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. And so abortion is typically wrong—and this holds whether or not fetuses are persons.

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)

Romanis and Adkins explore the near-term prospect of artificial amnion and placenta technology (AAPT) which is being developed to supplement the gestational process following the premature ending of a pregnancy.1 While fetal-centric narratives prevail in discussions surrounding AAPT, the authors subvert this trend by centering the experience of pregnant persons with respect to pregnancy loss. The overarching aim of their paper is to move beyond a ‘philosophical understanding of pregnancy towards practical-orientated conclusions regarding the care pathways surrounding (...) [AAPT]’ (Romanis and Adkins,1 p1). This commentary will critically examine the viability of this aim. Romanis and Adkins use the term ‘pregnancy loss’ to refer to the phenomenon where individuals experience a complex set of emotions following the premature ending of pregnancy, despite the survival of the gestated entity. Following Golish and Powell, the authors note how parents may experience contradictory emotions, such as joy mixed with grief, as well as a range of negative feelings including shame, disappointment and a sense of failure.2 At present, this phenomenon has been recognised among parents, particularly the (formerly) pregnant person, in the context of neonatal intensive care units (NICUs) when the infant survives preterm delivery and …. (shrink)

In this paper, I suggest that, if we are committed to accepting a threshold approach to personhood, according to which all beings above the threshold are persons with equal moral status, there are strong reasons to also recognise a second threshold that would be reached through human pregnancy, and that would confer on pregnant women a temporary superior moral status. This proposal is not based on the moral status of the fetus, but on the moral status of the pregnant (...) woman. It is not only the fetus which is an organism sui generis: the pregnant woman, also, is a unique being. Following almost any view on the moral status of the fetus, the pregnant woman should be regarded, herself, as more than a singular individual. She is, herself, ‘more than one’. Pregnant women are also necessary for the continued survival of the human species, and there are important justice-based reasons to recognise the higher status. Furthermore, the recognition of a superior moral status for pregnant women does not imply that pregnancy should always be viewed as desirable, or imply any position on the permissibility of abortion. My proposal is not as radical as it might seem, as it does not require that pregnant women should always receive superior treatment, but only that they should to some extent. It could have a range of potential positive practical consequences. Finally, my approach does not threaten, but rather promotes, human equality. (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)

In this paper, we explore how the prospect of artificial placenta technology (nearing clinical trials in human subjects) should encourage further consideration of the loss experienced by individuals when their pregnancy ends unexpectedly. Discussions of pregnancy loss are intertwined with procreative loss, whereby the gestated entity has died when the pregnancy ends. However, we demonstrate how pregnancy loss can and does exist separate to procreative loss in circumstances where the gestated entity survives the premature ending of (...) the pregnancy. In outlining the value that can be attached to pregnancy beyond fetal-centric narratives, we illustrate how pregnancy loss, separate to procreative loss, can be experienced. This loss has already been recognised among parents who have experienced an unexpected early ending of their pregnancy, resulting in their child being cared for in neonatal intensive care unit. Artificial placentas, however, may exacerbate these feelings and make pregnancy loss (without procreative loss) more visible. We argue that pregnancy is an embodied state in which gestation is facilitated by the body but gestation itself should be recognised as a process—and one that could be separable from pregnancy. In demarcating the two, we explore the different ways in which pregnancy loss can be understood. Our objective in this paper goes beyond contributing to our philosophical understanding of pregnancy towards practical-orientated conclusions regarding the care pathways surrounding the artificial placenta. We make recommendations including the need for counselling and careful consideration of the language used when an artificial placenta is used. (shrink)

This paper aims to problematize pregnancy and support the development of a safe alternative method of gestation. Our arguments engage with the health risks of gestation and childbirth, the value assigned to pregnancy, as well as social and medical attitudes toward women’s pain, especially in labor. We claim that the harm caused by pregnancy and childbirth provides a prima facie case in favor of prioritizing research on a method of extra corporeal gestation.

Part graphic novel, part feminist and philosophical analysis, The Pregnancy ≠ Childbearing Project explores how pregnancy can be a meaningful and distinct phenomenon from childbirth and does not equate with childbearing or the production of children.

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)

Anna Smajdor and Joona Räsänen argue that we have good reason to classify pregnancy as a disease. They discuss five accounts of disease and argue that each account either implies that pregnancy is a disease or, if it does not, it faces problems. This strategy allows Smajdor and Räsänen to avoid articulating their own account of disease. Consequently, they cannot establish that pregnancy is a disease, only that plausible accounts of disease suggest this. Some readers will dismiss (...) Smajdor and Räsänen’s claims as counterintuitive. By analogy, if a mathematical proof concludes ‘2+2=5’, readers will know—without investigation—that an error occurred. Rather than dismiss Smajdor and Räsänen’s work, however, the easiest way to undermine their argument is to describe at least one plausible account of disease that (i) excludes pregnancy and (ii) avoids the problems they raise for it. This is our strategy. We focus on dysfunction accounts of disease. After outlining Smajdor and Räsänen’s main arguments against dysfunction accounts, we explain why pregnancy is not a disease on these accounts. Next, we defend dysfunction accounts against the three problems that Smajdor and Räsänen raise. If successful, then contra Smajdor and Räsänen, at least one plausible account of disease does not imply that pregnancy is a disease. We suspect that defenders of other accounts can respond similarly. Yet, we note that insofar as dysfunction accounts align with the commonsense intuition that pregnancy is not a disease, this, all else being equal, seems like a point in their favour. (shrink)

Nietzsche employs the concept of pregnancy metaphorically at various points in his writings; discussing the pregnancy of philosophers (GM III 8, BGE 292), spiritual pregnancy (EH, Clever 3; GS 72) and being pregnant with thoughts or deeds (D 552). I explore how Nietzsche uses the notion of pregnancy in Dawn, arguing that it connects to the theme of self-cultivation. I employ the various associations that Nietzsche makes with pregnancy, including the unknown, selfishness, strangeness, and solitude, (...) to elucidate Nietzsche’s understanding of self-cultivation. I show how the metaphor of pregnancy, in which we do not control what we give birth to, both expresses and helps us explore the problem of what, if the self is made up of and directed by many competing drives, shapes and directs self-cultivation. I argue that Nietzsche’s deliberate references to the context of Plato’s discussion of pregnancy involve a self-conscious challenge to Plato’s concept of the philosopher, and of philosophy, and a reimagining of what they will give birth to. The appropriation of Plato’s famous metaphor thus underscores how Nietzsche’s concept and method of self-cultivation contrasts to Plato’s care for the soul and is rooted in attentiveness to the body and its drives. (shrink)

In his paper, ‘Twin pregnancy, fetal reduction and the ‘all or nothing problem’, Räsänen sets out to apply Horton’s ‘all or nothing’ problem to the ethics of multifetal pregnancy reduction from a twin to a singleton pregnancy. Horton’s problem involves the following scenario: imagine that two children are about to be crushed by a collapsing building. An observer would have three options: do nothing, save one child by allowing their arms to be crushed, or save both by (...) allowing their arms to be crushed. Horton offers two intuitively plausible claims: it is morally permissible not to save either child and it is morally impermissible to save only one of the children, which taken together lead to the problematic conclusion that if an observer does not save both children, then it is better to save neither than save only one. Räsänen applies this problem to the case of 2-to-1 MFPR, arguing ultimately that, in cases where there is no medical reason to reduce, the woman ought to bring both fetuses to term. We will argue that Räsänen does not provide adequate support for the claim, crucial to his argument, that aborting only one of the fetuses in a twin pregnancy is wrong, so the ‘all or nothing’ problem does not arise in this context. Furthermore, we argue that the scenario Räsänen presents is highly unrealistic because of the clinical realities of 2-to-1 MFPR, making his argument of limited use for real-life decision making in this area. (shrink)

This paper focuses on the relations among critique, destruction and negation, on the one hand, and creation, affirmation, love, and care on the other, in Nietzsche’s writings from Daybreak to Zarathustra. In doing this, it traces a movement in Nietzsche's thought that can be understood as an integration of critique in the process of affirmation, which consolidates in Nietzsche’s project of self-overcoming. In contrast to readings that use the metaphor of art and the creativity of the artist, this paper presents (...) pregnancy as a cipher to understand Nietzsche’s project as well as the dynamics that are involved. A key issue addressed throughout the entire paper concerns the way in which Zarathustra says that he loves those who want their own downfall (Untergang) and go “zu Grunde” (or perish). To fully grasp the meaning of these rather puzzling utterances, the paper analyzes Nietzsche's engagement with Pascal (as a very particular case of “going under”). (shrink)

The pregnancy rescue case (PRC) is supposed to show that when forced between preventing a fetus from being killed and preventing someone from remaining unwillingly pregnant, we are morally required to do the former. If this is true, then Hendricks argues that the typical abortion is morally wrong. I pose four problems for PRC and how Hendricks uses it here. First, one might simply deny the intuition Hendricks takes PRC to pump for reasons having to do with the moral (...) status of the fetus. Second, even if it is true that we should prevent the fetus from being killed in PRC, this might not tell us much about the moral permissibility of abortion in typical cases because there are important differences between PRC and the typical abortion. Third, I propose some modifications to PRC that would better isolate whether fetal personhood does any work to pump the target intuition. Fourth, I argue that PRC only succeeds if we presuppose that Thomson’s defence is unsound, but presupposing this comes at too high a cost. (shrink)

In their paper, Romanis and Adkins delve into the potential impact of artificial amnion and placenta technology (AAPT) on cases of pregnancy loss1 that do not involve procreative loss. First, they call for more recognition of the negative feelings a person might have due to the premature end of their pregnant state. They claim that, should AAPT minimise concerns about prematurity as anticipated, individuals might feel pressured to opt for partial ectogestation to preserve their or their fetus’ well-being; moreover, (...) they point out that the feelings of loss in the context of AAPT are likely to be worse than the ones reported in neonatal intensive care units cases. Finally, they advocate for care pathways focusing on how the transfer of a fetus to the AAPT could affect the pregnant person, with particular attention to managing the grief potentially caused by the pregnancy loss. I praise the authors for such a call to action—especially since partial ectogestation is expected to become a reality in the short-term future—and I share their demands for additional and more attentive care of (formerly) pregnant patients. However, I am concerned that their approach is so focused on negative feelings towards pregnancy loss that it risks becoming …. (shrink)

This paper develops a phenomenological defense of Ian Hacking's experimental realism about unobservable entities in physical science, employing historically undervalued resources from the phenomenological tradition in order to clarify the warrant for our ontological commitments in science. Building upon the work of Husserl, Merleau-Ponty and Heelan, the paper provides a phenomenological correction of the positivistic conception of perceptual evidence maintained by antirealists such as van Fraassen, the experimental relevance of which is illustrated through a phenomenological interpretation of the 1974 discovery (...) of the J/ ψ particle generally regarded as evidence for the charmed quark. The argument then turns to address known problems in Hacking's account, demonstrating that his own instrumentalist criterion of the real is inadequately rooted in the phenomenology of perception, and as a result, passes over the true ontological significance of experimental phenomena. The paper maintains that the proper criterion, only indirectly related to instrumentality, is the distinctive style of the real encountered in perception: empirical pregnancy. With this notion and Merleau-Ponty's associated reversibility thesis, I show that the phenomenological tradition provides insights into the warrant for our realist commitments that have yet to be adequately acknowledged by philosophers of science. (shrink)

This highly original book argues for increased recognition of pregnancy, birthing and childrearing as social activities demanding simultaneously physical, intellectual, emotional and moral work from those who undertake them. Amy Mullin considers both parenting and paid childcare, and examines the impact of disability on this work. The first chapters contest misconceptions about pregnancy and birth such as the idea that pregnancy is only valued for its end result, and not also for the process. Following chapters focus on (...) childcare provided in different circumstances and on the needs of both providers and receivers of care. The book challenges the assumption that isolated self-sacrifice should be the norm in either pregnancy or childcare. Instead reproductive labor requires greater social support. Written from the perspective of a feminist philosopher, the book draws on the work of, and seeks to increase dialogue between, philosophers and childcare professionals, disability theorists, nurses and sociologists. (shrink)

Ethical and legal traditions recognize prenatal duties to avoid harm to offspring. However, applying the harm principle to pregnancy requires a careful balancing of a baby's welfare with a pregnant woman's interest in liberty and bodily integrity. In the case of maternal PKU the mother can prevent harm to her baby by returning to the admittedly unpleasant diet that prevented her from being retarded. Informing, counseling, and access to medical care should be the primary policy. Seizures and forced treatment (...) cannot be justified in this case, and only rarely in other situations. (shrink)

Individuals with disabilities face significant challenges, both physically and socially. To claim a disability, therefore, is not something one ought to do lightly. Pregnancy, however, presents a very difficult and interesting case. Pain, discomfort, and inconvenience are often daily aspects of pregnancy, and pregnancy itself can cause physical, as well as social, impediments that can substantially interfere with one's day-to-day work and life. In practice, based on our current laws concerning family leave, ailments brought on by (...) class='Hi'>pregnancy can be cited as a temporary disability in certain circumstances. However, the kind of "pregnancyrelated disability" that is built into such leave policies and laws falls short of... (shrink)

This book provides extensive and critical engagement with some of the most recent and compelling arguments favoring abortion choice. It features original essays from leading and emerging philosophers, bioethicists and medical professionals that present philosophically sophisticated and novel arguments against abortion choice. The chapters in this book are divided into three thematic sections. The first set of essays focuses primarily on unborn human individuals--zygotes, embryos and fetuses. In these chapters it is argued, for example, that human organisms begin to exist (...) at conception and that zygotes, embryos and fetuses are persons. These chapters also explore questions about whether or not zygotes, embryos and fetuses are part of their mothers' bodies. The second set of essays focuses primarily on elective abortion and the debates surrounding it. These chapters consider whether or not opponents of abortion are commonly hypocritical, how opponents of abortion should think about adoption, how emerging technologies may affect the current debate and whether or not those participating in the debate should rely on analogies to support their case. Finally, the third set of essays shifts focus from the legal and moral status of elective abortion to its place in medical practice. In these chapters it is argued that elective abortion embodies a kind of ableism, and that elective abortion is medically unnecessary, harmful to women's mental health and that telemedicine abortion poses significant risks to women's health. Agency, Pregnancy and Persons offers an up-to-date examination of unborn human beings, the debates surrounding elective abortion and the place of elective abortion within medical practice. It will be of interest to medical professionals and those who work in philosophy, bioethics and medical ethics alike. (shrink)

Although Plato's notion of spiritual pregnancy has received a great deal of critical attention in recent years, the development of the metaphor in the Symposium has not been fully analysed. Close attention to the details of the image reveals two important points which have so far been overlooked: There are two quite different types of spiritual pregnancy in the Symposium: a ‘male’ type, which is analogous to the build-up to physical ejaculation, and a ‘female’ type, which is analogous (...) to the physical experience of pregnancy as normally understood. (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)

Background: The pregnancy and psychological status of infertile couples has always been a concern, but there is no clear evidence for the efficacy of psychotherapy for infertile couples. This study aimed to summarize the current evidence of the effects of psychotherapy on psychological and pregnancy outcomes for infertile couples. Method: We searched Ovid MEDLINE, Ovid EMbase, The Cochrane Library, and Web of Science for articles published from 1946 to June 26, 2020. The pregnancy outcomes, psychological outcomes, and (...) acceptability were involved in the study. Results: Overall, 29 studies with a combined total of 3,522 adult participants were included in the meta-analysis. Compared with a placebo, psychotherapy was associated with the pregnancy rate [risk ratio = 1.43, 95% CI [1.07, 1.93]], total psychological scales associated with infertility [standardized mean difference = −0.33 95% CI [−0.63, −0.02]], subsymptoms of psychological scores using the 28-item version of GHQ, and the integrative body–mind–spirit ; total psychological scales associated with infertility using other treatments and more than a month; and anxiety using BMS had significant statistical significance. The funnel plots of all outcomes were approximately symmetrical, and no significant publication bias was found. Conclusions: The study showed that psychotherapy can lead to improvements in the pregnancy rate for infertile patients, especially for patients receiving assisted fertility. In addition, it may help improve total psychological scales associated with infertility and depression. CBT and BMS play an important role in improving rate of pregnancy, and BMS is associated with reducing anxiety. Although psychological interventions had limited effects on the pregnancy outcomes of infertility, our study still recommended that psychotherapies, in particular CBT and BMS, were applied to the therapeutic regimen for infertility, especially for patients receiving assisted fertility. (shrink)

One of the most influential philosophical arguments in favour of the permissibility of abortion is Judith Jarvis Thomson’s violinist analogy, presented in ‘A Defense of Abortion’. Its appeal for pro-choice advocates lies in Thomson’s granting that the fetus is a person with equivalent moral status to any other human being, and yet demonstrating—to those who accept her reasoning—that abortion is still permissible. In her argument, Thomson draws heavily on the parable of the Good Samaritan, arguing that gestating a fetus in (...) some circumstances is what she calls a Good Samaritan act, and claiming that we are not morally required to be Good Samaritans. Here, I argue that Thomson has subverted the parable to justify an action that is the antithesis of its meaning. I contend that Christians are required to be Good Samaritans, and explain that for Christians, this entails abortion is impermissible in all circumstances. Further, I argue that the parable shows the fetus is our neighbour in need of our mercy and assistance, and consequently Christians should be actively involved in helping to ensure the unborn are protected, whether they are fetuses in danger of induced abortion or miscarriage, or surplus frozen embryos. (shrink)

In this paper, I reflect on an important article by Bob Veatch in the inaugural issue of the Hastings Center Report, entitled “Experimental Pregnancy.” It is a report and elegant analysis of the Goldzieher Study, in which nearly 400 women were randomized to receive hormonal contraception or placebo absent consent or disclosure about placebo use, resulting in several pregnancies. Noting the study’s limited notoriety, I first consider the narratives that have instead dominated bioethics’ approach to pregnancy and research: (...) thalidomide and diethylstibesterol. These narratives have facilitated a narrow focus on avoiding fetal risk, to the exclusion of other ethically relevant considerations. I then revisit “Experimental Pregnancy” and offer two ways in which Bob’s analysis serves as an important corrective, first, by foregrounding research subjects, and second, by normalizing pregnancy and thus foregrounding foundational ethical considerations that are sometimes lost amidst pregnancy’s presumed exceptionalism. (shrink)

Pregnancy has been traditionally defined as the period during which developing embryos are incubated in the body after egg–sperm union. Despite strong similarities between viviparity in mammals and other vertebrate groups, researchers have historically been reluctant to use the term pregnancy for non‐mammals in recognition of the highly developed form of viviparity in eutherians. Syngnathid fishes (seahorses and pipefishes) have a unique reproductive system, where the male incubates developing embryos in a specialized brooding structure in which they are (...) aerated, osmoregulated, protected and likely provisioned during their development. Recent insights into physiological, morphological and genetic changes associated with syngnathid reproduction provide compelling evidence that male incubation in these species is a highly specialized form of reproduction akin to other forms of viviparity. Here, we review these recent advances, highlighting similarities and differences between seahorse and mammalian pregnancy. Understanding the changes associated with the parallel evolution of male pregnancy in the two major syngnathid lineages will help to identify key innovations that facilitated the development of this unique form of reproduction and, through comparison with other forms of live bearing, may allow the identification of a common set of characteristics shared by all viviparous organisms. BioEssays 29:884–896, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

IntroductionGlobally, 15% of adolescents give birth before turning 18, leading to considerable personal, social, and medical impacts on adolescents and to the general society.ObjectiveThis study aimed at exploring and comparing three psychological attributes between parents and teachers for the phenomena.Method672 teachers and 690 parents participated in the study.ResultsThe results indicated a significant mean difference between parents and teachers on empathy, attribution of blame, and feelings of responsibility. Except for attribution of blame, parents’ mean scores of other variables were higher than (...) that of teachers.DiscussionTeachers’ higher attribution of blame to pregnant adolescents and lower empathetic concern raises a prominent concern over students’ healthy environment at school.ConclusionUnderstanding social feelings about responsibilities over adolescents’ general health is very essential, especially for fighting against the problem of early pregnancy. (shrink)

To what extent are women obliged to be child-bearers? If reproductive technology could offer some form of ectogenesis, would feminists regard it as a liberating reproductive option? Three lines of reproductive rights arguments currently used by feminists are applied to ectogenesis. Each fails to provide strong grounds for prohibiting it. Yet, there are several ways in which ectogenesis could contribute to women's oppression, in particular, if it were used to undermine abortion rights, reinforce traditional views of fertility, increase fetal rights (...) in pregnancy, and perpetuate the unequal distribution of scarce medical resources. A re-thinking of women's relationship to pregnancy is needed in order to challenge ectogenetic research. (shrink)

The commentaries in response to our feature paper1 are indicative of the varied perspectives that can be taken towards artificial amnion and placenta technology (AAPT) and more specifically its relationship with pregnancy (loss). Kennedy rightly argues that empirical research is essential for understanding the experiences of pregnancy loss and AAPT2 and our own advocacy of empirical research is evident in previous work.3–5 Kennedy also acknowledges the current impossibility of researching AAPT experiences since it has not yet been applied (...) in clinical settings. It is precisely for this reason that we draw on the reported experiences of neonatal intensive care (NICU) parents since they present the closest analogy which can be drawn with the technology.1 What we reject in Kennedy’s response, however, is the claim that the experiences of NICU parents have been ‘exploited’ by us.2 Studies documenting the experiences of NICU parents were drawn on to indicate that our considerations are more than mere speculation. As stated, the experiences of NICU parents, particularly the pregnant individual who experiences pregnancy loss, are the closest indication we have of how AAPT and what it entails may be experienced. To claim that this data is being exploited by us is to undermine the very purpose that such research is undertaken—to indicate how future care may be improved. It would be much more harmful to not use this information. While we believe that experiences of …. (shrink)

Inside and outside of a Christian worldview, bioethicists have discussed ectopic pregnancy at some length as a maternal-fetal vital conflict. Most bioethicists agree that methotrexate and salpingostomy are low-risk, successful interventions for this life-threatening pathology, and are thus beneficent, just, and wholly acceptable. A small cohort of Christian, largely Catholic, bioethicists have reservations about methotrexate and salpingostomy, but cannot resolve their internal disputes about these because of flawed casuistry. This paper aims to settle the issue about whether methotrexate and (...) salpingostomy are acceptable within a Catholic worldview: despite the best arguments in favor of methotrexate as a moral option, it is morally unacceptable, and despite hesitation about salpingostomy related to analogies with previable delivery, it is the optimal procedure for ectopic pregnancy. (shrink)

Termination of pregnancy after a certain gestational age and following prenatal diagnosis, in many nations seem to be granted with a special status to the extent that they by law have to be discussed within a predominantly medical context and have physicians as third parties involved in the decision-making process (‘indication-based’ approach). The existing legal frameworks for indication-based approaches, however, do frequently fail to provide clear guidance for the involved physicians. Critics, therefore, asked for professional ethics and professional institutions (...) in order to provide normative guidance for the physicians in termination of pregnancy on medical grounds. After outlining the clinical pathway in an indication-based approach and the involved types of (clinical) judgements, this paper draws upon different understandings of professional ethics in order to explore their potential to provide normative guidance in termination of pregnancy on medical grounds. The analysis reveals that professional ethics will not suffice—neither as a set of established norms nor as internal morality—in order to determine the normative framework of indication-based approaches on termination of pregnancy. In addition, there seem to be considerable inconsistencies regarding the target and outcome between prenatal testing on the one hand and following termination of pregnancy on the other hand. A source of morality external to medicine has to be the basis of evaluation if a consistent and workable normative framework for termination of pregnancy and prenatal testing should be established. (shrink)

The traditional conception of immune function is that of a system which differentiates the organism’s own tissues (the self) from any foreign invaders (nonself), preserving the former by rejecting the latter. In a mammalian pregnancy, however, the immunologically foreign foetus is accepted by the gestator’s immune system. This presents a serious challenge to the self–nonself theory which has sometimes been called the immunological paradox of pregnancy. In this paper I shall defend the self–nonself theory against the critique posed (...) by Thomas Pradeu. In addition I critically examine the alternative he proposes—the continuity theory. The main problem I will raise for any theory of immunology is that the phenomenon to be explained in pregnancy is the non-rejection of the foetus despite the triggering of the gestator’s immune system. I will argue that contemporary modified versions of the self–nonself theory can rise to this challenge but that continuity theory cannot. As such, the immunology of pregnancy gives us a good reason to favour contemporary self–nonself theory over the continuity theory. (shrink)

This paper looks at the Catholic justification of medical interventions in ectopic pregnancies. The paper first shows that the way how Double Effect Reasoning is often applied to ectopic pregnancies is not consistent with the way Aquinas introduces this mode of reasoning. The paper then shows certain problems in common defences of the use of salpingectomies. The paper then re-evaluates the medical interventions used in the management of ectopic pregnancies, with both a focus on the aim of the treatment and (...) the timing of the treatment. (shrink)

The pregnancy compensation hypothesis provides a mechanistic explanation for the evolution of sex differences in immune system functioning, the excess of women experiencing autoimmune disease, and why this is observed only in industrialized nations; none of which can be explained by the staying alive theory, as proposed by the authors of the target article.

Respected Catholic ethicists have recently defended the use of salpingostomy and methotrexate in the management of ectopic pregnancies.This article examines the arguments for the revised assessments to determine whether there are sound reasons to believe that these two methods do not constitute the direct and immediate killing of innocent human beings. National Catholic Bioethics Quarterly 11.1 (Spring 2011): 65–82.

A new kind of argument has been proposed to explain why health-care workers can sometimes refuse to offer a service or treatment. But this new kind of argument must also be evaluated and invoked differently.

While the Internet has emerged as a significant resource for women negotiating the questions and circumstances that arise during conception, pregnancy and childbirth, it remains unclear what role the Internet plays in challenging the current biomedical paradigm and empowering women to make meaningful choices. This article explores how women use the Internet to manage their pregnancies and mediate their doctor–patient relationships, particularly examining the role of social class and personal health history in shaping such Internet use. Drawing from in-depth (...) interviews with white middle-class mothers, the findings show that rather than using technology to resist the dominant biomedical paradigm, most women turned to online resources that affirmed mainstream medical authority and continued to rely on their doctors. By providing the means to confirm normalcy and take control in their reproductive experiences, the Internet enables socially privileged women to more fully perform the informed patient role in order to demonstrate their competence as mothers. (shrink)

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

Pregnancy leave and comparable worth deal with differences between female and male employees. In each case feminists are divided as to whether special treatment for women will promote equality or reinforce sex stereotypes and gender based segregation in the workplace. A radical restructuring of the workplace is necessary, to make possible a more human life for men and women. This restructuring is articulated in terms of the concepts of equality as "participation" or "incorporation" of all individuals into a community, (...) and androgyny. (shrink)

Problématisation, individuation, (dés)adaptation L’inventivité du vivant : la « disparation » Mouvements à vide. La spontanéité selon Simondon La prégnance des images Ontogenèse, phylogenèse, eikogenèse. L’image comme médiation .

Prenatal and preimplantation testing technologies have offered unprecedented access to information about the genetic and congenital makeup of our prospective progeny. Future developments such as preconception testing, non-intrusive prenatal testing and more extensive preimplantation testing promise to increase that access further still. The result may be greater reproductive choice, but it also increases the burden on women and men to avail themselves of these technologies in order to avoid having a child with a disability. The overwhelming question for legislators has (...) been whether and, if so, how to regulate the use of these technologies in the face of compelling but seemingly contradictory claims about the advancement of reproductive choice and the dangers of eugenic or discriminatory effects. This book examines the evolution of this legislative oversight across a number of jurisdictions and explores the tensions and ambiguities that inform these laws. (shrink)

A woman, perhaps a couple, learn they are pregnant. Perhaps she is elated for this desired news. Perhaps she is also overwhelmed or scared by the daunting task of parenthood ahead. Then, a prenatal screening reveals something worrisome about the fetus. A tumbling series of appointments and exams confirm the concerning findings. As Pope Francis notes, this news “changes the experience of pregnancy.” In place of optimistic wonderment for the future, parents now have new worries about whether their baby (...) will have a shortened life, experience suffering, or face many medical interventions in order to survive. I am a pediatric and perinatal palliative care doctor. I am often called to meet these wounded yet resilient... (shrink)

An interesting question, in both the moral and the legal context, is whether babies born of an infertility treatment-induced supernumerary pregnancy are properly considered to have been harmed. One might wonder how such a question could even arise in the face of data that clearly demonstrate that ITISP leaves an unduly large number of babies blind, deaf, and palsied, and facing lifelong disabilities. In fact, however, a number of arguments, based on the problem of collective form and two forms (...) of the so-called “nonidentity problem,” challenge the claim of harm in the ITISP context. The purpose of the present paper is to establish, as against these arguments, that harm has been imposed on the ITISP-damaged offspring. (shrink)

Mammals are usually considered unproblematic as biological individuals. This article contends the opposite. Once we consider pregnancy, criteria for biological individuality are not easily applicab...