This chapter contains sections titled: Abortion and Mother‐Fetus Conflict Moral Obligations to the Unborn The Obstetrical Cases: Forced Cesareans Fetal Surgery Conclusion References Further reading.

Is the “act itself” of separating a pregnant woman and her previable child neither good nor bad morally, considered in the abstract? Recently, Maureen Condic and Donna Harrison have argued that such separation is justified to protect the mother’s life and that it does not constitute an abortion as the aim is not to kill the child. In our article on maternal–fetal conflicts, we agree there need be no such aim to kill (supplementing aims such as to remove). However, we (...) argue that to understand “abortion” as performed only where the death of the child is intended is to define the term too narrowly. Respect for the mother, the fetus, and the bond between them goes well beyond avoiding any such aim. We distinguish between legitimate maternal treatments simply aimed at treating or removing a damaged part of the woman and illegitimate treatments that focus harmfully on the fetal body and its presence within the mother’s body. In obstetrics as elsewhere, not all side effects for one subject of intervention can be outweighed by intended benefits for another. Certain side effects of certain intended interventions are morally conclusive. (shrink)

Who has more rights-the mother or the fetus? Interdisciplinary in scope and character, this latest volume of Humana's classic series, Biomedical Ethics Reviews, focuses on the complex moral and legal problems involving human fetal life. Each article in Bioethics and the Fetus provides an up-to-date review of the literature and advances bioethical discussion in its field. The authors have avoided much of the technical jargon of philosophy and medicine in order to speak directly to a broad and general readership. Topics (...) include: • maternal-fetal conflict • the disposition of aborted fetuses • frozen embryos • creating children to save sibling's lives • fetal tissue transplantation • moral implications of fetal brain integration • the embryo as patient • prenatal diagnosis. Probing deeply into these thorny issues, Bioethics and the Fetus offers thought-provoking reading-and paves the ground for new insight-for a host of healthcare and other professionals, as well as concerned laypersons. (shrink)

Fetuses and their mothers (and other adults) share many objective interests. These include interests in disjunctive ways of achieving human well-being, including the formation and success of good projects such as particular friendships. Pursuing such good projects is in the individual’s interests and is what growing up is all about. Some interests are time-sensitive, and determining which interests apply at what stages in life requires asking which benefits are in some sense appropriate to the individual and still in his/her actual (...) or possible or even hypothetical future. Human individuals not only have interests in unconditional benefits to them, including the welfare of existing family members, but in conditional benefits to them, including the welfare of possible future family members. Even if not all interests apply to the individual at every stage, if an adult-type benefit is still in the (long-term) future, the young individual including the fetus has a stake in that benefit, conditional as the benefit may sometimes be. Fulfilment is enhanced by pursuit and conscious enjoyment of ‘human goods’, but as with adults, the stake in these remains strong even if psychological links with the long-term future in which this happens are tenuous or non-existent. (shrink)

This article considers M. Therese Lysaught’s analysis of an apparent abortion that occurred in Phoenix, Arizona, in 2009. Since Lysaught invokes it, the article considers Rev. Martin Rhonheimer’s theory about the bearing of vital conflict situations on the object of the act performed. A vital conflict situation is present when, for instance, the life of a mother might be spared if her fetus is aborted, otherwise she and the fetus will die. The article argues that the use of (...) such situations in this way by Lysaught and Rhonheimer (and possibly others) is incompatible with Church teaching. The article concludes by suggesting that certain cases might be analyzed in such a way that the mother’s life is saved and the fetus dies but there is no direct abortion. National Catholic Bioethics Quarterly 11.4 (Winter 2011): 691–704. (shrink)

The authors respond to a recent consensus statement on maternal–fetal vital conflicts. Sound ethical analysis must depend on accurate medical facts, but there appear to be inconsistencies in the medical analysis. The consensus statement says that the specific threat to the health of the mother immediately subsides following detachment of the placenta from the uterus. The authors refute this assertion, since death from peripartum cardiomyopathy may occur months to years following delivery of the neonate or following termination. The authors assert (...) further that the placenta is an organ of the fetus and that any act on the placenta is a direct act on the fetus itself. National Catholic Bioethics Quarterly 15.1 : 31–37. (shrink)

A recent statement of consensus held that the principle of double effect would allow the induction of a previable fetus in order to eliminate a grave and present danger to the life of a mother suffering from peripartum cardiomyopathy. The author responds to this declaration, points out some limitations preventing it from being a vehicle for broader agreement, and offers an alternative, namely, medical induction of labor in cases of maternal–fetal vital conflict can be justified if the fetus has (...) at least a fair chance of survival. This support of induction in cases of periviability considers the interests of both fetus and mother and, unlike the earlier consensus statement, can be defended by those who hold that one’s moral intention includes both the ultimate and proximate ends, or the immediate consequences of one’s act. (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)

We should not think of babies as having a right to be born healthy. We cannot say what such a right involves, and if we could, enforcing it would infringe on the mother's most basic rights. Most importantly, positing such a right casts the fetus and mother as adversaries, and so destroys the maternal‐fetal relationship.

Since testing for HIV infection became possible in 1985, testing of pregnant women has been conducted primarily on a voluntary, ‘opt-in’ basis. Faden, Geller and Powers, Bayer, Wilfert, and McKenna, among others, have suggested that with the development of more reliable testing and more effective therapy to reduce maternal-fetal transmission, testing should become either routine with ‘opt-out’ provisions or mandatory. We ask, in the light of the new rapid tests for HIV, such as OraQuick, and the development of antiretroviral treatment (...) that can reduce maternal-fetal transmission rates to <2%, whether that time is now. Illustrating our argument with cases from the United States (US), Kenya, Peru, and an undocumented Mexican worker in the US, we show that when testing is accompanied by assured multi-drug therapy for the mother, the argument for opt-out or mandatory testing for HIV in pregnancy is strong, but that it is problematic where testing is accompanied by adverse events such as spousal abuse or by inadequate intrapartum or follow-up treatment. The difference is not a ‘double standard’, but reflects the presence of conflicts between the health interests of the mother and the fetus – conflicts that would be abrogated by the assurance of adequate, continuing multi-drug therapy. In light of these conflicts, where they still occur, careful processes of informed consent are appropriate, rather than opt-out or mandatory testing. (shrink)

Mother and Fetus: Rights in Conflict A. INTRODUCTION After fertilization of the female egg (ovum) with male sperm the resulting zygote may implant ...

Approaches to supporting autonomy in medicine need to be able to support complex and sensitive decision-making, incorporating reflection on the patient's values and goals. This should involve deliberation in partnership between physician and patient, allowing the patient to take responsibility for her decision. Nowhere is this truer than in decisions around pregnancy and Caesarean section where maternal autonomy can seem to directly conflict with foetal interests. Medical and societal expectations and norms such as the expectations of a ‘mother’, constraints (...) of making decisions in an emergency, and the role of technology in viewing the foetus as a separate patient and surgery as a guarantor of results can all act to limit a woman's autonomy. In considering decisions about Caesarean section, maternal interests in bodily integrity can be dismissed as being less important than the foetus's own interests and the mother's duties to it, despite the inherent risks and impacts of such a major surgical procedure... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Aquinas on the Beginning and End of Human Life by Fabrizio AmeriniPatrick LeeAquinas on the Beginning and End of Human Life. By Fabrizio Amerini. Translated by Mark Henninger. Cambridge, Mass.: Harvard University Press, 2013. Pp. xxii + 260. $29.95 (cloth). ISBN: 978-0-674-07247-3.This book provides a comprehensive and textually grounded presentation of Thomas Aquinas’s teaching on embryology and an assessment of its bioethical implications. Despite (what I regard as) (...) some mistakes on the application of that teaching to contemporary embryological data, it is an invaluable sourcebook for Aquinas on this issue. At times, Amerini’s “aporetic” style makes for convoluted arguments, but it raises challenging questions and thus will assist anyone working through these issues. (As the title indicates, it also treats the end of life—but only very briefly, in a couple of pages near the end of the book.)The first two chapters examine Aquinas’s general principles regarding matter, form, and substantial generation (the coming to be of a substance), and his positon on the human soul as both subsistent and the substantial form of the human body. Amerini’s treatment is thorough and provides an extensive bibliographical guide to this issue. However, it seems to me that Amerini is less than clear on the distinctiveness of substantial change. Since there are (according to Aquinas and Aristotle) no degrees in the category of substance, generation is not a process but an instantaneous change. Amerini’s frequent use of the term “process of generation,” as well as the position he later proposes on the identity of the embryo, seems to conflict with that point. [End Page 489]Chapters 3 and 4 contain detailed exposition of Aquinas’s basic embryological position, and chapter 4 raises various questions about this position (including doubts that Amerini evidently has about the unicity of the human being’s substantial form). Applying his basic metaphysical principles to what he at the time believed were the embryological facts, Aquinas concluded that the human being with a rational soul is not present until forty days after fertilization for males or ninety days for females. The father and the mother generate the offspring, but the mother provides only the material cause in the form of menstrual blood; the father is the efficient and formal cause, acting through the semen as an instrumental cause. With the power (virtus) of the principal cause in it, the semen gradually organizes the menstrual blood provided by the mother to form, first, a being with a vegetative soul, then an animal, and finally an animal with a body suited to be formed by a rational soul, which God then infuses into it. Aquinas holds that, unlike a sensitive or vegetative soul, a rational soul must be directly created by God, since the rational soul is the source of operations that are independent of matter, that is, performed by the human being but without a bodily organ. Only matter that is suited to a form can receive it. Therefore the matter must be suitably disposed. Just as one can make a knife only with matter capable of supporting its function—and so the matter must be hard and capable of being sharp—so only a body with sense organs, and thus capable of supporting those actions prerequisite to rational operations, can receive a rational soul.Chapter 5 sets out in detail Amerini’s exposition and interpretation of Aquinas on the identity of the embryo. Amerini recognizes, of course, Aquinas’s mistakes and ignorance regarding basic embryological facts—inevitable given the time in which he wrote. Still, Amerini holds that Aquinas’s main conclusion regarding delayed hominization is still valid. He agrees with Aquinas that the general proportionality requirement implies that the embryo/fetus must first possess sensory organs to have a body apt for the reception of a rational soul.On the other hand, Amerini also advances what he believes is a via media between proponents of delayed hominization and proponents of immediate hominization. He argues that although the embryo is not numerically identical with the human being (which comes to be only with the infusion of the rational soul), nevertheless, the embryo from... (shrink)

We began with three propositions: that people have a right not to be treated as mere means to the ends of others, that a woman who voluntarily becomes pregnant nevertheless has the right to an abortion, and that a woman who voluntarily gives birth does not have a right to abandon her child until she finds a substitute caretaker. These propositions initially seemed inconsistent, for the prohibition on treating others as mere means appeared to rule out the possibility of positive (...) rights, thus making it impossible to countenance the right to abort or the right not to be abandoned . But we have seen that the prohibition on treating people as mere means to the ends of others is best understood as ruling out basic positive rights while permitting derivative ones. Since a willing mother is responsible for bringing her child into the world in the first place, she cannot abandon it without violating its negative right not to be killed, and so such a child has a derivative positive right not to be abandoned. A pregnant woman, on the other hand, has a negative right not to have her body invaded, and from this negative right derives a positive right to abort her fetus, so long as doing so is not disproportionate to the seriousness of the threat . Therefore, far from being in conflict, propositions , , and have been shown to be in harmony with one another, the latter two being plausibly grounded in the first. Insofar as we have reason to accept , then, we have reason to accept and . Moreover, we have seen that a proper understanding of allows us to embed and in a larger moral perspective in which the limits of compulsory altruism are firmly drawn: enforceable rights to the use or assistance of others may be allowed into the moral domain only if they are “sponsored” by some negative right. Every putative positive right must find such a sponsor, or perish. (shrink)

We analyzed the patients’ perception of prenatal diagnosis of fetal cardiac pathology, and the reasons for choosing to continue with pregnancy despite being eligible to receive a medical termination of pregnancy. We also identified the challenges, the motives interfering in decision-making, and the consequences of the decisions on pregnancy, child and mother. This descriptive, prospective and longitudinal study was conducted in France, amongst pregnant women who wished to continue their pregnancy despite an unfavorable medical advice. Socio-demographic data were collected through (...) a questionnaire. Such questionnaire covered information assessing the parents/mother’s perception of prenatal diagnosis, and medical termination of pregnancy, their interpretation of the established diagnosis and their motives for not considering pregnancy termination. 72 eligible patients were analyzed over one year: mean age 33 ± 6.89 years, 47 patients had already given birth to ≥1 healthy child. Mean gestational age at the detection of fetal cardiac pathologies was 30 ± 4.37 weeks of amenorrhea. Patients decided to keep the child after 3 ± 1.25 consultations. 56 patients made their decision with their husbands and 16 made their decision alone. Reasons for declining the medical termination were culpability and responsibility, ideologies and convictions, mistrust and hope. Newborns of 67 patients died with a mean survival duration of 38 days. Patient informed consent should be sought before any decision in neonatology, even if conflicting with the medical team’s knowledge and the pregnant mother’s benefits. Decisions to accept or decline pregnancy termination depend on the patients’ psychological character, ideologies, convictions, and mistrust in the diagnosis/prognosis, or hope in the fetus survival. (shrink)

The jurists, taking as reference the texts and the experiential studies of the period, preached various provisions regarding the issues such as fetal development, full birth or birth and death in this process. The majority made evaluations on the basis of the hadith about the fetal development process -mentioned in three separate periods of forty days-, but it was observed that this did not overlap with some medical guidance. Because the development period expressed by the jurists could not be prolonged, (...) it was determined that this process was completed before according to modern medicine. Jurists stated that he did not have any law regarding the fetus born before this period, since it was based on this period, and evaluated and evaluated whether those born later were alive or not. It has been presented in different jurisprudence in terms of various branches in fiqh, which is called “frequency” of the previous abortion effect after/during the full birth, and which is considered to be soul-blowing at the end of four months. These conflicts affected sons' abilities such as bathing, shrouding, burial and burial of the miscarriage. The mother also created many provisions such as her legal status such as nifas, talaq and ummu'l-veled, punishment lessons such as abortion and gurra, financial concepts such as heir and inheritance, and its effects on conditional contracts. In our study, in the event that the fetus dies due to the cell in the womb where the study medical information is located, the protections against it and the judgment it gives birth to in relation to it are discussed. (shrink)

Abortion and embryo destruction prevent a future of value, but that does not make them wrong.Abortion involves the killing of a fetus. One bad thing about killing a fetus is that the fetus is deprived of a future of value. Think of all the things which make your life good and worth living: understanding the world, seeing your children grow into independent, intelligent, and happy people, watching a sunset over the hills, enjoying good times with friends. By killing the fetus, (...) we are depriving it of a future life likely to contain these things. And more. The fetus would likely grow to be a person who would have contributed to the world in many ways—bringing joy to its parents, happiness, and friendship to many. That person would have laboured for society and perhaps even discovered a cure for cancer or developed the first bionic eye.The loss of these possible futures is bad. It makes the killing of a fetus wrong. This is Don Marquis's argument against abortion.1 It is one of the best arguments against abortion which does not rest on theological premises.Another way of putting this is to say that we have a good reason not to kill a fetus. A reason for acting is a fact or circumstance forming a sufficient justification for an action. Or in this case, not to perform an action. We have all sorts of reasons for action. Our reasons often conflict. I may have a good reason to visit my mother and a good reason to take my children to the park. What we have most reason to do is what it is right to do. It is what we should do. If we have most reason not to perform an act, …. (shrink)

An ongoing debate in Catholic bioethical circles today centers around the liceity of inducing labor in a woman with a healthy previable fetus in order to save her life. Many Catholic bioethicists have defended the view that such inductions are morally licit even though the fetus itself has no medical issues and it is the combination of the pregnancy along with a weakened heart of the mother that is causing problems. Typically the basis for this view is the procedure’s satisfaction (...) of the four criteria of the principle of double effect, namely: the act itself is not evil, the evil effect is not intended, the evil effect is not produced by means of the good effect, and there is proportionate reason for the procedure. A few Catholic bioethicists have worried that the procedure does not satisfy the fourth criterion, the principle of proportionate reason. Here I present arguments showing that it is also unlikely to satisfy the first criterion, that the act itself is not evil. This hinges on the principle that it is only permissible to perform acts from which evil effects follow necessarily when such acts only directly target a pathology. Fortunately such vital conflict cases are rare and hopefully medical advances will eliminate them. (shrink)

Obstetricians face difficult decisions when the interests of fetus and mother conflict. An example is the problem of choosing the delivery method when labour begins prematurely and the fetus is breech. Vaginal delivery involves risks for the breech fetus of brain damage or death caused by umbilical cord compression and head entrapment. Caesarean section might avoid these dangers but involves risks for the mother, including infection, haemorrhage and even death in a small percentage of cases. If a caesarean section (...) is performed the infant might die anyway, due to complications of prematurity. Thus, decisions about delivery method involve balancing the risks to mother and fetus. Uncertainty about the frequency of fetal injuries in vaginal breech deliveries adds to the difficulty of these decisions. (shrink)

There are limitations of obstetric estimation of neonatal outcome in extremely premature newborns. Predicting outcomes, survival, and morbidity are often uncertain, such as in cases of extreme prematurity, certain fetal anomalies, intrauterine growth restriction, and intrauterine infection. Informed consent, truth telling, the maternal–fetal conflict, decision making, and the fetus as a patient are the most important issues of obstetric and neonatal ethics. Because the boundary between utility and futility is not clear, the best interest of the mother, the fetus, (...) and the newborn will be subject of discussion every time. Here, we report a case of obstetric patient to discuss. (shrink)

We hypothesize that rapid eye movement or REM sleep evolved, in part, to mediate sexual/reproductive behaviors and strategies. Because development of sexual and mating strategies depends crucially on early attachment experiences, we further hypothesize that REM functions to mediate attachment processes early in life. Evidence for these hypotheses comes from (1) the correlation of REM variables with both attachment and sexual/reproductive variables; (2) attachment-related and sex-related hormonal release during REM; (3) selective activation during REM of brain sites implicated in attachment (...) and sexual processes; (4) effects of maternal deprivation on REM; (5) effects of REM deprivation on sexual behaviors; and (6) the REM-associated sexual excitation. To explain why we find associations among REM sleep, attachment, and adult reproductive strategies, we rely on recent extensions of parent-offspring conflict theory. Using data from recent findings on genomic imprinting, Haig (2000) and others suggest that paternally expressed genes are selected to promote growth of the developing fetus/child at the expense of the mother, while maternally expressed genes counter these effects. Because developmental REM facilitates attachment-related outcomes in the child, developmental REM may be regulated by paternally expressed genes. In that case, REM may have evolved to support the “aims” of paternal genes at the expense of maternal genes. (shrink)

In ethical debate the questions often matter more than the answers. By raising questions about the anomalies in clinical practice concerning the moral status of the fetus, Boyle et al are contributing to the debate.There can be no starker reminder of the legal anomaly around fetal/infant rights than the hospital which deals simultaneously with abortions and intensive care of neonates. In the course of my own clinical practice I have recoiled from the horror of late abortions being whisked to the (...) neonatal intensive care unit , and struggled with the ethical complexities of decision making for infants born at the edge of viability. But many years of detailed researching of the lived experiences of both staff and parents in relation to limitation of treatment,1,2 lead me to the conclusion that to focus discussion on fetal/infant rights is unhelpful. Theoretically the issues may well be conceptualised in this way, but the reality is very different.It is true that a mother has the right to request termination of her pregnancy at a stage where there is at least some possibility of a viable fetus . It is also true that the rights of the fetus may only be realised once it has passed through the birth canal and established itself as a separate individual. A sharp divide at 24 weeks seems illogical, and indeed the whole notion of viability is something of a legal fiction. But in reality things are not as confrontational or as irreconcilable as this paper seems to suggest. Viewed from the perspective of the doctors, nurses, and parents at the coalface of NICU, talk of the child’s rights and interests suddenly superseding those of the parents is a distortion; and a picture of arbitrary conflicting reactions on the two …. (shrink)

An error that medicine has long shared is to attribute to a desire or an effect of the mother’s imagination during gestation, the deformities, growths or spots that a child bears at birth. The imagination would be capable of imprinting external modifications on a matter and would have an impact on the perceptions and sensory development of the fetus. Returning briefly to the genealogy and posterity of the topos, this article focuses on the successes and refutations of the Malebranchist paradigm (...) in the 18th century, through a corpus of medical popularization texts where the debates oppose the supporters of the imagination for whom emotion alters the organs of the fetus and the detractors of this thesis who only see it as prejudice. Mechanistic systems had in common that they avoided the soul to explain life. Although each era has its hermeneutic system of representations, and that medicine—closely dependent on the philosophical and moral conceptions of its time—is also a cultural production, it is nevertheless not uninteresting to question on the fortune of a motive and the scientific topicality of the question. What does the baby perceive in utero? Does he feel his mother’s pain? If so, what is the biological impact? To what extent can the maternal imagination and experience mark the child’s body? Informed by functional imaging technologies, recent research returns to the symbiotic link of mother-fetus interactions. Convergences appear between this 18th century and our 21st century. In no case did we want to contrast today’s scientists who are firmly in touch with reality and their predecessors who are prey to imagination. Science, whatever the era, always feeds on imagination. (shrink)

Definition of the problem: The rapid pace of medical progress has drawn renewed attention to the various possible ways of treating dead or brain-dead pregnant women since the 1980's. The discussion today revolves around medical, social, legal and economic aspects. The historical areas of conflict which surrounded deliveries carried out on dead mothers (usually by means of a Sectio in mortua, nowadays known as a perimortem Caesarean section) and their significance in today's debate are, for the most part, regarded (...) as being of little relevance.Arguments: The history of the Sectio in mortua was, for a long time, influenced by the difficulty in establishing whether the mother and foetus were actually dead, by the degree of autonomy of the foetus in the womb, by religious issues, by the lack of acceptance among the people because of their irrational fears concerning the operation and by legal regulations and constraints especially in relation to operations carried out on the dying. Each of these areas shows remarkable parallels to the present-day medical and ethical discussion.Conclusion: The value of such considerations does not lie in the uncritical application of experience gained in the past, but rather in a growing awareness of the wide spectrum of parameters and in a deeper understanding of the various possible approaches to a given situation. The tradition in the Western world of carrying out a delivery on a dead mother, in spite of the conflict of interests between the mother and the foetus, is of particular importance. In practice, the many non-medical factors should be taken more into consideration, with special emphasis being placed on the informed consent of the relatives. (shrink)

The medical model of childbearing assumes that a pregnancy always has the potential to turn into a risky procedure. In order to advocate humanized birth in high risk pregnancy, an important step involves the enlightenment of the professional’s preconceptions on humanized birth in such a situation. The goal of this paper is to identify the professionals’ perception of the potential obstacles and facilitating factors for the implementation of humanized care in high risk pregnancies. Twenty-one midwives, obstetricians, and health administrator professionals (...) from the clinical and academic fields were interviewed in nine different sites in Japan from June through August 2008. The interviews were audio taped, and transcribed with the participants’ consent. Data was subsequently analyzed using content analysis qualitative methods. Professionals concurred with the concept that humanized birth is a changing and promising process, and can often bring normality to the midst of a high obstetric risk situation. No practice guidelines can be theoretically defined for humanized birth in a high risk pregnancy, as there is no conflict between humanized birth and medical intervention in such a situation. Barriers encountered in providing humanized birth in a high risk pregnancy include factors such as: the pressure of being responsible for the safety of the mother and the fetus, lack of the women’s active involvement in the decision making process and the heavy burden of responsibility on the physician’s shoulders, potential legal issues, and finally, the lack of midwifery authority in providing care at high risk pregnancy. The factors that facilitate humanized birth in a high risk include: the sharing of decision making and other various responsibilities between the physicians and the women; being caring; stress management, and the fact that the evolution of a better relationship and communication between the health professional and the patient will lead to a stress-free environment for both. Humanized birth in a high risk pregnancy is something that goes beyond just curing women of their illnesses. It can be considered as a token of caring, and continued support, which positively consolidates the doctor-patient relationship. As yet, it has not been described as a practiced guideline, due to its ever-changing complexities. (shrink)

The medical treatment in utero of human beings raises several ethical questions. I argue that treatment is sufficient to establish the fetus as person; and consider how conflicts between the interests of the fetus and mother are to be resolved when such treatment is proposed. My arguments rest upon a ‘relational model’ of ethical discourse derived from H. Richard Niebuhr's “ethics of the fitting.”I conclude that the limitation of personal autonomy is rarely justified, but may be when direct, grave, harm (...) to others is imminent; and that educative rather than punitive measures are the best prospect for protecting fetal life. (shrink)

Literature on consumer ethics tends to focus on issues within the public sphere, such as the environment, and treats other drivers of consumption decisions, such as family, as non-moral concerns. Consequently, an attitude–behaviour gap is viewed as a straightforward failure by consumers to act ethically. We argue that this is based upon a view of consumer behaviour as linear and unproblematic, and an approach to moral reasoning, arising from a stereotypically masculine understanding of morality, which foregrounds abstract principles. By demonstrating (...) the importance of context to consumption decisions and articulating the impact of caring relationships, we highlight how such decisions are both complex and situated. This is particularly evident for decisions involving the needs of others, as occurs in family life. We argue that the incorporation of care ethics provides both theoretical insights and a more complete account of consumer ethics. This is explored empirically through an investigation of the ethical dilemmas arising from consumption decisions made by mothers of young children. Such decisions juxtapose an ethical consumption orientation with care for one’s child. Therefore, what has been previously considered a failure to act ethically may in fact be the outcome of complex decision making, which involves competing ethical considerations. We discuss the implications of our findings for theory and practice and how this approach to consumer ethics could be applied more widely. (shrink)

When a mother kills her child, we call her a bad mother, but, as this book shows, even mothers who intend to do their children harm are not easily categorized as "mad" or "bad." Maternal love is a complex emotion rich with contradictory impulses and desires, and motherhood is a conflicted state in which women constantly renegotiate the needs mother and child, the self and the other. Applying care ethics philosophy and the work of Emmanuel Levinas, Maurice Merleau-Ponty, and Simone (...) de Beauvoir to real-world experiences of motherhood, Sarah LaChance Adams throws the inherent tensions of motherhood into sharp relief, drawing a more nuanced portrait of the mother and child relationship than previously conceived. The maternal example is particularly instructive for ethical theory, highlighting the dynamics of human interdependence while also affirming separate interests. LaChance Adams particularly focuses on maternal ambivalence and its morally productive role in reinforcing the divergence between oneself and others, helping to recognize the particularities of situation, and negotiating the difference between one's own needs and the desires of others. She ultimately argues maternal filicide is a social problem requiring a collective solution that ethical philosophy and philosophies of care can inform. (shrink)

Practitioners’ ethical orientation and responses vary between practice settings. Yet, currently, the ethics for midwifery practice that is explicit in the literature and which provides the ideals of socialization into practice, is that of bio(medical)ethics. Traditional bioethics, developed because of World War II atrocities and increased scientific research, is based on moral philosophy, normative theory, abstract universal principles and objective problem solving, all of which focus on right and wrong ‘action’ for resolving dilemmas. They exclude context and relationship. Personal narratives (...) of mothers and midwives contest the appropriateness of these accepted values and systems for childbirth because they induce conflict between work-place/service provider ethics and personal/professional midwifery ethics. In contrast to the disembedded and disembodied approach of biomedical ethics, an ethically adequate response in midwifery practice resonates more with the ethics of intimates, such as feminist virtue ethics. (shrink)

When a mother deliberately harms her child, it is tempting to assume that she must be either insane or lacking the "natural" love of a mother for her children. We want to believe that such mothers have almost nothing in common with "good" mothers. Drawing extensively on empirical research, Sarah LaChance Adams' Mad Mothers, Bad Mothers, and What A "Good" Mother Would Do shows that maternal ambivalence, simultaneous desires to nurture and violently reject one's children, is both common and reasonable, (...) the result of genuine conflicts between mothers' interests and those of their children. Both appropriate support and deliberative agency are necessary to avoid maternal ambivalence... (shrink)

Sara Ruddick's Maternal Thinking: Towards a Politics of Peace is both an anomaly and a product of the tradition associating maternal activities with peace. Ruddick argues that maternal work gives mothers distinct motives for rejecting war, unique abilities for nonviolent conflict resolution, and a critical perspective on military thinking. If she is correct, maternal thinking may provide the foundation for a feminist peace politics. My project is a critical account of maternal thinking as Ruddick unfolds it in her book. (...) Ruddick's argument has two central components: The theoretical development of maternal thinking, which she explains in terms of a "practicalist conception of truth" , and The case that maternal thinking can ground a feminist peace politics, based on Nancy Hartsock's version of feminist standpoint theory. ;Ruddick constructs mothering as a genderfree practice under the PCT to distinguish from earlier accounts of mothering. This is problematic for three reasons. First, it portrays mothers as autonomous, ahistorical, and acultural caretakers and ignores how other practices shape and contribute to maternal practice's definition. Second, Ruddick does not say enough about the identity of her mothers. She acknowledges racial and cultural differences, but does not explore the implications of her pluralism. Also, her genderfree account excludes any discussion of masculine and feminine styles of mothering. Third, the cross-practice critical power of MT is restricted by the practicalist view that "there is no truth by which all truths can be judged." I suggest Ruddick can overcome this confusion by distinguishing between internal and external goals of practices. I argue that a holistic view, which places maternal practice within a complex web of related practices, helps to eliminate the remaining problems with mothering under the PCT. ;Ruddick's move from a practicalist to a standpoint version of MT solves a critical problem for her. Feminist standpoint theorists typically argue that distinctions between men's and women's understandings of the world are rooted in the sexual division of labor; they maintain that "thinking from women's lives" makes available a privileged view on male supremacy. Ruddick draws on Hartsock's radical version of a feminist standpoint, which holds that both the sexual division of labor in women's subsistence activities and the intimate involvement of their bodies in "menstruation, coitus, pregnancy, childbirth, and lactation" have epistemological consequences. To show the superiority of feminist standpoint, she compares maternal and military "histories of the human flesh." The central role of this comparison in Ruddick's argument makes her position dangerously close to the essentialist arguments she desires to avoid. (shrink)

At some point in the future – perhaps within the next few decades – it will be possible for foetuses to develop completely outside the womb. Ectogenesis, as this technology is called, raises substantial issues for the abortion debate. One such issue is that it will become possible for a woman to have an abortion, in the sense of having the foetus removed from her body, but for the foetus to be kept alive. We argue that while there is a (...) right to an abortion, there are reasons to doubt that there is a right to the death of the foetus. Our strategy in this essay is to consider and reject three arguments in favour of this latter right. The first claims that women have a right not to be biological mothers, the second that women have a right to genetic privacy, and the third that a foetus is one's property. Furthermore, we argue that it follows from rejecting the third claim that genetic parents also lack a right to the destruction of cryopreserved embryos used for in vitro fertilization. The conclusion that a woman possesses no right to the death of the foetus builds upon the claims that other pro-choice advocates, such as Judith Jarvis Thomson, have made. (shrink)

Dominant cultural ideologies of motherhood define the nature of mother love. Recent developments in motherhood studies, and the work of a small number of feminist philosophers and scholars of motherhood, have challenged the tenets of these ideologies by daring to speak the “unspeakable”: that mother love is often and for all mothers, whether consciously or not, permeated by powerful negative and conflicting emotions termed maternal ambivalence. In this essay, relying on recorded personal narratives by Bosnian women who are raising children (...) born of wartime rape, as well as recent studies on empowered motherhood, my aim is to show that maternal love, like love in any other close relationship, encompasses and assimilates healthy ambivalence, and can inform maternal care in a constructive and positive manner. I argue that the acknowledgment of healthy maternal ambivalence as an integral aspect of mother love involves honoring the mother's subjectivity and validates her personhood, and as such it opens up the possibility of redefining mother love in terms that are empowering to mothers. (shrink)

Dominant cultural ideologies of motherhood define the nature of mother love. Recent developments in motherhood studies, and the work of a small number of feminist philosophers and scholars of motherhood, have challenged the tenets of these ideologies by daring to speak the “unspeakable”: that mother love is often and for all mothers, whether consciously or not, permeated by powerful negative and conflicting emotions termed maternal ambivalence. In this essay, relying on recorded personal narratives by Bosnian women who are raising children (...) born of wartime rape, as well as recent studies on empowered motherhood, my aim is to show that maternal love, like love in any other close relationship, encompasses and assimilates healthy ambivalence, and can inform maternal care in a constructive and positive manner. I argue that the acknowledgment of healthy maternal ambivalence as an integral aspect of mother love involves honoring the mother's subjectivity and validates her personhood, and as such it opens up the possibility of redefining mother love in terms that are empowering to mothers. (shrink)

This paper critically evaluates current conceptions of pregnancy as a possession of either mother or infant. In opposition to the more common stance that marks birth as the beginning of intercorporeality and perception, pregnancy is instead phenomenologically delineated as a chiasmic relationship between mother and her pre‐infant from a Merleau‐Pontian perspective. This paper maintains that during pregnancy a mother‐to‐be and her pre‐infant are deepened and modified through their intertwining.

A number of developments in the medical field have changed the debate about the ethics of abortion. These developments include: advances in fetal physiology, the increase in neonatal intensive care and the survival rates of premature infants. This paper discusses the idea of selective termination and the effects that these decisions have on disabled people of today. It presents a critique of the counselling services that are provided for the parents of a disabled fetus and discusses how this is viewed (...) from a social perspective. The article ends with an argument that the mother deserves to be autonomous in the decision of abortion. The easiest and most fair way to develop her autonomy is to consider the relationship between a professional and a mother as an expert–expert relationship. Here both parties are considered experts in diagnostic information, treatment options, possibilities, and their history, family roots, philosophy and way of life, respectively. (shrink)

During the past four decades, China has gone through rapid urbanization and modernization. As people adapt to dramatic sociodemographic shifts from rural communities to urban centers and as economic level rises, individualistic cultural values in China have increased. Meanwhile, parent and child behavior in early childhood has also evolved accordingly to match a more individualistic society. This mixed-method study investigated how social change in China may have impacted parenting goals and child development in middle childhood, as seen through the eyes (...) of the current generation of mothers. Thirty mothers of fifth-grade elementary school students from Shenzhen, China were recruited and took part in semi-structured interviews. Participants answered questions and provided examples about their children’s life, their own childhood, and the perceived differences between the two generations. Participating mothers were also asked to rate which generation, themselves or their parents, cared more about the childrearing goals of academic competitiveness and socioemotional well-being. Using both qualitative and quantitative analysis, we expected and found an intergenerational increase in the perceived value mothers placed on individualistic traits: current mothers care more about their children’s academic competitiveness, personal happiness, and social adjustment, compared to their experience of their own mothers’ attitudes during their childhood a generation earlier. They also experience conflict between their children’s academic competitiveness and socioemotional well-being. As a function of both urbanization and increased economic means, children’s collectivistic family responsibilities for essential household chores have declined as the importance of schoolwork has increased. (shrink)

I reviewed Pope Francis’s Address as one acutely aware of the extremely murky psycho-political cloud surrounding womb-determinism in the United States, and coming to it without any religion-based predisposition on the issue.I made note that Pope Francis’s main point is not proscriptive. He gives a low profile to any dogmatic definition of the sanctity of life. His tone is humane, not doctrinal.The Pope proposes that the fetus, like the child who follows, is basically a messenger, communicating from the womb and (...) creating the universe that will define the mother, the family, and the wider community. This point is not moral—he calls it “pre-religious”—but semiotic, concerned with the nature and structure of how we... (shrink)

Usage of psychotropics during pregnancy and lactation has always been a topic of debate and controversy. The debate stems from the potential adverse effects on the growing fetus or infants due to the transfer of psychotropic drugs through placenta or breast milk of mothers receiving them; and the problem of discontinuing psychotropics in lactating mother considering chances of relapse. However, most of the psychotropics are found to be relatively safe when used cautiously during the lactation phase. This article describes available (...) data on the use of psychotropics in lactating mothers, in particular, in relation to the safety profile of infants. (shrink)