Reproductive Rights

Conservative and liberal approaches to the problem of abortion are oversimplified and deeply flawed. Accepting that the moral status of the conceptus changes during gestation, the author advances a more nuanced perspective. Through applying a form of rules in practice utilitarianism within the context of overall population policy, he provides a compelling ethical and legal framework for regulating contraception and abortion practices.

Anne Donchin attended graduate school while raising four children, received her doctorate from the University of Texas in 1970, taught for 18 years in Texas and New York, then joined the philosophy department at Indiana University–Purdue University Indianapolis in 1982. Here she developed a Women’s Studies program, specialized and in numerous ways pioneered in feminist bioethics, and won two prestigious grants. She co-edited two books, published some forty articles, and co-founded and co-ordinated The International Network on Feminist Approaches to Bioethics. (...) Before and after retiring she served on the editorial boards of an encyclopedia, several international bioethics collections and nine prestigious journals. Her publications have influenced many scholars here and abroad. At the time of her death she was at work on a book: Procreation, Power and Personal Autonomy: Feminist Reflections, which is now available on IUPUIScholarWorks. Laura Purdy has generously edited, organized, and, where possible, updated the manuscript. (shrink)

This article examines how current bioethics legislation in France forbids trans men from accessing assisted reproductive technology (ART) and how aesthetic imagery of trans experience may resist such legal prohibition. That is, the aesthetics of transgender pregnancy and its possible focus on the body as a site of resistance has the potential to subvert the grounds on which current French reproductive policy is founded. As it stands, French political groups like GIAPS have been unsuccessful in arguing the unconstitutionality of laws (...) that forbid trans men from accessing ART, because the constitutional law of equality between the sexes need not be upheld if differential treatment is in the best interest of the state. Claims for differential treatment are due to preconceived biases of trans individuals, biases that may be challenged with an increase in exposure to trans experience/trans aesthetics. (shrink)

Say The Pro-Life View is the position that abortion involves unjustifiedly killing a fetus. And say The Anti-Factory Farming View is the position that factory farms are deeply immoral. One recent objection to The Pro-Life View is that it entails violence against abortion doctors is justified—a view that many find implausible. For the sake of argument, I don’t initially contest this claim—I grant (initially) The Pro-Life View is committed to this position. However, I argue The Anti-Factory Farming View is committed (...) to a similar view, namely, that violence against factory farm workers is justified. Therefore, if this is a good objection to The Pro-Life View, it’s a good objection to The Anti-Factory Farm View. And if it’s not a good objection to the latter, it’s not a good objection to the former. Furthermore, I show why it isn’t crazy to think that violence against abortion doctors is only contingently wrong, and I provide an error theory for why people may think otherwise. (shrink)

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

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

Is moral or other regret for abortion an indicator that abortion may not be morally or prudentially choice worthy? This paper examines the work of Kate Greasley in this area, who offers an explanation of any asymmetry in openness to regret between women who have abortions and women who give birth. The latter, not unlike Derek Parfit’s 14-year-old who conceives deliberately, may feel duty-bound not to regret their decision (in their case, to continue their pregnancy) and to affirm the life (...) of their child. In response to Greasley, testimonial evidence of one group cannot be dismissed simply because regret may be less available to another group of decision-makers. Moreover, if moral regret for childbearing is uncommon, this is not because mothers have a moral duty, as Greasley argues, not to regret even a morally mistaken choice to conceive. On the contrary, one must separate the evaluation of choices and of the results of these choices, whether positive or negative. Regret, while not infallible, can elucidate values at stake in choices, and testimonial evidence in the form of regret should be taken more seriously in regard to certain kinds of choice. (shrink)

This study explores parents’ perspectives on expanded genomic testing in pregnancy and its implications for reproductive autonomy. We conducted four workshops using dialogue group methodology and involving thirty-three Australian parents with recent experience of pregnancy. Participants used a fictional scenario involving prenatal testing to reflect on their own experiences and views. Four interconnected themes were identified: barriers to autonomous testing and choice, the need for guidance and support through the decision-making process, the impact of stress and social expectations on reproductive (...) autonomy, and the importance of information to reproductive autonomy. Participants valued genomic information to help in decision-making and to give reassurance but struggled to comprehend the nature of the information that expanded testing could provide. They relied on trusted healthcare professionals to interpret the meaning of test results but recognized the reality of constraints on healthcare resources. Our findings show that reproductive autonomy in this context is both individual and relational and requires health systems that support values-based decision-making. In an era of expanding prenatal genomic testing, our study highlights the need for a framework for reproductive autonomy that goes beyond information provision, to provide the conditions necessary for genuinely autonomous decision-making. (shrink)

James Robinson defends the claim that abortion and infanticide are morally distinct. This claim is defensible, he argues, because we have good reasons to condemn infanticide that do not apply to abortion. Specifically, Robinson claims that infanticide involves violation of infants’ bodily rights. Abortion does not involve the violation of fetuses’ bodily rights, however, because fetuses do not have bodily rights. Here, I offer a response. Robinson provides two reasons for thinking that fetuses lack bodily rights: (1) they do not (...) possess bodies of their own and (2) we have clear duties to infants—which seemingly implies that infants have rights—whereas the same duties do not apply to fetuses. Robinson’s first claim, that fetuses do not possess bodies of their own, rests upon a mistaken view of the metaphysics of pregnancy (i.e., the “parthood view”). Further, Robinson assumes that to have bodily rights, one must be functionally independent from others’ bodies. I argue that this is false. Second, I argue that the same duties listed by Robinson— which he claims apply to infants—apply to fetuses too. By Robinson’s own lights, therefore, we should conclude that fetuses (like infants) have bodily rights. Alternatively, we would have to explain the wrongness of harming fetuses along some other lines (i.e., in a way that does not posit fetal rights). This would be unjustifiably ad hoc. Hence, Robinson fails to provide compelling reasons to support the claim that abortion and infanticide are morally distinct. (shrink)

Surrogacy and uterus transplantation (UTx) are current forms of assisted gestation. Support for UTx is often grounded on the basis that it would ethically and legally mitigate the moral issues associated with surrogacy. In this article, I problematize this narrative by highlighting the perspective of third parties to assisted gestation through the topics of incentivization and compensation. I demonstrate that the ethical, legal, and social idiosyncrasies associated with each technique make it the case that UTx does not easily resolve the (...) shortcomings of surrogacy – and vice versa. (shrink)

Holt argues against my account of the moral disanalogy between the situation of a pregnant person having an abortion and a parent committing the infanticide of their newborn. I explain that this critique fails because Holt constructs a straw man of my account by misrepresenting its scope, misrepresents one of my arguments and presents false equivalences between both, withdrawing consent for sex and withdrawing from parenthood, and the relationship between a homeowner and their property and the relationship between a parent (...) and their child, which demonstrates misunderstandings of the notions of parenthood, obligation and consent. (shrink)

According to a recent survey, a significant majority of professional philosophers support the permissibility of induced abortion in the first trimester of pregnancy. This thesis aims to defend the minority ‘pro-life’ view that abortion is immoral throughout pregnancy. To achieve this goal, the metaphysical and moral account of human beings known as the substance view of persons will be critically examined. This account maintains that all human beings deserve equal consideration in their treatment. That is, they have equal moral value; (...) they are moral persons. Accordingly, prenatal human beings, like adults, enjoy the same ‘right to life’, and therefore, the substance view implies that abortion is prima facie impermissible. In the course of my investigation of the substance view, I argue that it can be defended against many of the objections of critics. Yet, I nonetheless find that the substance view has important shortcomings. Therefore, I recommend an alternative account I have developed as a replacement, the rational animal account. During this investigation, I also develop some critiques of important pro-choice arguments and evaluate other pro-life arguments that try to avoid the issue of moral personhood. (shrink)

This chapter examines the choice and consent experiences of people who are too often reduced to ‘just a body’ or a ‘single story’. Drawing on two studies carried out for and by the charity Birthrights, into the maternity experiences of disabled women and those facing multiple disadvantage during pregnancy, it identifies three key themes which illustrate some of the ways in which both birthing people and the possibility of consent itself may be invisibilised within care. The first theme, ‘invisible choice’ (...) demonstrates the way in which the ability to consent itself can be invisibilised, either through opportunities to consent not being offered or being subsumed by a focus on apparent clinical risk. The second, ‘failing to be recognised as a person’, describes the way in which women in the studies were conceptualised as walking, talking risky objects, rather than people in their own right, with knowledge and experience which are a vital component of safe and holistic consent discussions. The third, ‘bodily integrity and boundaries’, examines consent failures in the most intimate of spheres: clinical vaginal penetration. In concluding, the chapter reflects on the relationships between consent and choice, and the tensions and complexities in asserting and supporting choice in care. (shrink)

In Dobbs v. Jackson, the Supreme Court found that ‘the Constitution does not confer a right to abortion.’ Rather, individual states must determine whether a right to abortion exists. Following Dobbs, state abortion laws have diverged significantly. This has generated confusion over what the law permits. Consequently, some pregnant women reportedly have not received timely treatment for life-threatening conditions. Clear guidance on abortion policy is essential, therefore, since continued confusion risks lives. Sweeping calls to improve patient access to abortion will (...) not provide clear guidance, however, since ‘abortion’ is defined differently across jurisdictions. In fact, there are six variables to consider when defining ‘abortion’: (1) the definition of ‘pregnancy,’ (2) whether prescribing abortifacients counts as an abortion, (3) whether abortion successfully terminates pregnancy, (4) whether abortion has some characteristic intention, (5) whether providers must know that they likely will harm fetuses, and (6) whether providers must know that their patients are pregnant. States address each variable differently, so ‘abortion’ means different things across jurisdictions. One may respond that legislators are solely to blame for confusion here, since medical experts, by contrast, possesses a clear definition of ‘abortion.’ Not so. ‘Abortion’ is defined inconsistently throughout medical literature too. As such, both legal and medical domains would benefit from careful discussions of ‘abortion.’ Attending to the six variables identified here is a good starting place. In this essay, I suggest how best to think about each and I propose a definition of ‘abortion’ well-suited for developing clear abortion policy in a polarized society. (shrink)

Con base en una metodología embriológica y neuro-jurídica, el propósito del presente artículo es identificar los fundamentos biológicos, en virtud de los cuales una mujer gestante, a propósito del aborto, puede invocar y ejercer su derecho reproductivo fundamental a la interrupción voluntaria del embarazo. El problema central es que en la reciente jurisprudencia de la Corte Constitucional colombiana, el nonato, si bien es considerado un ser humano durante el período gestacional, no posee estatus de persona jurídica hasta su nacimiento y (...) por ello no ostenta un amparo legal integral. Es decir, no posee derechos fundamentales, sino valores constitucionales. Son resultados del presente los siguientes: embriológicamente, la despenalización del aborto en Colombia debió configurarse hasta la semana vigesimoprimera y no la vigésimo cuarta de gestación del feto; y neurojurídicamente, la mujer gestante posee cinco neuroderechos fundamentales que potencian sus derechos sexuales y reproductivos: la consciencia, la conciencia, la identidad, la autonomía y la privacidad psicosomáticas. (shrink)

Most states in the United States have conscience laws protecting conscientious refusal to perform some medical service. Yet many state conscience laws protect providers from being even indirectly involved with some procedure they find objectionable, which can include not only referrals but also simply informing patients of medically indicated but morally contentious options. I argue that such policies are unjust, offering too much protection for integrity in the face of competing values and patient interests. In other words, these policies grant (...) too much weight to integrity. One promising response to this concern is that in addition to integrity, the state should protect professionals so that they avoid complicity that could undermine their moral right to hold others accountable. I argue that this response fails, since it is implausible that these professionals actually lose that right in such contexts. I conclude that these policies should be restricted to better protect patient interests. (shrink)

Pallikkathayil argues that restrictions on abortion are inconsistent with the usual demands that states place on their citizens. States don't require their citizens to make their bodies available for the protection of other people's interests. Yet, when abortion is restricted, women who can be pregnant are less entitled than other citizens to decide on how their bodies are to be used; then, states fail to treat women as equal before the law. The argument is supposed to hold even if one (...) assumes that fetuses at various stages of development are as morally considerable as (already born) children, and even if, moreover, fetuses have passive citizenship status – that is, if they have claims to state protection. Pallikkathayil's argument comes at excessive theoretical costs, ruling out (a) general duties to help others in the protection of vital interests via relatively non‐burdening donation, e.g. of blood, and (b) plausible although demanding special duties of procreative parents. Nevertheless, I agree with Pallikkathayil's conclusion that existing legal restrictions on abortion violate the state's duty to treat its citizens as equals, and are hence illegitimate; namely, because they fail to hold all procreators ‐ whether or not gestational ‐ equally liable. (shrink)

Consent is the golden principle that determines the legality of most medical treatment. However, whilst choice is the much-vaunted central tenet of maternity care, its importance emphasised in policy documents, the lived experience is often rather different, particularly in the case of individuals constructed as ‘other’. This collection brings together a range of researchers from multiple disciplines to address the issue of choice in the context of reproduction, focussing upon narratives of consent as they pertain to reproductive subjects who all (...) too often are rendered invisible by the law, by the healthcare professionals treating them, or by society. It explores the contours of consent in England and Wales, engaging with reproductive justice by focussing upon the way in which reproductive subjects are othered, treated differently due to their skin colour, their genetic makeup, the fact that they have a serious mental illness or even those who do not want to be mothers. It presents original research, bringing together multiple perspectives in examining the way in which individuals are rendered invisible in the context of reproductive healthcare. The book will be essential reading for academics and professionals in law, nursing, medicine, midwifery, sociology, ethics and anthropology. (shrink)

Is there a moral line to be drawn at the human germline? For a long time, the dominant view on gene technology was that there is a moral line drawn at the human germline such that somatic gene editing as part of therapy is morally permissible, but heritable gene editing of early embryos or germline cells is not. The germline has been interchangeably referred to as a “boundary,” a “barrier,” and a “red line.” This previously dominant position has slowly weakened (...) over the past decade. Has the germline as a moral boundary lost its relevance? The aim of the book The Risks and Ethics of Human Gene Editing is to provide a philosophical guide to these arguments, both old and new. This first chapter introduces the book and its main research questions: Is there, after all, something particularly morally problematic about editing the human germline? Is there something unique about such germline editing, and, if so, does this suggest that we ought not to edit the human germline, or only in particular circumstances or for particular purposes? What would be a wise and responsible approach to editing the human germline from a moral perspective? (shrink)

The chapter explores the matter of a sufficiently cautious boundary and where that could be drawn based on the three distinctions from the second chapter and the various ethical considerations discussed throughout the book. It is argued that a sufficiently precautionary approach would need to take all three dimensions of risk into account: risk of harm, epistemic risk, and risk of making irreparable moral mistakes. Until these risks have been sufficiently addressed, human germline editing should be treated with great caution. (...) In conclusion, the germline could thus, for now, be regarded as a kind of locum tenens moral principle. (shrink)

The chapter takes a closer look at arguments for and against germline gene editing for human enhancement, including radical human enhancement. On the one hand, there are hopes of taking control of evolution, dreams of perfecting humankind and reaching a posthuman Utopia, and visions of saving humanity from natural disasters, while on the other hand, there are fears about jeopardizing the existence of humanity itself. Even though these arguments are indeed speculative, it is stressed in the chapter that they raise (...) some difficult questions about the kind of future we value, who we might want to be in that future, and who would and would not truly benefit from such interventions. (shrink)

This Open Access book is about the risks and the ethics of human germline gene editing, i.e., the possibility to make heritable changes to the DNA of early human embryos or germ cells. Is there something particularly morally problematic about editing the human germline? Is there something unique about germline editing, and, if so, does this suggest that we ought not to edit the human germline, or only in particular circumstances or for particular purposes? What would be a wise and (...) responsible approach to editing the human germline from a moral perspective? The book has three broad aims. First, to present an inclusive map over the current scholarly debate on the ethics of human germline gene editing. Second, to provide a philosophical and critical guide to the various ideas and arguments in this debate. Third, to apply an ethics of risk perspective and defend a morally cautious position on human germline gene editing. (shrink)

This chapter takes a closer look at so-called categorical objections to human germline gene editing. Categorical objections played an important part in some of the earlier debate and has informed some of the legal and regulatory frameworks on germline gene editing. The chapter explores different categorical objections as well as various objections to these. Are there convincing reasons to presume that germline gene editing interventions violates fundamental moral norms? The chapter explores different versions of such arguments based on deontological concepts (...) such as human dignity, individual and collective rights, autonomy, and informal consent. Could germline gene editing, if adopted on broad scale, lead to disastrous outcomes such as eugenics, injustice, and loss of values? Is there a risk for an unavoidable slippery slope? Or is there something inherently wrong in the use of this technology (such as “humans playing God”)? The chapter concludes that these kinds of objections fail to make a convincing case that it is categorically wrong to edit the human germline. They nevertheless highlight ethical concerns that need to be taken seriously. (shrink)

The chapter identifies and explores three distinct moral outlooks found in the gene editing debate with different implications on what the relevant moral questions and answers are with regard to germline gene editing. The Technical View equates ethical questions with questions about the direct risks of the intervention itself, that is if it is sufficiently safe and precise. The Democratic View stress that ethical questions are not only technical questions, but also pertain to values and must find solutions that all (...) affected parties can agree upon. Finally, the Moral View treats the ethical questions from a moral philosophy perspective. It takes safety and democratic legitimacy seriously but asks further questions: Does the technology promote what is genuinely good, or is there an aspect of it that violates fundamental moral norms or principles? (shrink)

This chapter explores various consequence-based arguments on the ethics of germline gene editing. First, the chapter distinguishes between descriptive and normative consequence arguments. Second, it takes a deep dive into arguments related to risks and safety, on the one hand, and into arguments related to prospective benefits, on the other. Both arguments for and against germline gene editing appeal to different kinds of consequence-arguments. The chapter highlight various questions raised by a focus on the potential consequences. This includes the question (...) of who the beneficiary of germline gene editing is, whether germline gene editing can be considered to be a therapeutic, and how germline gene editing compares to embryo selection. The chapter distinguishes between descriptive and normative consequence arguments and between weak and strong normative consequence arguments. A key take away is how different techno-optimists and techno-pessimists assess the expected outcomes of germline gene editing. (shrink)

The chapter provides an overview over various ethical positions in relation to the ethical challenges associated to human genome editing: a categorical position against, a cautious intermediate position, and a more liberal position in favour of germline editing. While the first position advocates a ban on moral grounds, and the second argues for some kind of moratorium until scientific and other questions have been resolved, the third emphasizes the medical potential and the importance of taking advantage of scientific progress as (...) soon as it is sufficiently safe to do so. The chapter also presents the current broad lines of ethical consensus in the scientific community. (shrink)

The chapter gives a short background to the ethical debates surrounding the gene editing tool CRISPR. It discusses the early worries and alarm bells when the first studies came out that demonstrated that heritable germline editing on humans was realistically possible as well as the subsequent calls for ethics. Three key distinctions that has done a lot of moral boundary work in this debate are presented: between somatic and germline interventions; between research and clinical application; and between therapy and enhancement.

In this chapter, three types of basic philosophical approaches to moral analyses are outlined to provide context and analytical tools for the subsequent analysis of and discussion about the arguments for or against human germline editing. According to the first approach, moral rightness is determined by the value of the consequences (value maximization). In the second approach, it is not only the consequences that determine the moral rightness of an action, but moral boundaries, principles, and norms that regulate what is (...) permissible or not (moral permissibility). The third approach is about the pursuit of ideals, which deals with arguments about the desirability of various futures and to what extent our actions prevent or enable such futures. The chapter argues that even though these approaches are typically associated with specific moral theories they can be understood as distinct modes of reasoning in their own right. The chapter argues that when it comes to addressing the ethics of new and potentially disruptive technologies it becomes more important to include also the kinds of moral considerations raised by third kind of approach. (shrink)

Is there something particularly morally problematic about human germline gene editing, to the extent that it would warrant another moral approach than weighing the pros against the cons, or asking whether it violates any moral principles or norms? In this chapter the ethical arguments discussed in the previous chapters is revisited via the perspective of risk. The relevant risks are divided into three different kinds—technical, social, and moral and metaphysical risks—and it is also discussed what the “most severe kind of (...) risks” would be. Are there things that we could not live with having permanently lost? If so, are any such losses that we could bring about through some practices of germline gene editing? What would that be and is it a realistic risk? (shrink)

Genomic-based testing in reproduction is expanding, with more tests offered to more people for more indications. These tests are offered in the name of reproductive autonomy. However, ‘reproductive autonomy’ is often interpreted to over-emphasize maximal choice and information, overlooking the role of relationships and structural influences. In this paper, we consider how reproductive autonomy can be conceptualized to be useful for challenges presented by expanded prenatal genomics. After critically examining the epistemological assumptions connecting (genomic) information and autonomy, as well as (...) the ideological pressures these tests potentially intensify, we present and defend a more fitting approach to reproductive autonomy. Our account is characterized by relationality, substantivism, the fulfillment of certain institutional conditions, and the provision of adequate options. By providing deeper philosophical context to the way we understand reproductive autonomy in expanded prenatal genomic testing, our approach nuances how the offer and uptake of prenatal genomic testing should progress. (shrink)

East Asian countries such as South Korea have recently made headlines for experimenting with different methods to incentivise people to have (more) children, in a bid to reverse declining birth rates. Many such incentives—child benefits, cash bonuses, dating events, and so on—appear morally innocuous at first glance. I will demonstrate in this analysis, however, that they amount to stopgap measures which reveal fundamental shortcomings with the way various nation states are approaching the so-called ‘problem’ of fertility decline.

INVOcell is an in vivo fertilisation device marketed as an alternative to in vitro fertilisation treatment. In this paper, we explore the ethical implications that arise when this device is framed as a type or process of ‘gestation’. We anticipate several effects that may be of ethical interest: marketing in vivo fertilisation as being comparable to traditional gestation may be misleading and even harmful to its users, but on the other hand, it captures a potential need to acknowledge and be (...) more inclusive of those who wish to identify diverse reproductive experiences as gestative experiences. In light of these insights, we articulate the concept of ‘simulated gestation’ as a novel framework to explain, and potentially accommodate, the diverse ways in which assisted reproductive technologies are shaping people's ideas about—and desires for—gestation. (shrink)

This book explores how considerations of justice apply to procreative decision-making. -/- Despite its immense personal significance, procreation is an inherently other-regarding endeavor. By its very nature, the decision to procreate is the decision to bring into existence another morally considerable being, one who will be exposed to the full range of harms, benefits, and risks that accompany a typical human life, and one who cannot by its nature ever consent to being born. Moreover, when this decision is undertaken in (...) a community of persons, it is also a decision to affect the lives of others in a host of profound if often underappreciated ways, from its effects on population size and environmental sustainability to its consequences for a community’s distribution of resources. In many ways, of course, these interests coincide: adults need children for their parenting projects, societies need citizens for the maintenance of their institutions, and children themselves are often happy to have been brought into existence. However, as the book demonstrates, the various interests that are implicated by procreative decision-making can also come into conflict as well, and in ways that raise basic questions of justice. Through a systematic examination of six of these questions, the author argues that taking adequate stock of the conflicting interests at stake in procreative decision-making leads to a narrower view of the conditions under which it is morally permissible to procreate and a much more demanding conception of our procreative responsibilities. -/- Procreative Justice will be of interest to researchers and advanced students working on the morality of procreation and related areas of philosophy, including bioethics, intergenerational ethics, environmental ethics, population ethics, and the ethics of the family. (shrink)

What should have happened in the tragic case of Adriana Smith, the two-months-pregnant woman who was declared brain dead but has been on life support since February at Emory Hospital in Atlanta, so that her baby might eventually be delivered by C-section? The hospital refused to let her die, concerned it would violate Georgia’s abortion ban, so her family wasn’t given a choice to let her die. -/- Ms. Smith should have been allowed to die because she, or her body, (...) was no longer a person. Understanding why she wasn’t a person helps us see why her beginning fetus was not a person either and why her being newly pregnant was not a good moral reason to not let her body die. This helps us even better understand why abortion bans like Georgia’s—which were a partial root of this tragedy, due to not specifying what’s legally allowed in cases like these—are unjust laws. (shrink)

White progressives in the United States are currently experiencing two profound reckonings that typically are assumed to be unrelated. On one hand, the Dobbs verdict overturned the assumption that the right to choose with respect to abortion is too socially entrenched, juridically settled, or politically sacred to be denied. On the other hand, climatological conditions for possibly having a comfortable existence are increasingly under threat in locales in which residents have come to expect to enjoy secure lives and livelihoods. This (...) article highlights what Indigenous communities across the United States already know well. Namely, threats to reproductive freedom and climate crisis are neither new nor separable. Both phenomena have common colonial roots that continue to proliferate, each a result of the disruption and destruction of Indigenous kinship assemblages. Indeed, in aiming to remediate their current reckonings, white progressives routinely (if unthinkingly) support forms of settler-state violence that perpetuate reproductive and climate injustice in Indigenous communities. The authors appeal to white progressives, notably including white feminists, to embrace the proposition that their reckonings cannot be properly understood nor successfully addressed without prioritizing Indigenous futurity. They call for centering forms of Indigenous feminist praxis that facilitate robust Indigenous coalitions of anti-colonial resistance. (shrink)

How should defenders of liberalism think about access to reproductive technologies? Mitochondrial replacement technique (MRT) enables women with pathogenic variations of mitochondrial disease to have children without the fear of transmission. This technology can also allow lesbians, or partners with female-assigned physiology (PFP), to have genetically related offspring. Cavaliere and Palacios-Gonzalez argue that lesbians should be able to access MRT on autonomy grounds. They argue MRT should not be restricted to those with mitochondrial disease because it is non-therapeutic and invokes (...) the Millian harm principle. Yet, Baylis argues that a desire for genetically related offspring is not sufficient to access MRT because it contributes to harmful social narratives about adopted families. I strengthen Cavaliere and Palacios-Gonzalez’s liberal defence by bringing another liberal commitment—equality. Ultimately, I argue that the liberal state must allow PFPs to use MRT. I first show that the use of MRT by PFPs is permissible even if MRT is therapeutic by comparing MRT with cosmetic surgery—that is, social uses of therapeutic interventions are permitted if we are interested in doing so. Borrowing from Dillard, a possible interest is self-replication. Next, I outline and respond to a possible criticism by Baylis—MRT is necessary but not sufficient for self-replication. Ultimately, I show that the liberal state must permit MRT because (a) it provides PFPs with an equal opportunity to experience having genetically related offspring with their partner and (b) contributing to harmful social narratives is insufficient for limiting autonomy. (shrink)

I am grateful that the editors of this volume invited me to write a chapter on beginning-of-life issues. In examining the enormous corpus of Pellegrino’s writing, they could not find articles that directly address the issues of fertility control, reproduction, and abortion. It is quite a peculiar anomaly in his prolific writing career, mainly because these issues were hotly debated in the early days of bioethics during which he was a prominent protagonist. As president of the Catholic University of America (...) (CUA) and as director of the Kennedy Institute of Ethics, Pellegrino was directly involved in the debate. He testified in the court case against theologian Charles Curran who was fired from CUA because of his open dissent with Catholic teaching on contraception and which was therefore deemed incompatible with the university’s identity. CUA won that court case against Curran. As a doctoral student under Dr. Pellegrino, I was fortunate to enjoy long conversations with him on some of these topics since my dissertation touches on the secularization of bioethics and the debate on fertility control in the 1960s and ’70s. He was familiar with the stances of Joseph Fuchs, Richard McCormick, Warren Reich, Bernard Häring, Bruno Schüller, and William E. May, all prominent moral theologians and bioethicists. From these exchanges and the clues that he left in his writings, we can garner some of the reasons he shied away from addressing these issues publicly... (shrink)

Mitochondrial replacement therapy has been developed in order to prevent the transmission of mitochondrial mutations, yet it raises ethical concerns, particularly regarding the involvement of third-party DNA and the risks associated with donor procedures. This paper explores an alternative approach using synthetic DNA (synDNA) to construct mitochondrial organelles, thereby bypassing the need for donor oocytes and bypassing risks to donors. We argue that those who support mitochondrial replacement techniques as an ethically acceptable means of preventing the transmission of mitochondrial disease (...) should consider the use of synthetic mitochondria as a preferable ethical alternative, should it prove technically viable. That this will be viable is more than we can demonstrate here. However, progress in synDNA technology suggests that it is not unreasonable to think that synthetic mitochondria creation is feasible, and perhaps even probable. (shrink)

This book rethinks procreative responsibility considering the continuous development of Assisted Reproductive Technologies. It presents a person-affecting moral argument, highlighting that the potential availability of future Assisted Reproductive Technologies brings out new procreative obligations. Traditionally, Assisted Reproductive Technologies are understood as practices aimed at extending the procreative freedom of prospective parents. However, some scholars argue that they also give rise to new moral constraints. This book builds on this viewpoint by presenting a person-affecting perspective on the impact of current and (...) future Assisted Reproductive Technologies on procreative responsibility, with a specific focus on reproductive Genome Editing and ectogenesis. The author shows that this perspective is defensible both from a consequences-based person-affecting perspective and from a person-affecting account that considers morally relevant intuitions and attitudes. (shrink)

This issue of Christian Bioethics explores theological, metaphysical, and ethical questions surrounding emerging reproductive technologies. Narratives concerning such technologies are often manipulated via “language games.” Language games involve toying with language to ensure that one’s vision of the good gains or retains political prominence. Such games are common in academic discussions of “artificial womb” technologies. Abortion proponents, for example, are already using language to dehumanize subjects within “artificial wombs.” This is unsurprising. Were relevant subjects considered persons, then abortion access (and (...) other forms of “reproductive autonomy”) might be curtailed. Here, I show that abortion proponents’ language games often depend on dubious metaphysical claims. Second, I argue that Christians should oppose dehumanizing language games, since those games undermine “neighbor-love,” which Christians are commanded to show others. I also highlight how discussions of other technologies—such as medication abortion—are affected by confused (or manipulative) language. Ultimately, the language games I critique aim to preserve and expand the “rights” of the powerful to dehumanize, control, and kill vulnerable human beings. Since neighbor-love commands Christians to provide for “the least of these,” however, Christians must expose these manipulative language games, refute them, and resist the corrupt ideologies from which they flow. (shrink)

Steven Landsburg argues that from a legal perspective, “most abortions should be unrestricted.” This conclusion, he claims, follows from combining insights from Judith Jarvis Thomson (1971) with a “careful Rawlsian analysis,” where “Rawlsianism is the industry-standard approach” for settling conflicts like those that arise in debates over abortion policy. If correct, then “the right approach to policy questions” implies that abortion access should remain relatively open. Here, I argue that Landsburg has drawn from Rawlsian tools the wrong conclusion about abortion. (...) I defend what he terms “naive Rawlsian”: the view that as a matter of justice, “many abortions... should be prohibited.” If correct, then “the industry-standard approach” for settling conflicts (as Landsburg calls it) should lead society to prohibit abortion in most cases. Proponents of abortion who wish to avoid this outcome, therefore, should abandon the “industry standard” approach to conflict resolution. (shrink)

This paper reconsiders Tommie Shelby's (2016) analysis of procreation in poor black communities. I identify three conceptual frames within which Shelby situates his analysis—feminization, choice-as-control, and moralization. I argue that these frames should be rejected on conceptual, empirical, and moral grounds. As I show, this framing engenders a flawed understanding of poor black women's procreative lives. I propose an alternative framework for reconceiving the relationship between poverty and procreative justice, one oriented around reproductive flourishing instead of reproductive responsibility. More generally, (...) the paper develops a methodological challenge for nonideal moral and political philosophy, especially concerning the obligations of the oppressed. Specifically, I argue that in the absence of descriptive and conceptual accountability, the moral gaze of the philosopher risks preserving, rather than destabilizing, oppressive ideologies. (shrink)

In this paper, I address the philosophical consistency of the term “three-parent babies,” which is often used to describe children born through mitochondrial replacement therapy. I will argue that two primary arguments, based respec-tively on identity and causality, fail to excludeegg donors as candidates as mor-al parents due to their essential contribution to the child’s existence (moral parenthood encompasses a set of rights and responsibilities that are not direct-ly regulated by a legal system). Finally, I shall show how the potential (...) extension of parental status to donors is conceivable, relying on the concept of “investment” in the procreative dynamic, and a conventional and institutional conception of parenthood. (shrink)

Surrogacy involves a private agreement whereby a woman who gestates a child attempts to surrender her (putative) moral right to become the parent of that child such that another person (or persons), of the woman’s choice, can acquire it. Since people lack the normative power to privately transfer custody, attempts to do so are illegitimate, and the law should reflect this fact.

In cases in which we must choose between either (i) preventing a woman from remaining unwillingly pregnant or (ii) preventing a fetus from being killed, we should prevent the fetus from being killed. But this suggests that in typical cases abortion is wrong: typical abortions involve preventing a woman from remaining unwillingly pregnant over preventing a fetus from being killed. And so abortion is typically wrong—and this holds whether or not fetuses are persons.

In this article, I confront Jessica Flanigan’s recent attempt to show not merely that women have a right to commit prenatal injury, but also that women who act on this right are praiseworthy and should not be criticized for this injury. I show that Flanigan’s arguments do not work, and I establish presumptive grounds against any such right—namely, prenatal injury, by definition, involves intentional or negligent harm and, as such, may be subsumed under a wider class of actions that are (...) presumptively wrong. (shrink)

A global trend of institutionalised pronatalism situates low fertility as a site of demographic disaster – positioning primarily women’s bodies as both its cause and solution. In light of such demographic dread, assisted reproductive technologies (ART) may be utilized by pronatalist states as a strategy for fertility recovery, rather than as a benefit for individual aspiring parents. In other words, ARTs are at risk of being co-opted by nation-states for problematic demographic designs which do not advance emancipatory goals. The underlying (...) issue of pronatalism, however, is not always explicitly acknowledged in feminist bioethics as a barrier to ethical ART usage. In my paper, I argue that it would be a mistake to assume ART can be used for emancipatory ends if we do not, at the same time, critically investigate its connections to institutionalised pronatalism. (shrink)