This article presents results from an empirical investigation of the role and importance of ethics in the daily work of Danish oncologyphysicians and Danish molecular biologists. The study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company.We found that oncology physicians consider (...) ethical evaluation as part of their daily work. They discuss how to treat patients in groups and they have interdisciplinary seminars. In contrast, molecular biologists employed at the university do not think that basic research causes significant ethical problems, they do not talk about ethics in their daily work and they do not want to prioritise seminars on ethics. Molecular biologists employed in a private biopharmaceutical company do not think that basic research causes significant ethical problems, but the private company prioritises ethical evaluation. If the company behaves unethical, they will be punished by the consumers and by the investors in the last end. In general, oncology physicians working in the clinic experience a closer relationship between their daily work and ethical problems concerning human beings than molecular biologists conducting basic research. (shrink)

This article discusses the function, development and maintenance of meaning and the importance of meaning-making from different perspectives, as it is based on a collaboration between professionals from health science and psychology. The aim is to discuss how meaning-making processes can be employed in the health context to enhance individuals’ well-being. Starting point is a description of the common basis of the understanding of meaning-making. Afterwards brief examples from the different professional areas will show how meaning-making can improve health care (...) practice. We will focus on the processual nature of meaning-making, its existential layers, as well as the ways in which meaning-making is at play in everyday activities and limit situations, such as illness or suicidality. (shrink)

Within the caring science paradigm, variations of a method of interpretation inspired by the French philosopher Paul Ricoeur's theory of interpretation are used. This method consists of several levels of interpretation: a naïve reading, a structural analysis, and a critical analysis and discussion. Within this paradigm, the aim of this article is to present and discuss a means of creating distance in the interpretation and the text structure by using narration in a poetic language linked to the meaning of the (...) text. Ricoeur's ‘Hermeneutical function of distanciation’ will be introduced, and this concept of distanciation will be illustrated with reference to narrations from a study of patient's life experiences living with chronic illness and home mechanical ventilation in Denmark. Distanciation in the interpretation objectifies the text, and narration in a poetic language creates a particular kind of mediation in the interpretation. That narration represents an interpreted understanding of the whole, which facilitates an appropriate and evocative presentation of the interpreted data. This way of objectifying the text through narration can contribute yet another perspective to Ricoeur's rich and varied theory of interpretation. (shrink)

Bioethical research has tended to focus on theoretical discussion of the principles on which the analysis of ethical issues in biomedicine should be based. But this discussion often seems remote from biomedical practice where researchers and physicians confront ethical problems. On the other hand, published empirical research on the ethical reasoning of health care professionals offer only descriptions of how physicians and nurses actually reason ethically. The question remains whether these descriptions have any normative implications for nurses and physicians? In (...) this article, we illustrate an approach that integrates empirical research into the formulation of normative ethical principles using the moral-philosophical method of Wide Reflective Equilibrium (WRE). The research method discussed in this article was developed in connection with the project ‘Bioethics in Theory and Practice’. The purpose of this project is to investigate ethical reasoning in biomedical practice in Denmark empirically. In this article, we take the research method as our point of departure, but we exclusively discuss the theoretical framework of the method, not its empirical results. We argue that the descriptive phenomenological hermeneutical method developed by Lindseth and Norberg (2004) and Pedersen (1999) can be combined with the theory of WRE to arrive at a decision procedure and thus a foundation for the formulation of normative ethical principles. This could provide health care professionals and biomedical researchers with normative principles about how to analyse, reason and act in ethically difficult situations in their practice. We also show how to use existing bioethical principles as inspiration for interpreting the empirical findings of qualitative studies. This may help researchers design their own empirical studies in the field of ethics. (shrink)

This article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work.

BackgroundThis study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups.MethodThis study is based on 12 semi-structured interviews with (...) three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company.ResultsIn this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology physicians and molecular biologists from the private biopharmaceutical company. Molecular biologists employed at a public university are, in this study, concerned with allocation, however, they do not propose a specific theory of justice.ConclusionThis study demonstrates that each of the four bioethical principles of the American bioethicists Tom L. Beauchamp & James F. Childress – respect for autonomy, beneficence, nonmaleficence and justice – are reflected in the daily work of physicians and molecular biologists in Denmark. Consequently, these principles are applicable in the Danish biomedical setting. (shrink)

It is commonly assumed that there are differences in physicians’ and caregivers’ ethical attitudes towards clinical situations. The assumption is that the difference is driven by different values, views and judgements in specific situations. At Aalborg University Hospital, Denmark, we aimed to investigate these assumptions by conducting a large quantitative study. The study design, based on the Factorial Survey Method, was a carefully constructed survey with 50 questions designed to test which factors influenced the respondents’ ethical reasoning. The factors were (...) clustered into three categories of ethical reasoning and values. The categories were formulated in terms of easily recognizable ethical positions: consequential ethics, deontological ethics and relational ethics. Based on 2129 respondents, we found significant support for the assumption of differences between physicians and caregivers. The group of caregivers favoured the relational ethics view in clinical ethical situations, and the group of ph... (shrink)

_Vi gennemførte i 2016 et omfattende empirisk studie på Aalborg Universitetshospital med henblik på at afdække de forskellige sundhedsprofessioners etiske holdninger. Hensigten var at afdække eventuelle forskelle mellem professionerne samt at få begrebsliggjort de etiske tankemønstre, der er tilstede i den kliniske praksis. Vi fandt i den indledende dataanalyse, at vi med signifikans kunne vise, at plejegruppen i højere grad bruger nærhedsetiske og omsorgsetiske vurderinger, til forskel fra lægegruppen, der er mere pligtetisk funderet__. Undersøgelsen blev sat op ved brug af (...) vignetmetoden, der giver mulighed for at indsamle kvantitative data, der er velegnede til en statistisk analyse, men som samtidig også muliggør en kvalitativ undersøgelse ved en efterfølgende hermeneutisk analyse af udvalgte besvarelser. I denne artikel studerer vi undersøgelsens resultater inden for sygeplejegruppen alene med det formål at uddrage, hvad deres vurderinger kommer an på, og at diskutere, hvordan disse faktorer indbyrdes forholder sig til hinanden og skaber sammenhæng. Med udgangspunkt i dette finder vi frem til, hvordan sygeplejerskernes etiske holdninger som helhed formes af de særlige værdier, som den nærhedsetiske profil understøtter, men som videre også giver et mere fleksibelt og nuanceret billede af sygeplejeetikken._ _Nøgleord:_ sygeplejeetik, vignetmetoden, hermeneutik, patientperspektiv, klinisk praksis _ _ _English title: _Factors that influence nurses' attitude to "good clinical practice" - a qualitative analysis of data from an empirical study at Aalborg University Hospital In 2016, we conducted a comprehensive empirical study at Aalborg University Hospital in order to uncover the ethical attitudes of various health professions. The intention was to uncover any differences between professions as well as to conceptualize the ethical thought patterns present in clinical practice. We found in the preliminary data analysis that we could show with significance that the group of care givers uses relational ethics and care ethics assessments to a greater extent as opposed to the more duty ethics based group of physicians. The study was set up using the vignette method, which allows for the collection of quantitative data suitable for statistical analysis, but which also allows for a qualitative study by a subsequent hermeneutical analysis of selected answers. In this article we study the results of the study within the nursing group solely for the purpose of extracting what their assessments depend on and discussing how these factors relate to each other and create some form of moral coherence. Based on this we find how nurses' ethical attitudes are shaped by the particular values ​​that the relational ethical profile supports, but also how this profile is modified and flexible to the conditions of clinical settings and situations. In the end our interpretation provides us with a more nuanced picture of nursing ethics than a single theoretical perspective or a set of guidelines provide. _Keywords:_ nursing ethics, the vignette method, hermeneutics, patient perspective, clinical practice. (shrink)

BackgroundThe experiences of UK ethnic minority healthcare workers are crucial to ameliorating the disproportionate COVID-19 infection rate and outcomes in the UKEM community. We conducted a qualitative study on UKEM healthcare workers’ perspectives on COVID-19 vaccine hesitancy in the UKEM community.MethodsParticipants were 15 UKEM healthcare workers. Data were collected using individual and joint interviews, and a focus group, and analyzed using thematic analysis.ResultsWe generated three themes: heterogeneity, mistrust, and mitigating. Therein, participants distinguished CVH in the UKEM community in educational attainment (...) and ethnicity. They pointed to the role of mistrust in CVH in the UKEM community. They opined that the mistrust underlying CVH in the UKEM community is rooted in history and religion, conspiracy theories, the speedy development and novelty of the vaccines, post-vaccination complications/side effects, false positive test results, and social media and social support/influence. Participants recommended that interventions targeted at mitigating CVH in the UKEM community need to, in a non-judgmental way, tackle dis/misinformation and provide education, and incorporate UKEM healthcare worker endorsement. They also suggested such interventions be community-oriented, enhance the convenience of vaccination centers and the possibility of vaccine choice, and appreciate that overcoming CVH and accepting vaccination is a gradual process involving personal assessment of risks and benefits.ConclusionCVH in the UKEM community is a multifaceted phenomenon requiring multicomponent interventions. (shrink)

The assumption in current U.S. mainstream medicine is that birthing requires hospitalization. In fact, while the American College of Obstetricians and Gynecologists supports the right of every birthing person to make a medically informed decision about their delivery, they do not recommend home birth owing to data indicating greater neonatal morbidity and mortality. In this article, we examine the evidence surrounding home birth in the United States and its current limitations, as well as the ethical considerations around birth setting.

This paper explains why and how we should introduce birth into the canon of subjects explored by philosophy. It focuses on the epistemology of birth, namely, on the nature, origin, and limits of the knowledge produced by and/or related to giving birth. The paper provides a view on the philosophy of birth, i.e., an approach to construct a new logos for genos.

Holobionts are multicellular eukaryotes with multiple species of persistent symbionts. They are not individuals in the genetic sense— composed of and regulated by the same genome—but they are anatomical, physiological, developmental, immunological, and evolutionary units, evolved from a shared relationship between different species. We argue that many of the interactions between human and microbiota symbionts and the reproductive process of a new holobiont are best understood as instances of reciprocal scaffolding of developmental processes and mutual construction of developmental, ecological, and (...) evolutionary niches. Our examples show that mother, fetus, and different symbiotic microbial communities induce or constitute conditions for the development and reproduction of one another. These include the direct induction of maternal or fetus physiological changes, the restructuring of ecological relations between communities, and evolutionary selection against undesirable competitors. The mutual scaffolding and niche constructing processes start early—prior to amniotic rupture. We are evolutionarily, physiologically, and developmentally integrated holobiont systems, strung together through mutual reliance and mutual construction. Bringing the processes of niche construction and developmental scaffolding together to interpret holobiont birth conceptually scaffolds two new directions for research: in niche construction, identifying the evolutionary implications of organisms actively constructing multiple overlapping niches and scaffolds, and in Evolutionary Developmental Biology, characterizing evolutionary and ecological processes as developmental causes. (shrink)

Birth order has been examined over a wide variety of dimensions in the context of modern populations. A consistent message has been that it is better to be born first. The analysis of birth order in this paper is different in several ways from other investigations into birth order effects. First, we examine the effect of birth order in an egalitarian, small-scale, kin-based society, which has not been done before. Second, we use a different outcome measure, fertility, rather than outcome (...) measures of social, psychological, or economic success. We find, third, that being born late in an egalitarian, technologically simple society rather than being born early has a positive outcome on fertility, and fourth, that number of older siblings and sibling set size are even stronger predictors of fertility, especially for males. (shrink)

Bioethics represents a dramatic revision of the centuries-old professional ethics that governed the behavior of physicians and their relationships with patients. This venerable ethics code was challenged in the years after World War II by the remarkable advances in the biomedical sciences and medicine that raised questions about the definition of death, the use of life-support systems, organ transplantation, and reproductive interventions. In response, philosophers and theologians, lawyers and social scientists joined together with physicians and scientists to rethink and revise (...) the old standards. Governments established commissions to recommend policies. Courts heard arguments and legislatures passed laws. This book is the first broad history of the growing field of bioethics. Covering the period 1947-1987, it examines the origin and evolution of the debates over human experimentation, genetic engineering, organ transplantation, termination of life-sustaining treatment, and new reproductive technologies. It assesses the contributions of philosophy, theology, law and the social sciences to the expanding discourse of bioethics. Written by one of the field's founders, The Birth of Bioethics is based on extensive archival research into sources that are difficult to obtain and on interviews with many of the leading figures in the moral debates in medicine. A very readable and comprehensive account of the evolution of bioethics, this book stresses the history of ideas but does not neglect the social and cultural context and the people involved. It will serve the information needs of philosophers, ethicists, social historians, and everyone interested in the origins of some of today's most hotly debated issues. (shrink)

In The Birth of Tragedy Nietzsche expounds on the origins of Greek tragedy and its relevance to the German culture of its time. He declares it to be the expression of a culture which has achieved a delicate but powerful balance between Dionysian insight into the chaos and suffering which underlies all existence and the discipline and clarity of rational Apollonian form. In order to promote a return to these values, Nietzsche critiques the complacent rationalism of late nineteenth-century German culture (...) and makes an impassioned plea for the regenerative potential of the music of Wagner. A wide ranging discussion of the nature of art, science, and religion, The Birth of Tragedy's argument raises important questions about the problematic nature of cultural origins which are still valid today. (shrink)

To know the nature of any phenomenon or practice, it is often a good idea to learn about how it might have emerged or might have been constructed. The Birth of Ethics offers an account of how morality might have emerged, without any planning, in a society with language but without any properly ethical concepts or practices. The conjectural history that it documents serves a philosophical purpose, for it directs us the role that morality plays in human life and the (...) nature of morality that enables it to play that role. (shrink)

In this research, an Artificial Neural Network (ANN) model was developed and tested to predict Birth Weight. A number of factors were identified that may affect birth weight. Factors such as smoke, race, age, weight (lbs) at last menstrual period, hypertension, uterine irritability, number of physician visits in 1st trimester, among others, as input variables for the ANN model. A model based on multi-layer concept topology was developed and trained using the data from some birth cases in hospitals. The evaluation (...) of testing the dataset shows that the ANN model is capable of correctly predicting the birth weight with 100% accuracy. (shrink)

Two representative and important works in one volume by one of the greatest German philosophers. The Birth of Tragedy (1872) was Nietzsche's first book. Its youthful faults were exposed by Nietzsche in the brilliant "Attempt at a Self-Criticism" which he added to the new edition of 1886. But the book, whatever its excesses, remains one of the most relevant statements on tragedy ever penned. It exploded the conception of Greek culture that was prevalent down through the Victorian era, and it (...) sounded themes developed in the twentieth century by classicists, existentialists, psychoanalysts, and others. The Case of Wagner (1888) was one Nietzsche's last books, and his wittiest. In attitude and style it is diametrically opposed to The Birth of Tragedy. Both works transcend their ostensible subjects and deal with art and culture, as well as the problems of the modern age generally. Each book in itself gives us an inadequate idea of its author; together, they furnish a striking image of Nietzsche's thought. The distinguished translations by Walter Kaufmann superbly reflect in English Nietzsche's idiom and the vitality of his style. Professor Kaufmann has also furnished running footnote commentaries, relevant passages from Nietzsche's correspondence, a bibliography, and, for the first time in any edition, an extensive index to each book. (shrink)

Low birth weight, intrauterine growth retardation, and prematurity are overwhelming risk factors associated with infant mortality and morbidity. The lack of efficacious prenatal screening tests for these three outcomes illuminates the problems inherent in bivariate estimates of association. A biocultural strategy for research is presented, integrating societal and familial levels of analysis with the metabolic, immune, vascular, and neuroendocrine systems of the body. Policy decisions, it is argued, need to be based on this type of biocultural information in order to (...) impact the difficult-to-change problems of low birth weight, intrauterine growth retardation, and prematurity. (shrink)

Abortion is largely accepted even for reasons that do not have anything to do with the fetus' health. By showing that (1) both fetuses and newborns do not have the same moral status as actual persons, (2) the fact that both are potential persons is morally irrelevant and (3) adoption is not always in the best interest of actual people, the authors argue that what we call ‘after-birth abortion’ (killing a newborn) should be permissible in all the cases where abortion (...) is, including cases where the newborn is not disabled. (shrink)

Although birth marks the entrance of a human being into the world and establishes the very possibility of experience the philosophical implications of this event have been largely ignored in the history of thought. This is particularly troubling in phenomenology in general and in the work of Martin Heidegger in particular. While Heidegger raises the issue of birth he drops it very quickly on the path to defining Dasein''s existence as constituted from the standpoint of death, as being-towards-death. In this (...) paper I argue, contra Heidegger, that intentional existence can only be understood from the standpoint of birth. I begin by showing that intentionality inheres in a double difference that is fundamentally dependent on birth insofar as birth is an original differentiating from prenatal existence. I conclude with the argument that only a philosophy that regards Dasein from the standpoint of birth, as being-from-birth, can give an adequate account of humans as beings who live with others and who can initiate sense constitution and action. (shrink)

This paper is a response to a recent paper by Bobier and Omelianchuk in which they argue that the critics of Giubilini and Minerva’s defence of infanticide fail to adequately justify a moral difference at birth. They argue that such arguments would lead to an intuitively less plausible position: that late-term abortions are permissible, thus creating a dilemma for those who seek to argue that birth matters. I argue that the only way to resolve this dilemma, is to bite the (...) naturalist bullet and accept that the intuitively plausible idea that birth constitutes a morally relevant event is simply mistaken and biologically misinformed. (shrink)

We examine the relationship between birth order and reproductive behaviors in a sample of Australian residents, accounting for personality, personal achievements, and family structure. Using generalized linear models and survival analyses we build predictive models for each reproductive measure and test those models on an independent data subset. Compared with functional firstborns (middle-borns more than 5 years younger than their next older sibling), male middle-borns and last-born females had younger ages of first sexual intercourse, and middle-born females had a younger (...) age at first pregnancy. There was no difference in females’ age at first birth. Male middle-borns tended to have an older average age at first birth. Controlling for age, both male and female middle-borns had fewer children. Overall, middle-borns differ more from functional firstborns than do last-borns. Given the significant but small effect sizes demonstrated in this study, we suggest that developmental characteristics that may facilitate middle-borns’ success within the natal family carry slight fitness costs during the reproductive years. (shrink)

In the past four decades, obstetric and neonatal care practices have changed dramatically throughout the western world. As a result, humans now confront unprecedented situations for which they have no biological preparation or cultural experience. In these special issues, an integrated view of the evolving practices of birthing and infant care are discussed from a variety of perspectives. Contributors attempt to show how understanding of the biomedical and psychosocial issues can be informed by cross-cultural and cross-species evidence concerning birth management, (...) neonatal care, and early development. The individual contributions are summarized in this introductory article. (shrink)

The word "civilisation", coined by French intellectuals in the middle of the 18th century, was soon adopted by other European societies. This name meant that they were different and superior to all other societies. Ottoman bureaucrats and writers translated the word "civilisation" into Turkish as "medeniyet". However, "medeniyet", one of the important concepts of the Islamic tradition, was far from expressing the mentality and lifestyle meant by civilisation. The concept of "civilisation" was specific to Europe under the existing conditions and (...) expressed the understanding that Europe was unique and superior. At the same time, it represented an understanding that legitimized the invasion and exploitation of non-European countries by some European states, particularly Britain and France. In order to reduce the reactions of the societies that were the victims of their occupation and exploitation and to idealize being European, Europeans claimed that there were other "civilisations" in history. The concept of "Islamic civilisation" was born under these circumstances. Şemseddin Sami, who wrote the first book entitled "Islamic civilisation" in 1879, defended the thesis that Muslims had a "civilisation" in history and that this "civilisation" had contributed to the formation of the European one. However, after a while, he significantly changed his view and argued that "Islamic civilisation" was completely lost in history and that "European civilisation" was the only and the most superior "civilisation" in the present world. This study aims to examine the conceptualization process of the word "civilisation" and especially Şemseddin Sami's comparison of "civilisations" in the context of this process. The subject will be examined with reference to the written texts of the period and current studies on "civilisation". (shrink)

'Yes, what is Dionysian? - This book provides an answer - "a man who knows" speaks in it, the initiate and disciple of his god.' The Birth of Tragedy is a book about the origins of Greek tragedy and its relevance to the German culture of its time. For Nietzsche, Greek tragedy is the expression of a culture which has achieved a delicate but powerful balance between Dionysian insight into the chaos and suffering which underlies all existence and the discipline (...) and clarity of rational Apollonian form. In order to promote a return to these values, Nietzsche undertakes a critique of the complacent rationalism of late nineteenth-century German culture and makes an impassioned plea for the regenerative potential of the music of Wagner. In its wide-ranging discussion of the nature of art, science and religion, Nietzsche's argument raises important questions about the problematic nature of cultural origins which are still of concern today. ABOUT THE SERIES: For over 100 years Oxford World's Classics has made available the widest range of literature from around the globe. Each affordable volume reflects Oxford's commitment to scholarship, providing the most accurate text plus a wealth of other valuable features, including expert introductions by leading authorities, helpful notes to clarify the text, up-to-date bibliographies for further study, and much more. (shrink)

What role does birth play in the debate about elective abortion? Does the wrongness of infanticide imply the wrongness of late-term abortion? In this paper, I argue that the same or similar factors that make birth morally significant with regard to abortion make meaningful viability morally significant due to the relatively arbitrary time of birth. I do this by considering the positions of Mary Anne Warren and José Luis Bermúdez who argue that birth is significant enough that the wrongness of (...) infanticide does not imply the wrongness of late-term abortion. On the basis of the relatively arbitrary timing of birth, I argue that meaningful viability is the point at which elective abortion is prima facie morally wrong. (shrink)

The subject of life, birth and death constitutes one of the main topics in Democritus’ reflection on human questions. He seeks to understand what men think about the processes of birth and death and how they, accordingly, determine their behavior and attitudes. His reflections comprise a wide range of perspectives and aspects that include examining human behaviour and investigating how it reveals a certain temperament or inclination, inquiring about the nature of these processes and extending the analyses of the processes (...) of birth and death to whole beings through the couple generation-corruption. In the present paper, I intend to examine the main theses and arguments which appear in the testimonies and fragments through which Democritus’ thought was transmitted from antiquity. Furthermore, I will also discuss the hypotheses that for Democritus the most important opposition was not life-death, but rather birth-death and that, at the same time, his idea of nature and life comprises both processes in the perspective of atomistic philosophy. I shall show that corruption has to be considered in two different ways, that is, in the context of physical processes that keep the kosmos in its persistence and in the context of the existence of natural beings, both living and lifeless. (shrink)

During the COVID-19 pandemic, several hospitals implemented “birthing alone” policies, banning companions from accompanying individuals giving birth. We offer an ethical analysis of these policies. First, we examine them through a consequentialist framework of risks and benefits. Second, we consider the significance of birth, highlighting the unique ways in which risks, relationships, and rights are understood in the context of obstetrics. We conclude that birthing alone policies are largely unjustified, as the harm they are certain to cause outweighs their possible (...) benefits and because they fail to take into account what matters to mothers. (shrink)

Definition of the problem: The medical progress made in human reproduction and prenatal diagnosis is having an increasing effect on the responsibility of doctors concerning reproduction and birth. A faulty diagnosis or professional error is causing lawyers to be confronted with difficulties in which ethical views are involved. It is becoming clear that there will be difficulties if the courts have to rule on the question whether the doctor is under an obligation to pay maintenance following the birth of an (...) unwanted child or a child with genetic defects. Arguments and conclusion: First, the controversy about parental claims on maintenance as a result of an unwanted child (”wrongful birth”) is presented, and the ethical arguments against physician liability are critically discussed. Subsequently, the claims of a genetically defective child against the doctor (”wrongful life”) are dealt with. It should be stressed that it is unjust for the court to reject physician liability in this case. The intention is to point out that ethical judgements are improper and inadequate in both cases. (shrink)

Previous studies (Salmon 1999; Salmon and Daly 1998) have found that sex and birth order are strong predictors of familial sentiments. Middleborns tend to be less family-oriented than firstborns or lastborns, while sex differences seem to focus on the utility of kin in certain domains. If this is a reflection of middleborns receiving a lesser degree of support from kin (particularly in terms of parental investment), are middleborns turning to reciprocal alliances outside the family, becoming friendship specialists? Are there comparable (...) birth order differences with respect to mating strategies? In this study, the impact of birth order on attitudes toward family, friends, and mating were examined. Two hundred and forty-five undergraduates completed a questionnaire relating to their attitudes toward friends and family as well as some aspects of mating behavior. Birth order did have a significant impact in several areas. Middleborns expressed more positive views toward friends and less positive opinions of family in general. They were less inclined to help family in need than firstborns or lastborns. Mating strategies also appeared to be influenced by birth order, most notably in the area of infidelity, with middleborns being the least likely birth order to cheat on a sexual partner. (shrink)

We summarize the ethnographic literature illustrating that “abnormal birth” circumstances and “ill omens” operate as cues to terminate parental investment. A review of the medical literature provides evidence to support our assertion that ill omens serve as markers of biological conditions that will threaten the survival of infants. Daly and Wilson (1984) tested the prediction that children of demonstrably poor phenotypic quality will be common victims of infanticide. We take this hypothesis one stage further and argue that some children will (...) be poor vehicles for parental investment yet are not of demonstrably poor quality at birth. We conclude that when people dispose of infants due to “superstitious beliefs” they are pursuing an adaptive strategy in eliminating infants who are poor vehicles for parental investment. (shrink)

The aim of this study is an analysis of the possible adaptive consequences of delivery of low birth weight infants. We attempt to reveal the cost and benefit components of bearing small children, estimate the chance of the infants’ survival, and calculate the mothers’ reproductive success. According to life-history theory, under certain circumstances mothers can enhance their lifetime fitness by lowering the rate of investment in an infant and/or enhancing the rate of subsequent births. We assume that living in a (...) risky environment and giving birth to a small infant may involve a shift from qualitative to quantitative production of offspring. Given high infant mortality rates, parents will have a reproductive interest in producing a relatively large number of children with a smaller amount of prenatal investment. This hypothesis was tested among 650 Gypsy and 717 non-Gypsy Hungarian mothers. Our study has revealed that 23.8% of the Gypsy mothers had low birth weight (<2,500 g) children, whose mortality rate is very high. These mothers also had more spontaneous abortions and stillbirths than those with normal weight children. As a possible response to these reproductive failures, they shortened birth spacing, gaining 2–4 years across their reproductive lifespan for having additional children. Because of the relatively short interbirth intervals, by the end of their fertility period, Gypsy mothers with one or two low birth weight infants have significantly more children than their ethnic Hungarian counterparts. They appear to compensate for handicaps associated with low birth weights by having a larger number of closely spaced children following the birth of one or more infants with a reduced probability of survival. The possible alternative explanations are discussed, and the long-term reproductive benefits are estimated for both ethnic groups. (shrink)

The concept of brain birth has assumed a position of some significance in discussions on the status of the human embryo and on the point in embryonic development prior to which experimental procedures may be undertaken on human embryos. This paper reviews previous discussions of this concept, which have placed brain birth at various points between 12 days' and 20 weeks' gestation and which have emphasised the symmetry of brain birth and brain death. Major developmental features of brain development are (...) outlined, including the gradualness with which new features generally appear, and also the electroencephalogram (EEG) characteristics of premature infants. From this it is concluded that, if the concept of brain birth is a valid one, it should be placed at 24-28 weeks' gestation. More importantly, it is concluded that the differences between brain development and brain death throw doubt on the concept itself. (shrink)

Obstetric violence – psychological and physical violence by medical staff towards women giving birth – has been described as structural violence, specifically as gender violence. Many women are affected by obstetric violence, with awful consequences. The phenomenon has so far been mainly investigated by the health and social sciences, yet fundamental theoretical and conceptual questions have gone unnoticed. Until now, the phenomenon of obstetric violence has been understood as one impeding autonomy and individual agency and control over the body. In (...) this article I will argue that the phenomenon of obstetric violence occurs in a specific state of embodied vulnerability and that might be destructive for subjectivity since it fails to recognize that state and instead disallows support and demolishes relationships and interdependence. This might introduce a conceptual shift and the phenomenon might be reconceptualized as a moment where vulnerability is misrecognized and ambiguity, relations and support are banned. In this case violence is recognized as cutting the original links to our bodies and the world that constitute our phenomenological condition, instead of as hurting the autonomous subject. Obstetric violence, thus, calls to be reflected upon through de Beauvoir’s ideas on ambiguity, the embodied and situated subject and the subject as essentially construed in relations. I believe that de Beauvoir’s conception of the authentic embodied subject as necessarily ambiguous – immanent and transcendent at the same time and ineludibly linked to the world and its others – will be extremely useful for construing this new understanding of how obstetric violence happens and of what precisely constitutes its damage. (shrink)

Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women 'choosing' to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature of autonomy in birth. Whereas mainstream bioethical discourse is used to associating autonomy with having a large array of choices, this conception of autonomy does not (...) seem adequate to capture concerns and intuitions that have a strong grip outside this discourse. An empirical and conceptual exploration of how delivery decisions ought to be negotiated must be guided by a rich understanding of women's agency and its placement within a complicated set of cultural meanings and pressures surrounding birth. It is too early to be 'for' or 'against' women's access to cesarean delivery in the absence of traditional medical indications – and indeed, a simple pro- or con- position is never going to do justice to the subtlety of the issue. The right question is not whether women ought to be allowed to choose their delivery approach but, rather, taking the value of women's autonomy in decision-making around birth as a given, what sorts of guidelines, practices, and social conditions will best promote and protect women's full inclusion in a safe and positive birth process. (shrink)

The central problem posed in these essays, collected from over a decade, is how in the wake of Western ontologies to conceive the coming, the birth that characterises being. The first part of this book, 'Existence' asks how, today, one can give sense or meaning to existence as such, arguing that existence itself, as it comes nude into the world, must now be our 'sense'. In examining what this birth to presence might be, we should not ask what presence 'is'; (...) rather, we should conceive presence as presence to someone, including to presence itself. The second section, 'Poetry', asks: What if art exposes this? In writing, in the voice, in painting? And what if art is exposed to it? How does it inscribe the coming of existence as such? The author's trajectory in this book crosses those of Hegel, Schlegel, Baudelaire, Nietzsche, Freud and Heidegger, in their comments on art and politics, existence and corporeality, everyday life and its modes of existence, and ecstasy. An analysis that dares this crossing involves all the varied accounts of existence, political and philosophical, as well as all the realms of poetry. (shrink)

In this remarkable book Michel Foucault, one of the most influential thinkers of recent times, calls us to look critically at specific historical events in order to uncover new layers of significance.