In the UK, regulation of clinical services is being restructured. We consider two clinical procedures, abortion and IVF treatment, which have similar ethical and political sensitivities. We consider factors including the law, licensing, inspection, amount of paperwork and reporting requirements, the reception by practitioners and costs, to establish which field has the greater ‘regulatory burden’. We test them based on scientific, ethical, social, political factors that might explain differences. We find that regulatory burden borne by IVF services is (...) greater than in abortion, but none of the explanatory theses can provide a justification of this phenomenon. We offer an alternative explanation based on regulatory ‘overspill’ from research regulation and policy making, conceptualisation of risk regulation and a high public profile that locks a regulator into self-preservation. (shrink)

Global reproductive landscapes and with them cross-border routes are rapidly changing. This paper examines the reproductive routes and choices of fertility travellers from China to Russia as reported by medical professionals and fertility service providers. Providing new empirical data, it raises new ethical questions on the facilitation of cross-border reproductive travel and the commercialisation of reproductive treatment. The relaxation of the one-child policy in 2014 in China, the increasing demand for ART exceeding the capacity of national fertility (...) clinics and the difficulty of accessing treatment with donor eggs concomitant with a growing economic power of the upper–middle class are shaping the ART industry in Asia in new ways. A new development is Chinese citizens increasingly seeking ART treatment in Russia, which has a long-standing practice of ART governed by a liberal legislation. Furthermore, as China prohibits the export of gametes, Chinese fertility travellers rely on acquiring donor gametes once starting treatment abroad. Clinicians in Russia report three strategies amongst their Chinese patients: One group is using donor eggs of women of Asian appearance living in Russia or is hiring women of resembling appearance from third-party countries to donate their eggs in Russia to create resemblance in their offspring. Another group is buying white donor gametes to create Eurasian mixed children and thus ‘enhance’ their offspring. Providing novel empirical data, this article informs ethical deliberation and raises imminent questions for further research in this understudied geographic region and on cross-border reproductive treatment. (shrink)

Over the last two decades, social scientists across disciplines have been researching how value is extracted and governed in the reproductive bioeconomy, which broadly refers to the various ways reproductive tissues, bodies, services, customers, workers, and data are inserted into capitalist modes of accumulation. While many of these studies are empirically grounded in single country–based analyses, this paper proposes an integrative political economy framework, structured around the concept of “global fertility chains.” The latter articulates the reproductive bioeconomy as (...) a nexus of intraconnected practices, operations, and transactions between enterprises, states, and households across the globe, through which reproductive services and commodities are produced, distributed, and consumed. Employing a diffractive reading of the literature on commodity chains and care chains, this unified approach scrutinizes the coproduction of value, biology, and technoscience and their governance mechanisms in the accumulation of capital by taking into account the unevenly developed geographies of global fertility chains, their reliance on women’s waged and unwaged reproductive labor, and the networked role of multiple actors at multiple scales without losing sight of the constitutive role of national states in creating demand, organizing supply, and accommodating the distribution of surplus value. We empirically ground this integrative political economy approach of the reproductive bioeconomy through collaborative, multisited fieldwork on transnational reproduction networks in Israel/palestine, Romania, Georgia, and Spain. (shrink)

BackgroundWhile fertility preservation is recommended practice for paediatric oncology patients, it is increasingly being considered for transgender children and young people in paediatric care. This raises ethical issues for clinicians, particularly around consent and shared decision-making in this new area of healthcare.MethodsA systematic review of normative literature was conducted across four databases in June 2020 to capture ethical considerations related to fertility counselling and preservation in paediatric transgender healthcare. The text of included publications was analysed inductively, guided by (...) the Qualitative Analysis Guide of Leuven.ResultsTwenty-four publications were identified for inclusion. Four key ethical considerations emerged from this literature: access to fertility preservation, conscientious objection, decision-making capacity of children and young people, and shared decision-making.ConclusionIn the identified literature, there is consensus that transgender children and young people should not be refused access to fertility preservation services solely due to their gender identity, and that clinicians with conscientious objections to fertility preservation for this group have an obligation to refer on to willing providers. Factors that create ethical complexity in this area of paediatric care include the child’s age, mental health, and parents’ views. (shrink)

An ethical issue that has largely been overlooked and neglected is the potential conflict of interests faced by medical professionals in the recruitment, counselling and reimbursement of egg donors. It must be noted that fertility treatment in private practice is an overwhelmingly profit-driven enterprise. To attract more patients and generate more income, there is a strong incentive for fertility clinics and doctors to actively and aggressively recruit women for their egg donation programme. In some countries where substantial financial (...) remuneration for egg donation is permitted—for example, the United States,1 2 fertility doctors and clinical embryologists often act as the “middleman” or broker to facilitate the transaction of eggs between donor and recipient. Very often, the usual practice is for fertility clinics to charge patients a commission for sourcing egg donors, which is an additional profit on top of substantial medical fees that would be earned from provision of fertility treatment to the same patient. This is ethically contentious; because the money earned is not directly related to medical services rendered to the patient, but is instead attributed to the brokerage and transaction of donated human material.There is a risk that the welfare of the …. (shrink)

NICE, the draft fertility guideline and dodging the big question: should fertility treatment be provided by the NHS?In August of this year the National Institute for Clinical Excellence made its draft guideline on fertility treatment available for consultation.1 As has been widely reported in the media the draft guideline recommends that the National Health Service should provide publicly funded fertility treatment in a consistent way across England and Wales. The guideline recommends that three cycles of IVF (...) should be available when “The woman is within the optimal range for in vitro fertilisation and there is an appropriately diagnosed cause of infertility of any duration, or unexplained infertility of at least three years’ duration .Those who need fertility treatment will celebrate the guideline, as will many fertility clinics. The guideline does not, however, address key questions that will be obvious to many. Is fertility treatment the kind of thing that ought to be available on the NHS? Will the inevitable increase in demand mean that resources are directed away from other services? Is fertility treatment really the same kind of intervention as heart or hip replacement surgery?My view is that there are good reasons for doing what we can to help people access fertility services. Most of us will start a family and for those of us who do it is probably the most important of all of our life projects. Given that social status and wealth can be significant obstacles to many of the things that people would like to do with their lives, the fact that most of us are able to pursue this important life project is good from an egalitarian …. (shrink)

For individuals pursuing medically assisted gender transition, gender-affirming surgical treatments, such as oophorectomy (removal of the ovaries) and orchiectomy (removal of the testicles), cause sterility, and gender-affirming hormone treatment with medications (i.e., testosterone and estrogen) may negatively impact infertility. The major United States (US) medical associations already endorse fertility preservation (FP) through cryopreservation (i.e., “freezing” egg and sperm) for transgender individuals. Despite these endorsements from the relevant medical societies, medical insurance coverage for FP remains very limited in the US. (...) Given the high out-of-pocket costs for FP services, fertility preservation remains financially out of reach for many transgender individuals who may desire it. We present an ethical justification for universal FP coverage for all transgender and gender diverse (TGD) individuals who request this option during medically assisted gender transition. First, we argue that gender-affirming medical care is analogous to other medical interventions and treatment regimens that compromise fertility, such as cancer care, and that both types of interventions need to be afforded the same medical benefits and assistance in pursuing fertility goals. Second, we argue that the lack of FP for transgender individuals contributes to the ongoing and profound transphobia and anti-trans bias that has been exacerbated in the past several years across the healthcare landscape in the United States. We argue that the provision of FP coverage for transgender individuals is necessary for clinicians and third-party payers to state their unequivocal support for TGD patients and their healthcare needs. (shrink)

Debate has raged in Canada recently over whether in vitro fertilization should be funded through public health insurance. Such a move would require that the provinces classify IVF as a medically necessary service. In this paper, I defend the position I have taken publicly—especially in Ontario, my own province—that IVF is not medically necessary. I contend that, by funding IVF on grounds of medical necessity, governments like Ontario's violate their commitments to equality and fairness, and cause harm. They do the (...) last by suggesting that the lives of people who forgo procreation, and perhaps have children in other ways, will be stunted. (shrink)

The right to conceive and bear children has been protected both in law and in policy. Human society has from its earliest time valued children and defended procreation as a basic right.Modern health technology offers the possibility of conception to the estimated 2.5 million infertile couples who may wish to have children. For these persons, infertility treatment offers the hope of having children, an activity deemed basic and essential in human society.In general, the state has been reluctant to directly interfere (...) in the reproductive decisions of individuals. However, the state may act to increase or reduce access to reproductive services in a variety of ways. For example, recent legislation regulating fertility clinics affects the distribution of assisted reproductive technology in the United States. The purpose of this paper is to describe this legislation, project its probable effects on the distribution of ART services, and analyze these effects based on distributive theories of justice. (shrink)

This work sought to carry out a comparative analysis of in vitro fertilization (IVF) vis-à-vis St. Thomas Aquinas’ Natural Law Theory. Both of them emanated from problem of infertility. IVF makes use of artificial insemination for fertilization which is quite contrary to the natural process of sexual reproduction. This work makes use of analytic method to analyse comparatively in vitro fertilization and St. Thomas Aquinas’ Natural Law Theory. Thus, this work conceives that IVF is one of the assisted reproductive technologies (...) in the scientific exploration of genetic engineering and bio-technology which emanated to tackle the problem of genetic inheritance outside marriage. It contravenes the coital or natural reproduction which conforms to St. Thomas Aquinas’ second precept of natural law. Again, IVF is artificial as such it is pruned to many complications. There is no adequate information given by the medical practitioners or providers of this service on the health hazards or risks involve in IVF. In addition, in vitro fertilization makes provision for donor gamete and surrogate motherhood which may have many negative implications both for the couples, off-spring, gestation mother, and society at large. (shrink)

SummaryFrom 1996 to 2006, Nepal experienced a substantial fertility decline, with the total fertility rate dropping from 4.6 to 3.1 births per woman. This study examines the associations between progress towards universal primary and secondary schooling and fertility decline in rural Nepal. Several hypotheses regarding mechanisms through which education affects current fertility behaviour are tested, including: the school environment during women's childhood; current availability of schools; knowledge of educational costs; and women's own educational attainment. Data for (...) the analysis come from the 2003–04 Nepal Living Standards Survey, a nationally representative random sample of households, which includes detailed data on fertility, household expenditure, educational attainment, demographic characteristics and the use of social services. Census and administrative data are also used to construct district-level gross enrolment ratios for primary and secondary schools during the women's childhood. Discrete dependent variable modelling techniques are used to estimate the effects of the following variables on the probability of women giving birth in a given year: district-level gross enrolment ratios for primary and secondary schools during women's childhood; having had a child previously in school; women's own educational level; current school availability; and other covariates. Separate models are estimated for the overall sample of rural women of reproductive age, and for parity-specific sub-samples. The results suggest that district-level gross enrolment ratios for secondary schools and, in some instances, having had a previous child enrolled in school are significant determinants of fertility in rural areas. These results are highly independent of women's own educational levels. Overall, the results suggest that, in the rural Nepal context, mass schooling influences the fertility transition through both community- and household-level pathways. (shrink)

The productive services of nature, such as the ability of fertile soil to grow crops, receive low market prices not because markets fail but because many natural resources, such as good cropland, are abundant relative to effective demand. Even when one pays nothing for a service such as that the wind provides in pollinating crops, this is its 'correct' market price if the supply is adequate and free. The paper argues that ecological services are either too 'lumpy' to (...) price in incremental units, priced competitively, or too cheap to meter. The paper considers counter-examples and objections. (shrink)

Workplace learning and competence development in work are frequently used concepts. A wide spread notion is that societal, institutional, and organizational changes require the development of knowledge, methods and strategies for learning at workplaces, in both public and private enterprises. In research on learning and competence development at work, the organizational learning and development as well as individual accomplishments are investigated from various perspectives and in different contexts. The theoretical base for research projects can, accordingly, be focused at a number (...) of organizational and system levels. This paper describes a research project called "Workplace development and learning in elder care" in which learning and knowledge were key issues and where Activity Theory was used as the theoretical base. The project was joint project between two research and development field units. These were UFFE, a municipal social services’ field research unit, and Äldrecentrum Västerbotten, a county council field research unit which aims to serve the interests of the elderly. The project was launched in the fall of 2000 and ended in the summer of 2003. I was employed part-time as a research leader at the municipal research unit and became the research leader for this particular project. A number of students, as well as employees from the county council geriatric care services and the municipal elder care participated in the project. The general aims of the project were to: a) investigate the prerequisites for development and learning; b) test and evaluate interventions at a workgroup level; and c) identify the need for new knowledge. The results were expected to be useful for the field research units as well as for the municipal and county eldercare services in their research and development work. I start with a presentation of the theoretical concepts and apply them in order to form a tentative hypothesis on the status of learning and knowledge in elder care. The next section contains a short description of the different parts of the project and the main results are presented. Finally, the results are discussed and related to the conditions and impact of workplace interventions. (shrink)

I argue that asymmetries in taste and talent can explain markets in bodily services, just as they explain other kinds of work. While inequality is a powerful explanation for participation in bodily-service markets, such markets are not unique in their reliance on inequality. Finally, I address another kind of inequality that deserves our attention -- the advantage of the providers of bodily services over those who require them. While those who suffer from infertility or face the terror of (...) organ failure may have a financial advantage over others, they may still be worse off than fertile and organ-rich people who suffer economic or social disadvantage. Egalitarians ought to concern themselves with the whole scope of disadvantage, not just economic disadvantage. (shrink)

Biofuels have lately been indicated as a promising source of cheap and sustainable energy. In this paper we argue that some important ethical and environmental issues have also to be addressed: (1) the conflict between biofuels production and global food security, particularly in developing countries, and (2) the limits of the Human Appropriation of ecosystem services and Net Primary Productivity. We warn that large scale conversion of crops, grasslands, natural and semi-natural ecosystem, (such as the conversion of grasslands to (...) cellulosic ethanol production, or plantation of sugar cane and palm oil), may have detrimental social and ecological consequences. Social effects may concern: (1) food security, especially in developing countries, leading to an increase of the price of staple food, (2) transnational corporations and big landowners establishing larger and larger landholdings in conflict with indigenous areas and the subsistence of small farmers. Ecological effects may concern: (1) competition with grazing wild and domesticated animals (e.g., millions of grazing livestock in USA prairies), (2) an excessive appropriation of Net Primary Production from ecosystems, (3) threatening biodiversity preservation and soil fertility. We claim that is it well known how ecological and social issues are strictly interwoven and that large scale biofuels production, by putting high pressure on both fronts, may trigger dangerous feedbacks, also considering the critical fact that 9 billion people are expected to inhabit the planet by 2050. There is a need to conduct serious and deep analysis on the environmental and social impact of large scale biofuels production before important energy policies are launched at global level. Biofuels will not represent an energetic panacea and their role in the overall energy consumption will remain marginal in our present highly energivorous society, while their effect on food security and environment preservation may have detrimental results. We should also have the courage to face two key issues: (1) we cannot keep increasing resources consumption at present pace, and have to change our life style accordingly, and (2) we have to deal with population growth; we cannot expect to have 9–10 billions people inhabiting the earth by 2050, without this representing a major impact on its support system. (shrink)

A methodical study of the primitive cultures of the hunting-gathering peoples which focuses on their social structures and economic relations.

Chapter on The Australian class system previously published as Sociocentre relationship terms and the Australian class system qv. for annotation.

New Blackfriars, Volume 103, Issue 1103, Page 159-161, January 2022.

ABSTRACT Global biodiversity declines are increasingly recognized as profound ecological and social crises. In areas subject to colonialization, these declines have advanced in lockstep with settler colonialism and imposition of centralized resource management by settler states. Many have suggested that resurgent Indigenous-led governance systems could help arrest these trends while advancing effective and socially just approaches to environmental interactions that benefit people and places alike. However, how dominant management and conservation approaches might be decolonized (i.e., how their underlying colonial structure (...) might be addressed, transformed, and replaced) is not always clear. Here, we describe a ‘Decolonial Model of Environmental Management and Conservation’ as an alternative paradigm to dominant approaches of conservation and management. The tenets of the model describe characteristics that might be expected of decolonized management, contrasted with those of dominant state-led approaches such as those embedded in the North American Model of Wildlife Conservation. The model does not prescribe how Indigenous governments or communities ought to govern their own territories, but instead offers insights into how external management and conservation agencies and practitioners might support (or stop impeding) Indigenous-led governance. We illustrate the model with a conservation ‘bright spot’: grizzly bear stewardship in the area now referred to as the Great Bear Rainforest in British Columbia, Canada, with a focus on work led by or in collaboration with, and within the territories of, the Haíɫzaqv, Kitasoo/xai’xais, Nuxalk, and Wuikinuxv First Nations. While acknowledging the important context-specific variability among place-based management and conservation applications, we also discuss the model’s broader applicability. (shrink)

Previous studies of verbal short-term memory indicate that STM for serial order may be linked to language development and developmental language disorder. To clarify whether a domain-general mechanism is impaired in DLD, we studied the relations between age, non-verbal serial STM, and language competence. We hypothesized that non-verbal serial STM differences between groups of children with DLD and typically developing children are linked to their language acquisition differences. Fifty-one children with DLD and sixty-six TD children participated as part of the (...) HelSLI project in this cross-sectional study. The children were 4–6-year-old monolingual native Finnish speakers. They completed several tests of language and cognitive functioning, as well as new game-like tests of visual and auditory non-verbal serial STM. We used regression analyses to examine how serial STM moderates the effect of age on language. A non-verbal composite measure of serial visual and auditory STM moderated cross-sectional development of receptive language in the children with DLD. This moderation was not observed in the TD children. However, we found more rapid cross-sectional development of non-verbal serial STM in the TD children than in the children with DLD. The results suggest that children with DLD may be more likely to have compromised general serial STM processing and that superior non-verbal serial STM may be associated with better language acquisition in children with DLD. (shrink)

This book contains programmatic essays that focus on broad-ranging proposals for re-envisioning a discipline of comparative philosophy of religions. It also contains a number of case studies focussing on the interpretation of particular religio-historical data from comparatively oriented philosophical perspectives.

A subcategory of medical tourism, reproductive tourism has been the subject of much public and policy debate in recent years. Specific concerns include: the exploitation of individuals and communities, access to needed health care services, fair allocation of limited resources, and the quality and safety of services provided by private clinics. To date, the focus of attention has been on the thriving medical and reproductive tourism sectors in Asia and Eastern Europe; there has been much less consideration given (...) to more recent ‘players’ in Latin America, notably fertility clinics in Chile, Brazil, Mexico and Argentina. In this paper, we examine the context-specific ethical and policy implications of private Argentinean fertility clinics that market reproductive services via the internet. Whether or not one agrees that reproductive services should be made available as consumer goods, the fact is that they are provided as such by private clinics around the world. We argue that basic national regulatory mechanisms are required in countries such as Argentina that are marketing fertility services to local and international publics. Specifically, regular oversight of all fertility clinics is essential to ensure that consumer information is accurate and that marketed services are safe and effective. It is in the best interests of consumers, health professionals and policy makers that the reproductive tourism industry adopts safe and responsible medical practices. (shrink)

Social, political, and economic environments play an active role in nurturing professional virtue. Yet, these environments can also lead to the erosion of virtue. As such, professional virtue is fragile and vulnerable to environmental shifts. While physicians are often considered to be among the most virtuous of professional groups, concern has also always existed about the impact of commercial arrangements on physicians’ willingness and capacity to enact their professional virtues. This article examines the ways in which commercial arrangements have been (...) negotiated to secure medical virtue from real or perceived threats of erosion. In particular, we focus on the concern surrounding conflicts of interest arising from commercial arrangements that have developed as a result of neoliberal economic and social policies. The deregulation of medical markets and privatization of services have produced new commercial relationships that are often misunderstood by patients, publics, and physicians themselves. ‘Conflicts of interest’ policies have been introduced in an attempt to safeguard ethical conduct and medical practice. However, a number of virtue ethicists have critiqued these policies as inadequate for securing virtue. We examine the ways in which commercial arrangements have been seen to impact upon medical virtue, both historically and in the context of modern medicine. We then describe and critique current efforts to restore clinical virtue through both conflict of interest policies and through virtue ethics. Finally, we suggest some possible ways of addressing the corrosive effects of neoliberalism on medical virtue. (shrink)

This paper interprets the British legislative process that initiated the first comprehensive national regulation of embryo research and fertility services and examines subsequent efforts to restrain the assisted reproduction industry. After describing and evaluating British regulatory measures, I consider successive failures to control the assisted reproduction industry in the US. I discuss disparities between UK and US regulatory initiatives and their bearing on regulation in other countries. Then I turn to the political and social structures in which the (...) assisted reproduction industry is embedded. I argue that regulatory bodies are seldom neutral arbiters. They tend to respond most readily to special interests and neglect strategies that could more effectively meet the health needs of the people they represent. Neither national nor international bodies have aggressively pursued policies to harness the industry, reduce infertility rates, or meet the needs of people whose fertility is threatened by substandard healthcare and environmental neglect. In conclusion, I consider recent initiatives by activist groups to mount an alternative response to the industry's current practices and build a transnational reproductive justice movement. (shrink)

This article will examine current US health insurance policies for providing fertility services and Assisted Reproductive Technologies and analyze the open-ended policies of the Commonwealth of Massachusetts. This state in particular will be discussed in depth, as there are virtually no limits on infertility provision or coverage. However, tightening up Massachusetts’s health insurance policies by putting parameters on provision and coverage of Assisted Reproductive Technologies will allow the infertile to continue to access paid-for treatment while ensuring that the (...) goal of health insurance coverage—which I understand to be the provision of paid coverage to address medical conditions—is maintained. (shrink)

Fertility clinicians participate in non-sexual reproductive projects by providing assisted reproductive technology (ART) to those hoping to reproduce, in support of their reproductive goals. In most countries where ART is available, the state regulates ART as a form of medical treatment. The predominant position in the reproductive rights literature frames the clinician’s role as medical technician, and the state as a third party with limited rights to interfere. These roles broadly align with established functions of clinician and state in (...) Western liberal democracies, where doctors have duties to provide safe, beneficial and legal healthcare to all who seek it. Recognised state responsibilities include safeguarding equitable access to medical services and protecting and promoting reproductive liberty.I argue against this normative moral framing of clinician and state involvement in non-sexual reproduction, suggesting that clinician and state join the non-sexual reproductive project at the point of triggering conception. Begetting a child is more than just the provision and regulation of healthcare; it generates rights and confers responsibilities on all who join this morally significant project. All who collaborate have the right to join or refuse to join the project. I suggest this is intuitively understood in the sexual realm, but not in the non-sexual realm. My key substantive claim is that non-sexual reproduction is a pluralist pursuit that morally implicates more than the genetic and gestational contributors. I find that while the moral basis of a clinician or the state’s right to refuse to join the ART project is the same as for those providing gestational or genetic input, the reasons that morally underpin their refusal differs. (shrink)

Studies on the association of demographic phenomena and religion have shown that religious institutions and religious identity of individuals can influence in various ways the demographic behavior of followers. This study aimed to identify and analyze possible differences in the fertility behavior and accordance religions among women between 15-49 years old in Brazil, including analyzes from the conversion and the frequency in religious worship and ceremonies. For this data from the National Survey of Demography and Health of Women and (...) Children of 2006 were used. The results suggest that there are differences in fertility rates and types of religions. The same are also observed for those women who were always had the same religion and that changed religion throughout their reproductive period and there are also important differences on the fertility levels and pattern by participation in religious worship and ceremonies. (shrink)

In Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26·4%), low knowledge of HIV status and a total fertility rate of 3·5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15–49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women (...) have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services. Copyright © Cambridge University Press 2008. (shrink)

Contemporary medicine offers more and more possibilities as far as procreation is concerned. They are available, first of all, to infertile couples (IVF – In Vitro Fertilization). However, the advanced reproductive technology is also used by people who are biologically capable of having children. These people are ready to resign voluntarily from pregnancy and childbirth difficulties. The surrogate motherhood appears as a phenomenon known already from biblical times but existing nowadays in a different context. At the same time, some issues (...) are emerging – questions concerning social, ethical, moral and legal consequences. This paper presents the issue of surrogate motherhood in the context of social changes, which could lead to a development of such practices as well as the reasons of parents and surrogate mothers. Can this phenomenon be perceived as a service for people who want to fulfill their desires for having children? Would surrogate motherhood become a socially approved practice? What are the ethical, religious and legal norms concerning this phenomenon? The religious norms are connected, first of all, with an attitude of the Catholic Church which recognizes surrogacy as unacceptable and states that “it offends the dignity and the right of a child to be conceived, carried in the womb, delivered to the world and brought up by their own parents”. The ethical norms refer to the biotechnological issues and include matters of creating and implanting human embryos as well as the problem of the surrogate mother – child – biological parents relationship. As far as legal norms are concerned, the case is still open hence Polish law does not take into consideration in vitro fertilization or the admissibility of surrogate motherhood. (shrink)

Access to state-funded fertility treatments is age-restricted in many countries based on epidemiological evidence showing age-associated fertility decline and aimed at administering scarce resources. In this article, we consider whether age-related restrictions can be considered ageist and what this entails for a normative appraisal of access criteria. We use the UK as a case study due to the state-funded and centrally regulated nature of in vitro fertilization provision. We begin by reviewing concepts of ageism and age discrimination in (...) gerontological scholarship and contend that it is analytically useful to differentiate between them when considering age-restricted health services. We then argue that criteria to access IVF could be considered indirectly ageist so far as they rely on an age-related evidence base that manifests ageist categorizations of persons. Lastly, we examine whether there could be more normatively desirable alternatives to devise criteria to access fertility treatment, considering “lifestyle” as a potential candidate. We conclude, however, that lifestyle-based discrimination is problematic because, unlike age-based discrimination, it risks exacerbating existing socioeconomic and ethnic inequalities. (shrink)

Psychological attitudes towards service and personal robots are selectively examined from the vantage point of psychoanalysis. Significant case studies include the uncanny valley effect, brain-actuated robots evoking magic mental powers, parental attitudes towards robotic children, idealizations of robotic soldiers, persecutory fantasies involving robotic components and systems. Freudian theories of narcissism, animism, infantile complexes, ego ideal, and ideal ego are brought to bear on the interpretation of these various items. The horizons of Human-robot Interaction are found to afford new and fertile (...) grounds for psychoanalytic theorizing beyond strictly therapeutic contexts. (shrink)

Sex, Love, and Gender is the first volume to present a comprehensive philosophical theory that brings together all of Kant's practical philosophy — found across his works on ethics, justice, anthropology, history, and religion — and provide a critique of emotionally healthy and morally permissible sexual, loving, gendered being. By rethinking Kant's work on human nature and making space for sex, love, and gender within his moral accounts of freedom, the book shows how, despite his austere and even anti-sex, cisist, (...) sexist, and heterosexist reputation, Kant's writings on happiness and virtue (Part I) and right (Part II) in fact yield fertile philosophical ground on which we can explore specific contemporary issues such as abortion, sexual orientation, sexual or gendered identity, marriage, trade in sexual services, and sex- or gender-based oppression. Indeed, Kant's philosophy provides us with resources to appreciate and value the diversity of human ways of loving and the existential importance of our embodied, social selves. Structured on a thematic basis, with introductions to assist those new to Kant's philosophy, this book will be a valuable resource for anyone who cares about these issues and wants to make sense of them. -/- Alternatively: Sex, Love, and Gender identifies a set of possibilities that define human beings’ sexuality. These sets come with their own concepts, which specify how the possibilities are realized and what effects they have on our lives lived together. Partly the task is descriptive. The description has to be plausible. Plausibility comes from the phenomenology (and not the other way around). Partly the task is normative. The normative content also has to be plausible. Plausibility here comes from vindicating the principles that underwrite the possibilities that define human beings’ sexualities and sexual experiences and behaviors lived by human beings and from the philosophical explanations and conclusions that follow. Overall plausibility, then, comes from discursive analysis of alternatives, from a priori argument, and, in the evaluative case, from showing how the Kantian account of a good life fits with reasonable conceptions of goodness consistent with the phenomenology of human lives. Although this exploration leads us, as we will see, to most corners of Kant’s practical philosophy, including his metaethics and metaphysics, the main focus is on an account of human sex, love, and gender explored explicitly with respect to happiness and ethics (virtue) and justice (right). It is because of this focus that the book is divided into two parts: Part 1 (“Human Sexuality and Virtue”) and Part 2 (“Human Sexuality and Right”). (shrink)

Background During the pandemic, social and health care professionals operated in ‘crisis conditions’. Some existing rules/protocols were not operational, many services were closed/curtailed, and new ‘blanket’ rules often seemed inappropriate or unfair. These experiences provide fertile ground for exploring the role of virtues in professional life and considering lessons for professional ethics in the future. Research design and aim This article draws on an international qualitative survey conducted online in May 2020, which aimed to explore the ethical challenges experienced (...) by social workers during Covid-19. Participants and research context 607 social workers responded from 54 countries, giving written online responses. This article first summarises previously published findings from the survey regarding the range of ethical challenges experienced, then develops a new analysis of social workers’ accounts of ethically challenging situations from a virtue ethics perspective. This analysis took a narrative ethics approach, treating respondents’ accounts as stories featuring the tellers as moral agents, with implicit or explicit implications for their professional ethical identity and character. The article is illustrated with accounts from the 41 UK respondents, drawing particularly on two case examples. Ethical considerations Ethical approval was gained from Durham University and anonymity was ensured for participants. Findings/results This article explores the nature of the ethical space created during the pandemic showing how practitioners were able to draw more on ‘inner resources’ and professional discretion than usual, displaying virtues such as professional wisdom, care, respectfulness and courage as they took account of the specific contexts of their work, rather than simply adhering to blanket rules. Conclusion Exploring practice through a virtue ethical lens provides valuable lessons for ‘building back better’ in social and health care professions. (shrink)

This paper explores the wartime creation of veterinary expertise in cattle breeding, and its contribution to the transition between two very different types of agriculture. During the interwar period, falling prices and steep competition from imports caused farmers to adopt a ‘low input, low output’ approach. To cut costs, they usually butchered, marketed or doctored diseased cows in preference to seeking veterinary aid. World War II forced a greater dependence on domestic food production, and inspired wide-ranging state-directed attempts to increase (...) agricultural output. However, the weak connection between veterinary services and livestock productivity meant that the drive for greater milk yields did not automatically translate into a demand for improved veterinary health care. Rather veterinary expertise had to be actively created and made relevant to the new context. Leaders of the profession secured this goal through establishing a government-backed ‘scheme for the control of certain diseases of dairy cows’. Drawing on pre-existing but rarely applied reproductive technologies, the scheme provided the opportunities and education necessary for more extensive veterinary interventions in cattle breeding. I show how its operation transformed understandings of fertility, raised veterinarians to the status of experts, won them the patronage of farmers and the state, and facilitated the shift to a productivity-oriented agriculture. (shrink)

On occasion, British in vitro fertilization practitioners look over the ocean to the practice of IVF and embryo research in the United States, wonder why these areas are subject to less regulation than in the United Kingdom, and ask how much less risky and more progressive IVF and embryo research might be if subject to additional federal, or at least state, regulation. To an American audience, imbued with the centuries‐old spirit of independence, regulation and autonomy can seem in tension. From (...) a British perspective, there is no necessary conflict. There is no dissent in the United Kingdom from the proposition that individual activities, services, and industries can be regulated and, at the same time, retain and exercise such autonomy as is their right within a safe sphere. From 1994 to 2002, I was the chair of the United Kingdom's Human Fertilisation and Embryology Authority, which regulates the practice of IVF and embryo research. The existence of the HFEA assures patients that safety and aspects of the practice of assisted reproduction are monitored, leaving them free to choose without worrying about danger, in the same way that the public may take only those drugs that have passed health and safety tests. I would propose that anxious and vulnerable patients do not have more autonomy in a less regulated, market‐driven field. (shrink)

Beginning with the representation of age in extremis in the nature morte or still life, a depiction of aged artifacts and representations of vanitas, artistic representations particularly in painting associate woman and death. Looking at artistic allegories for age and ageing, raising the question of aura for Walter Benjamin along with Ivan Illich and David Hume, this essay reflects on Heidegger on history together with reflections on the ‘death of art’ as well as Arakawa and Gins and Bazon Brock, both (...) as artists ‘at your service,’ as Brock would say, contra death, and including a brief discussion of wabi sabi and kintsugi. The ‘ageing’ of art includes a review of the (ongoing) debate concerning Michelangelo’s forging of the Laocoon as well as ancient views of age together with contemporary philosophic reflections (Simone de Beauvoir and Michel de Certeau). The figure of Baubô in ancient Greek sculpture and cultic context can make it plain, as Nietzsche shows (as Sarah Kofman follows him on this), that laughter and death are connected (along with fertility cults in antiquity). Satire preserves the Greek tradition of laughing at death and the essay closes with Swinburne. (shrink)

Approximately 15% of couples are affected by infertility worldwide. Subsequently, the use of assisted reproductive technologies is becoming increasingly popular, including the use of donor eggs, sperm and embryos. Despite ongoing ethical debate surrounding gamete donation, this is now a widely accepted practice in Western countries. Assisted reproductive technology is becoming more commonly utilised within the Muslim population; however, gamete donation remains a relatively controversial and taboo topic within this religion. Interestingly, there are significant differences in beliefs between Sunni and (...) Shi’a Muslims. Whilst Sunni Islam absolutely forbids the use of third-party reproductive assistance, Shi’a Islam is somewhat more lenient towards this practice. Reproductive tourism has therefore become prevalent in Shi’a Middle Eastern countries that permit the use of donor gametes in assisted reproductive technologies; however, this continues to evoke a strong bioethical debate, particularly around sperm donation. With the increased influx of reproductive tourism, this is beginning to weaken the regional Sunni Islam ban on the use of donor technologies, questioning the morality of their current beliefs. Consideration of religious beliefs is also crucial for patient-centred care in UK patients treated by the National Health Service for fertility issues. Of note, there is a lack of non-Caucasian donors in the United Kingdom. Reproductive tourism is also becoming increasingly common in the United Kingdom and needs to be considered in terms of future patient management in delivering good obstetric care. (shrink)