This paper examines maternal trade-offs between subsistence/economic activities and caregiving, and it explores the effect of allomaternal investment on maternal time allocation and child care. I examine how nonmaternal investment in two multiple caregiving populations may offset possible risk factors associated with reductions in maternal caregiving. Behavioral observations were conducted on 8- to 12-month-old infants and their caregivers among the Aka tropical forest foragers and Ngandu farmers of Central Africa. Analysis demonstrates that mothers face trade-offs between (...) subsistence/economic activities and infant care. Infants receive less investment when their mothers engage in subsistence/economic activities, indicating a potential risk to those infants. However, results indicate that allomothers target their assistance during times when mothers are engaged in work activities, partially offsetting potential risks associated with the maternal trade-off. The effects of intercultural variability on maternal time allocation and allomaternal investment are also explored as a means of examining the potential impact of their behaviors on infant care. (shrink)

It has recently been reported that some hospitals in the UK have placed a blanket restriction on the provision of maternal request caesarean sections as a result of the COVID-19 pandemic. Pregnancy and birthing services are obviously facing challenges during the current emergency, but we argue that a blanket ban on MRCS is both inappropriate and disproportionate. In this paper, we highlight the importance of MRCS for pregnant people’s health and autonomy in childbirth and argue that this remains crucial (...) during the current emergency. We consider some potential arguments—based on pregnant people’s health and resource allocation—that might be considered justification for the limitation of such services. We demonstrate, however, that these arguments are not as persuasive as they might appear because there is limited evidence to indicate either that provision of MRCS is always dangerous for pregnant people in the circumstances or would be a substantial burden on a hospital’s ability to respond to the pandemic. Furthermore, we argue that even if MRCS was not a service that hospitals are equipped to offer to all pregnant persons who seek it, the current circumstances cannot justify a blanket ban on an important service and due attention must be paid to individual circumstances. (shrink)

Kant's contribution to modern Protestant theology is as unmistakable as it is controversial. The authors of this volume are investigating a new perspective on the work of theology and the effects of Kant's philosophy of religion concentrated on biblical hermeneutics and dogmatic theology.

Cet article a pour objectif de montrer l’importance de la réception de la théologie politique de J.B. Metz auprès de certains théologiens soucieux de la dimension politique de la foi chrétienne. L’étude présente les réactions immédiates au projet théologique de Metz pour ensuite se focaliser sur des théologiens contemporains. Premièrement, on trouve J. Milbank, qui apprécie la pensée de Metz en la confrontant à son programme de Radical Orthodoxy. Deuxièmement, on rencontre H.-J. Gagey et J.-L. Souletie, qui évaluent la force (...) politique de la théologie de Metz. Enfin, on découvre la façon dont L. Boeve reprend de façon personnelle certains aspects de la pensée du théologien allemand. Pour terminer, l’article propose une réflexion synthétique et critique sur cette réception, avec le souci de montrer la pertinence de la théologie politique de Metz et sa capacité à stimuler la réflexion sur le rapport foi et société. (shrink)

In den Publikationen der Synthetischen Biologie und in Darstellungen dieser neuen Biotechnologie finden sich häufig Begriffe des Herstellens, Konstruierens, Erschaffens und Kreierens. Im folgenden Beitrag wird dieses Begriffsfeld auf der Basis von technikphilosophischen und kunsttheoretischen Ansätzen systematisiert. Es wird erstens untersucht, inwiefern sich die verschiedenen Forschungsrichtungen in der Synthetischen Biologie mit diesem Begriffsinstrumentarium angemessen beschreiben lassen; zweitens wird analysiert, welche ethischen Fragestellungen mit den unterschiedlichen Begriffen des Herstellens und Erschaffens im Fall der Synthetischen Biologie verbunden sind.

Can mammalian mothers adaptively control the sex of their offspring? The influential Trivers-Willard hypothesis proposes that when maternal condition increases the fitness of sons more than that of daughters, the proportion of sons produced should increase with maternal condition. Studies of mammals, however, often fail to support this hypothesis. This article highlights recent advances, including studies on the assumptions of the TWH and physiological mechanisms for sex-ratio manipulation. Particular emphasis is placed on how factors such as paternal quality, (...) maternal reproductive costs and environmental conditions experienced by mothers early in life can mask/alter the expected relationship between maternal condition and offspring sex ratio or lead to apparent support for the TWH. While there is growing evidence that sex ratio around conception may be maternally and paternally manipulated, a challenge for future studies on sex allocation is to integrate how multiple and potentially opposite selective pressures affect offspring sex ratio. The relationship between offspring sex and maternal condition lies at the heart of one of the most controversial hypotheses in evolutionary biology. This review highlights recent findings on the Trivers-Willard hypothesis with particular emphasis on factors which may mask the relationship of interest or falsely demonstrate it. (shrink)

While across the animal kingdom offspring are born smaller than their parents, notable exceptions exist. Several dipteran species belonging to the Hippoboscoidea superfamily can produce offspring larger than themselves. In this essay, the blood‐feeding tsetse is focused on. It is suggested that the extreme reproductive strategy of this fly is enabled by feeding solely on highly nutritious blood, and producing larval offspring that are soft and malleable. This immense reproductive expenditure may have evolved to avoid competition with other biting flies. (...) Tsetse also transmit blood‐borne parasites that cause the fatal diseases called African trypanosomiases. It is discussed how tsetse life history and reproductive strategy profoundly influence the type of vector control interventions used to reduce fly populations. In closing, it is argued that the unusual life history of tsetse warrants their preservation in the areas where human and animal health is not threatened. (shrink)

This article will examine the Catholic concept of global justice within a health care framework as it relates to women's needs for delivery doctors in the developing world and women's demands for assisted reproduction in the developed world. I will first discuss justice as a theory, situating it within Catholic social teachings. The Catholic perspective on global justice in health care demands that everyone have access to basic needs before elective treatments are offered to the wealthy. After exploring specific discrepancies (...) in global health care justice, I will point to the need for delivery doctors in the developing world to provide basic assistance to women who hazard many pregnancies as a priority before offering assisted reproduction to women in the developed world. The wide disparities between maternal health in the developing world and elective fertility treatments in the developed world are clearly unjust within Catholic social teachings. I conclude this article by offering policy suggestions for moving closer to health care justice via doctor distribution. (shrink)

This article reviews the effects of malnutrition on early brain development using data generated from animal experiments and human clinical studies. Three related processes, each with their own functional consequences, are implicated in the alteration of brain development. (1) Maternal undernutrition at the start of pregnancy results in reduced transfer of nutrients across the placenta, allowing the conservation of effort for future reproductive episodes. (2) Differential allocation to growing organs by the fetus in response to nutritional stress spares (...) the brain to a large though still limited degree, reflecting the organ’s relative contribution to survival and reproductive success. (3) Prenatal malnutrition disrupts developing neurotransmitter systems, which results in the expression of specific cognitive and affective traits. It is argued that the increasing size and therefore cost of the brain, in conjunction with increasing ecological instability and marginality, reinforced selection for maternally controlled growth suppression of offspring, reallocation of organ growth rates by offspring, and behavioral changes related to development of neurotransmitter systems. (shrink)

The doctrine of double effect (DOE) has its origins in Roman Catholic thought and has been held to have widespread applications in bioethics. Its applications range over issues of maternal-fetal conflict, organ donation and transplant, euthanasia, and resource allocation, among other controversial issues. Recently, Joseph Boyle, the foremost proponent of the DOE over the past few decades, has argued that the DOE is required by the absolutist context of the Catholic tradition, and, further, that anyone who rejects this (...) particular context is not entitled to use the doctrine. In this essay, I will focus exclusively on the intention condition of the DOE and its central distinction, i.e., intention/side effect. I will proceed by considering in turn (1) Boyle's argument that the absolutist moral framework of the Catholic tradition requires the intention/side effect distinction; (2) the ways in which that framework is made vulnerable by this requirement; and (3) just why the DOE should be viable even outside of the Catholic tradition if it turns out that a feature of (l) is correct and the challenges of (2) can be met. (shrink)

In this paper I use measures of childhood growth to assess from both an evolutionary theoretical and an applied public health perspective the impact of polygyny on maternal-child welfare among the Datoga pastoralists of Tanzania. I report that the growth and body composition of children varies in such a way as to suggest that polygyny is not generally beneficial to women in terms of offspring quality. Cross-sectional analysis of covariance by maternal marriage status revealed that children of first (...) and second wives in polygynous marriages grow relatively poorly, that this is correlated with maternal physical status, and that the pattern is not modified by household wealth. I discuss how the dynamics of sexual conflicts operating during the formation and maintenance of marriages may be important factors in the etiology of poor child growth in this population, leading to complex patterns of variation in anthropometric indicators of both women and children. The theoretical conclusion is that improved evolutionary models of polygyny should be designed to examine the potential for adaptive tradeoffs between the currencies of offspring quality and quantity for all types of parents in a polygynous population. The practical conclusion is that a better understanding of the relationships between marriage practices and health outcomes would assist in the development of culturally appropriate health and nutrition interventions. (shrink)

Four ethical values — maximizing benefits, treating equally, promoting and rewarding instrumental value, and giving priority to the worst off — yield six specific recommendations for allocating medical resources in the Covid-19 pandemic: maximize benefits; prioritize health workers; do not allocate on a first-come, first-served basis; be responsive to evidence; recognize research participation; and apply the same principles to all Covid-19 and non–Covid-19 patients.

The most popular uniting theme in feminist peace literature grounds women's peace work in mothering. I argue if maternal arguments do not address the variety of relationships different races and classes of mothers have to institutional violence and/or the military, then the resulting peace politics can only draw incomplete conclusions about the relationships between maternal work/thinking and peace. To illustrate this I compare two models of mothering: Sara Ruddick's decription of "maternal practice" and Patricia Hill Collins's account (...) of racial-ethnic women's "motherwork.". (shrink)

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as tirzepatide, have been found to be effective for treating obesity and diabetes, significantly reducing weight and the risk or predicted risk of adverse cardiovascular events. There is a global shortage of these medications that could last several years and raises questions about how limited supplies should be allocated. We propose a fair-allocation framework that enables evaluation of the ethics of (...) current practices and could guide governments, professional societies, and physicians in allocation decisions. (shrink)

The most popular uniting theme in feminist peace literature grounds women's peace work in mothering. I argue if maternal arguments do not address the variety of relationships different races and classes of mothers have to institutional violence and/or the military, then the resulting peace politics can only draw incomplete conclusions about the relationships between maternal work/thinking and peace. To illustrate this I compare two models of mothering: Sara Ruddick's decription of "maternal practice" and Patricia Hill Collins's account (...) of racial-ethnic women's "motherwork.". (shrink)

Inflicting harm is generally preferable to inflicting death. If you must choose between the two, you should generally choose to harm. But prenatal harm seems different. If a mother must choose between harming her fetus or aborting it, she may choose either, at least in many cases. So it seems that prenatal harm is particularly objectionable, sometimes on a par with death. This paper offers an explanation of why prenatal harm seems particularly objectionable by drawing an analogy to the all-or-nothing (...) problem. It then argues that this analogy offers independent support for the ‘voluntarist’ view that at least some parental role obligations are grounded in the choice to be a parent. (shrink)

This monograph is a critical assessment of the foundations of microeconomic theory, rationality, welfare resource allocation and capital reproduction. It examines the various concepts of rationality that have been constructed by 20th-century economists.

Sara Ruddick's Maternal Thinking represents a great contribution to moral philosophy-in particular, by bringing women's "private" virtues into the public sphere. However, there remain problems in the analysis which need to be addressed: How can one possibly generalize about the practice of mothering from one, necessarily limited, perspective, given the facts of cultural diversity? Is Ruddick's normative account of mothering congruent with the reflective judgments of others? Is her account of the transformation of parochial mothering into feminist peace work (...) viable? After exploring these three questions, this reviewer calls, with Ruddick, for the telling of more maternal stories, from different cultural, racial and economic perspectives. (shrink)

Assessing the risk-benefit ratio has always been considered key in designing clinical trials. These benefits can be diverse and may include social value and psychological benefits. When it comes to...

There has been increased interest in the potential of maternal immunisation to protect maternal, fetal, and infant health. Maternal tetanus vaccination is part of routine antenatal care and immunisation campaigns in many countries, and it has played an important part in the reduction of maternal and neonatal tetanus. Additional vaccines that have been recommended for routine maternal immunisation include those for influenza and pertussis, and other vaccines are being developed. Maternal immunisation is controversial since (...) regulators, professionals, and the public are often reluctant to accept pharmaceutical interventions during pregnancy. So far, little attention has been given to the ethics of vaccination during pregnancy. In this Personal View we argue that maternal immunisation should be offered in response to concrete, severe risks of disease for mother and child, and we explain how this requirement of serious risk can be used to guide ethical decision-making about maternal immunisation. (shrink)

Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, (...) quality-adjusted life-years, and disability-adjusted life-years. We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles. (shrink)

In ____Maternal Ethics and Other Slave Moralities__ which includes the first extended philosophical discussion of the works of Frederick Douglass, Cynthia Willett puts forward a novel theory of ethical subjectivity that is aimed to counter prevailing pathologies of sexist, racist Eurocentric culture. Weaving together accounts of the self drawn from African-American and European philosophies, psychoanalysis, slave narratives and sociology, Willett interrogates what Hegel locates as the core of the self: the desire for.

The COVID-19 pandemic will likely recede only through development and distribution of an effective vaccine. Although there are many unknowns surrounding COVID-19 vaccine development, vaccine demand will likely outstrip early supply, making prospective planning for vaccine allocation critical for ensuring the ethical distribution of COVID-19 vaccines. Here, we propose three central goals for COVID-19 vaccination campaigns: to reduce morbidity and mortality, to minimise additional economic and societal burdens related to the pandemic and to narrow unjust health inequalities. We evaluate (...) five prioritisation approaches, assess their likely impact on advancing the three goals of vaccine allocation and identify open scientific questions that may alter their outcomes. We argue that no single prioritisation approach will advance all three goals. Instead, we propose a multipronged approach that considers the risk of serious COVID-19 illness, instrumental value and the risk of transmission, and is guided by future research on COVID-19-specific clinical and vaccine characteristics. While we focus this assessment on the USA, our analysis can inform allocation in other contexts. (shrink)

Ample research links mothers’ postpartum depression (PPD) to adverse interactions with their infants. However, most studies relied on general population samples, whereas a substantial number of women are at elevated depression risk. The purpose of this study was to describe mothers’ interactions with their 6- and 12-month-old infants among women at elevated risk, although with a range of symptom severity. We also identified higher-order factors that best characterized the interactions and tested longitudinal consistency of these factors from 6 to 12 (...) months of infant age. We leveraged data from eight projects across the United States (n = 647), using standardized depression measures and an adaptation of the NICHD Mother-Infant Interaction Scales. Overall, these depression-vulnerable mothers showed high levels of sensitivity and positive regard and low levels of intrusiveness, detachment, and negative regard with their infants. Factor analyses of maternal behaviors identified two overarching factors—“positive engagement” and “negative intrusiveness” that were comparable at 6 and 12 months of infant age. Mothers’ ability to regulate depressed mood was a key behavior that defined “positive engagement” in factor loadings. An exceptionally strong loading of intrusiveness on the second factor suggested its central importance for women at elevated depression risk. Mothers with severe depressive symptoms had significantly more “negative intrusiveness” and less “positive engagement” with their 6-month-old infants than women with moderate or fewer depressive symptoms, suggesting a potential tipping point at which symptoms may interfere with the quality of care. Results provide the foundation for further research into predictors and moderators of women’s interactions with their infant among women at elevated risk for PPD. They also indicate a need for evidence-based interventions that can support more severely depressed women in providing optimal care. (shrink)

In this provocative new book, renowned educator and philosopher Nel Noddings extends her influential work on the ethics of care toward a compelling objective—global peace and justice. She asks: If we celebrate the success of women becoming more like men in professional life, should we not simultaneously hope that men become more like women—in caring for others, rejecting violence, and valuing the work of caring both publicly and personally? Drawing on current work on evolution, and bringing concrete examples from women’s (...) lived experience to make a strong case for her position, Noddings answers this question by locating one source of morality in maternal instinct. She traces the development of the maternal instinct to natural caring and ethical caring, offering a preliminary sketch of what a care-driven concept of justice might look like. Finally, to advance the cause of caring, peace, and women’s advancement, Noddings urges women to abandon institutional, patriarchal religion and to seek their own paths to spirituality. (shrink)

The valence–space metaphor research area investigates the metaphorical mapping of valenced concepts onto space. Research findings from this area indicate that positive, neutral, and negative concepts are associated with upward, midward, and downward locations, respectively, in the vertical plane. The same research area has also indicated that such concepts seem to have no preferential location on the horizontal plane. The approach–avoidance effect consists in decreasing the distance between positive stimuli and the body and increasing the distance between negative stimuli and (...) the body. Thus, the valence–space metaphor accounts for the mapping of valenced concepts onto the vertical and horizontal planes, and the approach–avoidance effect accounts for the mapping of valenced concepts onto the “depth” plane. By using a cube conceived for the study of allocation of valenced concepts onto 3D space, we show in three studies that positive concepts are placed in upward locations and near the participants’ body, negative concepts are placed in downward locations and far from the participants’ body, and neutral concepts are placed in between these concepts in both planes. (shrink)

Allocating access to unapproved COVID-19 drugs available via Pre-Approval Access pathways or Emergency Use Authorization raises unique challenges at the intersection of clinical care and research....

The unpredictability of maternal sensory signals in caregiving behavior has been recently found to be linked with infant neurodevelopment. The research area is new, and very little is yet known, how maternal anxiety and depressive symptoms and specific parental characteristics relate to the unpredictable maternal care. The aims of the current study were to explore how pre- and postnatal maternal anxiety and depressive symptoms and self-regulation capacity associate with the unpredictability of maternal sensory signals. The (...) study population consisted of 177 mother-infant dyads. The unpredictability of the maternal sensory signals was explored from the video-recorded mother-infant free play situation when the infant was 8 months of age. Pre- and postnatal anxiety and depressive symptoms were measured by questionnaires prenatally at gwks 14, 24, 34, and 3 and 6 months postpartum. Maternal self-regulation capacity, a trait considered to be stable in adulthood, was assessed using adult temperament questionnaire when the infant was 12 months of age. We found that elevated prenatal maternal anxiety symptoms associated with higher unpredictability in the maternal care while depressive symptoms were unrelated to the unpredictability of maternal care. Moreover, the association was moderated by maternal self-regulation capacity, as higher anxiety symptoms during pre-and postnatal period were associated more unpredictability among the mothers with low self-regulation capacity. The combination of higher amount of maternal anxiety symptoms and lower self-regulation capacity seems to constitute specific risk for the unpredictable maternal care. (shrink)

Driven by interests in workforce planning and patient safety, a growing body of literature has begun to identify the reality and the prevalence of missed nursing care, also specified as care left undone, rationed care or unfinished care. Empirical studies and conceptual considerations have focused on structural issues such as staffing, as well as on outcome issues – missed care/unfinished care. Philosophical and ethical aspects of unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covert rationing/missed care/care (...) left undone – suggesting that nurses, in certain contexts, are actively engaged in rationing care – in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicit decision-making frameworks within which to consider rationing of nursing care. In reality, the assumption of policy makers and health service managers is that nurses will continue to provide full care – despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appear that rationing/missed care/nursing care left undone is a direct response to overwhelming demands on the nursing resource in specific contexts. A discussion of resource allocation and rationing in nursing therefore seems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resource allocation and rationing as they relate to nursing care and the distribution of the nursing resource. (shrink)

Pre-natal exposure to acute maternal trauma or chronic maternal distress can confer increased risk for psychiatric disorders in later life. Acute maternal trauma is the result of unforeseen environmental or personal catastrophes, while chronic maternal distress is associated with anxiety or depression. Animal studies investigating the effects of pre-natal stress have largely used brief stress exposures during pregnancy to identify critical periods of fetal vulnerability, a paradigm which holds face validity to acute maternal trauma in (...) humans. While understanding these effects is undoubtably important, the literature suggests maternal stress in humans is typically chronic and persistent from pre-conception through gestation. In this review, we provide evidence to this effect and suggest a realignment of current animal models to recapitulate this chronicity. We also consider candidate mediators, moderators and mechanisms of maternal distress, and suggest a wider breadth of research is needed, along with the incorporation of advanced -omics technologies, in order to understand the neurodevelopmental etiology of psychiatric risk. (shrink)