Journal of Social Philosophy, EarlyView.

Uterus transplantation (UTx) is an experimental surgery likely to face the issue of organ shortage. In my article, I explore how this issue might be addressed by changing the prevailing practices around live uterus donor recruitment. Currently, women with children – often the mothers of recipients – tend to be overrepresented as donors. Yet, other potentially eligible groups who may have an interest in providing their uterus – such as transgender men, or cisgender women who do not wish to gestate (...) or to have children – tend to be excluded as potential donors. Moving forward, I recommend that donor inclusion criteria for UTx be broadened to be more inclusive of these latter groups. (shrink)

Should involuntarily childless people have the same opportunities to access parenthood as those who are not involuntarily childless? In the context of assisted reproductive technologies, affirmative answers to this question are often cashed out in terms of positive rights, including rights to third-party reproduction. In this paper, we critically explore the scope and extent to which any such right would hold up morally. Ultimately, we argue for a departure away from positive parental rights. Instead, we argue that the state has (...) an imperfect duty to benefit involuntarily childless people in relation to their parental aspirations. (shrink)

Assisted conception can be distinguished from assisted gestation.1 These processes have tended to be grouped together under the generic term assisted reproductive technology in the bioethical literature. According to Chloe Romanis, however, it is worth distinguishing interventions such as surrogacy, uterus transplantation, and potentially artificial placenta technology, as falling under the genus assisted gestative technologies. This is because gestation carries unique ethico-legal implications as compared with conception. The proposed genus of assisted gestative technologies is a helpful first step in the (...) endeavour to distinguish between the different ethico-legal landscapes across various ‘assisted reproductive technologies.’ I am generally in favour of adopting AGT as a term which separates various forms of gestational services from other kinds of reproductive technologies. Yet, if assisted gestative technologies can be considered a genus of assisted reproductive technologies, we might consider surrogacy, UTx, and artificial placenta technology their individual species. Between these various species of AGTs, I would argue, there remains enough ethico-legal diversity to warrant independent discussion about the descriptive and normative functions of each AGT and the relationship between gestation, genetic relatedness and legal/moral parenthood. Chloe Romanis claims that legal and social issues about attribution of parenthood and the importance that might be placed on information about gestational origins affect all forms of AGTs.1 I take it ethical ambiguities arise because the relationship between who gestates, genetic relatedness to the prospective child, and claims to legal/moral parental responsibility can be disrupted or made ambivalent with the involvement of third-party support. For many of those who do not require reproductive assistance, the gestational labour, genetic relatedness and parental responsibility would traditionally …. (shrink)

A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients’ perception of material risks, by trained interviewers. Patients’ demographics were obtained. Mann–Whitney U (...) test and Kruskal-Wallis one-way analysis of variance was used. Statistical significance was taken at p < 0.05. Four hundred fourteen patients were eligible of which 26 refused to participate and 24 were excluded due to language barrier. 364 patients were recruited. A higher level of education, being employed and younger age group are factors identified in patients who wanted greater participation in medical decisions. Gender, marital status, type of surgery, and previous surgical history did not affect their level of participation. The complications most patients knew about were Nausea, Drowsiness and Surgical Wound Pain. Patients ranked Heart Attack, Death and Stroke as the most significant risks that they wanted to be informed about in greater detail. Most patients wanted to make a joint decision with the anaesthetist, instead of letting the doctor decide or deciding for themselves. Discussion with the anaesthetist is the preferred medium of communication compared to reading a pamphlet or watching a video. Age and educational level can influence medical decision-making. Despite the digital age, most patients still prefer a clinic consult instead of audio-visual multimedia for pre-operative anaesthetic counselling. The local population appears to place greater importance on rare but serious complications compared to common complications. This illustrates the need to contextualize information provided during informed consent to strengthen the doctor-patient relationship. (shrink)

Natalie Stoljar posits that purely procedural theories of autonomy are unable to explain the ‘feminist intuition’, which is the idea that the internalization of false and oppressive norms are incompatible with autonomy. She claims instead that an account based on ‘normative competence’ – which requires true beliefs and critical reflection – can explain why oppressive norms should be excluded as legitimate decision-making inputs. On my view, however, the normative competence approach is subject to a worrying problem. While Stoljar's view successfully (...) problematizes the internalization of oppression, her view misattributes non-autonomy also to those who perpetrate the oppression. I suggest that this is implausible, arguing instead that we can establish an asymmetry of autonomy between those who oppress others and those who are made target of oppression. (shrink)

In this review essay, I critically evaluate the concept of autonomy and the role that it plays in the philosophy of sex and love in Patricia Marino’s book, Philosophy of Sex and Love: An Opinionated Introduction.