Over the past few years, mobile health applications (mHealth apps) have gained popularity regarding the management of chronic conditions, such as diabetes, as they are considered to enhance follow‐up and treatment. Indeed, these applications are powerful tools that support individualised pharmaceutical and non‐pharmaceutical care by remotely monitoring the patient's health status in real‐time. Nevertheless, concerns have been raised regarding trust and trustworthiness towards their use, in particular, when they are powered by Artificial Intelligence (AI). Trust in AI is a multifaceted (...) notion that encompasses aspects such as reliance, risk, as well as ethical principles (e.g., respect for human autonomy and prevention of harm). In this paper, we provide an analysis of trust and trustworthiness in AI‐powered mHealth apps for diabetes through the lens of philosophy and risk analysis to promote the patient's well‐being. (shrink)

In his lectures on the significance of utopia in the political life of the people from the 1950s, Tillich takes a rather ciritical stance towards any form of theological or political utopianism. In this he differs from his contemporaries, especially with regards to the use of the imagination. While he holds true that phantasy, or imagination, plays a crucial role for laying out possible futures, Tillich underlines the necessity of a critical framework to abolish any “mere phantasy” from within the (...) realms of truth. This stance is deeply rooted in Tillich’s former development, especially from the Frankfurt phase of his work, and it contains several inspirations for recent and contemporary debates on future knowledge within philosophical theology. (shrink)

Kant's contribution to modern Protestant theology is as unmistakable as it is controversial. The authors of this volume are investigating a new perspective on the work of theology and the effects of Kant's philosophy of religion concentrated on biblical hermeneutics and dogmatic theology.

Paul Tillich’s eschatology is strongly linked to his ethics. In order to understand the theological and philosophical implications of this linkage it is necessary to consult his systematic main works from the 1920’s era. The intellectual environment of the Weimar era was used to apocalyptical descriptions of its present age - which within protestant theology was reflected in eschatological terms. Tillich’s contribution to the eschatological discourse of that time consisted in the development of an eschatology which (while preserving the critical (...) attitude of dialectic theology) was designed to be a transcendental theory reflecting the conditions of the constitution of agency. (shrink)

Cet article a pour objectif de montrer l’importance de la réception de la théologie politique de J.B. Metz auprès de certains théologiens soucieux de la dimension politique de la foi chrétienne. L’étude présente les réactions immédiates au projet théologique de Metz pour ensuite se focaliser sur des théologiens contemporains. Premièrement, on trouve J. Milbank, qui apprécie la pensée de Metz en la confrontant à son programme de Radical Orthodoxy. Deuxièmement, on rencontre H.-J. Gagey et J.-L. Souletie, qui évaluent la force (...) politique de la théologie de Metz. Enfin, on découvre la façon dont L. Boeve reprend de façon personnelle certains aspects de la pensée du théologien allemand. Pour terminer, l’article propose une réflexion synthétique et critique sur cette réception, avec le souci de montrer la pertinence de la théologie politique de Metz et sa capacité à stimuler la réflexion sur le rapport foi et société. (shrink)

In den Publikationen der Synthetischen Biologie und in Darstellungen dieser neuen Biotechnologie finden sich häufig Begriffe des Herstellens, Konstruierens, Erschaffens und Kreierens. Im folgenden Beitrag wird dieses Begriffsfeld auf der Basis von technikphilosophischen und kunsttheoretischen Ansätzen systematisiert. Es wird erstens untersucht, inwiefern sich die verschiedenen Forschungsrichtungen in der Synthetischen Biologie mit diesem Begriffsinstrumentarium angemessen beschreiben lassen; zweitens wird analysiert, welche ethischen Fragestellungen mit den unterschiedlichen Begriffen des Herstellens und Erschaffens im Fall der Synthetischen Biologie verbunden sind.

The most popular uniting theme in feminist peace literature grounds women's peace work in mothering. I argue if maternal arguments do not address the variety of relationships different races and classes of mothers have to institutional violence and/or the military, then the resulting peace politics can only draw incomplete conclusions about the relationships between maternal work/thinking and peace. To illustrate this I compare two models of mothering: Sara Ruddick's decription of "maternal practice" and Patricia Hill Collins's account of racial-ethnic women's (...) "motherwork.". (shrink)

Midwifery philosophy views childbearing as primarily normal, indicative of a woman's overall health. Midwifery practice focuses on supporting the human‐to‐human relationship between the midwife and the woman holding primacy. Despite the traditional focus on wellness, maternity care in today's risk averse world is increasingly complex. Technology has been increasingly implemented into maternity care to detect complications early and reduce harm. The Maternity Early Warning Tool is a technological innovation in this regard. Actor‐network theory (ANT) offers a framework (...) for analysing the connections between human actors (women, fetuses, and midwives) and nonhuman actors (machines, tools, and policies) within healthcare. This paper through drawing on the tenets of ANT, particularly in understanding the adoption of Maternity Early Warning Tools in midwifery practice, examines and explores the implications of integrating these tools in relation to midwifery practice. ANT also guides thoughtful considerations regarding the potential trajectory of Artificial Intelligence in midwifery, specifically regarding how these technological advancements alter midwifery practice by creating new hybrid assemblages and fluid identities. This discussion of subversive elements enhances understanding of the implications of Maternity Early Warning Tools on contemporary midwifery practice. (shrink)

Research in epigenetics is demonstrating the importance of maternal care towards offspring early in life for long-term health and behavioral outcomes. Although most of this research has been conducted in rodents, these findings are increasingly framing broader debates about mothers’ moral responsibilities for the health of their offspring. In this paper, I investigate the implications of scientific narratives and research agendas of maternal care for current discourses surrounding maternal epigenetic responsibility. I show how despite clear differences between rodent and human (...) contexts of care, researchers tend to construct rodent maternal care as a form of love or emotional commitment. This construction, which ignores fathers’ care for their offspring, reflects widespread social assumptions about mothers’ particular or “natural” capacities to love their children. This has important implications for how we assign moral blame. Because love is important to our widespread understandings of parental virtues, mothers who act “unlovingly” are prone to being judged in an especially harsh manner. By embedding simplistic and gendered assumptions about mothers’ love for their children, then, epigenetics research perpetuates the tendency to consider mothers especially blameworthy where they are perceived as failing to sufficiently care for or love their children. (shrink)

Extensively employed in reproductive science, the term fetal–maternal interface describes how maternal and fetal tissues interact in the womb to produce the transient placenta, purporting a theory of pregnancy where ‘mother’, ‘fetus’, and ‘placenta’ are already-separate entities. However, considerable scientific evidence supports a different theory, which is also elaborated in feminist and new materialist literatures. Informed by interviews with placenta scientists as well as secondary sources on placental immunology and the developmental origins of health and disease, I explore evidence not (...) of interfacing during pregnancy, but of intra-action, or the mutual emergence of entities in simultaneous practices of differentiation and connection. I argue that attending to evidence that can be figured as intra-action enables us to recognize, account for, and attend to diffuse responsibilities for fetal–maternal outcomes that extend beyond mothers to the biosocial milieus of pregnancy. In reimaging the intra-action of placentas, a new understanding of what constitutes a ‘healthy pregnancy’ becomes possible. (shrink)

In this provocative new book, renowned educator and philosopher Nel Noddings extends her influential work on the ethics of care toward a compelling objective—global peace and justice. She asks: If we celebrate the success of women becoming more like men in professional life, should we not simultaneously hope that men become more like women—in caring for others, rejecting violence, and valuing the work of caring both publicly and personally? Drawing on current work on evolution, and bringing concrete examples from women’s (...) lived experience to make a strong case for her position, Noddings answers this question by locating one source of morality in maternal instinct. She traces the development of the maternal instinct to natural caring and ethical caring, offering a preliminary sketch of what a care-driven concept of justice might look like. Finally, to advance the cause of caring, peace, and women’s advancement, Noddings urges women to abandon institutional, patriarchal religion and to seek their own paths to spirituality. (shrink)

This pаpеr invеstigаtеs thе intеrgеnеrаtiоnаl еffеcts оf mаtеrnаl еducаtiоn оn child hеаlth in 68 dеvеlоping cоuntriеs аcrоss fivе cоntinеnts оvеr nеаrly thrее dеcаdеs. Еxplоiting thе bеtwееn-sistеrs vаriаtiоn in thе еducаtiоnаl аttаinmеnt оf thе mоthеrs, wе find thаt mоthеr’s еducаtiоn is pоsitivеly аssоciаtеd with child hеаlth mеаsurеd by thе thrее mоst cоmmоnly usеd indicеs, nаmеly hеight-fоr-аgе, wеight-fоr-hеight, аnd wеight-fоr-аgе. Оur mеchаnism аnаlysеs furthеr shоw thаt thеsе fаvоrаblе еffеcts cоuld bе, аt lеаst in pаrt, аttributеd tо fеrtility bеhаviоr, аssоrtаtivе mаtching, hеаlth cаrе (...) utilizаtiоn, аccеss tо infоrmаtiоn, hеаlth knоwlеdgе, аnd lаbоr mаrkеt оutcоmе. Givеn thе lоng-lаsting impаcts оf еаrly-lifе hеаlth оvеr thе lifе cyclе, оur findings undеrlinе thе impоrtаncе оf mаtеrnаl еducаtiоn in imprоving еcоnоmic аnd sоciаl cоnditiоns in dеvеlоping cоuntriеs. (shrink)

In ____Maternal Ethics and Other Slave Moralities__ which includes the first extended philosophical discussion of the works of Frederick Douglass, Cynthia Willett puts forward a novel theory of ethical subjectivity that is aimed to counter prevailing pathologies of sexist, racist Eurocentric culture. Weaving together accounts of the self drawn from African-American and European philosophies, psychoanalysis, slave narratives and sociology, Willett interrogates what Hegel locates as the core of the self: the desire for.

Background Addressing drug use among pregnant and postpartum women is complicated by the social, ethical, and legal interplay between maternal and child needs. The moral experiences of providers as they care for this population are poorly understood. The purpose of this review is to synthesize the qualitative literature on the moral experiences of prescribing maternity providers managing the care of pregnant and postpartum women who use drugs (PPWUD), specifically focused on drug testing and child welfare reporting decisions. Methods The (...) Hunt and Carnevale (2011) bioethics framework was used to define moral experience as “a person’s sense that values that he or she deem important are being realized or thwarted in everyday life.” A systematic search of PubMed, PsycINFO, and CINAHL resulted in 31 eligible articles. Study quality was assessed using the Critical Appraisal Checklist for Qualitative Research from the Joanna Briggs Institute (2015). Thematic narrative analysis was used to synthesize results and identify themes. Findings Overall, maternity providers’ experiences were characterized by ethical conflicts influenced by provider-level and policy-level factors. Even when endorsing patient autonomy and parental rights, no maternity providers endorsed continued maternal substance use that placed the fetus or child at significant risk. Structural constraints within healthcare systems and punitive laws were cited as significant barriers to providing optimal care to PPWUD. Biased drug testing protocols and some child welfare reporting policies created ethical conflict by placing maternity providers’ relationship with their patients in opposition to their legal and ethical responsibility to report child maltreatment. Implications More rigorous characterization of these moral experiences is needed to support the development of provider-level interventions and policy-level changes as maternity providers care for both mothers and children impacted by drug use. (shrink)

The study examined the links among maternal warmth and adolescents’ empathic concern, moral conviction and prosocial behaviors. Participants were 311 adolescents from a low-income community (M age = 16.10 years; range = 14–19 years; 58.7% girls; 82.7% white; 13.6% Latinx). The results demonstrated that maternal warmth was positively associated with adolescents’ empathic concern and moral conviction. Empathic concern was positively associated with three common forms of prosocial behaviors, and moral conviction was positively associated with four types of prosocial behaviors. Empathic (...) concern and moral conviction also interacted to predict selfishly and selflessly motivated prosocial behaviors. Discussion will focus on the role of maternal warmth in fostering sociomoral tendencies. (shrink)

This article takes as its starting point Sara Ruddick’s discussion of “vulnerability” in her 1989 groundbreaking book Maternal Thinking: Toward a Politics of Peace. It examines the kind of thinking about vulnerability that Ruddick describes as developed through maternal practice and uses it as a heuristic device for rethinking the conceptions of and responses to vulnerability that permeate national and international security discourses. It explores the specific forms of practice and reason that are implicated by these different stances toward vulnerability (...) and shows that the (often unexamined) assumptions underlying these stances are profoundly consequential for both policy and practice. Specifically, it takes both nuclear weapons and the so-called Global War on Terror as particular forms of response to perceived vulnerability and scrutinizes the practices associated with each in light of the forms of rationality arising from maternal practice. It also explores the assumptions underlying the concept of “vulnerable groups” commonly employed in international policy institutions, teasing out their implications for politics, policy, and action. Overall, it argues that Ruddick’s articulation of maternal thinking provides a valuable resource for reimagining transformed and transformative security practices. (shrink)

Feminist analyses have made important contributions to the sociocultural experiences of pregnancy, birth and breastfeeding. This article draws upon recent theorizing within science studies to focus on the mattering of these processes. Specifically, the article expands upon Mauss's notion of the ‘gift’, which Diprose develops through the idea of ‘corporeal generosity’. I am interested in corporeal generosity insofar as it circumvents descriptions of relationships in terms of a closed economy in which resources are exchanged without excess or remainder. Corporeal generosity (...) refers to the often missed but nevertheless inescapable debt that a body owes to other bodies. At the same time, this embodied ‘gifting’ is both unpredictable and intrusive – there is as much possibility of threatening the integrity of bodies as there is of opening new possibilities. (shrink)

The relationships between maternal parenting attitudes and preschoolers’ hot and cool executive functions (EF) were examined. Forty-eight children aged 3 to 4 years and their mothers took part in the study. Self-report questionnaire concerning parenting attitudes was obtained from the mothers of children who performed a set of EF tasks. Additionally, both maternal and child verbal ability were controlled. It was found that maternal parenting attitudes were related only to child cool EF. Protecting attitude was positively related to child inhibitory (...) control and autonomy support was negatively related to child set-shifting ability. Further analyses revealed that maternal autonomy support accounted for unique variance in child set-shifting, above and beyond the child’s age. On the other hand, protecting attitude accounted for unique variance in child inhibitory control, above and beyond child verbal ability. The findings provide further evidence for the importance of mother-child relationships in children’s EF development. (shrink)

In this paper, we explore young Polish Catholic mothers' moral reasoning on abortion. We draw on the concept of maternal knowledge and theoretical insights developed within the ethics of care to shed light on the complexities and contradictions experienced by Catholic mothers in the context of reproductive choices. The narratives we gathered through in-depth interviews illustrate how mothers evoke embodied, experience-based maternal knowledge to challenge hegemonic frameworks associated with legal, medical, and religious authoritative knowledges. We show how mothers engage critically (...) with ideologized notions of sacrifice and suffering by placing these concepts in the context of relational maternal care work and argue that mothers adopt a position on the moral permissibility of abortion by reinterpreting religious norms and ideas, such as the protection of the family and vocation of care. (shrink)

This paper attempts to theorise the labour and corporeal carcerability of the non-citizen non-subjects in contemporary democracies of the United States and India. I reappropriate Joy James’ framework of ‘Captive Maternals’ to understand the relationality between the undocumented, racialised, or incarcerated with the neo-liberal states that they inhabit and serve but where they do not belong. James describes Captive Maternals as those bodies subject to consumption by the democratic order in the tradition of slavery. I expand upon her framework to (...) argue that the dehumanisation of illegal ‘aliens’ and racially policed bodies not only challenges the notion of freedom in the modern democratic social organisation but rather manifests the fundamental correlation between democratic sovereignty and its exclusionary violence. This phenomenon internal to the workings of democracies challenges Hegel’s idealisation of the modern rational state as the most advanced form of government characterised primarily by freedom. Democracy also constitutes the exercise of necropolitical sovereignty which I interpret not as the right to kill but as the right to police and incarcerate. Against the Hegelian struggle for recognition (Anerkennung), I deliberate on the possibility of transcending to a less than fully-determined Sittlichkeit that does not rely upon reciprocal recognition. (shrink)

Inflicting harm is generally preferable to inflicting death. If you must choose between the two, you should generally choose to harm. But prenatal harm seems different. If a mother must choose between harming her fetus or aborting it, she may choose either, at least in many cases. So it seems that prenatal harm is particularly objectionable, sometimes on a par with death. This paper offers an explanation of why prenatal harm seems particularly objectionable by drawing an analogy to the all-or-nothing (...) problem. It then argues that this analogy offers independent support for the ‘voluntarist’ view that at least some parental role obligations are grounded in the choice to be a parent. (shrink)

Ample research links mothers’ postpartum depression (PPD) to adverse interactions with their infants. However, most studies relied on general population samples, whereas a substantial number of women are at elevated depression risk. The purpose of this study was to describe mothers’ interactions with their 6- and 12-month-old infants among women at elevated risk, although with a range of symptom severity. We also identified higher-order factors that best characterized the interactions and tested longitudinal consistency of these factors from 6 to 12 (...) months of infant age. We leveraged data from eight projects across the United States (n = 647), using standardized depression measures and an adaptation of the NICHD Mother-Infant Interaction Scales. Overall, these depression-vulnerable mothers showed high levels of sensitivity and positive regard and low levels of intrusiveness, detachment, and negative regard with their infants. Factor analyses of maternal behaviors identified two overarching factors—“positive engagement” and “negative intrusiveness” that were comparable at 6 and 12 months of infant age. Mothers’ ability to regulate depressed mood was a key behavior that defined “positive engagement” in factor loadings. An exceptionally strong loading of intrusiveness on the second factor suggested its central importance for women at elevated depression risk. Mothers with severe depressive symptoms had significantly more “negative intrusiveness” and less “positive engagement” with their 6-month-old infants than women with moderate or fewer depressive symptoms, suggesting a potential tipping point at which symptoms may interfere with the quality of care. Results provide the foundation for further research into predictors and moderators of women’s interactions with their infant among women at elevated risk for PPD. They also indicate a need for evidence-based interventions that can support more severely depressed women in providing optimal care. (shrink)

This essay addresses the relationship between home, belonging and the maternal in feminist theory and fiction. Feminist discourse isoften typified by its critique of home: analysing the gendered assumptions underlying the depiction of home as nurturing, or exposing the regressive and essentialist connotations of the search for safe homes. A number of recent feminist theorists (Probyn, Bammer, Young) have, however, pointed to thepersistence of ‘retrograde’ desires for safety and belonging, particularly in an era of widespread dislocations. At the same time, (...) feminist critics such as Roberta Rubenstein have re-invoked the contested relationship between home and the maternal by arguing that the desire for home speaks to our earliest needs for security: a desire that ultimately maps on to a longing for the (idealized) mother as the ‘original safe home’ (Rubenstein, 2001). This essay draws upon the work of Rubenstein, Bammer and Young in order to examine the relationship between home and the maternal in a recent Irish novel, Mary Morrissy’s Mother of Pearl. The plot of this novel, dealing with the events surrounding an incident of baby snatching, suggests both the persistence of (the maternal) home as a desire and the impossibility of identifying an original or authentic maternal/home. By exploring how the protagonists of this novel negotiate the demands and appeals of home and motherhood, this essay will ask to what extent it may be possible for feminism to recuperate, or re-envision, the maternal/home as utopian ideal. (shrink)

It is important to identify the developmental antecedents of externalizing behavioral problems in early childhood. The current study examined the main effects of maternal personality and its interactive effects with child temperamental reactivity in predicting child externalizing behavioral problems, indicated by impulsivity and aggression. This study was composed of 70 children (Mage= 17.6 months, SD = 3.73) and their mothers. The results showed that maternal agreeableness was negatively associated with child impulsivity. Child temperamental reactivity moderated the effect of maternal conscientiousness (...) on child impulsivity in support of the differential susceptibility model. Specifically, for highly reactive children, maternal conscientiousness was negatively associated with child impulsivity whereas this association was nonsignificant for low reactive children. Child reactivity also moderated the contribution of maternal neuroticism to child impulsivity. That is, maternal neuroticism was negatively associated with impulsivity, only for highly reactive children. (shrink)

This paper argues that the concept of paternalism is currently overextended to include a variety of actions that, while resembling paternalistic actions, are importantly different. I use the example of Japanese physicians’ non-disclosures of cancer diagnoses directly to patients, arguing that the concept of maternalism better captures these actions. To act paternalistically is to substitute one's own judgement for that of another person and decide in place of that person for his/her best interest. By contrast, to act maternalistically is to (...) decide for another person based on a reasonable understanding of that person's own preferences. The concept of maternalism allows for a more thorough assessment of the moral justification of these types of actions. I conclude that it is possible, at least in principle, to justify Japanese physicians’ non-disclosures, and that this justification must be based on an understanding of these actions as maternalistic. (shrink)

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

Introduction Although there have been reports of misbehavior and disrespectful maternal care by healthcare providers worldwide, there are few intervention studies aimed at promoting respectful care, particularly among midwives. Research objectives The aim of this study was to examine the effect of Moral Case Deliberation (MCD) on the of midwives’ knowledge and practice in the field of respectful maternity care. Research design and methods This semi-experimental study involved 46 midwives working in the maternity departments of two hospitals affiliated (...) with Bushehr University of Medical Sciences in 2023. The two hospitals were randomly divided into control and intervention groups. All midwives from both hospitals were included in the study. The Dilemma Method of MCD was implemented for midwives of intervention hospital. The Midwives’ Knowledge and Practice of Respectful Maternity Care scale was used for data collection. It was administered both before and two weeks after the intervention. Data were analyzed using SPSS (version 20). Ethical considerations The study was approved by ethics committee of Bushehr University of Medical Sciences in Bushehr, Iran (ethics code: IR.BPUMS.REC.1402.017). All participants provided written informed consent. Findings The intervention group showed a significantly greater increase in knowledge scores from pre-test to post-test compared to the control group ( p <.001). The intervention group had a significantly higher mean change score in practice self-assessment and practice peer evaluation, from pre-test to post-test, than in the control group ( p <.001). Discussion MCD based on the dilemma method can improve practice in the field of respect-oriented midwifery care by increasing knowledge and potentially changing attitudes. Conclusion The Dilemma Method of MCD improved midwives’ knowledge and practice regarding respectful maternity care. This method can be included in the midwifery care quality improvement program to promote respectful maternity care. It is necessary to develop methods for wider dissemination of MCD in the cultural context of Iran. (shrink)

A pronatalist perspective on maternal bodies renders the adoptive maternal body queer. In this essay, I argue that the queerness of the adoptive maternal body makes it a useful epistemic standpoint from which to critique dominant views of mothering. In particular, exploring motherhood through the lens of adoption reveals the discursive mediation and social regulation of all maternal bodies, as well as the normalizing assumptions of heteronormativity, “reprosexuality,” and family homogeneity that frame a traditional view of the biological family. As (...) participants in motherhood who resist “repro-narrativity,”“reprosexuality,” and essentialism, adoptive maternal bodies have the potential to both queer our notions of normal mothering and normalize our notions of queer mothering. (shrink)

This paper examines the construction of maternal responsibility in transgenerational epigenetics and its implications for pregnant women. Transgenerational epigenetics is suggesting a link between maternal behaviour and lifestyle during pregnancy and the subsequent well-being of their children. For example, poor prenatal diet and exposure to maternal distress during pregnancy are linked to epigenetic changes, which may cause health problems in the offspring. In this field, the uterus is seen as a micro-environment in which new generations can take shape. Because epigenetics (...) concerns how gene expression is influenced by the social realm, including a range of environmental conditions such as stress, diet, smoking, exercise, exposure to chemicals, pollution, and environmental hazards, the research findings in this area have direct policy relevance. For policy makers, rather than controlling this complex range of determinants of health, isolating and targeting maternal body and responsibilising mothers for the control of this micro-environment might seem feasible. Yet, examining the maternal body in isolation as a powerful environment to shape the health of next generations not only responsibilises women for the environment that they cannot control but also makes them a target for intrusive and potentially exploitative biomedical interventions. Even though ‘social factors’ are increasingly considered in epigenetics writing, the phrase is usually taken as self-explanatory without much elaboration. Drawing on the Covid-19 pandemic, this paper moves the current debate forward by providing consolidated examples of how individuals, including pregnant women, have little control over their environment and lifestyle. As evidenced by the pandemic’s disproportionate effects on people with low socioeconomic or poor health status, some pregnant women bore considerable physical and psychological stress which combined with other stress factors such as domestic violence. (shrink)

Maternity careproviders often have strong views concerning a woman’s choice of where to give birth. These views may be based on the ethical principle of autonomy, or on the principle of beneficence. The authors propose that an approach utilizing shared decision making allows careproviders and women to move beyond disagreements regarding which evidence on risk should “count,” instead adopting a process of increased knowledge and support for women and their partner while they make choices regarding place of birth.

It has recently been reported that some hospitals in the UK have placed a blanket restriction on the provision of maternal request caesarean sections (MRCS) as a result of the COVID-19 pandemic. Pregnancy and birthing services are obviously facing challenges during the current emergency, but we argue that a blanket ban on MRCS is both inappropriate and disproportionate. In this paper, we highlight the importance of MRCS for pregnant people’s health and autonomy in childbirth and argue that this remains crucial (...) during the current emergency. We consider some potential arguments—based on pregnant people’s health and resource allocation—that might be considered justification for the limitation of such services. We demonstrate, however, that these arguments are not as persuasive as they might appear because there is limited evidence to indicate either that provision of MRCS is always dangerous for pregnant people in the circumstances or would be a substantial burden on a hospital’s ability to respond to the pandemic. Furthermore, we argue that even if MRCS was not a service that hospitals are equipped to offer to all pregnant persons who seek it, the current circumstances cannot justify a blanket ban on an important service and due attention must be paid to individual circumstances. (shrink)

Investigating maternity tourism to the United States from Russia through the lens of technological mediation, this study foregrounds the geopolitical patterns of human reproduction that shape, and are shaped by, individual choices of maternal healthcare in a neoliberal healthcare market. Following the history of a highly popular Russian-language forum, I demonstrate how this online community gets imbricated into communicative biocapitalism – a neoliberal logic that commodifies the voice of an online user, turning networked publics into markets for medical services. (...) Adding to the literature on data colonialism, I explore a case in which data-driven algorithms effectively alter geographical distribution of reproductive bodies, outsourcing the production of new generations of neoliberal subjects through regimes of technological mediation. (shrink)

The Chicago Maternity Center provided obstetrical services for the medically underserved on Chicago's Near West Side for nearly eight decades (1895–1974). While its founder's vision, its outreach to underserved communities, the reasons for its decline, and the perceived abandonment of the community when it closed have been well documented, less attention has been paid to the role of trainees in providing obstetrical care. Medical students and residents routinely delivered babies in patients' homes, often without adequate supervision. This aspect of (...) the center's history can help illustrate the evolution of experiential education in clinical medicine, along with emerging concepts of equitable access and quality of care. This work explores the center's role in medical education in light of contemporary perceptions of some participants—trainees, faculty, and institutional leadership—and through analysis of scholarly and popular publications, institutional archives, and communications with alumni and retired faculty. The popularity of the experience with trainees and its constituents, segregation of the center's activities from those of the sponsoring medical center, and its well-respected history led to the persistence of a model for clinical medical education that was an anachronistic remnant of earlier approaches to education and to care for the poor and disenfranchised. (shrink)

Maternal fetal surgery (MFS) trials have the potential to substantially increase the survival and quality of life of fetuses with life-threatening conditions, but they also entail relevant and yet overlooked fair access challenges. In this topic piece, we will present the fair access concerns in MFS trials/practice and their ethical ramifications as well as some possible ways to address them. The most obvious challenge is cost. Although the cost of the surgery itself is generally covered, costs are high for participants, (...) including commute or housing near the hospital. This might hinder participations of parents from lower economic status. Strict eligibility criteria aimed at protecting participants further limit accessibility. These issues further affect the scientific validity of the trial. For example, the above-mentioned issues contribute to difficulties in recruitment which already lead to MFS trials delays and cancellations. They also contributed to homogeneous samples that are difficult to generalize. Hence, it is important that researcher first acknowledge the existence of fair access issues beyond those related to the cost of the surgery itself and that these issues affect participants’ right to fair access to the trial benefits as well as the scientific validity of the trial. Second, it is important that researchers actively try to foresee and reduce these issues. (shrink)