The wealthy elite males of nineteenth-century Krummhörn (Ostfriesland, Germany) achieved an above-average reproductive success. Membership in the elite class was determined from a list of the 300 richest men in the Ostfriesland district compiled by authorities in 1812. The main components establishing the link between cultural success and reproductive success aredifferences in the number of offspring owing to differences both in time spent in fecund marriage (mating success) and in rate of reproduction;differences in the probabilities of one’s adult (...) offspring marrying locally vs. emigrating unmarried owing to differential ability to allocate resources that enhance the “social placement” of adult offspring; anddifferences in the probability of total reproductive failure (lineage extinction).Contrary to what might be expected, infant survivorship was lowest amongst the richest families. We conclude that to a great extent females’ reproductive decisions contribute to the greater reproductive success of the elite males. (shrink)

Should there be a female age limit on public funding for assisted reproductive technology (ART)? The question bears significant economic and sociopolitical implications and has been contentious in many countries. We conceptualise the question as one of justice in resource allocation, using three much-debated substantive principles of justice—the capacity to benefit, personal responsibility, and need—to structure and then explore a complex of arguments. Capacity-to-benefit arguments are not decisive: There are no clear cost-effectiveness grounds to restrict funding to those (...) older women who still bear some capacity to benefit from ART. Personal responsibility arguments are challenged by structural determinants of delayed motherhood. Nor are need arguments decisive: They can speak either for or against a female age limit, depending on the conception of need used. We demonstrate how these principles can differ not only in content but also in the relative importance they are accorded by governments. Wide variation in ART public funding policy might be better understood in this light. We conclude with some inter-country comparison. New Zealand and Swedish policies are uncommonly transparent and thus demonstrate particularly well how the arguments we explore have been put into practice. (shrink)

Going through reproductive experiences (especially pregnancy and childbirth) in contemporary Western societies almost inevitably involves interaction with medical practitioners and various medical technologies in institutional context. This has important consequences for women as embodied subjects. A critical appraisal of these consequences—coming dominantly from feminist scholarship—relied on a problematic theory of both technology and the subject, which are in contemporary approaches no longer considered as given, coherent and well individualized wholes, but as complex constellations that are locally situated and that (...) can only be described empirically. In this study, we will be relying on the developments in phenomenological theory to reconceptualize women as technologically mediated embodied subjects and on the new paradigms in philosophy of technology and STS to reconstruct medical technology as situated—with the aim of reconceptualizing their relationship and exploring different possibilities for the mediating role of medical technology. It will be argued that technologization of female reproductive processes and alienating consequences for women are not necessary or directly interrelated. The role of technology varies from case to case and depends mainly on the nontechnological and relational aspects of institutional context, in which medical practitioners play a decisive role. (shrink)

Even though female food acquisition is an area of considerable interest in hunter-gatherer research, the ecological determinants of women’s economic decisions in these populations are still poorly understood. The literature on female foraging behavior indicates that there is considerable variation within and across foraging societies in the amount of time that women spend foraging and in the amount and types of food that they acquire. It is possible that this heterogeneity reflects variation in the trade-offs between time (...) spent in food acquisition and child care activities that women face in different groups of hunter-gatherers. In this paper we discuss the fitness trade-offs between food acquisition and child care that Hiwi and Ache women foragers might face. Multiple regression analyses show that in both populations the daily food acquisition of a woman’s spouse is negatively related to female foraging effort. In addition, nursing mothers spend less time foraging and acquire less food than do nonnursing women. As the number of dependents that a woman has increases, however, women also increase foraging time and the amount of food they acquire. Some interesting exceptions to these general trends are as follows: (a) differences in foraging effort between nursing and nonnursing women are less pronounced when fruits and roots are in season than in other seasons of the year; (b) foraging return rates decrease for Ache women as their numbers of dependents increase; and (c) among Ache women, the positive effect of number of dependents on foraging behavior is less pronounced when fruits are in season than at other times of the year. Lastly, in the Hiwi sample we found that postreproductive women work considerably harder than women of reproductive age in the root season but not in other seasons of the year. We discuss how ecological variation in constraints, the number of health insults to children that Hiwi and Ache mothers can avoid, and the fitness benefits they can gain from spending time in food acquisition and child care might account for differences and similarities in the foraging behaviors of subgroups of Hiwi and Ache mothers across different seasons of the year. Valid tests of the explanations we propose will require considerable effort to measure the relationship between maternal food acquisition, child care, and adverse health outcomes in offspring. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Female in Aristotle’s Biology: Reason or RationalizationTony PreusRobert Mayhew. The Female in Aristotle’s Biology: Reason or Rationalization. Chicago: University of Chicago Press, 2004. Pp. xi +136. Cloth, $28.00.Aristotle's views on the ethical, social, and political roles of women have repeatedly drawn the attention of scholars. Often, the central focus of the discussion is Politics I.13, 1260 a13, where Aristotle says that although women have a (...) deliberative faculty, it is akuron, "without authority." A charitable (from our point of view) interpretation of that word would have him mean that women are capable of ethical and political decision-making, but fourth-century BCE Athenian social arrangements prevent their exercising that capacity outside the home. However, many readers of Aristotle suppose that he means to indicate a natural difference between men and women, some mental or moral inferiority of women. A few passages in the Politics support that interpretation (e.g., Pol. I.2, 1254 b13, 12.1259 a40), but those do not provide a "scientific" or "biological" grounding of female inferiority. That sort of thing one would expect to find in the biological works. Mayhew's monograph is an exposition of the errors and exaggerations of some of those writers, from the usually careful Martha Nussbaum to the usually unreliable Luce Iragaray.The least cautious critics of Aristotle's views on women typically fasten on his views on sexual generation; as Mayhew shows (ch. 3), such critics either claim that Aristotle believed that women contribute only a place for generation to occur, or that women contribute totally passive matter. Mayhew is able to demonstrate, rather easily, that either claim depends on total ignorance or total misunderstanding of the actual contents of the Generation of Animals. In Aristotle's opinion, the female provides proximate matter for the offspring, something that is almost able to develop into a new individual and needing only the impetus and form provided by the male contribution. Having started with the "form/matter" distinction, it is pretty obvious that the female provides the matter (a bird egg is all of the matter that goes to make the chick), and the male is necessary for reproduction to [End Page 109] occur, so it must be a source of movement (at least) and some element of form (since the offspring partially resembles its male parent) that comes from that source. (For older discussions of this issue, see my Science and Philosophy in Aristotle's Biological Works [Hildesheim, 1975], ch. 2, and J. Morsink, "Was Aristotle's Biology Sexist?" J. Hist. Biol.12 [1979]:83-112, neither noted by Mayhew). But what would be the ethical or political implications of that distinction? Aristotle says that it is "better" to provide form, but there's no straightforward way to conclude from that difference that a woman's deliberative faculty is less authoritative than a man's, any more than there is any straightforward way to argue from the fact that a woman might spend some time pregnant that a permanent pay differential is justified. And Aristotle does not try to make that sort of argument, as a matter of fact.Mayhew deals with most of the other arguments that some have derived from the biological works to support their view that Aristotle's "science" is the foundation of his (supposed) sexism. For example, he points out that although Aristotle does call "kings" the bees that we call "queens," he also calls the analogue among wasps the "mothers" or "wombs"; Mayhew says that Aristotle seems to have thought that the king/queen bee was hermaphroditic and parthenogenetic. Mayhew also has an original and interesting chapter on Aristotle's comparisons between women and eunuchs; although he notes that Aristotle was friendly with at least one eunuch, Hermeias, the uncle of Aristotle's young wife, he leaves out Aristotle's poetic praise of Hermeias (see R. Renehan, in Greek, Roman, and Byz. Stud.23 [1982]: 251-74). Suppose women were "eunuchoid" according to Aristotle, it couldn't mean that they were consequently intellectually inferior, since at least one eunuch was, in Aristotle's opinion, intellectually superior.Mayhew also discusses, adequately enough, the issues of brain... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Female in Aristotle’s Biology: Reason or RationalizationTony PreusRobert Mayhew. The Female in Aristotle’s Biology: Reason or Rationalization. Chicago: University of Chicago Press, 2004. Pp. xi +136. Cloth, $28.00.Aristotle's views on the ethical, social, and political roles of women have repeatedly drawn the attention of scholars. Often, the central focus of the discussion is Politics I.13, 1260 a13, where Aristotle says that although women have a (...) deliberative faculty, it is akuron, "without authority." A charitable (from our point of view) interpretation of that word would have him mean that women are capable of ethical and political decision-making, but fourth-century BCE Athenian social arrangements prevent their exercising that capacity outside the home. However, many readers of Aristotle suppose that he means to indicate a natural difference between men and women, some mental or moral inferiority of women. A few passages in the Politics support that interpretation (e.g., Pol. I.2, 1254 b13, 12.1259 a40), but those do not provide a "scientific" or "biological" grounding of female inferiority. That sort of thing one would expect to find in the biological works. Mayhew's monograph is an exposition of the errors and exaggerations of some of those writers, from the usually careful Martha Nussbaum to the usually unreliable Luce Iragaray.The least cautious critics of Aristotle's views on women typically fasten on his views on sexual generation; as Mayhew shows (ch. 3), such critics either claim that Aristotle believed that women contribute only a place for generation to occur, or that women contribute totally passive matter. Mayhew is able to demonstrate, rather easily, that either claim depends on total ignorance or total misunderstanding of the actual contents of the Generation of Animals. In Aristotle's opinion, the female provides proximate matter for the offspring, something that is almost able to develop into a new individual and needing only the impetus and form provided by the male contribution. Having started with the "form/matter" distinction, it is pretty obvious that the female provides the matter (a bird egg is all of the matter that goes to make the chick), and the male is necessary for reproduction to [End Page 109] occur, so it must be a source of movement (at least) and some element of form (since the offspring partially resembles its male parent) that comes from that source. (For older discussions of this issue, see my Science and Philosophy in Aristotle's Biological Works [Hildesheim, 1975], ch. 2, and J. Morsink, "Was Aristotle's Biology Sexist?" J. Hist. Biol.12 [1979]:83-112, neither noted by Mayhew). But what would be the ethical or political implications of that distinction? Aristotle says that it is "better" to provide form, but there's no straightforward way to conclude from that difference that a woman's deliberative faculty is less authoritative than a man's, any more than there is any straightforward way to argue from the fact that a woman might spend some time pregnant that a permanent pay differential is justified. And Aristotle does not try to make that sort of argument, as a matter of fact.Mayhew deals with most of the other arguments that some have derived from the biological works to support their view that Aristotle's "science" is the foundation of his (supposed) sexism. For example, he points out that although Aristotle does call "kings" the bees that we call "queens," he also calls the analogue among wasps the "mothers" or "wombs"; Mayhew says that Aristotle seems to have thought that the king/queen bee was hermaphroditic and parthenogenetic. Mayhew also has an original and interesting chapter on Aristotle's comparisons between women and eunuchs; although he notes that Aristotle was friendly with at least one eunuch, Hermeias, the uncle of Aristotle's young wife, he leaves out Aristotle's poetic praise of Hermeias (see R. Renehan, in Greek, Roman, and Byz. Stud.23 [1982]: 251-74). Suppose women were "eunuchoid" according to Aristotle, it couldn't mean that they were consequently intellectually inferior, since at least one eunuch was, in Aristotle's opinion, intellectually superior.Mayhew also discusses, adequately enough, the issues of brain... (shrink)

Background Female genital mutilation and circumcision (FGM/C) practices present physicians in Germany with numerous challenges. One possible intervention is elective clitoral reconstruction for esthetic and physiological recovery after FGM/C. Even if the study situation regarding the results achieved by clitoral reconstruction is controversial, the range of reconstruction options is increasing. Arguments The aim of this study is to critically examine the epistemic and ethical dimensions of the interdisciplinary debate on clitoral reconstruction that has arisen over the last 20 years. (...) It is intended to provide orientation in the complex field in which cultural, gender-specific, sexual, and psychosocial factors interact with anatomical–physiological knowledge and the lack thereof. The analysis shows the ambivalent role of evidence claims and promises in relation to clitoral reconstruction. Conclusions Difficulties in testing and comparing existing surgical procedures and in the use of standardized questioning tools demonstrate how essential cultural competence and diversity awareness are in dealing with those affected. The prima facie correct argument of insufficient evidence on the efficacy, comparability, and long-term consequences of reconstruction procedures proves to be problematic for ethical and epistemic reasons. In order to generate valid and useful data on sexuality, body perception, pain, and pleasure before and after clitoral reconstruction, survey modalities that address the culturally heterogeneous target group of women with FGM/C are needed. Cultural competence and sensitivity in medicine are also urgently needed for target group-oriented education and counseling as a prerequisite for self-determined decisions for/against clitoral reconstruction. (shrink)

In this dissertation, I have analyzed some of the problems associated with male reproduction. I discuss basic notions regarding the origin of parental rights concluding that whatever rights parents have regarding their children arise because of the biological connection between the parents and child. A biological parent has prima facie rights to his child because that parent has property-type rights to his own body. ;I suggest that parental responsibilities automatically incur whenever the conception of a child is intentional or voluntary, (...) or when conception is the result of negligent or reckless sexual activity. Only when procreation is involuntary does automatically delegating parental responsibilities to a male seem morally problematic. The category of acts which would constitute involuntary procreation, however, is very narrow. ;I discuss morally problematic issues that arise when a child is born against the wishes of the male progenitor. Focusing specifically on the issue of child support, I conclude that the father should have some responsibility for the support of the child. The only time for which the imposition of parental responsibilities upon a reluctant father is morally questionable would involve the fraudulent misrepresentation of the female regarding her use of contraceptives, combined with some affirmative action by her to undermine the male's attempted effort at contraception. ;Finally, I discuss the moral and legal implications of a woman's decision to obtain an abortion against the wishes of the potential father. I conclude that her abortion could seriously harm the male's procreation interests. But, given the vital role women have in the reproductive process, women should possess rights superior to those males might possess. The evolution of reproductive technology, however, has made these greater rights a contingent fact. (shrink)

This article discusses section 156 of the Criminal Justice and Public Order Act 1994 which prohibits the use of eggs from aborted female foetuses for the purposes of reproduction. I argue that the pre-legislative debates focus only on the biological relationship between the aborted foetus and any ensuing child and foreclose the possibility of useful discussion about the potential merits of such technology. Kristeva's theory of abjection has been used in order to elucidate the strength of feeling about the (...) use of eggs from the expelled foetus. I suggest that the ‘yuk’ factor stems from the potential for the blurring of the boundaries between life and death. In addition, I suggest that the stress placed on the biological link means that the foetus is ascribed special properties not given to live donors. Woman's very crucial role in reproductive technologies is therefore erased. The article argues that there are very good reasons why the debate on the subject should remain open. At present women donors have to undergo highly intrusive procedures in order to give eggs and the process is not without its health risks. The use of eggs from aborted foetuses certainly raises important consent issues but these could be addressed by placing women at the centre of the decision making process, starting with the recognition that it is women and not foetuses who have the remit and responsibility for giving consent for the use of their genetic material. Moreover, there should be an acknowledgement that women are perfectly capable of making informed decisions about donation and of considering the potential implications of participating in egg donation. (shrink)

ABSTRACT Although a preference for sons is reportedly a universal phenomenon, in some Asian societies daughters are considered financial and cultural liabilities. Increasing availability of ultrasonography and amniocentesis has led to widespread gender screening and selective abortion of normal female foetuses in many countries, including India. Feminists have taken widely divergent positions on the morality of this practice. Feminists from India have strongly opposed it, considering it as a further disenfranchisement of females in their patriarchal society, and have agitated (...) successfully for legislative prohibitions. Libertarian feminists on the other hand, primarily from the United States, have argued that any prohibition of the use of this technology is a curtailment of a woman's reproductive choices and a violation of her right to make autonomous decisions regarding procreation. Using India as an illustrative case, this paper argues that in the context of what prevails in some societies, an ethical argument that hinges on the principle of autonomy as understood in the West can be problematic. Furthermore, a liberal theoretical assumption that it is always better to have more rather than fewer choices may not hold up well against the realities of life for such women. Although feminists have little disagreement concerning substantive matters, it is in the area of strategy that differences of opinion have arisen, their moral reasoning and responses shaped by the culture, ethnicity, class and race to which they belong. A view that a single ‘orthodox’ feminism of any variety can embody the aspiration of all women reverts to the problematic issues in the evolution of the rationalistic, individualistic, ‘male’ ethics against which women have consistently raised objections. (shrink)

IntroductionElements mark the reality of reading the female body in symbolic constructions and social symbols in the exercise of their reproductive health. The study aims to identify elements that characterize the female condition while analyzing the reproductive health of Brazilian and French women.Materials and MethodsA qualitative, multicenter, international study was conducted in Brazil and in France between 2016 and 2019. Data were produced through the use of semi-structured scripts. Focus group discussions and individual interviews were conducted (...) with women who gave birth, hetero-female couples who lived the experience of gestation and birth of a baby, and professionals of maternal and childcare services or members of the associations concerned with the health of mothers and babies. It was guided by the theoretical-methodological framework of institutional analysis in line with the French Institutional Socioclinics.ResultsSexual and reproductive health in the realities researched in Brazil and France are sometimes close and sometimes far apart. In what involves the Brazilian health system, abortion is criminalized and often performed illegally. Furthermore, pregnancy, childbirth, and the postpartum period are highly medicalized. In addition, childbirth is not assured as an experience for a woman and her family. This aspect is confirmed by high numbers of cesarean sections performed or by maternal and infant mortality indicators. The French health system prioritizes vaginal deliveries and seems to assure more autonomy to women, but at the same time, it is worn out by the logic of profit, the efficiency of actions, and the rationalization of practices. In association with these, there are other intrinsic elements in the functioning of the institution that delineates the format of each country: notion of women's rights, violence against women, and discussion regarding the oppression markers of race, gender, sexuality, and social class.ConclusionsBoth countries reveal aspects related to the social role of women's bodies. The established logic reflects in the decision to have children, motherhood, women's autonomy over their own bodies, and in the core values linked to the termination of pregnancy and the professional practices developed in prenatal care, childbirth, and postpartum. (shrink)

The feasibility of posthumous reproduction when the surviving partner is female has brought to light many ethical, moral, social, and legal issues. This review aims to summarize these issues and to assist clinicians who may be faced with such requests. A question list, used for health technologies assessment, was utilized in a question-answer approach as the review methodology. Of the 1,208 publications identified through a comprehensive literature search in biomedical, psychological, and ethical databases, 31 articles included arguments related to (...) one or more questions from the predefined question set. Key stakeholders identified include the deceased, the requesting party, the resultant child, the physician, and society. Key ethical issues relevant to posthumous reproduction include the four traditional pillars of medical ethics—autonomy, beneficence, nonmaleficence, justice—as well as the stakeholders’ rights and sociocultural attitudes. The ethical framework formulated by these issues has been incorporated in a clinical ethics decision-making tool that could prove useful to clinicians and decision makers. (shrink)

This response reinforces several major themes in our target article: (a) the importance of sex-specific, within-sex variation in mating tactics; (b) the relevance of optimality thinking to understanding that variation; (c) the significance of special design for reconstructing evolutionary history; (d) the replicated findings that women's mating preferences vary across their menstrual cycle in ways revealing special design; and (e) the importance of applying market phenomena to understand the complex dynamics of mating. We also elaborate on three points: (1) Men (...) who have indicators of genetic fitness may provide more direct benefits when female demand for extra-pair and short-term sex is very low; (2) both men and women track ecological cues to make mating decisions; and (3) more research on female orgasm is needed. (shrink)

In Turkey, as in many other countries, infertility is generally regarded as a negative phenomenon in a woman’s life and is associated with a lot of stigma by society. In other words, female infertility and having a baby using Assisted Reproductive Technologies have to be taken into consideration with respect to gender, motherhood, social factors, religion and law. Yet if a woman chooses to use ART she has to deal with the consequences of her decision, such as being (...) ostracized by society. Other types of procedures in this area, such as sperm and ova donation or surrogate motherhood, are not permitted in law. However, both before and after the development of this techonology, society has been finding its own solutions which are rarely questioned and are still performed. This article will discuss what these practices are and try to reach some pragmatic conclusions concerning female infertility, the concept of motherhood and some traditional practices in Turkey. (shrink)

Due to a history of coerced sterilization, a federal Medicaid sterilization policy mandates that a specific consent form be signed by a patient at least thirty days prior to when the patient undergoes sterilization. However, in contemporary obstetrical practice, the Medicaid sterilization policy serves as a policy‐level barrier to autonomously desired care. We review the clinical and ethical implications of the current Medicaid sterilization policy. After discussing the utility and impact of waiting periods for other surgical procedures, we explore the (...) psychology of time required for decision‐making and consider scientific understanding of regret. We argue that the current Medicaid sterilization waiting period is clinically and ethically unjustifiable and that the policy ought to be revised in light of the goals, preferences, and concerns of the people most affected by it. While the need for continued protection against coercion remains, the current mandated waiting period does little to enforce the high‐quality shared decision‐making that is desired for sterilization counseling. (shrink)

BackgroundSwedish healthcare providers are supposed to be value-neutral when making clinical decisions. Recent conducted studies among Swedish physicians have indicated that the proportion of those whose personal values influence decision-making vary depending on the framing and the nature of the issue.ObjectiveTo examine whether the proportions of value-influenced and value-neutral participants vary depending on the extent to which the intervention is considered controversial.MethodsTo discriminate between value-neutral and value-influenced healthcare providers, we have used the same methods in six vignette based studies (...) including 10 more or less controversial interventions. To be controversial was understood as being an intervention where conscientious objections in healthcare have been proposed or an intervention that is against law and regulations.ResultsEnd of life decisions and female reproduction issues are associated with conscientious objection and more or less against regu... (shrink)

The female reproductive axis in mammals is a highly complex dynamic system which goes through different transient or absorbent states during the course of a life-time. Little is known about the mechanisms controlling this system during fetal life and at birth, although it has been shown in numerous species, including primates, that the whole machinery is already functioning . After a delay ranging from a few days to a few weeks, according to the species, the reproductive axis (...) becomes quiescent and activity apparently resumes only at the time of puberty. Here again understanding of the phenomenon is still limited. (shrink)

In the mid 1970s labor-saving technology was introduced into a Maya subsistence agricultural community that markedly increased the efficiency with which maize could be ground and water collected. This increased efficiency introduces a possible savings in the time that women allocate to work, which can be reapportioned to child care, food production, domestic work, or leisure. An earlier study suggested that this labor-saving technology had a positive effect in decreasing the age at which these Maya women begin their reproductive (...) careers. Although there is a statistical association between the age at which women bear their first child and the introduction of modern technology, this association does not demonstrate that the decline in age at first birth is causally related to the presence of technology. This paper pursues two objectives to evaluate this potential causal relationship in greater detail. First, a theory relating technological change to the initiation of a reproductive career is briefly developed in order to make qualitative predictions about behavioral changes as a response to changing technology. Second, these predictions are then tested against time allocation data recently collected in this same Maya community.We suggest that both of the conditions necessary to initiate reproduction—fecundity and access to mates—fundamentally depend on the amount of help that a girl provides to her family. Further, the help that a girl provides can be affected by technological changes. Analyses show that when modern technology is available, unmarried young women do not change the time allocated to domestic tasks and child care, and allocate more time to low-energy leisure activities. This lack of perceived benefit to working more and a potential concomitant shift towards a positive energy balance may in part explain why Maya women leave home and initiate reproduction at a younger age after labor-saving technology is introduced. (shrink)

With the ever‐increasing lifespan along with societal changes, women can marry and procreate later than in previous centuries. However, pathogenic genetic variants segregating in the population can lead to female subfertility or infertility well before the average age of normal menopause, leading to counter‐selection of such deleterious alleles. In reviewing this field, we speculate that a logical consequence would be the later occurrence of menopause and the extension of women's reproductive lifespan. We illustrate this point with a simple (...) model that applies to other variants that contribute to female infertility, including epigenetic variation. We also consider the effect of medical interventions and lifestyle. (shrink)

In this article I will address the question of determining the moral limits of reproductive decisions. In so doing I will examine the contributions made by John Harris, who has over the years consistently addressed the ethical implications of advancing reproductive technologies. In addressing these matters, Harris has centred his arguments on the principle of harm and with this in mind has set out a specific theoretical framework from which decisions about disability and causing harm, as (...) in the case of reproductive decisions, can be rationally addressed. This discussion will attempt to question the conceptual scheme that he proposes. The aim here is not to present an alternative theoretical contribution to the morality of reproductive choice. Rather, in the attempt to follow some of the directives in Wittgenstein’s later philosophy, the aim is to demonstrate some of the pitfalls of what Wittgenstein has described as the “craving for generality” in contemporary philosophy. I propose that this craving can distort, in this instance, our ordinary usage of concepts such as harm, suffering and disability and their role in the moral vocabulary of reproductive decision making. (shrink)

People are worried that advances in genetics will lead to a revival of eugenics. Such worries are often associated with eugenic practices carried out early in the 20th century---the forcible sterilization of feebleminded persons in the United States and the Nazi program of Racial Hygiene. A "new eugenics" involving prenatal genetic testing and the selective abortion of fetuses diagnosed with severe genetic disorders might, nonetheless, be acceptable. In chapter one I examine the history of eugenics and discuss what might make (...) a new eugenics more tolerable. ;Chapters two and three discuss reproductive decision making by individuals . Chapter 2 investigates the morality of abortion. I conclude that the moral status of the fetus is ultimately uncertain. In exceptional circumstances, such as the case where a fetus would develop into a severely disabled infant, there are good reasons for thinking that abortion is morally permissible. It is plausible, for example, that the value of a fetal life is a function of its future quality of life. ;In chapter three I discuss what quality of life consists in. I develop a pluralistic perspective according to which quality of life is a function of multiple independent components. When deciding to bring a child into existence parents should consider the quality of life expected for the child and also take into account the likely impact on their own lives, the lives of other family members, and society as a whole. ;Chapter four asks whether or not governmental restrictions should be placed on the kinds of genetic interventions which will be permitted. A worry is that interventions aimed at enhancement would only be available to the financially fortunate and thus promote unjust social inequalities. Another worry is that the development and use of such interventions would drain medical resources away from more fruitful purposes and thus have a negative impact on aggregate utility. The social aim to promote liberty, on the other hand, speaks against the imposition of restrictions. Faced with conflicting social values, we need to think more about how to make trade-offs between liberty, equality, and aggregate utility. (shrink)

In Evans, both the U.K. High Court and Court of Appeal upheld Howard Johnston’s right to refuse Natallie Evans access to the stored embryos which represented her only hope of having a child which was genetically her own. In this note, I focus on claims of gender (in)equality in the resolution of Evans. My argument is that such claims are often made all too easily, without full consideration of the problems of advancing them in the context of procreative decision-making, where (...) men and women are inevitably differently situated. I conclude that although equality arguments are not wholly without value in this context, they need be used with extreme care. And, with due caution, I set out an equality argument of my own which was not made in Evans. (shrink)

Opponents of reproductive choice are attempting to limit reproductive decisions based on certain underlying reasons. This commentary explores the rationales for these limitations and the objections to them. It concludes that reasoned-based limitations are unsupportable and unenforceable.

Nearly a million Indian women lack access to safe and dignified abortion services from public healthcare facilities and instead opt to induce abortions by themselves or with the help from unskilled and unauthorized practitioners. Unsafe abortions account for an estimated 9% of all maternal deaths in India despite the legalization of abortion on all grounds since 1971 via the MTP Act. However, the Act technically does not make any provision for abortion based on a woman’s request alone, subjecting her decision (...) to the approval of her healthcare provider, limiting reproductive autonomy. Moreover, the problem of female feticide through sex‐selective abortions has also contributed to a conflicting public agenda that prioritizes preventing the former over allowing women access to abortion services for other reasons. Women who are socio‐economically, culturally, and educationally vulnerable and minors may experience further abortion related stigmatization. These ethico‐legal considerations highlight the need for transition from a provider‐centered to a woman‐centered abortion service model. (shrink)

: Prenatal and preconceptual testing and screening programs provide information on the basis of which people can choose to avoid the birth of children likely to face disabilities. Some disabilities advocates have objected to such programs and to the decisions made within them, on the grounds that measures taken to avoid the birth of children with disabilities have an "expressive force" that conveys messages disrespectful to people with disabilities. Assessing such a claim requires careful attention to general considerations relating (...) meaning, intention, and social practices; it has only begun to receive such attention. Building on work by Allen Buchanan, who has challenged this claim, I further consider the disabilities advocates' objection, ultimately concluding that it is misplaced; neither individual actions nor general practices of this type necessarily express disrespectful messages. (shrink)

Advances in reproductive technologies continue to present ethical problems concerning their implementation and use. These advances have preoccupied bioethicists in their bid to gauge our moral responsibilities and obligations when making reproductive decisions. The aim of this discussion is to highlight the importance of a sensibility to differences in moral perspective as part of our ethical inquiry in these matters. Its focal point is the work of John Harrisi, who has consistently addressed the ethical issues raised by (...) advancing reproductive technologies. The discussion is aimed at a central tenet of Harris’s position on reproductive decision-making—namely, that in some instances, giving birth to a worthwhile life may cause harm and will therefore be morally wrong. It attempts to spell out some of the implications of Harris’s position that the author takes to involve a misplaced generality. To support this claim, some examples are explored that demonstrate the variety of ways in which concepts may manifest themselves as moral considerations within the context of reproductive decision-making. The purpose is to demonstrate that Harris’s general conception of the moral limits of reproductive autonomy obscures the issues raised by particular cases, which in themselves may reveal important directions for our ethical inquiry. (shrink)

In their article “Implementing Expanded Prenatal Genetic Testing: Should Parents Have Access to Any and All Fetal Genetic Information?” Bayefsky and Berkman briefly mention that: “[s]ome are...

I present evidence that humans have evolved convergently to social insects with regard to a large suite of social, ecological, and reproductive phenotypes. Convergences between humans and social insects include: (1) groups with genetically and environmentally defined structures; (2) extensive divisions of labor; (3) specialization of a relatively restricted set of females for reproduction, with enhanced fertility; (4) extensive extramaternal care; (5) within-group food sharing; (6) generalized diets composed of high-nutrient-density food; (7) solicitous juveniles, but high rates of infanticide; (...) (8) ecological dominance; (9) enhanced colonizing abilities; and (10) collective, cooperative decision-making. Most of these convergent phenotypic adaptations stem from reorganization of key life-history trade-offs due to behavioral, physiological, and life-historical specializations. Despite their extensive socioreproductive overlap with social insects, humans differ with regard to the central aspect of eusociality: reproductive division of labor. This difference may be underpinned by the high energetic costs of producing offspring with large brains. (shrink)

The identification and valorization of unacknowledged, feminized forms of economic productivity has been an important task for feminist theory. In this article, we expand and rethink existing definitions of labour, in order to recognize the essential economic role women play in the stem cell and regenerative medicine industries, new fields of biomedical research that are rapidly expanding throughout the world. Women constitute the primary tissue donors in the new stem cell industries, which require high volumes of human embryos, oöcytes, foetal (...) tissue and umbilical cord blood. Such material is generally given for free in the advanced industrial democracies, constituted as a surplus (‘spare’ embryos) or waste (umbilical cord ‘afterbirth’, cadaveric foetuses, poor quality oöcytes) whose generative powers should not be withheld from others. At the same time, among impoverished female populations in developing nations, such biological material is now often procured through frankly transactional relations, where women undertake risky procedures for small fees. In each case, female bodily productivity is mobilized to support bioeconomic research, yet the economic value involved in these relations is largely unacknowledged. In this article, we consider both the gift economy and the transactional economy for reproductive tissues as a form of labour. In order to fully conceptualize the specificities of feminized productivity in the bioeconomy, we distinguish between earlier feminist theories of reproductive labour and the emerging practices generated by stem cell research, which we term regenerative labour. We consider how historical transformations in the regulation of feminized labour and the technical repertoires of stem cell research renegotiate the productivity limits of female reproductive biology, opening it out to novel and profitable forms of surplus value and enrolling women in complex negotiations over their role in bioeconomic activity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Promoting Health and Social Progress by Accepting and Depathologizing Benign Intersex TraitsHida ViloriaI was born with ambiguous genitalia and it was a doctor who, by honoring my bodily integrity and not “fixing” me, gave me the greatest gift I’ve ever received. Because my body and its sexual traits are a positive, fundamental part of my experience and identity as a human being, I know that having my genitals removed (...) or altered according to someone else’s vision would have deeply damaged me, both physically and psychologically.The doctor who protected my autonomy was, unsurprisingly, my father. I say “unsurprisingly” because in my experience parents are typically more protective of their children than doctors are of their patients. Also, doctors do not discuss cases with other doctors in the same way they do with laypeople, as doctors know more about medical issues such as the risks involved in infant genital surgery.Other than having clitoromegaly (a large clitoris), my reproductive anatomy is typically female, and so I was assigned female and raised as such without incident. My parents didn’t discuss my intersex traits with me, and I grew up thinking of myself and being accepted as, a girl.When I began menstruating, my father told me I’d need to take pills to “grow taller.” I thought this unusual, as I wasn’t short, and later overheard my mother arguing with him, saying that the pills were “experimental”. I was reminded of this discussion years later, when she told me that the pills had actually been hormones to make my breasts grow. I never took them though as she convinced my father not to make me.Article 7 of The International Covenant on Civil and Political Rights states that, “No one shall be subjected without his free consent to medical or scientific experimentation,” and I’m grateful to both my parents for protecting my civil rights as they protected my health.Due to my Catholic upbringing and schooling, I had no opportunity to compare my genitals to other girls’, and it wasn’t until the age of twelve that I realized, while perusing magazines with friends, that I have atypical sex anatomy. Contrary to common speculation however, this awareness didn’t make me question being female. I simply assumed there must be some genital variation in humans.I feel my parents made the wisest decision possible by registering me as one of the two accepted, available genders but allowing me to live, physically and behaviorally, as who I am. Despite not having developed a stereotypically curvaceous female figure, I was popular and excelled in typically feminine social activities, as well as sports and academics. For example, I was one of four girls selected out of one hundred twenty–five that competed for a spot on my high school cheerleading [End Page 114] squad when I tried out to help a friend who needed a tryout partner.Other than escaping IGM (Intersex Genital Mutilation) and estrogen therapy, I’ve had only a few experiences pertaining to my medical care around being intersex. These experiences fall into two categories: seeing medical doctors who treated me the same after discovering that I have ambiguous genitalia, and seeing ones who didn’t. I feel incredibly blessed that my experiences in the former category vastly outweigh the latter.My first experience came at the age of twenty, when a gynecologist asked me if my clitoris had always been as large as it is. I responded that it had, and she said, while looking at me disapprovingly, that she’d like to do some tests. When I asked her what they were for though, she wouldn’t respond directly. She said I’d reported having some upper lip hair, and acne, on my intake forms. I replied that neither were above average, and asked if there were health issues I should be concerned about. She reluctantly said no. I asked what reason there was then for undergoing tests because of the size of my clitoris.She finally responded, “It’s just not normal.”Fortunately, I’d had positive reactions to my sex traits from the people I’d dated. For example, the first... (shrink)

Courts are divided as to whether abortion informed consent mandates violate the First Amendment. This article argues that given the doctor's and patient's unique expertise, the patient's strong interests in autonomous decision making, and the fact that these laws regulate speech, rather than conduct, heighted or strict scrutiny should apply to such mandates.

Household structure may have strong effects on reproduction. This study uses household demographic data for 59 women in a Caribbean village to test evolutionary hypotheses concerning variation in reproductive strategies. Father-absence during childhood, current household composition, and household economic status are predicted to influence age at first birth, number of mates, reproductive success, and pair-bond stability. Criterion variables did not associate in a manner indicative of r- and K-strategies. Father-absence in early childhood had little influence on subsequent reproduction. (...) Household wealth and alloparenting were positively associated with age at first birth. Alloparenting was negatively associated with reproductive success. Women in long-term conjugal unions had higher reproductive success than did single women. Number of adult male kin resident in the household was negatively associated with women’s number of mates. (shrink)

Sexual dimorphism, symmetry, and coloration in human faces putatively signal information relevant to mate selection and reproduction. Although the independent contributions of these characteristics to judgments of attractiveness are well established, relatively few studies have examined whether individuals prioritize certain features over others. Here, participants (N = 542, 315 female) ranked six sets of facial photographs (3 male, 3 female) by their preference for starting long- and short-term romantic relationships with each person depicted. Composite-based digital transformations were applied (...) such that each image set contained 11 different versions of the same identity. Each photograph in each image set had a unique combination of three traits: sexual dimorphism, symmetry, and color cues to health. Using conjoint analysis to evaluate participants’ ranking decisions, we found that participants prioritized cues to sexual dimorphism over symmetry and color cues to health. Sexual dimorphism was also found to be relatively more important for the evaluation of male faces than for female faces, whereas symmetry and color cues to health were relatively more important for the evaluation of female faces than for male faces. Symmetry and color cues to health were more important for long-term versus short-term evaluations for female faces, but not male faces. Analyses of utility estimates reveal that our data are consistent with research showing that preferences for facial masculinity and femininity in male and female faces vary according to relationship context. These findings are interpreted in the context of previous work examining the influence of these facial attributes on romantic partner perception. (shrink)

An Indian Court recently awarded 50,000 rupees damages to a couple who gave birth to their fourth daughter. The couple were mistakenly told they were carrying a male fetus. The doctor mistook a section of the umbilical cord for a penis. The husband said: “We are already struggling to raise three children. This was a big sacrifice for us to have a fourth child. We would have had an abortion if we had known it was a girl”. The cost of (...) damages amounted to the dowry they would have to pay at the time of their daughter's marriage.This is a fictional case. But the cases of Nicholas Perruche and Lionel1 are not fictional. According to reports, damages were paid to these children on the basis of what the media has described as a “right not to be born”. Is there a “right not to be born?” Was it right to compensate Nicholas Perruche for being born with congenital rubella and Lionel for being born with Down's syndrome?HARM TO THE CHILDWhat constitutes a right is a complex question. On one interpretation, rights protect interests. This implies that a right not to be born would exist if a child had an interest in not being born. Is it ever in a child's interests not to have been born? If it were, this might imply the child is better off dead than alive, as the Collective against Handiphobia claim. Is it better to be dead than have Down's syndrome?Some people do believe that Down's syndrome constitutes a life not worth living.2 But this view seems false. Children with Down's syndrome can and often do lead happy and worthwhile lives. After all, we do not suggest that other animals have a right not to be born or a life not worth …. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Bleed: Destroying Mythsand Misogyny in Endometriosis Care by Tracey LindemanSarah Seabrook (bio)Bleed: Destroying Myths and Misogyny in Endometriosis Care by Tracey Lindeman. Toronto: ECW Press, 2023Endometriosis—a complex and painful health condition in which tissue similar to the endometrium tissue that normally lines the inside of a person's uterus grows outside—has gained considerable attention over the last few years. Because endometriosis patients' concerns about their reproductive health and (...) menstrual experiences are often dismissed by healthcare professionals (Wahl 2021; Alberta Women's Health Foundation 2022), there has been a groundswell of conversations about abnormal menstruation and endometriosis, not by government or medical professionals but rather by patients who validate each other's experiences and relate to one another's struggles in seeking access to care (EndoAct Canada 2024). Experiences about the trials and tribulations endometriosis patients endure seeking medical care and diagnosis are shared through op-eds and Facebook support groups and have appeared on special feature segments on the local news. With increased attention around endometriosis, there remains a lot of work to do around dispelling what endometriosis truly is and why people are not being adequately treated.In BLEED: Destroying Myths and Misogyny in Endometriosis Care, author and endometriosis patient Tracey Lindeman (2023), takes on the work of that dispelling. With a focus on the North American context (largely Canada and the United States), Lindeman shines a light on the deeply embedded systemic discrimination that shapes experiences of endometriosis and other gendered health conditions that prevent women, trans, and non-binary people from receiving a diagnosis and/or adequate treatment. This compelling part memoir, part investigation of the systemic barriers to care for endometriosis patients, reveals the long-standing and ongoing history of misogyny in contemporary gynecology and healthcare (Davis-Floyd 1997; Wetherell, Taylor, and Yates 2001; Young, Fisher, and Krikman 2019), including how pharmaceutical funding and interests are prioritized at the expense of endometriosis patients' health and well-being, and how sexism and racism, among other markers of discrimination, are [End Page 181] institutionalized features in healthcare systems that strip women, trans, and non-binary people of their agency over their bodies and decision-making capacity.BLEED is a particularly timely and important contribution to feminist health scholarship because it offers an intimate account of how the historical medicalization of female-specific health issues has normalized power asymmetries between patients and medical professionals. She demonstrates how the contemporary dynamics in healthcare settings leave women and gender-nonconforming people to navigate the intersections of misogyny and myths surrounding endometriosis. Lindeman does so by discussing her own experiences, including being asked by medical professionals to provide a written letter of support from her male partner indicating his approval of her requested hysterectomy.As both a researcher and someone with endometriosis, Lindeman is able to take the narrative of BLEED in several directions. She offers readers the intimacy of her perspective and experiences with endometriosis in Canada's health system while also offering readers a broader view of how age, race, gender identity, sexual orientation, and geography inform the experiences of others who have endometriosis. Her ability to situate her experiences as a cis-white woman as the focal point of her analysis provides readers with a strong reference point to recognize and understand the heightened systemic discrimination experienced by her nonwhite, non-cis interviewees. In particular, the contrast between Lindeman's experiences of being prescribed sixty-tablet refills of the painkiller naproxen for endometriosis pain and the experiences of her interviewee, Denise, a black cis-woman who was only given five naproxen pills a month provides insight into racialized dimensions of endometriosis care (39).Recognizing that a history unlearned results in history being repeated, Lindeman opens BLEED by situating the painfully paternalistic and misogynistic experiences of endometriosis patients in the healthcare system in the context of the evolution of gynecology as a subfield. Lindeman highlights how the medicalization of endometriosis as a condition went hand in hand with the professionalization of gynecology, which has since created and perpetuated a power asymmetry between patients and their care providers. Whereas gynecological care was historically provided by women—witches, midwives, and healers—the long male-dominated... (shrink)

In the mid-1990s, fairtrade-organic registration data showed that only 9 % of Oaxaca, Mexico’s organic coffee ‘farm operators’ were women; by 2013 the female farmer rate had increased to 42 %. Our research investigates the impact of this significant increase in women’s coffee association participation among 210 members of two coffee producer associations in Oaxaca, Mexico. We find that female coffee organization members report high levels of household decision-making power and they are more likely than their male counterparts (...) to report control over their coffee income. These significant advances in women’s agency within the household are offset by the fact that the women experience significant time poverty as they engage in coffee production while bearing a disproportionate share of domestic labor obligations. The women coffee producers view organizational labor as a third burden on their time, after their reproductive and productive labor. The time poverty they experience limits their ability to fully participate in coffee organizational governance and consequently there are few women leaders at all levels of the coffee producer businesses. This is problematic because it limits women’s ability to fully benefit from organizational membership: when women fully participate in governance they gain valuable business and leadership skills and producer associations with active female members may also be more likely to develop and maintain programs and policies that enhance gender equity. Our findings indicate that targeted agricultural development programs to improve gender equity among agricultural smallholders should involve creative ways to ease women’s labor burdens and reduce their time poverty in order to facilitate full organizational participation. The research findings fill a gap in existing studies of agricultural global value chains (GVCs) by demonstrating how the certified coffee GVC depends on women’s under and un-paid labor not only within the household but also within producer organizations. (shrink)

The increasing number and influence of women in society brings up several issues related to values and ethics. Looking at business ethics from the gender perspective made us ponder if it would be fruitful to analyse the feminine and masculine dimensions of decision-making style. The article follows the research tradition using the multidimensional ethics scale, and it aims at developing the scale to better include female decision-making. We came to the conclusion that, as the multidimensional ethics scale used in (...) measuring managers' moral decision-making is derived from modern ethical theories focusing on indications of masculinities more than femininities, the scale leaves feminine decision-making dimensions invisible. Our argument is that in seeking a deeper understanding of (female) managers' moral decision-making, we must find a broader basis for the analysis and develop the scale further so that it allows different voices to be heard and different dimensions to be seen. (shrink)

Residency selection is a challenging process for medical students, one further complicated in the USA by the recentDobbs v Jackson Women’s Health Organization(Dobbs) decision over-ruling the federal right to abortion. We surveyed medical students to examine howDobbsis influencing the ideological, personal and professional factors they must reconcile when choosing where and how to complete residency.Between 6 August and 22 October 2022, third-year and fourth-year US medical students applying to US residency programmes were surveyed through social media and direct outreach to (...) medical schools. Analysis of quantitative and qualitative data from 494 responses was performed to assess downstream effects ofDobbson residency applicants’ family, health and career choices.Most respondents said changes in abortion access would likely or very likely influence their decision regarding location of considered residency programme (76.9%), where to start a family (72.2%) and contraceptive planning for them or their partner (57.9%). Cis-gender females were more influenced byDobbsregarding where (5 (4, 5) p<0.001) and when (3 (3, 5) p<0.001) to start a family. In qualitative responses, medical trainees highlighted the importance of abortion access for their patients, themselves and their loved ones.Medical trainees are incorporating state abortion access into their residency programme choices. Future physicians care about both the quality of care they will be able to provide and their own health. For personal and professional reasons, reproductive healthcare access is now a key factor in residency match decisions. (shrink)

As a neo-liberal economy, India has become one of the new health tourism destinations, with commercial gestational surrogacy as an expanding market. Yet the Indian Assisted Reproductive Technology Bill has been pending for five years, and the guidelines issued by the Indian Council of Medical Research are somewhat vague and contradictory, resulting in self-regulated practices of fertility clinics. This paper broadly looks at clinical ethics in reproduction in the practice of surrogacy and decision-making in various procedures. Through empirical research (...) in New Delhi, the capital of India, from December 2011 to November 2012, issues of decision-making on embryo transfer, fetal reduction, and mode of delivery were identified. Interviews were carried out with doctors in eighteen ART clinics, agents from four agencies, and fourteen surrogates. In aiming to fulfil the commissioning parents’ demands, doctors were willing to go to the greatest extent possible in their medical practice. Autonomy and decision-making regarding choice of the number of embryos to transfer and the mode of delivery lay neither with commissioning parents nor surrogate mothers but mostly with doctors. In order to ensure higher success rates, surrogates faced the risk of multiple pregnancy and fetal reduction with little information regarding the risks involved. In the globalized market of commercial surrogacy in India, and with clinics compromising on ethics, there is an urgent need for formulation of regulative law for the clinical practice and maintenance of principles of reproductive ethics in order to ensure that the interests of surrogate mothers are safeguarded. (shrink)

The spectacular progress in assisted reproduction technology that has been witnessed for the past thirty years resulted in emerging new ethical dilemmas as well as the revision of some perennial ones. The paper aims at a feminist approach to oocyte and spare embryo donation for research. First, referring to different concepts of autonomy and informed consent, we discuss whether the decision to donate oocyte/embryo can truly be an autonomous choice of a female patient. Secondly, we argue the commonly adopted (...) language of gift is misleading and that calling for altruism could put female patients at risk of exploitation. Finally, we point out that the presence of gender stereotypes in the procreative area casts doubt whether even a more robust notion of informed consent manages to overcome this risk. (shrink)

This study was conducted to corroborate findings that females invoke a decision rule that is significantly different from that of their male counterparts when making ethical value judgements. In addition, the study examines whether the same decision rule is used by men and women for all types of ethical situations. The results show that males and females use different decision rules when making ethical evaluations, although there are types of situations where there are no significant differences in decision rules used (...) by men and women. The results do not suggest that any one particular decision rule is used by the majority of either males or females in different types of ethical judgements. There is a greater diversity in decision rules used by females than by males. (shrink)

A historical survey of the inheritance practices of farming families in North America and elsewhere indicates that resource allocations among children differed through time and space with regard to sex bias and equality. Tensions between provisioning all children and maintaining a productive economic entity (the farm) were resolved in various ways, depending on population pressures, the family’s relative resource level, and the number and sex of children.Against a backdrop of generalized son preference, parents responded to ecological circumstances by investing in (...) offspring differentially within and between the sexes. Vesting the preponderance of family resources in one heir increased the likelihood of at least one line surviving across several generations, whereas varying degrees of parental investment in emigrating sons or out-marrying daughters might yield boom or bust harvests of grandchildren according to circumstances in more remote locales. Primogeniture (eldest son as primary heir) allowed early identification of heirs and appropriate socialization, as well as more time for parents to contribute to the heir’s reproductive success. Son bias and unigeniture decreased as numbers of children per family declined, as land became less critical to economic success, and as legal changes improved the resource-holding potential of females. We suggest that changing ecological conditions affected parental decisions regarding resource allocation among children at least as much as did changing ideologies of parent-child relations. (shrink)