In Reference re E.I. the Supreme Court of Canada was asked to assess the constitutionality of the federally administered maternity and parental leave benefit regime. This social programme has been a key site of feminist struggle in Canada, with attention focused in recent years on whether the benefit, as delivered, was an equality-enhancing regime. This note examines the way in which the questions posed to the Supreme Court of Canada were framed in a manner that obscured the essential (...) equality dimensions of the issue before the Court. It is argued, however, that, notwithstanding the relatively formal division of powers answer that the Court was called upon to give, the decision is a promisingly substantive reflection on the debate over the most effective means to recognize the care-giving labour of Canadian parents through the delivery of this benefit. (shrink)

BackgroundCritical to conducting high quality research is the ability to attract and retain participants, especially for longitudinal studies. Understanding participant experiences and motivators or barriers to participating in clinical research is crucial. There are limited data on healthy participant experiences in longitudinal research, particularly in low- and middle-income countries. This study aims to investigate quantitatively participant experiences in a South African birth cohort study.MethodsMaternal participant experience was evaluated by a self-administered survey in the Drakenstein Child Health Study, a longitudinal birth (...) cohort study investigating the early life determinants of child health. Pregnant mothers, enrolled during the second trimester, were followed through childbirth and the early childhood years. Satisfaction scores were derived from the participant experience survey and quantitatively analyzed; associations between satisfaction scores and sociodemographic variables were then investigated using a linear regression model.ResultsData were included from 585 pregnant mothers, who had participated in the study for a median time of 16 months. Overall participant satisfaction was high and associated with increased attendance of study visits. Reasons for participating were a belief that involvement would improve their health, their child’s health or the health of family and friends. Potential reasons for leaving the study were inconvenience, not receiving clinical or study results, and unexpected changes in study visits or procedures. Variables associated with higher overall satisfaction scores were no prior participation in research, higher socioeconomic status, less intensive follow-up schedules and having experienced stressful life events in the past year.ConclusionsSatisfaction scores were high and associated with increased visit attendance. Participants’ perceived benefits of study participation, most notably the potential for an improvement in the health of their child, were a significant motivator to enroll and remain in the study. The consistent theme of perceived health benefits as a motivator to join and remain in the study raises the question of whether participation in research results in actual improvements in health. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hyper-Abjects:Finitude, “Sustainability,” and the Maternal Body in the AnthropoceneBethany DoaneThe concept of the Anthropocene prioritizes a new paradigmatic scale that seems to outweigh that of “the political”: imagining deep time or the death of the human species as a result of climate change tends to negate the (relatively speaking) smaller-scale concerns of race, class, gender, or capitalism. While feminist critique is often circumscribed by this political scale, and thus (...) may seem to be dwarfed or rendered obsolete by the geological, deep-time scale of the Anthropocene, examining issues of feminist concern from this geological perspective has profound implications for thinking not only of gender politics but also of how to construct something like the political at all in this new era. Suggesting a new and normative global politics is, of course, beyond the scope of this article, but perhaps we might begin to conceive of a political schema that would function more appropriately in light of this grander scale. At the very least we may begin to think the borders or limits of the species as it has existed in the modern era in a way that neither environmentalism nor posthumanism has yet been able to sufficiently tackle.The Anthropocene marks the epoch in which human activities have caused global environmental changes that will leave their mark in the geological strata of the earth itself.1 While the specific moments of its onset are contested, its beginnings are generally associated with the industrial age; Crutzen and Stoermer mark its onset at roughly 1800 with the beginnings [End Page 251] of the industrial revolution. (Timothy Morton pinpoints it more specifically with the invention of the steam engine in 1794.) The changes made in this era of geological, technological, and climate convergence have accelerated in the last seventy years or so in what scientists call the Great Acceleration, which began around 1940 and quickened anthropogenic impact with events like the testing/dropping of atomic bombs, the homogenization of biodiversity, mass extinctions as a result of human activity, and various types of drilling and mining.2 In the era broadly conceived as modernity, the steady march of “progress” that has so shaped the paradigm of the period has been made possible only through its own abjections: those phenomena that mark the era as limited, limiting, and unsustainable. In other words, the “birth of the modern world” was made possible only through devastating acts of violence: institutionalized inequalities like slavery, oppression, colonization, and war. These acts of violence translate as cannibalization at the global scale: the exploitation of most members of the species and the consumption of their resources for the benefit and luxury of the few. While these forms of violence have been criticized and confronted by political and theoretical movements since at least the middle of the twentieth century, thinking of them in terms of the Anthropocene and deep time allows us to consider their consequences in a new light. Our present awareness of the Anthropocene makes visible phenomena like climate, global warming, earth, and the “anthropos” that present us with the very real eventuality of species finitude. Species finitude calls into question not just the practices of modernity that have brought about the Anthropocene (the exploitation of the many for the benefit of the few), but the entire paradigm of global thinking that is invested in progress, growth, and even in any environmentalism that calls for stewardship of the earth. The notion of care for an entity like “nature” or “the environment” only reinforces the separation between the human and its milieu, a separation that is impossible to maintain in light of the absolute inextricability that the Anthropocene brings to light.At the heart of this essay are two theoretical concepts: Julia Kristeva’s abjection, and Timothy Morton’s hyperobjects, both of which stand for a sort of insufficiency or impossibility of discourse (politics, the Symbolic, etc.) in managing some Real object or phenomenon. Kristeva’s abject is generally thought of as functioning at two levels or scales: the personal, in which an individual must cast off the abject of the maternal body in order to become a proper subject; and the social or... (shrink)

On 20 October 2010, the European Parliament proposed to give all women in the European Union (EU) minimally 20 weeks fully paid maternity leave, and to introduce a legal right for all fathers to 2 weeks fully paid paternity leave. In many other countries, individuals and groups are advocating for longer maternity leave, longer paternity leave, and/or longer parental leave. In this paper, I argue for two principles that proposals of maternity/paternity/parental (...) class='Hi'>leave systems should respect: the ?principle of non-discrimination? and the ?principle of balancing the interests of all affected parties?. The principle of non-discrimination requires that women should receive paid leave for the number of weeks that are needed as part of their pregnancy and to recover from childbirth, but that any additional weeks should be seen as birth leave rather than maternity leave, and be given on equal terms to men and women. The principle of balancing the interests of all parties suggests that it would be good for newborns, their parents, and for employers and society at large, that parents have enough time to spend with their children. To illustrate its practical relevance, I apply these principles to the current situation in the Netherlands and to the European Parliament's proposal to introduce a minimum of 20 weeks maternity leave and 2 weeks paternity leave. (shrink)

In Alabaster v. Barclays Bank plc and Secretary of State for Social Security (No. 2: [2005] E.W.C.A Civ. 508, [2005] I.R.L.R. 576.) Michelle Alabaster won a grand total of £204.53 (plus £65.86 interest) after eight years of litigation, which included two visits to the Court of Appeal and one to the European Court of Justice. This marathon resulted from the sex discrimination which Alabaster had alleged in relation to the calculation of her Statutory Maternity Pay (S.M.P.) whilst she was (...) pregnant 10 years earlier. The technicalities of the statutory schemes involved should not be allowed to disguise the important principle which finally emerges in the Court of Appeal and which underlines one of the longstanding criticisms of the equality legislation, namely the requirement that a woman must compare herself with a man in order to establish unlawful sex discrimination. (shrink)

BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms (...) of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder symptoms, as well as their toddler’s socioemotional development.ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties. (shrink)

This paper critically analyses ‘the paradox of autonomy and consent in maternity care’. It argues that maternity care has certain features that increase the need for explicit attention to, and respect for, both autonomy and rigorous informed consent processes. And, moreover, that the resulting need is considerably greater than in almost all other areas of medicine. These features are as follows: (1) maternity care involves particularly socially sensitive body parts that are regularly implicated in consent‐centred procedures, as (...) well as in unconsented interventions, in ordinary, non‐medical life; and (2) much of maternity care (especially intervening in childbirth) is medically unique, in that it harms one patient (the mother) not primarily for the promotion of her own health but for the benefit of another (the baby). The apt comparison, within medicine, is therefore with non‐therapeutic research and transplantation medicine—both of which have elevated consent requirements characterized by very rigorous consent processes. At the same time—and this delivers the titular paradox—the importance of autonomy and consent in maternity care is at particular risk of being denied or disregarded. Jointly, these considerations make a very strong case for change: attention to and respect for autonomy and consent should be (1) core values; (2) key points of practical attention in the years ahead; and (3) central quality indicators in maternity care. (shrink)

In six experiments, we investigated the role of resource valence in intergenerational attitudes and allocations. We found that, compared to benefits, allocating burdens intergenerationally increased concern with one’s legacy, heightened ethical concerns, intensified moral emotions (e.g., guilt, shame), and led to feelings of greater responsibility for and affinity with future generations. We argue that, because of greater concern with legacies and the associated moral implications of one’s decisions, allocating burdens leads to greater intergenerational generosity as compared to benefits. (...) Our data provide support for this effect across a range of contexts. Our results also indicate that the differential effect of benefits versus burdens in intergenerational contexts depends on the presence of two important structural characteristics that help enact concerns about legacies, including (1) future impact of decisions, and (2) a self-other tradeoff. Overall, our findings highlight how considering resource valence brings to the fore a number of key psychological characteristics of intergenerational decisions—especially as they relate to legacies and ethics. (shrink)

In six experiments, we investigated the role of resource valence in intergenerational attitudes and allocations. We found that, compared to benefits, allocating burdens intergenerationally increased concern with one’s legacy, heightened ethical concerns, intensified moral emotions (e.g., guilt, shame), and led to feelings of greater responsibility for and affinity with future generations. We argue that, because of greater concern with legacies and the associated moral implications of one’s decisions, allocating burdens leads to greater intergenerational generosity as compared to benefits. (...) Our data provide support for this effect across a range of contexts. Our results also indicate that the differential effect of benefits versus burdens in intergenerational contexts depends on the presence of two important structural characteristics that help enact concerns about legacies, including (1) future impact of decisions, and (2) a self-other tradeoff. Overall, our findings highlight how considering resource valence brings to the fore a number of key psychological characteristics of intergenerational decisions—especially as they relate to legacies and ethics. (shrink)

Racial discrimination uses race as grounds to discriminate in the treatment owed to others; sexual discrimination uses people’s sexual features as grounds for determining how they should be treated compared to others. Analogously, statistical discrimination treats statistical inferences about the groups to which individuals belong as grounds for discriminating amongst them in thought, word and deed. Examples of statistical discrimination include the employer who won’t hire women of childbearing age, because they are likely to take maternity leave at (...) some point in their careers; or insurers who wish to charge more to young drivers than to more experienced ones, because they are more likely to have accidents than the latter – or to favour women over men in the cost of premiums for similar reasons. Finally, a famous – infamous – example of statistical discrimination is racial profiling for police purposes, where statistical evidence of differential propensities to crime are used to justify preventive police measures, such as ‘stop and search’, which mainly target young black men, and other racialized minorities. The philosophical appeal of the concept of statistical discrimination is fairly easy to see: it draws our attention to the way that probabilistic claims figure, or might figure, in the distribution of social costs and benefits such as jobs, security, insurance. It therefore gives us a way to test our moral intuitions across different cases, enables us to see how far our moral judgements can be generalised, and whether they have been affected by particularly emotive examples, or by the particular features of a real or hypothetical case. But does that mean that statistical discrimination is unproblematic? This article takes issue with some arguments of Kasper Lippert Rasmussen on the topic. (shrink)

This article analyses the new demographic programme that was announced by the Russian president, Vladimir Putin, in 2006. The main goal of this programme is to encourage fertility, especially the birth of a second child. New benefits should elevate the status of wome taking maternity leave, who might otherwise suffer from discrimination in the family. The housewife is considered to be dependent and `degraded'. We argue that this demographic politics recalls continuity with soviet gender politics centred on (...) the support of wage-earning working mothers. The programme provokes different critiques. Liberal critics argue that the programme is a populist one and it may have undesired economic and social consequences. Conservative critics want to encourage more traditional `woman' and `family' roles in society. Feminist critics argue that this politcs would reinforce both the inferior position of women on the labour market and gender imbalances on the symbolic level. (shrink)

The benefits of full ectogenesis, that is, the gestation of human fetuses outside the maternal womb, for women ground many contemporary authors’ arguments on the ethical desirability of this practice. In this paper, I present and assess two sets of arguments advanced in favour of ectogenesis: arguments stressing ectogenesis’ equality-promoting potential and arguments stressing its freedom-promoting potential. I argue that although successfully grounding a positive case for ectogenesis, these arguments have limitations in terms of their reach and scope. Concerning (...) their limited reach, I contend that ectogenesis will likely benefit a small subset of women and, arguably, not the group who most need to achieve equality and freedom. Concerning their limited scope, I contend that these defences do not pay sufficient attention to the context in which ectogenesis would be developed and that, as a result, they risk leaving the status quo unchanged. After providing examples of these limitations, I move to my proposal concerning the role of ectogenesis in promoting women’s equality and freedom. This proposal builds on Silvia Federici’s, Mariarosa Dalla Costa’s and Selma James’ readings of the international feminist campaign ‘Wages for Housework’. It maintains that the political perspective and provocation that ectogenesis can advance should be considered and defended. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Negotiating Maternal IdentityAdrienne Rich’s Legacy for Inquiry into the Political-Philosophical Dimensions of Pregnancy and ChildbirthCandace JohnsonGiving birth has been described as the crossing of an imaginary threshold, which separates an independent maternal self from some sort of dual or subordinate existence. The metaphor of a border has also been employed to demonstrate this transformation, which may be liberating, oppressive, or some complex combination thereof (Weir 2006; Martinez 2004). What (...) happens, in psychic and sociopolitical terms, in the journey across this border? Can a woman, as an independent, autonomous being, preserve her identity, her selfhood as a mother? Is the transition to motherhood an expression of culture or nature? The answers to these questions are infinitely complex, yet are at the core of philosophical, political, and personal explorations of the maternal. Central to these explorations are academic critiques and personal responses to the biomedical mediation of the transition to motherhood. For some women, medical intervention in pregnancy and childbirth is inherently oppressive, whereas for other women such intervention is a marker of privilege. In a groundbreaking volume published in 1998, Margaret Lock and Patricia Kaufert argue that women respond to different biomedical interventions in pragmatic ways, which reflect their lived experiences. They claim that “it is more appropriate to understand women’s responses in medical settings as reflecting their daily experiences as part of a domestic group, a community, or a society” (19). [End Page 65]I would like to advance this analysis by suggesting that women respond to biomedical intervention in pregnancy and childbirth in ways that reflect not simply their practical needs and realities, but important details about inequality and identity. Women’s relative degrees of power and agency in society are expressed through their preferences for care during pregnancy and childbirth. In addition, and in connection with the (structural) dynamics of inequality, these preferences reflect the complexities of shifting, negotiated, maternal identities. In order to consider the ways in which women negotiate maternal identity through their preferences concerning care during pregnancy and childbirth, I will examine the contributions of Adrienne Rich, which effectively serve as the foundation for this and countless other areas of women’s and gender studies. In Of Woman Born, Rich dedicates two full chapters to childbirth, and explains in these chapters that the institution of childbirth has come to dominate and eclipse women’s experiences. Moreover, the patriarchal circumscription of childbirth is reinforced by the isolation of childbirth (and motherhood) from other life events. Rich demonstrates these problems through the metaphor of “giving birth to oneself ” (29), which has (at least) two distinct meanings: self actualization and self replacement.My investigation into these meanings will include an examination of Rich’s philosophical treatment of pregnancy and childbirth and an assessment of the sociopolitical implications of both conceptions of “giving birth to oneself.” I will then subject these conceptions to empirical testing, as Rich insists. Such empirical testing is crucial because the social and political dimensions of the institutions of childbirth and motherhood are complex and differ from one context to the next. Rich explains that[t]o hold power over others means that the powerful is permitted a kind of short-cut through the complexity of human personality. He does not have to enter intuitively into the souls of the powerless, or to hear what they are saying in their many languages, including the language of silence. Colonialism exists by virtue of this short-cut—how else could so few live among so many and understand so little?(65)This essay will avoid a similar shortcut often taken by theorists, which builds philosophical arguments without empirical support. The empirical cases to be considered in the context of philosophical debate include Canada, Honduras, and Cuba, and details of each case will be drawn from extensive interview data from a larger empirical study.1 In the Canadian context, resistance to the constraining effects of motherhood as institution is reduced to resistance to medical regulation of pregnancy and childbirth. The benefit indicated by this resistance is that women have found ways to expand their range of options and reinterpret the birthing event, thereby integrating it into other realms [End Page 66... (shrink)

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

In infancy, maternal socioeconomic status is associated with real-time language processing skills, but whether or not this relationship carries into adulthood is unknown. We explored the effects of maternal SES in college-aged adults on eye-tracked, spoken sentence comprehension tasks using the visual world paradigm. When sentences ended in highly plausible, expected target nouns, higher SES was associated with a greater likelihood of considering alternative endings related to the action of the sentence. Moreover, for unexpected sentence endings, individuals from higher SES (...) backgrounds were sensitive to whether the ending was action-related or unrelated, showing a benefit for plausible endings. Individuals from lower SES backgrounds did not show this advantage. This suggests maternal SES can influence the dynamics of sentence processing even in adulthood, with consequences for processing unexpected content. These findings highlight the importance of early lexical experience for adult language skills. (shrink)

Currently, many women who are expecting to give birth have no option but to attempt vaginal delivery, since access to elective planned caesarean sections (PCS) in the absence of what is deemed to constitute ‘clinical need’ is variable. In this paper, we argue that PCS should be routinely offered to women who are expecting to give birth, and that the risks and benefits of PCS as compared with planned vaginal delivery should be discussed with them. Currently, discussions of elective (...) PCS arise in the context of what are called ‘Maternal Request Caesarean Sections’ (MRCS) and there is a good deal of support for the position that women who request PCS without clinical indication should be provided with them. Our argument goes further than support for acceding to requests for MRCS: we submit that healthcare practitioners caring for women with uncomplicated pregnancies have a positive duty to inform them of the option of PCS as opposed to assuming vaginal delivery as a default, and to provide (or arrange for the provision of) PCS if that is the woman's preferred manner of delivery. (shrink)

During the last decade Russian politics have aimed at stimulating the birth rate, most famously by the maternity capital program. This article provides results from the first extensive study of citizen use and attitudes to this benefit and concludes that Russian women and families harbor a deep distrust of the program and Russian social policy, as it sends contradictory messages combining paternalistic and liberal trends. Many eligible mothers have not activated their capital due to various bureaucratic obstacles they encounter. (...) Contrary to the expectations of economists and sociologists, the results indicate that middle-class families have more resources to use their capital. (shrink)

Most putative cases of teaching in nonhuman animals involve parent-offspring interactions. The interpretation of these cases, particularly with regard to the cognitive processes involved, is controversial. Qualitative and quantitative observations made in nonhuman primates suggest that, in some species, mothers encourage their infants’ independent locomotion and that encouragement can be considered a form of instruction. In macaques, experience in raising previous offspring accounts in part for variability between mothers in propensity to encourage infant motor skills. Parsimony suggests that the cognitive (...) mechanisms underlying maternal encouragement of infant locomotion in primates as well as some other putative cases of animal teaching may involve first-order intentionality (i.e., goal-directed behavior) and not higher cognitive processes such as attribution of knowledge/ignorance or perspective-taking. Encouragement of infant independent locomotion early in life may have benefits to mothers later on, in terms of reduction of costs of infant carrying, earlier infant weaning, and increased probability of reproduction in the mating season. The elementary forms of teaching observed in nonhuman primates may have played an important role in the origin and evolution of human culture. (shrink)

Shared decision-making involves health professionals and patients/clients working together to achieve true person-centred health care. However, this goal is infrequently realized, and most barriers are unknown. Discussion between philosophers, clinicians, and researchers can assist in confronting the epistemic and moral basis of health care, with benefits to all. The aim of this paper is to describe what shared decision-making is, discuss its necessary conditions, and develop a definition that can be used in practice to support excellence in maternity (...) care. Discussion between the authors, with backgrounds in philosophy, clinical maternity care, health care management, and maternity care research, assisted the team to confront established norms in maternity care and challenge the epistemic and moral basis of decision-making for caesarean section. The team concluded that shared decision-making must start in pregnancy and continue throughout labour and birth, with equality in discourse facilitated by the clinician. Clinicians have a duty of care for the adequacy of women's knowledge, which can only be fulfilled when relevant knowledge is offered freely and when personal beliefs and biases that may impinge on decision-making (defeaters) are disclosed. Informed consent is not shared decision-making. Key barriers include existing cultural norms of “the doctor knows best” and “patient acquiescence” that prevent defeaters being acknowledged and discussed and can lead to legal challenges, overuse of medical intervention and, in some areas, obstetric violence. Shared decision-making in maternity care can thus be defined as an enquiry by clinician and expectant woman aimed at deciding upon a course of care or none, which takes the form of a dialogue within which the clinician fulfils their duty of care to the client's knowledge by making available their complete knowledge (based on all types of evidence) and expertise, including an exposition of any relevant and recognized potential defeaters. Research to develop measurement tools is required. (shrink)

We have argued that the counterfactual comparative account of harm and benefit (CCA) violates the plausible adequacy condition that an act that would harm an agent cannot leave her much better off than an alternative act that would benefit her. In a recent paper in this journal, however, Neil Feit objects that our argument presupposes questionable counterfactual backtracking. He also argues that CCA proponents can justifiably reject the condition by invoking so-called plural harm and benefit. In this reply, we (...) argue that Feit’s lines of criticism are both unsuccessful. (shrink)

In their paper, ‘How to reach trustworthy decisions for caesarean sections on maternal request: a call for beneficial power’, Eide and Bærøe present maternal request caesarean sections (MRCS) as a site of conflict in obstetrics because birthing people are seeking access to a treatment ‘without any anticipated medical benefit’. While I agree with the conclusions of their paper -that there is a need to reform the approach to MRCS counselling to ensure that the structural vulnerability of pregnant people making birth (...) decisions is addressed—I disagree with the framing of MRCS as having ‘no anticipated medical benefit’. I argue that MRCS is often inappropriately presented as unduly risky,without supporting empirical evidence,and that MRCS is most often sought by birthing people on the basis of a clinical need. I argue that there needs to be open conversation and frank willingness to acknowledge the values that are currently underpinning the presentation of MRCS as ‘clinically unnecessary’; specifically there needs to be more discussion of where and why the benefits of MRCS that are recognised by individual birthing people are not recognised by clinicians. This is important to ensure access to MRCS for birthing people that need it. (shrink)

Women in the labor force are at a disadvantage not only because of continuing discrimination in hiring and promotion, but because of factors extrinsic to the labor market hence adjusting conditions within the labor market will not completely eliminate women's disadvantage. Because, unlike most men, most women do not have spouses to take on the major responsibility of running their homes and caring for their children, the costs of working outside the home, particularly in a professional or managerial capacity, are (...) greater for women than they are for men. Thus, even if ongoing discrimination in the labor market were eliminated, through affirmative action policies or other such remedies, women would still be as a disadvantage relative to men.For women, the costs and benefits of behaving like men are different than they are for their male counterparts. To the extent that the costs and benefits of various policies of action are not the same for women as they are for men, men and women are not equal, therefore, arguably, it is not fair to treat them equally. (shrink)

Previously conducted research has determined that physiological and psychophysiological communications evident during pregnancy are vital to the bond formed prenatally. These innate biological responses are further enhanced through psychophysiological factors, such as maternal prenatal stress, which attest to the essential communication between a mother and child in maternal–fetal attachment. A consideration of these factors is necessary with the increase in assisted reproductive technology, such as in vitro fertilization, surrogacy, and elective cesarean section, as this may affect the development of the (...) maternal–fetal bond. It would be of benefit to the child, the mother, and every society to seek a more complete understanding of the intricate maternal–fetal bond, as the first friendship developed at the beginning of human life. (shrink)

The case, which occurred in a public hospital in Turkey in 2005, exhibits a striking dilemma between a mother’s and her fetus’ interests. For a number of reasons, the mother refused to cooperate with the midwives and obstetrician in the process of giving birth, and wanted to leave the hospital. The care providers evaluated the case as a matter of maternal autonomy and asked the mother to give her consent to be discharged from the hospital, which she did despite (...) the fact that her cervix was fully open. She left the hospital and gave birth shortly thereafter. Subsequently, the baby died two days later. In light of the contemporary ethical principles, the mother’s competency could be debatable due to the physical and psychological conditions the mother confronted. Furthermore, protection of the fetus’ life should have been taken into account by the caregivers when making a decision concerning discharging of the mother. (shrink)

A threat to women is obscured when we treat “abortion-as-evacuation” as equivalent to “abortion-as-killing.” This holds only if evacuating a fetus kills it. As technology advances, the equivalence will fail. Any feminist account of abortion that relies on the equivalence leaves moral room for women to be required to give up their fetuses to others when it fails. So an account of the justification of abortion-as-killing is needed that does not depend on the equivalence.

This debate article explores how smart technologies may create a double-edged sword for patient safety and effective therapeutic relationships. Increasing utilization of health monitoring devices by patients will likely become an important aspect of self-care and preventive medicine. It may also help to enhance accurate symptom reports, diagnoses, and prompt referral to specialist care where appropriate. However, the development, marketing, and use of such technology raise significant ethical implications for therapeutic relationships and patient safety. Drawing on lessons learned from other (...) direct-to-consumer health products such as genetic testing, this article explores how smart technology can also pose regulatory challenges and encourage overutilization of healthcare services. In order for smart technology to promote safer care and effective therapeutic encounters, the technology and its utilization must be safe. This article argues for unified regulatory guidelines and better education for both healthcare providers and patients regarding the benefits and risks of these devices. (shrink)

In this article, we use the principlist approach to identify, analyse and attempt to solve the ethical problem raised by a pregnant woman's request for cesarean delivery in absence of medical indications.We use two different types of premises: factual (facts about cesarean delivery and specifically attitudes of obstetricians as derived from the EUROBS European study) and value premises (principles of beneficence and non-maleficence, respect for autonomy and justice).Beneficence/non-maleficence entails physicians' responsibility to minimise harms and maximise benefits. Avoiding its inherent (...) risks makes a prima facie case against cesarean section without medical indication. However, as vaginal delivery can have unintended consequences, there is a need to balance the somewhat dissimilar risks and benefits. The principle of autonomy poses a challenge in case of disagreement between the pregnant woman and the physician. Improved communication aimed to enable better informed choice may overcome some instances of disagreement. The principle of justice prohibits unfair discrimination, and broadly favours optimising resource utilisation.Available evidence supports vaginal birth in uncomplicated term pregnancies as the standard of care. The principlist approach offered a useful framework for ethical analysis of cesarean delivery on maternal request, identified the rights and duties of those involved, and helped reach a conclusion, although conflict at the individual level may remain challenging. (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 number of cesarean sections performed globally has been consistently rising since the 1980s.1 The number of cesareans performed now greatly exceeds the number that experts predict are necessary.2 In Brazil, the world's "cesarean capital," over half of births are surgical. In the United States, approximately one third of babies are delivered by cesarean, and in the United Kingdom around 26 percent of births are by cesarean.3 Cesarean section can be a life-saving intervention when vaginal birth poses a risk to (...) woman or fetus.4 However, some doctors believe that cesareans performed in the absence of an emergency carry substantial risks for limited or no benefit (Wagner 2000... (shrink)

: A threat to women is obscured when we treat "abortion-as-evacuation" as equivalent to "abortion-as-killing." This holds only if evacuating a fetus kills it. As technology advances, the equivalence will fail. Any feminist account of abortion that relies on the equivalence leaves moral room for women to be required to give up their fetuses to others when it fails. So an account of the justification of abortion-as-killing is needed that does not depend on the equivalence.

Open access. This open-access book discusses vulnerability and the protection-inclusion dilemma of including those who suffer from serious poverty, severe stigma, and structural violence in research. Co-written with representatives from indigenous peoples in South Africa and sex workers in Nairobi, the authors come down firmly on the side of inclusion. In the spirit of leaving no one behind in research, the team experimented with data collection methods that prioritize research participant needs over researcher needs. This involved foregoing the collection of (...) personal data and community researchers being involved in all stages of the research. In the process, the term ‘vulnerability’ was illuminated across significant language barriers as it was defined by indigenous peoples and sex workers themselves. The book describes a potential alternative to exclusion from research that moves away from traditional research methods. By ensuring that the research is led by vulnerable groups for vulnerable groups, it offers an approach that fosters trust and collaboration with benefits for the community researchers, the wider community as well as research academics. Those living in low-income settings, in dire situations that are summarized with the term ‘vulnerability’ know best what their problems are and which priorities they have. To exclude them from research for their own protection is a patronizing approach which insinuates that researchers and research ethics committees know best. The team from this book have shown that minimally risky and minimally burdensome research tailored towards the needs of highly marginalized and stigmatized communities can be scientifically valuable as well as inclusive and equitable. I congratulate them. Prof. Klaus Leisinger, President Global Values Alliance, Former personal advisor to Kofi Annan on corporate responsibility. (shrink)

ABSTRACT In recent years, the medical establishment has been speaking in favor of women's autonomy in childbirth by advocating cesarean delivery on maternal request (CDMR). This paper offers to look at the ethical dimension of CDMR through a feminist critique of the medicalization of childbirth and its influence on present‐day medical ethics. I claim that the medicalization of childbirth reflects a sexist bias with regard to conceptions of the body and needs to be used with caution when applied to women's (...) reproductive health. I then use this perspective to critically analyze the position of the American College of Obstetricians and Gynecologists (ACOG) on the ethics of decision‐making in patient‐choice surgery. I claim that informed consent cannot be meaningfully exercised unless women are made aware of the sexist underpinnings of the medical model of childbirth and its influence on the ethical reasoning of the American College of Obstetricians and Gynecologists. I also express concern about the effects of normalizing patient‐choice cesarean sections on the choices available to pregnant women using as examples the institutional rules on mandatory cesarean sections for women with a previous cesarean delivery or breech presentation. I conclude with a call for more research into the real cost of convenience in CDMR, particularly as our increasingly strained publicly funded healthcare system would greatly benefit from the de‐medicalization of normal body functions rather than an increased dependence on costly surgical technology. (shrink)

The evolution of cooperative breeding is complex, and particularly so in humans because many other life history traits likely evolved at the same time. While cooperative childrearing is often presumed ancient, the transition from maternal self-reliance to dependence on allocare leaves no known empirical record. In this paper, an exploratory model is developed that incorporates probable evolutionary changes in birth intervals, juvenile dependence, and dispersal age to predict under what life history conditions mothers are unable to raise children without adult (...) cooperation. The model’s outcome variable (net balance) integrates dependent children’s production and consumption as a function of varying life history parameters to estimate the investment mothers or others have to spend subsidizing children. Results suggest that maternal-juvenile cooperation can support the early transition toward a reduction in birth intervals, a longer period of juvenile dependence, and having overlapping young. The need for adult cooperation is most evident when birth intervals are short and age at net production is late. Findings suggest that the needs of juveniles would not have been an early selective force for adult cooperation. Rather, an age-graded division of labor and the mutual benefits of maternal-juvenile cooperation could be an important, but overlooked step in the evolution of cooperative breeding. (shrink)

Studies in economics and humanities generally have intrinsic problems that this work illustrates, along with innovations for overcoming them. The main limitations and weak-points of orthodox theory necessitate the use in their stead of other multi-disciplinary approaches, like complexity science, agent-based simulations and artificial life simulations. An example of an artificial life simulation applied in the economics field concerning the exchange process shows the benefits of such new conceptual and methodological instruments.

Caesarean delivery is a common and life-saving intervention. However, it involves an overall increased risk for short-term and long-term complications for both mother and child compared with vaginal delivery. From a medical point of view, healthcare professionals should, therefore, not recommend caesarean sections without any anticipated medical benefit. Consequently, caesarean sections requested by women for maternal reasons can cause conflict between professional recommendations and maternal autonomy. How can we assure ethically justified decisions in the case of caesarean sections on maternal (...) request in healthcare systems that also respect patients’ autonomy and aspire for shared decisions? In the maternal–professional relationship, which can be characterised in terms of reciprocal obligations and rights, women may not be entitled to demand a C-section. Nevertheless, women have a right to respect for their deliberative capacity in the decision-making process. How should we deal with a situation of non-agreement between a woman and healthcare professional when the woman requests a caesarean section in the absence of obvious medical indications? In this paper, we illustrate how the maternal–professional relationship is embedded in a nexus of power, trust and risk that reinforces a structural inferiority for women. To accommodate for beneficial use of power, these decision processes need to be trustworthy. We propose a framework, inspired by Lukes’ three-dimensional notion of power, which serves to facilitate trust and allows for beneficial power in shared processes of decision-making about the delivery mode for women requesting planned C-sections. (shrink)

Dembroff and Wodak (2018, 2021) argue that we have a duty to use gender-neutral pronouns, but do not extend this argument to all other aspects of our language. We evaluate the extent to which gender neutral language is desirable in the context of parental leave schemes, taking as a case study the parental leave schemes found at a Higher Education Institution in the UK. We argue that the considerations Dembroff and Wodak (2018, 2021) take to speak against gender (...) specific pronouns and some other gender specific aspects of language also strongly speak against gender specific language in the context of parental leave policies. As a project in non-ideal theory, we argue against the framing of existing policies which refer to ‘maternity’ and ‘paternity’ leave, and for moving to the language of ‘parental’ or ‘family’ leave. The fact that the majority of those giving birth are women does not provide decisive reasons for framing policies in gender-specific terms. Moreover, we argue that given the welcome move to facilitate shared parental leave, any concerns for gender equity, and equity for carers, are better served by requesting demographic information for monitoring purposes, rather than by policies that refer to gender specific parenting roles. -/- . (shrink)

In April 1962, white segregationists paid money to African Americans agreeing to leave New Orleans. In 2010, the British National Party proposed paying non-white migrants money to leave the UK. Five years later, a landlord in New York paid African American tenants to vacate their apartments. This article considers when, if ever, it is morally permissible to pay minorities to leave. I argue that paying minorities to leave is demeaning towards recipients and so wrong. Although the (...) payments are wrong, it is not clear if they are impermissible, given the benefits for the recipients. I argue that payments are impermissible if at least one of two conditions are met: The payments demean or harm other members of society, or the payments are provided to recipients who have failed to consent to the payments. (shrink)

Science promises benefits, some true and some illusory. Consider a scientific agnostic who thinks that to reap the true benefits of a scientific theory he does not have to believe in its theoretical posits. Instead, it is enough if he believes that the theory successfully predicts the behavior of the observables, as ultimately only such predictions matter. -/- Say, however, that given the results of her thorough research, a psychologist proposes a theory describing a psychological mechanism underlying a (...) certain class of normative judgments. Moreover, the mechanism seems unfit for the task—once you see the details of the mechanism, you will realize that this is not the way they should be produced. Therefore, if the psychologist is right, it seems that these normative judgments should not inform one's normative theorizing or one's actions (Greene 2008, 2014, Kelly 2014). And say that the agnostic accepts the psychologist's theory, trusting that it makes correct predictions about, for example, fMRI images and subjects' reaction times, as they are observable. He also thinks that if the psychologist's description of the mechanism is correct, the judgments should not be trusted. Yet, since the mechanism posited by the theory is not observable, the agnostic is agnostic about it. He thus cannot be convinced that these judgments are produced in a flawed way and, consequently, has no reason to distrust them. -/- Scientific agnosticism comes, therefore, at the cost of dismissing normative arguments that invoke unobservable posits of psychological models. The ability to make such arguments is a true (rather than illusory) benefit of science, despite the agnostic's promise that his philosophical theory leaves intact benefits that genuinely matter. (shrink)

I respond here to an argument given recently in this journal by Erik Carlson, Jens Johansson, and Olle Risberg. The authors object to the counterfactual comparative account of harm. They argue that, on this account, an action that would harm the agent might leave her better off than would some alternative action that would benefit her, and they object to this implication. By appealing to group or plural harm, I argue that their objection fails.

This analysis tests the influence of personal, job, and family status characteristics on maternal employment. We use the Merged Child/mother File from the National Longitudinal Survey of Youth to examine employment patterns of mothers who gave birth between 1979 and 1986. Logistic regression is used to estimate the probabilities; proportional hazards techniques are used to estimate rates of leaving and return to employment after childbirth. We find that family status factors and the proportion of the family income the mother earns (...) are consistently important in predicting maternal employment. Human capital factors are more significant in predicting employment exits and the rate of exit than the rate of return or employment status one year after a birth. (shrink)

In this essay, the hypothesis that biliverdin pigment plays an antioxidant role in the avian eggshell is proposed. Due to its ability to scavenge free radical species and to reduce mutation, biliverdin potentially counteracts the oxidative action of pathogens that penetrate the eggshell and/or protects the shell membrane from oxidation, thus promoting the proven antioxidant and antimicrobial capacities of the shell membrane itself. Additionally, biliverdin may be able to inhibit viral replication in the eggshell due to its ascribed antiviral properties. (...) Moreover, previous results in other taxa leave open the question of whether biliverdin can be absorbed by the embryo from the eggshell and play a role in embryogenesis. These mechanisms of antioxidant action of eggshell biliverdin remain totally unexplored in birds and in other oviparous animals. The main assumptions and predictions of the antioxidant hypothesis are developed, and directions for future research are proposed. (shrink)

The increase in women’s labor market participation emphasizes the importance of understanding maternal separation anxiety, that is, the unpleasant maternal emotional state, due to the actual or anticipated short-term separation from the child. Drawing on the insights of the attachment and psychoanalytic perspectives, the Maternal Separation Anxiety Scale was developed to overcome existing measurement gaps. However, prior research did not replicate its original three-factor structure in the contemporary context and in other cultural settings, using large samples composed of mothers of (...) preschool children. This study aimed to examine the factorial structure of the MSAS in a sample of 597 Portuguese mothers of children aged 5–84 months who completed the questionnaire. The exploratory factor analysis conducted in subsample 1 revealed a four-factor structure: Maternal Negative Feelings, Beliefs about Exclusive Maternal Care, Need of Proximity, and Perceptions of Separation Benefits for Children. Confirmatory factor analyses conducted in subsample 2 revealed that the original three-factor structure revealed a poor fit, whereas the four-factor solution revealed an acceptable fit. As in previous studies, our findings report deviations from the original three-factor structure of the MSAS. Three of the newly identified factors seem to reflect specific sub-dimensions that originally guided item development in the MSAS, namely, maternal negative feelings, maternal attitudes about the value of exclusive maternal care, and the need of proximity with the child. The last factor appears to represent a refinement of original items pertaining to perceptions about separation effects for children. (shrink)

Dave Chappelle took an extended leave from comedy for moral reasons. I argue that, while he had every right to leave comedy because of his moral concerns, he was not obliged to do so. To make this case, I present Chappelle’s argument that the potential negative consequences of his racial humor obliged him to leave. Next, I argue against Chappelle’s argument about avoidable harms as the harms are not his responsibility, he was not being negligent, and the (...) benefits of his humor outweigh the harms. I also argue in support of the intuition that another’s failure of comprehension or moral character, even if that failure will predictably result in harms to others, should not convert moral acts into immoral ones. (shrink)

In research involving pregnant women and fetuses, a number of questions arise concerning the balancing of risks and benefits. In research that holds out a prospect of direct benefit for the woman, how much risk to the fetus is permissible? How should the principle of minimizing risks be applied when there are two subjects—pregnant woman and fetus? Should risks for each of them be minimized? What if minimizing risks for one increases risks for the other? These and other questions (...) are not addressed in the current federal regulations for the protection of human subjects. This paper reviews the current regulations, attempts to identify issues that need to be addressed, considers alternative viewpoints concerning those issues, and argues for particular views. It concludes with a set of proposed guidelines for balancing risks and benefits in research involving pregnant women and fetuses. (shrink)

This article presents an analysis and evaluation of what I call the “I’m not stupid” argument. This argument has ancient roots, which lie in Aristotle’s famous description of the weak man’s and strong man’s arguments. An “I’m not stupid” argument is typically used in a context of accusation and defense, by a defendant who argues that they did not commit the act of which they have been accused. The analysis of this type of argument takes the shape of an argumentative (...) pattern, which displays a full-fledged representation of its argumentation structure. It is based on a collection of ten contemporary instances of the “I’m not stupid” argument. Although ten instances constitute a small collection, the wide variation in the argumentative elements that they express explicitly or leave implicit made it possible to identify five new key premises in comparison with previous analyses of the weak man’s and strong man’s arguments (Walton, Tindale and Gordon 2014 in _Argumentation_ 28:85–119, 2014; Walton 2019 in _Argumentation_ 33:45–74, 2019). These new premises show that the crucial point of an evaluation of this argument is the arguer's supposedly rational character in making a gain-loss calculation. They also show that we need empirical data to strengthen our analyses of argument schemes and argumentation structures. (shrink)

In this paper data from a Tanzanian horticultural population are used to assess whether mother’s kin network size predicts several measures of children’s health and well-being, and whether any kin effects are modified by household socioeconomic status. This hypothesis is further tested with a questionnaire on maternal attitudes towards kin. Results show small associations between measures of maternal kin network size and child mortality and children’s growth performance. Together these results suggest that kin positively influence child health, but the effects (...) are small and it is unlikely that the high prevalence of undernutrition observed in this setting is influenced by the availability of kin. (shrink)

The “fair benefits” approach to international research is designed to produce results that all can agree are fair without taking a stand on divisive questions of justice. But its appealing veneer of collaboration masks ambiguities at both a conceptual and an operational level. An attempt to put it into practice would look a lot like an auction, leaving little reason to think the outcomes will satisfy even minimal conditions of fairness.

Mild signs of postpartum depression or anxiety are present in up to half of all new mothers. However, the impact of having the “baby blues” on infant development remains largely unknown. The current study explores a potential relation between mother’s self-reported depression or anxiety symptoms and infant’s motor development in a longitudinal sample of 50 mother-infant dyads. Further, we examine whether engaging in fetal kick counting during pregnancy may reduce maternal psychopathology symptoms and thereby positively influence infant motor development and (...) parent-child engagement during the first months of life. We hypothesized that subclinical maternal psychopathology would negatively impact infant motor development, and that completing a fetal kick count activity during the third trimester would reduce overall signs of maternal psychopathology. Results only partially support these hypotheses. Postpartum maternal anxiety seems to negatively affect the emergence of infants’ fine motor skills. However, engaging in fetal kick counting during pregnancy did not reduce maternal depression or anxiety symptoms. Nevertheless, preliminary evidence suggests that engaging in fetal kick counting may impact early child development by altering the mother’s attitudes toward the child. Future research is needed to examine the value of this low-cost intervention strategy more closely. (shrink)