Cet article explique pourquoi et comment introduire la naissance dans le canon des sujets explorés par la philosophie. Il porte sur l’épistémologie de la naissance, c’est-à-dire sur la nature, l’origine et les limites des connaissances produites par et/ou liées à l’accouchement. L’autrice offre un regard sur la philosophie de la naissance et explore une nouvelle généalogie – un nouveau logos pour le genos –, une méditation radicale sur notre origine et notre naissance.

Unconsented episiotomies and other procedures during labour are commonly reported by women in several countries, and often highlighted in birth activism. Yet, forced caesarean sections aside, the ethics of consent during labour has received little attention. Focusing on episiotomies, this paper addresses whether and how consent in labour should be obtained. We briefly review the rationale for informed consent, distinguishing its intrinsic and instrumental relevance for respecting autonomy. We also emphasise two non-explicit ways of giving consent: implied and opt-out consent. (...) We then discuss challenges and opportunities for obtaining consent in labour and birth, given its unique position in medicine.We argue that consent for procedures in labour is always necessary, but this consent does not always have to be fully informed or explicit. We recommend an individualised approach where the antenatal period is used to exchange information and explore values and preferences with respect to the relevant procedures. Explicit consent should always be sought at the point of intervening, unless women antenatally insist otherwise. We caution against implied consent. However, if a woman does not give a conclusive response during labour and the stakes are high, care providers can move to clearly communicated opt-out consent. Our discussion is focused on episiotomies, but also provides a useful starting point for addressing the ethics of consent for other procedures during labour, as well as general time-critical medical procedures. (shrink)

Nursing Ethics has published several pleas for care ethics and/or relationality as the most promising ethical foundation for midwifery philosophy and practice. In this article, we stand by these calls, contributing to them with the identification of the structural form of violence that a care ethical relational approach to reproductive care is up against: that of “maternal separation”. Confronted with reproductive and obstetric violence globally, we show that a hegemonic racialized, instrumentalized, and individualized conception of pregnancy is responsible for a (...) severance of relationalities that are essential to safe reproductive care: (1) the relation between the person and their child or reproductive capabilities; and (2) the relation between the pregnant person and their community of care. We pinpoint a separation of the maternal relation in at least two discursive domains, namely, the juridical-political and the ethical-existential. Consequently, we plea for a radical re-imagination of maternal relationality, envisioning what care ethical midwifery, including abortion care, could be. (shrink)

This paper addresses epistemic aspects of the phenomenon of obstetric violence—which has been described as a kind of gender violence—mainly from the perspective of recent theories on epistemic injustice. I argue that what is behind the dismissal of women’s voices in labor is mainly how the birthing subject, in general, is conceived. Thus, I develop a link between the phenomenon of testimonial injustice in labor and the marked irrationality that is seen as a core characteristic of birthing subjects: an irrationality (...) that appears to be always at odds with the kind of knowledge that is, wrongly, privileged within medicalized childbirth. I use Miranda Fricker’s analysis to argue that a central part of obstetric violence involves laboring women being “wrongfully undermined specifically in their capacity as knowers” : they are disbelieved in the labor room because of a double prejudice, one deriving simply from their condition as women, the second involving the kind of knowledge that many women find useful in the process of birthing. Women in labor thus suffer from both systematic and incidental kinds of testimonial injustice. (shrink)

L’article se concentre sur la pandémie de covid-19 dans une tentative d’évaluer la contribution éventuelle de l’analyse philosophique à la compréhension et à la résolution des problèmes éthiques, juridiques et sociopolitiques qu’elle soulève. On aborde une série de dilemmes cruciaux qui requièrent des décisions pratiques, avant et après la production et la disponibilité des vaccins, à la lumière des théories éthiques et politiques contemporaines. Il s’avère que dans la plupart des cas les conceptions déontologiques semblent l’emporter sur les considérations conséquentialistes, (...) qui ne s’imposent à notre raisonnement que dans des situations d’urgence immédiate. La pandémie nous permet également d’apprécier le rôle important des vertus éthiques et épistémiques dans la prise des décisions critiques. (shrink)