases. We consider two kinds of vaccine hesitancy. The first is geared to scientifically informed open questions about vaccines. We argue that in cases where the data is not representative of relevant groups, such as pregnant women and ethnic minorities, hesitancy can be reasonable on epistemic grounds. However, we argue that (...) hesitancy is not reasonable if a vaccine has passed well-conducted clinical trials. The second kind of hesitancy is to do with beliefs about the institutions offering a successfully trialled vaccine and the justifiability of cooperating with those institutions. For example, in the UK, distrust of the UK Government or the National Health Service is identified as a factor in the vaccine hesitancy of minority ethnic populations. We ask whether this sort of hesitation is reasonable given normative requirements of fair co-operation, both with those institutions and the wider population. We suggest that the answer is not straightforward. Sometimes the hesitation is unreasonable but understandable. -/- . (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)

Virtue signaling—using public moral discourse to enhance one’s moral reputation—is a familiar concept. But, what about profile pictures framed by “Vaccines work!”? Or memes posted to anti-vaccine groups echoing the group’s view that “Only sheep believe Big Pharma!”? These actions don’t express moral views—both claims are empirical (if imprecise). Nevertheless, they serve a similar purpose: to influence the judgments of their audience. But, where rainbow profiles guide their audience to view the agent as morally good, these acts guide their audience (...) to view the agent as epistemically good. They are instances of epistemic virtue signaling. The first goal of this paper is to offer an account of epistemic virtue signaling. I argue that epistemic virtue signaling occurs through both behavioral and propositional signals, and serves purposes similar to those of moral virtue signaling across a wide variety of discourses. The second is to show that there is much work for this concept to do. In particular, this concept illuminates a double bind faced by those who suffer from and seek to overcome testimonial injustice. I close by demonstrating how this double bind arises in the dissolution of medical autonomy, focusing on the care gap faced by pregnant women of color in the United States today, as compared with their white counterparts. (shrink)

English law is unambiguous that legal personality, and with it all legal rights and protections, is assigned at birth. This rule is regarded as a bright line that is easily and consistently applied. The time has come, however, for the rule to be revisited. This article demonstrates that advances in fetal surgery and (anticipated) artificial wombs do not marry with traditional conceptions of birth and being alive in law. These technologies introduce the possibility of ex utero gestation, and/or temporary existence (...) ex utero, and consequently developing human beings that are novel to the law. Importantly, therefore, the concepts of birth and born alive no longer distinguish between human beings deserving of legal protection in the way originally intended. Thus, there is a need for reform, for a new approach to determining the legal significance of birth and what being legally alive actually encompasses. Investigating the law of birth is of crucial importance, because of the implications of affording or denying the subjects of new reproductive technologies rights and protections. A determination of the legal status of the subject of fetal surgery or an artificial womb will determine what can and cannot be done to each entity. Moreover, the status afforded to these entities will drastically impact on the freedoms of pregnant women. (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)

Discussion of the behaviour of pregnant women and mothers, in academic literature, medical advice given to mothers, mainstream media and social media, assumes that a mother who fails to do something to benefit her child is liable for moral criticism unless she can provide sufficient countervailing considerations to justify her decision. I reconstruct the normally implicit reasoning that leads to this assumption and show that it is mistaken. First, I show that the discussion assumes that if any action (...) might benefit her child, the mother has a defeasible duty to perform that action. I suggest that this assumption is implicitly supported by two arguments but that each argument is unsound. The first argument conflates moral reasons and defeasible duties; the second misunderstands the scope of a defeasible duty to benefit. This argument has important practical and theoretical implications: practically, it provides a response to a highly damaging discourse on maternal behaviour; theoretically, it provides the framework for a clearer understanding of the scope and nature of defeasible duties to benefit. (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)

In ‘My body, not my choice: against legalised abortion’, Hendricks offers an intriguing argument that suggests the state can coerce pregnant women into continuing to sustain their fetuses. His argument consists partly in countering Boonin’s defence of legalised abortion, followed by an argument from analogy. I argue in this response article that his argument from analogy fails and, correspondingly, it should still be a woman’s legal choice to have an abortion. My key point concerns the burdensomeness of pregnancy (...) which is morally relevant to the question of whether the state can coerce people to use their bodies to help another person. (shrink)

Abortion remains a highly controversial issue in many countries and subject to intense public debate. The aim of this chapter is to summarize the most prominent assumptions and arguments concerning the moral and legal dimensions of abortion on which this debate rests. Where the moral justifiability of abortion is concerned, this chapter focuses on arguments relating to the moral status of the fetus or embryo, the notion of personhood, the biological development of the embryo or fetus, and the moral relevance (...) of specific points in the developmental process. In terms of the legal aspects, we consider concepts and principles invoked at law, principally, the rights of pregnant women and the medical concept of viability. For each moral and legal position in the abortion debate, we provide an overview of the principal assumptions and arguments and acknowledge the main criticisms. (shrink)

Some vaccine-hesitant people lack epistemic trust in the COVID-19 vaccine recommendation that because vaccines have been shown to be medically safe and effective, one ought to get vaccinated. Citing what I call exception information, they claim that whatever the general safety and efficacy of vaccines, the vaccines may not be safe and effective for them. Examples include parents citing information about their children's health, pregnant women's concerns about the potential adverse effects of treatment on pregnant women, (...) young people citing their relative invulnerability to extreme COVID-19 symptoms, or members of vulnerable racial groups citing epistemic injustice, such as a lack of representation in COVID-19 vaccine trials. This paper examines the extent to which a lack of epistemic trust in vaccine recommendations, based on such exemption information, is rational. (shrink)

The study aims to investigate indigenous communities’ socio-economic impacts as a result of the COVID-19 pandemic and to explore coping strategies to aid in the socio-economic recovery of indigenous communities. -/- The COVID-19 pandemic has had a negative impact on indigenous people's livelihoods, including employment and income, education, the migration of people, health, and natural resources. As a result of COVID-19, the indigenous people have lost their employment and income. The price of fish has decreased, which has lowered their ability (...) to make money from selling fish. Migrant workers returned home because they were concerned about their health security and many lost their jobs. Schools were closed because of COVID-19 and this increased education inequality. Health was impacted because it was difficult to access health services due to restrictions on travel. Returning migrants have pressured forest and fishery resources through increases in the number of fishers, which include the migrants who have returned to their own village. -/- The RGC, rural communities and indigenous communities have taken a number of measures to cope with the issues stemming from COVID-19. Migrant workers tried to look for local employment, used fishing to supplement household consumption and income needs, and often borrowed money from neighbors. Students attempted to use e-learning that was facilitated by the government; teachers visited some students’ homes, and older students supported younger students in their school lessons. In terms of health, home visits were facilitated for pregnant women, and people sought permission to travel to health centers. After giving birth, families were visited and offered a small amount of money to support their basic needs. To deal with natural resources, some coping strategies included smaller groups of patrolling teams, support grants from CSOs for forest and fishery resource patrolling, drone delivery to community fishery committees, and requesting community members to report illegal fishing or logging. And to minimize the spread of COVID-19, a mandatory 14-day quarantine at home was imposed on all people returning to the village. (shrink)

Jeremy Williams has argued that if we are committed to a liberal pro-choice stance with regard to selective abortion for disability, we will be unable to justify the prohibition of sex selective abortion. Here, I apply his reasoning to selective abortion based on other traits pregnant women may decide are undesirable. These include susceptibility to disease, level of intelligence, physical appearance, sexual orientation, religious belief and criminality—in fact any traits attributable to some degree to a genetic component. Firstly, (...) I review Williams’ argument, which claims that if a woman is granted the right to abort based on fetal impairment, then by parity of reasoning she should also be granted the right to choose sex selective abortion. I show that these same considerations that entail the permissibility of sex selective abortion are also applicable to genetic selection abortion. I then examine the objections to sex selective abortion that Williams considers and rejects, and show that they also lack force against genetic selection abortion. Finally, I consider some additional objections that might be raised, and conclude that a liberal pro-choice stance on selective abortion for disability entails the permissibility of selective abortion for most genetic traits. (shrink)

In recent years, a number of US states have adopted laws that require pregnant women to have an ultrasound examination, and be shown images of their foetus, prior to undergoing a pregnancy termination. In this paper, I examine one of the basic presumptions of these laws: that seeing one’s foetus changes the ways in which one might act in regard to it, particularly in terms of the decision to terminate the pregnancy or not. I argue that mandatory ultrasound (...) laws compel women into a position of moral spectatorship and require them to recognise the foetus as a being for whom they are responsible, particularly through empathic responses to ultrasound images. The approach I propose extends the project of a bioethics of the image and highlights the need for a critical analysis of the political mobilization of empathy in discussions of abortion. (shrink)

The article by MacKay and Saylor (2020) claims that the principle of fair subject selection yields conflicting imperatives (e.g. in the case of pregnant women) and should be understood as “a bundle of four distinct sub-principles” (i.e. fair inclusion, burden sharing, opportunity, distribution of third-party risks), each having conflicting normative recommendations (MacKay and Saylor 2020). The authors also offer guidance as to how we should navigate between subprinciples that may conflict with each other. The problem is a crucial (...) one since fair subject selection is one of the principles regulating clinical research that produces generalizable knowledge with the potential of improving people’s health. Therefore, there may be cases where the way in which participants are selected directly influences the generalizability (or its lack) of the clinically relevant knowledge and its value (if any) to different groups. In my commentary article, written from the philosophical perspective, I notice a number of interrelated problems which I believe have not been discussed thoroughly in the target article: (1) the precise way in which health care priority setting should influence the content of health research priority setting and fair inclusion principles; (2) the distinction between group and individual benefits and burdens from clinical research; (3) the reference class problem in medical research. (shrink)

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

Health service consumers' satisfaction with the services they receive has been a challenge over the past decade, and this has been attributed to many factors that diverse scholars have investigated using different variables. In this study, the attitude and ethical behaviours of healthcare providers as antidotes to health service consumers' satisfaction in the Primary Health Centre at Mgbuoshimini, Port Harcourt, Nigeria, were investigated. A cross-sectional descriptive research design was used to select participants from pregnant women, nursing mothers, couples (...) for family planning, and sick patients. The data were analysed using descriptive statistical tools. The results of the grand total response values were 400 (100%) and strongly agree had 190 (47.5%), agree had 160 (40%), 390 (100%) and strongly agree had 260 (66.7%), agree had 100 (25.6%), and strongly disagree had 13 (3.3%). The overall results were strongly agreed (66.7%) and agreed (25.6%); these connote that the attitudes and ethical behaviours of the healthcare providers towards healthcare service consumers in the primary healthcare facility were poor and that healthcare providers do not execute good ethical behaviour towards health service consumers in the facility, leading to low levels of health resource consumption, low patronage image promotion, and consumers' loss of confidence in the service provider. Therefore, the government should put mechanisms in place to ensure a positive attitude and favourable ethical behaviour among healthcare providers, and individual healthcare providers should also acquire soft skills to improve their attitude and ethical behaviour. (shrink)

Placebo-trials on HIV-infected pregnant women in developing countries like Thailand and Uganda have provoked recent controversy. Such experiments aim to find a treatment that will cut the rate of vertical transmission more efficiently than existing treatments like zidovudine. This scenario is first stated as generally as possible, before three ethical principles found in the Belmont Report, itself a sharpening of the Helsinki Declaration, are stated. These three principles are the Principle of Utility, the Principle of Autonomy and the (...) Principle of Justice. These are taken as voices of moral imperative. But although each has intuitive appeal, it can be shown that there are possible scenarios in which they give conflicting prescriptions. To achieve consistency, one must be subordinate to the others. The voice of utility is taken as subordinate to those of justice and autonomy and it is shown that given plausible assumptions about the level of poverty and education in the developing country targeted, the experiment is ruled morally wrong in the name of both justice and autonomy. Moreover, it is argued that no justification can be found for the inclusion of a placebo group, when strictly defined. By contrast, a ‘no- treatment’ control arm might be justified, but only when the demands of autonomy are satisfied, demands that are more stringent than they might appear. A utilitarian defence of the experiment is examined, namely that the would-be participants are in a no-loss situation, and it is shown that this defence is seriously flawed. Finally, it is concluded that there is no justification for amending the Declaration of Helsinki. (shrink)

This brief paper summarizes a series of postal investigations on the acceptance of selection for X or Y spermatozoa. These were conducted mainly in Germany but also in the UK, the Netherlands and the US. Selected families were approached with a series of questions about their wish to use sperm selection, and their choice of boys or girls. In general, large majorities opposed this approach for family balancing or sex selection on the basis of cost and inconvenience of the treatment. (...) The view was expressed that its use in medicine was more acceptable. Care was taken to compose a series of open questions to particular sections of the population, e.g.men versus women, differing ages, and families with imbalanced sex ratios. More favourable responses arose, for example in pregnant women. Overall, all four nations had large majorities against the use of sex selection. (shrink)

In this essay I argue that childbearing and various kinds of organ donation are morally analogous activities. I argue, further, that the ethos of giftgiving ought to inform our analyses of both of these forms of bodily life support. This reframing of the abortion and organ donation debates yields new insights into two relatively neglected subtopics. First, though frequently asserted, few have demonstrated why bodily life support--especially in the form of childbearing--cannot be morally required. This comparison yields insights into the (...) reasons for such an axiom. Second, while the giving of bodily life support is sometimes exhorted and almost always respected and admired, its intelligibility and political meaningfulness as a moral choice is rarely explored. This analogical wager reveals why one ought to give another bodily life support. In summary, the analogy yields insights crucial to the development of cogent arguments regarding both the grounds for and limits of the responsibility to give bodily life support. Further, the analogy displays the disparity between what has been demanded traditionally of those who are pregnant and of those men (and women) who by virtue of tissue or blood type can offer other forms of bodily life support. The analogy enables reflection on abortion (and organ donation) to develop in a context free of sexist biases. Finally, efforts are made to assess this giftgiving ethos in light of the feminist "hermeneutics of suspicion" regarding arguments which have and can sacralize victimization. (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)

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)

Are rights to privacy consistent with sexual equality? In a brief, but influential, article Catherine MacKinnon trenchantly laid out feminist criticisms of the right to privacy. In “Privacy v. Equality: Beyond Roe v. Wade” she linked familiar objections to the right to privacy and connected them to the fate of abortion rights in the U.S.A. (MacKinnon, 1983, 93-102). For many feminists, the Supreme Court’s decision in Roe v. Wade (1973) had suggested that, notwithstanding a dubious past, legal rights to privacy (...) might serve feminist objectives, and prove consistent with sexual equality. By arguing that Roe’s privacy justification of abortion rights was directly responsible for the weakness and vulnerability of abortion rights in America, MacKinnon took aim at feminist hopes for the right to privacy at their strongest point. Maintaining that Roe’s privacy justification of abortion is intimately, and not contingently, related to the Supreme Court’s subsequent decision in Harris v. McRae, (1980) MacKinnon concluded that privacy rights cannot be reconciled with the freedom and equality of women, and so can have no place in a democracy.1 In Harris, the Supreme Court held that the State need not provide Medicaid coverage for abortions that are necessary to preserve the health, but not the life, of a pregnant woman, effectively depriving poor women of almost all state aid for abortions.2 Moreover, the Court’s subsequent decision in Bowers v . Hardwick (1986) appeared to confirm the truth of MacKinnon’s observation – though this case concerned gay rights, rather than abortion rights, and occurred several years after MacKinnon’s condemnation of Harris. -/- This paper examines MacKinnon’s claims about the relationship of rights to privacy and equality in light of the reasoning in Harris and Bowers. When we contrast the Majority and Minority decisions in these cases, it shows, we can distinguish interpretations of the right to privacy that are consistent with sexual equality from those that are not. This is not simply because the two differ in their consequences – though they do - but because the former, unlike the latter, rely on empirical and normative assumptions that would justify sexual inequality whatever right they were used to interpret. So while I agree with MacKinnon that the Majority’s interpretation of the right to privacy in Harris is inconsistent with the equality of men and women, I show that there is no inherent inconsistency in valuing both privacy and equality, and no reason why we must chose to protect the one, rather than the other. Indeed, an examination of MacKinnon’s article, I suggest, can help us to see why rights to privacy can be part of a scheme of democratic rights, and how we might go about democratising the right to privacy in future. To avoid confusion I should emphasise that my arguments are of a philosophical, not a legal, nature. Thus, I will be ignoring the specifically legal and constitutional aspects of MacKinnon’s article, and of the Supreme Court decisions, in order to bring their philosophical significance into focus. -/- . (shrink)

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

It is now more than twenty years since Knight (1987) first presented his paradigm-shifting theory of how and why the ‘human revolution’ occurred — and had to occur — in modern humans who, as climates dried under ice age conditions and African rainforests shrank, found themselves surrounded by vast prairies and savannahs, with rich herds of game animals roaming across them. The temptation for male hunters, far from any home base, to eat the best portions of meat at the kill (...) site — as do other social carnivores — called for strong measures from human females, who were paying the heavy metabolic and physical costs of bearing large-brained but helpless children. Even in the modern west, with well stocked supermarkets, a pregnant or lactating woman can lose ten percent of the dry weight of her brain, because developing babies demand dietary lipids for brain growth (Horrobin, 1998). Hence the idea of the menstrual sex strike, designed to force males to deliver their kills entirely into the hands of women for cooking and distribution—a practice common in foraging communities to this day. (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)

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)

This paper considers how women and gender are conceptualised within early German Romanticism and argues that work by early German Romantic women should be addressed in scholarship on this movement. The chapter addresses feminist critiques of early German Romanticism as exemplified by the work of Friedrich Schlegel and Novalis, concluding that an essentialist view of traditional gender characteristics informs central aspects of these writers’ work, including their view of the relationship between human beings and nature and their theories (...) of language and poetry. The paper argues that a thoroughgoing critique of gender categories and development of the implications of this critique are found in the early German Romantic writings, not of Schlegel and Novalis, but of Dorothea Veit-Schlegel and Karoline von Günderrode. (shrink)

Many women wrote philosophy in nineteenth-century Britain, and they wrote across the full range of philosophical topics. Yet these important women thinkers have been left out of the philosophical canon and many of them are barely known today. The aim of this book is to put them back on the map. It introduces twelve women philosophers - Mary Shepherd, Harriet Martineau, Ada Lovelace, George Eliot, Frances Power Cobbe, Helena Blavatsky, Julia Wedgwood, Victoria Welby, Arabella Buckley, Annie Besant, (...) Vernon Lee, and Constance Naden. Alison Stone looks at their views on naturalism, philosophy of mind, evolution, morality and religion, and progress in history. She shows how these women interacted and developed their philosophical views in conversation with one another, not only with their male contemporaries. The rich print and periodical culture of the period enabled these women to publish philosophy in forms accessible to a general readership, despite the restrictions women faced, such as having limited or no access to university education. Stone explains how these women became excluded from the history of philosophy because there was a cultural shift at the end of the nineteenth century towards specialised forms of philosophical writing, which depended on academic credentials that were still largely unavailable to women. (shrink)

In this article, I explore two neglected works by the twentieth-century Jewish German Marxist philosopher Ernst Bloch, Avicenna and the Aristotelian Left and Natural Law and Human Dignity. Drawing on previous analyses of leftist Aristotelians and natural law, I blend Bloch’s two texts’ concepts of pregnant matter and maternal law into “pregnant materialist natural law.” More precisely, Aristotelian Left articulates a concept of matter as a dynamic, impersonal agential force, ever pregnant with possible forms delivered by artist-midwives, (...) building Bloch’s messianic utopia. And Natural Law resurrects the Stoics’ concept of natural law as drawing on a prehistoric matriarchal utopia, later channeled by earth goddess cults misconstrued by the nineteenth-century German anthropologist Johann Jakob Bachofen as political matriarchy. I then conclude by linking this pregnant materialist natural law to Dionysus as son of the Great Mother Goddess. Though stigmatized throughout homophobic Western history for his queerness and maternal dependence, Dionysus is also the patron god of Bloch’s hero, the slave revolutionary Spartacus, paramour of a priestess of Dionysus who prophesied his divine mission of liberation. (shrink)

1 Some philosophers defend the thesis that women are adult human females. Call this the adult human female thesis (AHF). There are two versions of this thesis—one modal and one definitional. Accord...

Abstract: The emergence of women entrepreneurs and their contribution to the national economy is quite visible in India. Women’s entrepreneurship has been recognized during the last decade as an important untapped source of economic growth. According to of statistics women in India 2010, proportion of female main workers to total population in percentage is 16.65 in rural areas and 9.42 in urban areas this shows overall less contribution of women in work but more percentage of (...) class='Hi'>women workers in rural areas. According to the quick result of the Fourth All India Census of MSMEs (2006-07), there are 26 million MSMEs in India which provides employment to about 60 million people. The sector contributes about 40 % GDP, beside 45% to the total manufacturing output and 40 % to the exports from the country. There could be many opportunities identification hidden inside the challenges for small business concerns. This paper examines various opportunities and challenges for Women Entrepreneurship Development in Micro Small and Medium Enterprise. More precisely the paper explores, rewards for starting a small business, myths about small businesses, new opportunities, four forms of entrepreneurship, identification practices among first generation and major challenges in small business. (shrink)

Are women (simply) adult human females? Dictionaries suggest that they are. However, philosophers who have explicitly considered the question invariably answer no. This paper argues that they are wrong. The orthodox view is that the category *woman* is a social category, like the categories *widow* and *police officer*, although exactly what this social category consists in is a matter of considerable disagreement. In any event, orthodoxy has it that *woman* is definitely not a biological category, like the categories *amphibian* (...) or *adult human female*. -/- In the first part, a number of arguments are given for the view that women are adult human females; the second part turns to rebutting the main objections. Finally, a couple of morals are briefly noted: one for activist sloganeering, and one for ameliorative projects that seek to change the meaning of ‘woman’. (shrink)

This chapter provides the background to the American women philosophers’ works that are introduced and collected in Knowledge, Mind and Reality: An Introduction by Early Twentieth-Century American Women Philosophers. We describe the institutional context which made these works possible and their methodological and theoretical background. We also provide biographies for their authors.

In this paper, I focus on the representations of Black women in contrast to Black men found within Frantz Fanon’s philosophical work Black Skin, White Masks. I propose that while Fanon’s racial dialectical work is very significant, he often lacks acknowledgement of the multidimensionality of the Black woman’s lived experience specifically. Drawing on the theory of intersectionality, coined by Kimberlé Crenshaw, I argue that Fanon does not recognize the different layers of oppression operating in Black women’s lives to (...) the degree that he fails to include them within his framework of both liberation and resistance from racial oppression. (shrink)

One of the key insights of Simone de Beauvoir’s The Second Sex is the idea that gender-based subordination is not just something done to women, but also something women do to themselves. This raises a question about ethical responsibility: if women are complicit, or actively implicated in their own oppression, are they at fault? Recent Beauvoir scholarship remains divided on this point. Here, I argue that Beauvoir did, in fact, ethically criticize many women for their complicity, (...) as a sign of what she called “bad faith”. I challenge recent accounts by Nancy Bauer and Manon Garcia, who both read Beauvoir as exonerating complicit women. According to this reading, women emerge as human “freedoms” within a social world where a “destiny” of inferiority is already prepared for them. Their self-subordination is then an inevitable product of acting in a patriarchal world. I argue, however, that this interpretation generates a crucial tension, leading Bauer and Garcia to call on women to stop being complicit, while also claiming they cannot avoid complicity. I propose instead a different interpretation, on which feminine complicity is often fueled by criticizable ethical attitudes that are far from inevitable. By revisiting Beauvoir’s notion of “bad faith”, I show that this account is compatible with recognizing the limitations imposed on women’s agency and I show that this feminist ethical criticism is itself an important part of a collective project of social transformation. (shrink)

Philosophy has the dubious distinction of attracting and retaining proportionally fewer women than any other field in the humanities, indeed, fewer than in all but the most resolutely male-dominated of the sciences. This short article introduces a thematic cluster that brings together five short essays that probe the reasons for and the effects of these patterns of exclusion, not just of women but of diverse peoples of all kinds in Philosophy. It summarizes some of the demographic measures of (...) exclusion that are cause for concern and identifies key themes that cross-cut these discussions: gender stereotypes and climate issues, ‘cognitive distortions’ and disciplinary norms. (shrink)

The paper identifies the phenomenal rise of increasingly invasive forms of elective cosmetic surgery targeted primarily at women and explores its significance in the context of contemporary biotechnology. A Foucauldian analysis of the significance of the normalization of technologized women's bodies is argued for. Three "Paradoxes of Choice" affecting women who "elect" cosmetic surgery are examined. Finally, two utopian feminist political responses are discussed: a Response of Refusal and a Response of Appropriation.