: This article critically examines the constitution of impairment in prenatal testing and screening practices and various discourses that surround these technologies. While technologies to test and screen prenatally are claimed to enhance women's capacity to be self-determining, make informed reproductive choices, and, in effect, wrest control of their bodies from a patriarchal medical establishment, I contend that this emerging relation between pregnant women and reproductive technologies is a new strategy of a form of power that began to (...) emerge in the late eighteenth century. Indeed, my argument is that the constitution of prenatal impairment, by and through these practices and procedures, is a widening form of modern government that increasingly limits the field of possible conduct in response to pregnancy. Hence, the government of impairment in utero is inextricably intertwined with the government of the maternal body. (shrink)

Reproductive freedom plays a pivotal role in debates on the ethics of procreation. This moral principle protects people’s interests in procreative matters and allows them discretion over whether to have children, the number of children they have and, to a certain extent, the type of children they have. Reproductive freedom’s theoretical and political emphasis on people’s autonomy and well-being is grounded in an individual-centred framework for discussing the ethics of procreation. It protects procreators’ interests and significantly (...) reduces the permissible grounds for interference by third parties. In this article I show that procreative decisions have far-reaching effects on the composition and size of the population. The upshot of considering these effects allows for the appreciation of the inadequacy of a framework that solely considers individual (i.e. procreators’) interests to discuss the ethics of procreation. To address such inadequacy, I assess costs and benefits of past and present proposals to reflect on procreation in such a way as to consider its far-reaching effects. I conclude by arguing that reproductive freedom should be defended as an imperfect but instrumentally necessary tool. This framing would enable those participating in debates on the ethics of procreative decisions to work towards an ethical framework that accounts for the cumulative effects of these decisions. (shrink)

In the _Republic, _the paradigmatic character of Plato’s best city appears incompatible with the use of deception in the procreative practices of the Auxiliaries and Guardians. I argue that this incongruity, as well as the exact provisions of Plato’s reproduction festival, are explained by three facts: his commitment to eugenics, his insistence on the abolition of the typical Greek household and his belief that there are serious limitations to the type of knowledge that Auxiliaries can achieve.

The origins of choice -- The reproductive rights debate that ignored reproduction -- Putting reproduction back into reproductive freedom -- Reproductive freedom and human evolution -- Enlisting men in support of reproductive freedom -- Defending reproductive freedom from the dangers of reproductive technology -- Ought there be a law? -- Beyond choice.

There isn’t much understanding in some marriages. My sister has six [children] and another has eight. I said to one of them that she shouldn’t have any more. And she said “What can I do? When my husband comes home drunk, he foxes me to sleep with him.” And that is what happens to a lot of women. And if the women don’t do it, the men hit them, or treat them badly. Or the men get jealous and think their (...) wives are with other men.—Rene, a 29-year old Peruvian womanGender violence is a major yet often underrecognized obstacle to reproductive choice. In both the abortion rights movement in the United States and the reproductive health movement globally, the “enemy” of self-determination and choice is usually seen as imposing from the top down. In the North, it is the government—through the courts, the legislature, and bureaucratic rulemaking—that threatens to “take away” women’s reproductive autonomy. The image is one of the public sphere invading that which is private—of the state interfering with a woman’s right to control her own body. (shrink)

There isn’t much understanding in some marriages. My sister has six [children] and another has eight. I said to one of them that she shouldn’t have any more. And she said “What can I do? When my husband comes home drunk, he foxes me to sleep with him.” And that is what happens to a lot of women. And if the women don’t do it, the men hit them, or treat them badly. Or the men get jealous and think their (...) wives are with other men.—Rene, a 29-year old Peruvian womanGender violence is a major yet often underrecognized obstacle to reproductive choice. In both the abortion rights movement in the United States and the reproductive health movement globally, the “enemy” of self-determination and choice is usually seen as imposing from the top down. In the North, it is the government—through the courts, the legislature, and bureaucratic rulemaking—that threatens to “take away” women’s reproductive autonomy. The image is one of the public sphere invading that which is private—of the state interfering with a woman’s right to control her own body. (shrink)

ABSTRACT Recent developments in generating gametes via in vitro gametogenesis (IVG) from induced pluripotent stem cells (iPSCs) and their successful use for reproductive purposes in animals strongly suggest that soon these methods could also be used in human reproduction. At least two questions emerge in this context: (a) if a legislator should permit their use and (b) if ethical claims emerge that support their provision, e.g., by public health care systems. This urges an ethical reflection of the new (...) class='Hi'>reproductive options this technique might offer. Since the concept of reproductive freedom is a key aspect for the ethical evaluation of artificial reproductive technologies (ARTs), it is necessary to analyze if the new possibilities emerging from IVG fall within the scope of this concept. The results may constitute a morally relevant difference between different imaginable applications of IVG and potentially justify differences in claims to access this technology. (shrink)

Continuing medico-technical progress has led toan increasing medicalisation of pregnancy andchildbirth. One of the most common technologiesin this context is ultrasound. Based on someidentified `pro-technology feminist theories',notably the postmodernist feminist discourse,the technology of ultrasound is analysedfocusing mainly on social and political ratherthan clinical issues. As empirical researchsuggests, ultrasound is welcomed by themajority of women. The analysis, however, showsthat attitudes and decisions of women areinfluenced by broader social aspects. Furthermore, it demonstrates how the visualtechnology of ultrasound, in addition to otherreproductive technology (...) in maternity care, islinked to the `personification' of the foetusand has therefore contributed to a new image ofthe foetus. The exploration of these issueschallenges some arguments of feministdiscourse. It draws attention to possibleadverse implications of the technology forwomen's reproductive freedom and indicates theimportance of the topic for politicaldiscussions. (shrink)

In this paper I argue that the account of deliberative democracy advanced by Amy Gutmann and Dennis Thompson (1996, 2004) is a useful normative theory that can help enhance our deliberations about public policy in morally pluralistic societies. More specifically, I illustrate how the prescriptions of deliberative democracy can be applied to the issue of regulating non-medical uses of pre-implantation genetic diagnosis (PGD), such as gender selection. Deliberative democracy does not aim to win a philosophical debate among rival first-order theories, (...) such as libertarianism, egalitarianism or feminism. Rather, it advances a second-order analysis that strives to help us determine what would constitute a reasonable balance between the conflicting fundamental values that arise in the context of regulating PGD. I outline a theoretical model (called the Reasonable Genetic Intervention Model) that brings these issues to the fore. Such a model incorporates the concern for both procedural and substantive principles; and it does so in way that takes provisionality seriously. (shrink)

In this paper, we argue that lesbian couples who wish to have children who are genetically related to both of them should be allowed access to mitochondrial replacement techniques. First, we provide a brief explanation of mitochondrial diseases and MRTs. We then present the reasons why MRTs are not, by nature, therapeutic. The upshot of the view that MRTs are non-therapeutic techniques is that their therapeutic potential cannot be invoked for restricting their use only to those cases where a mitochondrial (...) DNA disease could be ‘cured’. We then argue that a positive case for MRTs is justified by an appeal to reproductive freedom, and that the criteria to access these techniques should hence be extended to include lesbian couples who wish to share genetic parenthood. Finally, we consider a potential objection to our argument: that the desire to have genetically related kin is not a morally sufficient reason to allow lesbian couples to access MRTs. (shrink)

Bioethics scholarship considering the possibility of gestating an embryo to full term in an artificial womb (ectogenesis) often overstates the capacities of current technologies and underestimates the barriers to the development of full ectogenesis. Moreover, this debate causes harm by (1) neglecting more immediate problems in the development of artificial wombs, (2) treating abortion as a “problem with a technological solution,” bolstering anti-abortion rhetoric, and (3) presuming the stability of women’s reproductive rights. The ectogenesis conversation must consider anticipated uses (...) of the technology (neonatal intensive care) and acknowledge the immediate context (recognizing abortion as essential healthcare and existing reproductive inequities). (shrink)

In The Handmaid’s Tale and The Testaments, Margaret Atwood vividly portrays a dystopia from a woman’s point of view. The themes she explores are familiar, they are not shocking fictional devices designed to keep readers surprised and engaged. Instead, the stories describe how our own world might have been or, even worse, how it might be. It explores the dangers of treating women’s bodies as resources to be regulated and commodified. The series emphasizes the value of autonomy and highlights the (...) ways in which it can be eroded by oppression until it no longer exists in any meaningful way. This chapter will explore the theme of autonomy as it arises in The Handmaid’s Tale and The Testaments. It will situate these stories as part of a long philosophical tradition of sorting members of society into groups based on their perceived skills and abilities, allowing no room for transcendence or self-creation. It will explore how manipulation of love and relationships, religion, the use of language, and opportunities to think critically can, without bars or shackles, imprison a population by diminishing their capacity for self-determination. The story of The Handmaid’s Tale and The Testaments is cautionary. This chapter will explore the nature of the lesson that story teaches. (shrink)

On Oct. 24, 2019, French philosopher Sylviane Agacinski was scheduled to speak at the Université de Bordeaux-Montaigne on « l’être humain à l’époque de sa reproductibilité technique » [the human being in the era of its technological reproducibility]. Amidst “violent threats” and their purported inability to assure the safety of Agacinski, the organizers cancelled the event. Agacinski and other French intellectuals lament what they perceive to be part of a “drifting liberticide”, a form of censorship that forbids the exchange of (...) ideas and forecloses open space for debate. The story goes that Agacinski, notable for her staunch opposition to surrogacy and extending assisted reproductive technologies (ARTs) to non- heterosexual couples, as well as her anthropological claim that the fabric of our social order relies on the heteronormative structure of sexual difference, has been silenced. In a communiqué to the university, student organizations such as Riposte Trans and Mauvais Genre-s pleaded “no platform”, indicating that Agacinski’s reactionary homophobic and transphobic positions run contrary to the university’s mission of safeguarding against discrimination. What to do when an incitement to (epistemic) violence masks itself as free speech? Bring Sara Ahmed’s hammer to France. (shrink)

abstract In this article I consider whether the legalization of sex‐same marriage implies a right to incestuous marriage. I begin by suggesting that the liberal state get out of the ‘marriage’ business by leveling down to a universal civil union status. The question is then whether incestuous unions should be both legal and eligible for this status. I argue that the arguments compatible with public reason for prohibiting them outright, or even for excluding them from the permissible types of legally (...) registered partnerships, are quite weak. The objections to allowing such relations are those from (1) child abuse; (2) unfair burdening of society; and (3) the creation of bad lives. I argue that while rape and other forms of child abuse would be no more legal or tolerated than they are now, the concern about any form of weakening a society's legal and political resources to combat such abuses does indeed register on the justificatory scale, but does not prove that such first‐degree incestuous sexual relations are inherently bad enough to warrant intervention in their own right. I then argue that the concern about unfairly burdening society with unhealthy persons is not as dangerously totalitarian as we might initially fear, but nor is it strong enough to justify an outright prohibition. Finally, I argue that a concern to dissuade persons from creating certain kinds of lives (children with extreme birth defects) is also not as dangerously totalitarian as we might initially fear, and in fact goes further towards explaining why we might have a legitimate interest in intervening. Nonetheless, I argue that the criminalization of such acts only make sense when they are indicators of other offenses, namely negligence or abuse, and it thus seems that the act of consanguineous reproduction is itself insufficient. (shrink)

In this article I consider whether the legalization of sex-same marriage implies a right to incestuous marriage. I begin by suggesting that the liberal state get out of the 'marriage' business by leveling down to a universal civil union status. The question is then whether incestuous unions should be both legal and eligible for this status. I argue that the arguments compatible with public reason for prohibiting them outright, or even for excluding them from the permissible types of legally registered (...) partnerships, are quite weak. The objections to allowing such relations are those from (1) child abuse; (2) unfair burdening of society; and (3) the creation of bad lives. I argue that while rape and other forms of child abuse would be no more legal or tolerated than they are now, the concern about any form of weakening a society's legal and political resources to combat such abuses does indeed register on the justificatory scale, but does not prove that such first-degree incestuous sexual relations are inherently bad enough to warrant intervention in their own right. I then argue that the concern about unfairly burdening society with unhealthy persons is not as dangerously totalitarian as we might initially fear, but nor is it strong enough to justify an outright prohibition. Finally, I argue that a concern to dissuade persons from creating certain kinds of lives (children with extreme birth defects) is also not as dangerously totalitarian as we might initially fear, and in fact goes further towards explaining why we might have a legitimate interest in intervening. Nonetheless, I argue that the criminalization of such acts only make sense when they are indicators of other offenses, namely negligence or abuse, and it thus seems that the act of consanguineous reproduction is itself insufficient. (shrink)

Carolyn McLeod's book is timely and important, especially when one considers the state of conscientious objection in a country like the United States. During his presidency, Donald Trump announced an expanded "conscience rule" for healthcare workers according to which they would have the protected right to morally and religiously oppose a variety of procedures, including abortion, sterilization, assisted suicide, and other medical procedures. In 2019, a number of states, local governments, and healthcare organizations brought lawsuits against the proposed rule, leading (...) a federal judge to reject it. New York Attorney General Letitia James said the state of New York sued in part because the... (shrink)

Divergences and controversies are inevitable in the discussion of freedoms and rights, especially in the matter of reproduction. The Chinese first social egg freezing lawsuit raises the question: is the freedom to freeze eggs for social reasons justified because it is an instance of reproductive rights? This paper accepts social egg freezing as desirable reproductive freedom, but following Harel's approach and considering two theories of rights, the choice and interest theories of rights, we argue that social (...) egg freezing is not a reproductive right because one cannot justify a right or an instance of rights via merely describing the function of those instances that have been justified as right, that is, the choice theory lacks justifying normativity. Since reserving fertility and a suspension from reproduction do not serve reproductive ends per se, the sufficient reason for demanding social egg freezing as a right should be found in other ends rather than in right‐to‐reproduce, that is, the interest theory denies the demand as a right‐to‐reproduce. Permitting it on any grounds without guaranteeing adequate and accessible resources, especially in light of cross‐border reproductive care, raises serious questions about reproductive equality and violates the idea of reproductive rights. Therefore, any ground for social egg freezing should be weighed against whether more pressing reproductive needs, specifically those that are justified as rights, have been met. It would be social progress to shoulder these burdens for the vulnerable and then allow social egg freezing—if right‐to‐reproduce were not the only privilege of the few. (shrink)

What responsibilities, if any, do we have towards our genetic offspring, before or after birth and perhaps even before creation, merely by virtue of the genetic link? What claims, if any, arise from the mere genetic parental relation? Should society through its legal arrangements allow 'fatherless' or 'motherless' children to be born, as the current law on medically assisted reproduction involving gamete donation in some legal systems does? Does the possibility of establishing genetic parentage with practical certainty necessitate reform of (...) current legal regimes of parenthood? And what limits, if any, should we set on parental procreative choices in the interests of future children, particularly with regard to genetic engineering and related techniques? These are the questions explored in this book by some of the foremost legal, bioethical and biomedical thinkers. Assembled with a view to assisting the reader to reflect critically on the ongoing social experiment which medically assisted reproduction is today, the essays in this collection highlight what are - and what else might in the nearby future become - possible reproductive options and respond to the difficulties we encounter in assessing these practices and possibilities from our traditional ethical vantage points. Contributions by: Andrew Bainham, Thomas Baldwin, Lisa Bortolotti, John Harris, Martin H. Johnson, Judith Masson, Martin Richards, Alison Shaw, Sally Sheldon, Bonnie Steinbock and Mary Warnock. (shrink)

Proponents of human reproductive cloning do not dispute that cloning may lead to violations of clones' right to self-determination, or that these violations could cause psychological harms. But they proceed with their endorsement of human reproductive cloning by dismissing these psychological harms, mainly in two ways. The first tactic is to point out that to commit the genetic fallacy is indeed a mistake; the second is to invoke Parfit's non-identity problem. The argument of this paper is that neither (...) approach succeeds in removing our moral responsibility to consider and to prevent psychological harms to cloned individuals. In fact, the same commitment to personal liberty that generates the right to reproduce by means of cloning also creates the need to limit that right appropriately. Discussion of human reproductive cloning ought to involve a careful and balanced consideration of both the relevant aspects of personal liberty – the parents' right to reproductive freedom and the cloned child's right to self-determination. (shrink)

This paper focuses on a specific proposal connected with the issue of mitigating climate change by reducing GHG concentrations in the atmosphere. The idea of campaigning in favour of a temporary reproductive suspension, to be addressed to a range of citizens of developed countries , is explored. Some details of the proposal are specified, and the proposal itself is defended against four objec- tions: 1. that it encroaches reproductive freedom; 2. that it subtracts from the overall value (...) the value of future lives; 3. that it is costly and ineffectual; 4. that it is unfair, especially when women are considered. (shrink)

Since its inception, donor conception practices have been a reproductive choice for the infertile. Past and current practices have the potential to cause significant and lifelong harm to the offspring through loss of kinship, heritage, identity, and family health history, and possibly through introducing physical problems. Legislation and regulation in Australia that specifies that the welfare of the child born as a consequence of donor conception is paramount may therefore be in conflict with the outcomes. Altering the paradigm to (...) a child-centric model, however, impinges on reproductive choice and rights of adults involved in the process. With some lobby groups pushing for increased reproductive choice while others emphasise offspring rights there is a dichotomy of interests that society and legislators need to address. Concepts pertaining to a shift toward a child-centric paradigm are discussed. (shrink)

The predominant position in the reproductive rights literature argues that access to assisted reproductive technologies (ART) forms part of an individual’s right to reproduce. On this reasoning, refusal of treatment by clinicians (via provision) violates a hopeful parent’s reproductive right and discriminates against the infertile. I reject these views and suggest they wrongly contort what reproductive freedom entitles individuals to do and demand of others. I suggest these views find their origin, at least in part, (...) in the way we define “reproduction” itself. This paper critically analyses two widely accepted definitions of human reproduction and demonstrates that both are fundamentally flawed. While the process of reproduction includes the biological acts of begetting and bearing a child, I argue that it does not extend to include rearing. This reworked definition has little impact in the realm of sexual reproduction. However, it has significant ethical implications for the formulation and assignment of reproductive rights and responsibilities in the non-sexual realm in two important ways. First, a claim to access ART where one has an intention to rear a child (but does not beget or bear) cannot be grounded in reproductive rights. Second, lacking an intention to rear does not extinguish the reproductive rights and responsibilities for those who collaborate in the process. I conclude that clinicians collaborate in non-sexual reproduction at the point of triggering conception (begetting) and therefore have the right to refuse to be involved in non-sexual reproduction, in some instances, as do all reproductive collaborators. (shrink)

As reproductive freedoms in the U.S. undergo significant rollbacks, vital reproductive health services — and the care teams delivering them — face escalating legal threats and complexity. This qualitative case-control community-based participatory research study describes how legal problem-solving supports for reproductive care teams serving mothers with opioid use disorder are protective for both patients and care team members. We describe how medical legal partnerships (MLPs) can promote Reproductive Justice and argue for wider adoption of care-team facing (...) legal supports. (shrink)

The power of new medical technologies, the cultural authority of physicians, and the gendered power dynamics of many patient-physician relationships can all inhibit women's reproductive freedom. Often these factors interfere with women's ability to trust themselves to choose and act in ways that are consistent with their own goals and values. In this book Carolyn McLeod introduces to the reproductive ethics literature the idea that in reproductive health care women's self-trust can be undermined in ways that (...) threaten their autonomy. Understanding the importance of self-trust for autonomy, McLeod argues, is crucial to understanding the limits on women's reproductive freedom. -/- McLeod brings feminist insights in philosophical moral psychology to reproductive ethics, and to health-care ethics more broadly. She identifies the social environments in which self-trust is formed and encouraged. She also shows how women's experiences of reproductive health care can enrich our understanding of self-trust and autonomy as philosophical concepts. The book's theoretical components are grounded in women's concrete experiences. The cases discussed, which involve miscarriage, infertility treatment, and prenatal diagnosis, show that what many women feel toward themselves in reproductive contexts is analogous to what we feel toward others when we trust or distrust them. -/- McLeod also discusses what health-care providers can do to minimize the barriers to women's self-trust in reproductive health care, and why they have a duty to do so as part of their larger duty to respect patient autonomy. (shrink)

The reproductive justice movement started by black women’s rights activists made its way into the academic literature as an intersectional approach to women’s reproductive autonomy. While there are many scholars who now employ the term ‘reproductive justice’ in their research, few have taken up the task of explaining what ‘justice’ entails in reproductive justice. In this paper I take up part of this work and attempt to clarify the relevant kind of freedom an adequate theory (...) of reproductive justice would postulate. To do so, I compare two approaches to reproductive freedom: an approach based on freedom as non‐interference and an approach based on freedom as non‐domination. I then argue that the non‐domination approach better fits the ideals of the reproductive justice movement as set forth by its founders and should be treated as one of the necessary conditions in any non‐ideal account of reproductive justice. Towards the end, I single out epistemic non‐domination as crucial in shaping the narrative around reproductive justice. (shrink)

_Purpose_ of the article is to find out the main content and ways of embodying freedom as a value of the volunteer movement in the context of analyzing the social motivation of human behavior in general. _Theoretical basis._ The theoretical basis of the research is the philosophical and anthropological understanding of freedom as a person’s creative overcoming of obstacles to establish his or her eccentric essence. Such a vision is embedded, in particular, in Karl Jaspers’ philosophy of existence, (...) Helmuth Plessner’s philosophy of positioning in the world, and Paul Ricœur’s philosophy of rational choice of life path. _Originality__._ The importance of freedom as a value, as well as other social values, is revealed and specified through the analysis of the values of the volunteer movement. In the desire of people engaged in volunteer work to achieve freedom through other values, the content of freedom as a basis for self-reproduction of the individual, community and society is revealed. _Conclusions._ Representatives of various humanities and social sciences have distinct research interests in analyzing the values inherent in volunteers. As members of a certain society and certain communities in this society, volunteers do not act outside the economy, politics and other spheres of public life, but reveal their freedom through creative and non-standard solutions to economic, political, and other problems. At the same time, research psychologists focus attention on the personal self-realization of a person, theorists and practitioners of social work study volunteers’ desire to gain recognition from peers and other small social groups, and representatives of sociology, political science and other social sciences focus their attention on such socially significant values of volunteering as patriotism, solidarity, etc. The task of social philosophy is to justify the desire to contribute to the public good, which is common to all volunteers. Representatives of philosophical anthropology look for the best social intentions inherent in a person as a member of society in volunteering. Analysis of the values of volunteering as a motivator of human behavior provides knowledge of socially significant values inherent in every member of society to a greater or lesser extent. (shrink)

Reproduction is broadly recognised as fundamental to human flourishing. The presumptive priority of reproductive freedom forms the predominant position in the literature, translating in the non-sexual reproductive realm as an almost inviolable right to access assisted reproductive technology (ART). This position largely condemns refusal or restriction of ART by clinicians or the state as discriminatory. In this paper, I critically analyse the moral rights individuals assert in reproductive pursuit to explore whether reproductive rights entitle (...) hopeful parents to ART. I demonstrate that none of the protected actions performed, or entitlements generated are sui generis ‘reproductive’ rights, leading to the claim that there is no such thing as a right to reproduce. Under scrutiny, the reproductive right is a far narrower and weaker rights assertion than is recognised in the literature. I argue that the predominant position is grounded in a fundamental misunderstanding of the scope and strength of reproductive claims.I also highlight a significant conceptual inconsistency in the literature. On one hand, there is broad consensus that reproductive rights are predominantly negative, yet access to fertility treatment is framed as a component of the right. This wrongly contorts the negative nature of reproductive rights into a positive claim-right to ART. I conclude that this mistakenly frames ART access as sitting within the scope of reproductive freedom. I offer a revised conceptual paradigm of reproductive rights that has important clinical and policy implications for the provision and regulation of ART. (shrink)

In this article, I consider recent debates on the notion of procreative liberty, to argue that reproductive freedom can be understood as a form of positive freedom—that is, the freedom to make oneself according to various ethical and aesthetic principles or values. To make this argument, I draw on Michel Foucault’s later work on ethics. Both adopting and adapting Foucault’s notion of ethics as a practice of the self and of liberty, I argue that reproductive (...) autonomy requires enactment to gain meaning within the life contexts of prospective parents. Thus, I propose a shift away from the standard negative model of freedom that sees it solely as a matter of noninterference or nonimpedance, a view advocated by major commentators such as John Harris and John Robertson. Instead, reproduction should be understood as a deeply personal project of self-making that integrates both negative and positive freedom. (shrink)

Reproductive genetic carrier screening is increasingly being offered more widely, including to people with no family history or otherwise elevated chance of having a baby with a genetic condition. There are valid reasons to reject a prevention-focused public health ethics approach to such screening programs. Rejecting the prevention paradigm in this context has led to an emphasis on more individually-focused values of freedom of choice and fostering reproductive autonomy in RCS. We argue, however, that population-wide RCS has (...) sufficient features in common with other public health screening programs that it becomes important also to attend to its public health implications. Not doing so constitutes a failure to address the social conditions that significantly affect people’s capacity to exercise their reproductive autonomy. We discuss how a public health ethics approach to RCS is broader in focus than prevention. We also show that additional values inherent to ethical public health—such as equity and solidarity—are essential to underpin and inform the aims and implementation of reproductive carrier screening programs. (shrink)

My aim is to extend and complement the arguments that others have already made for the claim that women who are citizens of economically disadvantaged states and who have been trafficked into sex work in economically advantaged states should be considered candidates for asylum. Familiar arguments cite the sexual violence and forced labor that trafficked women are subjected to along with their well-founded fear of persecution if they’re repatriated. What hasn’t been considered is that reproductive rights are also at (...) stake. I explain how reproductive rights are implicated in sex trafficking. Moreover, I contend that sex traffickers’ abuse of women’s reproductive rights is persecutory and that that this persecutory abuse obliges destination states to offer asylum to transnational sex trafficking victims. I start by sketching reproductive human rights doctrine. I then examine studies of women who are in post-trafficking recovery programs in order to ascertain the impact of their past experience of forced sex work on their reproductive freedom and health. On the basis of these findings, I maintain that, among other outrages, sex trafficking systematically violates victims’ reproductive human rights. In view of this abuse, women trafficked into sex work might seem to be prime candidates for asylum in destination states. Yet, economically well-off destination states are not particularly receptive to this idea, and international law provides some justification for their chilliness. Preliminary to challenging them, I explicate four ways in which international anti-trafficking law and international refugee law interfere with viewing women trafficked into sex work as refugees and approving their applications for asylum. The second half of my paper aims to overcome those legal obstacles. In the interest of parsimony and because there are many continuities between U.S. refugee law and anti-trafficking law and the policies of similar destination states, I focus mainly on the U.S. in this part of the paper. To anchor my argument, I spotlight two precedents in refugee law for taking reproductive human rights seriously and several precedents for treating trafficked women as members of a distinct social group as required by refugee law. I then urge that a law enforcement gestalt has gained undue influence over U.S. legal practices where anti-trafficking law intersects with refugee protection law. A human rights gestalt is needed as a counterweight, for otherwise victims of sex trafficking and the reproductive abuse they’ve suffered are erased. Taking up a human rights perspective and mobilizing the precedents I’ve identified, I show that respecting the reproductive human rights of women who have been trafficked into sex work entails that affluent destination states must recognize their right to asylum. (shrink)