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

The actions of pregnant women can cause harm to their future children. However, even if the possible harm is serious and likely to occur, the law will generally not intervene. A pregnant woman is an autonomous person who is entitled to make her own decisions. A fetus in-utero has no legal right to protection. In striking contrast, the child, if born alive, may sue for injury in-utero; and the child is entitled to be protected by being removed from her parents (...) if necessary for her protection. Indeed, there is a legal obligation for health professionals to report suspected harm, and for authorities to protect the child's wellbeing. We ask whether such contradictory responses are justified. Should the law intervene where a pregnant woman's actions risk serious and preventable fetal injury? The argument for legal intervention to protect a fetus is sometimes linked to the concept of ‘fetal personhood’ and the moral status of the fetus. In this article we will suggest that even if the fetus is not regarded as a separate person, and does not have the legal or moral status of a child, indeed, even if the fetus is regarded as having no legal or moral status, there is an ethical and legal case for intervening to prevent serious harm to a future child. We examine the arguments for and against intervention on behalf of the future child, drawing on the example of excessive maternal alcohol intake. (shrink)

In 2008 the Human Fertilisation and Embryology Act amendments made deliberately choosing to bring disability into the world, using assisted reproduction, a criminal offence. This paper considers whether the legal prohibition above, should influence other policy areas concerning the welfare of future children such as new possibilities presented by foetal surgery and in utero gene therapy. If we have legal duties to avoid disability in one context should this influence our avoidance of disability in this other context? This paper investigates (...) whether the State might have a stake in wider promotion of practices to reduce the degree of disability in foetuses that will come to exist. Not selecting for disability does not affect the welfare of any future individual, whereas treating in utero abnormalities can optimize the eventual child’s welfare; antenatal interventions stand to improve clinical outcomes and welfare should that specific child be born. I explore why the State may want to intervene in the antenatal setting and to what extent, if at all; the State should implement these technologies. I argue that if the State is justified in intervening to outlaw the choosing to create disabled lives using assisted reproductive techniques, it is also justified in putting pressure on prospective parents to accept therapies in utero to help their child be born less disabled. However, I qualify this with the argument that the State is not justified in using force or the criminal law in this situation during pregnancy. (shrink)

La tecnología reproductiva alcanzó un nuevo récord en 2017 con el nacimiento de un infante de sexo femenino que se desarrolló dentro del útero de una donante fallecida. No se registraron complicaciones inusuales en el procedimiento ni en lo referente a la salud de la madre. Tres años antes, ensayos clínicos suecos señalan el nacimiento de dos infantes de sexo masculino provenientes de úteros extraídos de donantes vivas, vinculados a las madres. La ciencia había logrado curar el factor de infertilidad (...) uterino absoluto (AUFI por sus siglas en inglés), en mujeres con esta condición. Es importante que, si bien algunos ajustes en el procedimiento dominarán el desarrollo futuro, especialmente en los aspectos clínicos, no debemos olvidar las consideraciones éticas. Por lo anterior, esta revisión documental se centra en cómo se ven los trasplantes de útero de donantes fallecidas dentro de los datos disponibles en tres contextos principales: la antropología del ser humano, la medicina y la sociología, con énfasis en ciertas construcciones culturales de la sociedad liberal moderna. Subyacente al diagnóstico está el hecho de que el útero es un órgano no vital en la fisiología humana, y los trasplantes de útero de donantes fallecidas (DD UTX por sus siglas en inglés) plantean nuevos desafíos en la ética. En esta revisión se presentan los sesgos observados en los datos, las limitaciones de un procedimiento de menos de diez años y las conclusiones a las que llegamos. (shrink)

Perry Hendricks’ ‘impairment argument’, which he has defended in this journal, is intended to demonstrate that the generally conceded wrongness of giving a fetus fetal alcohol syndrome (FAS) shows that abortion must also be immoral, even if we allow that the fetus is not a rights-bearing moral person. The argument fails because the harm of causing FAS is extrinsic but Hendricks needs it to be intrinsic for it to show anything about abortion. Either the subject of the wrong of causing (...) FAS is a person who does not exist in the case of abortion or the wrong is negligible. (shrink)

Ectogestation involves the gestation of a fetus in an ex utero environment. The possibility of this technology raises a significant question for the abortion debate: Does a woman’s right to end her pregnancy entail that she has a right to the death of the fetus when ectogestation is possible? Some have argued that it does not Mathison & Davis. Others claim that, while a woman alone does not possess an individual right to the death of the fetus, the genetic parents (...) have a collective right to its death Räsänen. In this paper, I argue that the possibility of ectogestation will radically transform the problem of abortion. The argument that I defend purports to show that, even if it is not a person, there is no right to the death of a fetus that could be safely removed from a human womb and gestated in an artificial womb, because there are competent people who are willing to care for and raise the fetus as it grows into a person. Thus, given the possibility of ectogestation, the moral status of the fetus plays no substantial role in determining whether there is a right to its death. (shrink)

Providing in-utero treatments to target specific conditions in the fetus is a relatively new approach in perinatal care, with the vast majority of these treatments being used off-label. The high degree of off-label medication use in the perinatal and neonatal settings raises concern for the safety of both the fetuses and expectant mothers. This report presents two examples of intra-amniotic drug administration based on reported clinical cases. From the ethical framework of medical principlism, we examine the competing ethical duties of (...) autonomy, beneficence, and non-maleficence in this setting. We then lay out three fundamental ethical principles for obtaining informed consent and maximizing clinical benefit. (shrink)

In this paper, we aim to stimulate ethical debate about the morally relevant connection between ectogenesis and the foetus as a potential beneficiary of treatment. Ectogenesis could facilitate foetal interventions by treating the foetus independently of the pregnant woman and provide easier access to the foetus if interventions are required. The moral relevance hereof derives from the observation that, together with other developments in genetic technology and prenatal treatment, this may catalyse the allocation of a patient status to the foetus. (...) The topic of foetal medicine is of growing interest to clinicians, and it also deserves due attention from an ethical perspective. To the extent that these developments contribute to the allocation of a patient status to the foetus, normative questions arise about how moral responsibilities towards foetal interests should be balanced against the interests of the pregnant woman. We conclude that, even if ectogenesis could facilitate foetal therapy, it is important to remain sensitive to the fact that it would not circumvent the key ethical concerns that come with in utero foetal treatment and that it may even exacerbate potential conflicts between directive treatment recommendations and the pregnant woman's autonomous decision to the contrary. (shrink)

Over 35 years ago, Meltzoff and Moore (1977) published their famous article ‘Imitation of facial and manual gestures by human neonates’. Their central conclusion, that neonates can imitate, was and continues to be controversial. Here we focus on an often neglected aspect of this debate, namely on neonatal spontaneous behaviors themselves. We present a case study of a paradigmatic orofacial ‘gesture’, namely tongue protrusion and retraction (TP/R). Against the background of new research on mammalian aerodigestive development, we ask: How does (...) the human aerodigestive system develop and what role does TP/R play in the neonate’s emerging system of aerodigestion? We show that mammalian aerodigestion develops in two phases: (1) from the onset of isolated orofacial movements in utero to the post-natal mastery of suckling at 4 months after birth, and; (2) thereafter, from preparation to the mastery of mastication and deglutition of solid foods. Like other orofacial stereotypies, TP/R emerges in the first phase and vanishes prior to the second. Based upon recent advances in activity-driven early neural development, we suggest a sequence of three developmental events in which TP/R might participate: the acquisition of tongue control, the integration of the central pattern generator for TP/R with other aerodigestive CPGs, and the formation of connections within the cortical maps of S1 and M1. If correct, orofacial stereotypies are crucial to the maturation of aerodigestion in the neonatal period but also unlikely to co-occur with imitative behavior. (shrink)

Genomic interventions ex utero and in utero are already a reality in medicine. It is plausible to believe that this reality will lead to therapies at the preimplantation level, especially where such interventions are the only safe and effective way to truly prevent human suffering and disease in offspring. The plausibility of this type of genomic therapy is of particular interest for prospective parents who are Roman Catholic, since in vitro fertilization provides the only means by which an offspring’s genome (...) may be accessed prior to implantation. The goal of this essay is to provide a review of two traditional methodologies in Roman Catholic moral thought and the potential moral quandary they present Roman Catholic parents: adherence to moral teaching prohibiting IVF or relief of gene-based disease in their child. After finding little resolution of this quandary through these two methodologies, the essay proposes as an alternative a third approach that leans heavily on John Henry Cardinal Newman’s understanding of doctrinal development. National Catholic Bioethics Quarterly 11.4 (Winter 2011): 735–756. (shrink)

Converging data from different disciplines are showing the role of classical conditioning processes in the elaboration of human and animal behavior to be larger than previously supposed. Restricted views of classically conditioned responses as merely secretory, reflexive, or emotional are giving way to a broader conception that includes problem-solving, and other rule-governed behavior thought to be the exclusive province of either operant conditiońing or cognitive psychology. These new views have been accompanied by changes in the way conditioning is conducted and (...) evaluated. Data from a number of seemingly unrelated phenomena such as relapse to drug abuse by postaddicts, the placebo effect, and the immune response appear to involve classical conditioning processes. Classical conditioning, moreover, has been found to occur in simpler and simpler organisms and recently even demonstrated in brain slices and in utero. This target article will integrate the several research areas that have used the classical conditioning process as an explanatory model; it will challenge teleological interpretations of the classically conditioned CR and offer some basic principles for testing conditioning in diverse areas. (shrink)

Perinatal palliative and hospice care (hereafter, perinatal hospice) is a novel approach to addressing a family’s varied needs following an adverse in utero diagnosis. Christian defenses of perinatal hospice tend to focus on its role as an ethical alternative to abortion. Although these analyses are important, they do not provide adequate grounds to characterize the wide range of goods realized through this compassionate form of care. This essay draws on an analysis of the Christian virtue of humility to highlight the (...) ways a Christian virtue-based defense of perinatal hospice can account for these goods. I argue that humility can play an important facilitating role in helping Christian physicians to meet the needs of families in profoundly difficult circumstances. (shrink)

Pregnancy presents some interesting challenges for the philosophy of embodied cognition. Mother and fetus are generally considered to be passive during pregnancy, both individually and in their relation. In this paper, we use the enactive operational concepts of autonomy, agency, individuation, and participation to examine the relation between mother and fetus in utero. Based on biological, physiological, and phenomenological research, we explore the emergence of agentive capacities in embryo and fetus, as well as how maternal agency changes as pregnancy advances. (...) We show that qualitatively different kinds of agency have their beginnings already in utero, and to what extent fetal and maternal movement modulate affectivity and individuation in pregnancy. We thus propose that mother and fetus are both agents who participate in pregnancy. Pregnancy then emerges as a relational developmental organization that anchors and holds its developing participants. We end the paper with reflections on ethical implications of this proposal, and suggestions for future research. (shrink)

Abortion has become such an indispensable part of contemporary experience that even Christians sometimes find it difficult to oppose. Since taking the life in utero has ceased to be regarded as a grave sin and is not always recognized as an unmitigated evil, those who wish to remain faithful to the Word of God struggle to find ways of speaking against killing of the unborn. Some of them, like Erika Bachiochi, seek to beat modern culture at its own game, by (...) representing Catholic teaching on human sexuality as a “right kind” of feminism. However, in her appeal to secular rationality, foregoing the metaphysical commitments of faith and replacing them with the consequentialist reasoning and data from scientific research, she thereby renders her alternative unviable and un-Christian. In response to this failure, I would like to present some Orthodox Christian considerations pointing toward a more wholesome and consistent way forward. (shrink)

The catch 22 situation in psychiatry is that for precise diagnostic categories/criteria, we need precise investigative tests, and for precise investigative tests, we need precise diagnostic criteria/categories; and precision in both diagnostics and investigative tests is nonexistent at present. The effort to establish clarity often results in a fresh maze of evidence. In finding the way forward, it is tempting to abandon the scientific method, but that is not possible, since we deal with real human psychopathology, not just concepts to (...) speculate over. Search for clear-cut definitions/diagnostic criteria in psychiatry must be relentless. There is a greater need to be ruthless and blunt in this, rather than being accommodative of diverse opinions. Investigative tests - psychological, serum, CSF, or neuroimaging - are only corroborative at present; they need to become definitive. Medicalisation appears most prominent in psychiatry; so, diagnostic proliferation and fuzziness appear inevitable. And yet, the established diagnostic entities need to forward greater and conclusive precision. Also, the need for clarity and precision must outweigh pandering to and mollifying diverse interests, moreso in the upcoming revision of diagnostic manuals. This is specially because the DSM-5, being an Association manual, may need to accommodate powerful member lobbies; and ICD-11 may similarly need to cater to diverse country lobbies. Finding precise biological correlates of psychiatric phenomena, whether through neuroimaging, molecular neurobiology and/or neurogenomics, is the right way forward. It is in the 1.5-kg structure in the cranium that all secrets of psychiatric conditions lie. Social forces, behavioural modification, psychosocial restructuring, study of intrapsychic processes, and philosophical insights are not to be discounted, but they are supplementary to the primary goal - studying and deciphering those brain processes that result in psychiatric malfunction. Experimental breakthroughs, both in psychiatric aetiology and therapeutics, will come mainly from biology and its adjunct, psychopharmacology; while supplementary and complementary breakthroughs will come from the psychosocial, cognitive and behavioural approaches; the support base will come from phenomenology, epidemiology, nosology and diagnostics; while insights and leads can hopefully come from many fields, especially the psychosocial, the behavioural, the cognitive and the philosophical. Major energies must now be marshalled towards finding biomarkers and deciphering the precise phenotype-genotype-endophenotype axis of psychiatric disorders. Energies also need to be focussed on unravelling those critical processes in the brain that tip the scale towards psychiatric disorders. At how those critical processes are set into motion by forces de novo, in utero, in the genes and their expression, by the environment's psychopathological social forces - stress, peer pressure, poverty, deprivation, alienation, malnutrition, discrimination of various types (caste, gender, race, etc.), mass conflicts (war, terror attacks, etc.), disasters (natural and man-made), religious/ideological fascism - or social institutions like marriage, family, work place, political governance, etc. Ultimately, we must decipher how the brain goes into malfunction when such varied forces impinge on it, which precise cortical areas and neuronal cellular and molecular processes are involved in such malfunction and its manifestation, as also which of these are involved when malfunction ceases and health is restored, and the psychosocial processes and institutions which aid such health restoration, as also those which promote well-being and help in primary prevention. Emphasis on the brain and its intimate neurological and molecular mechanisms will not impinge on, or nullify, importance of the 'mind,' wherein subtle and gross brain functions in the form of behaviour, thought and emotions in all their ramifications will continue to be the focus of psychological, cognitive, sociological, psychopharmacological, behavioural and philosophical research. Progress in brain research must move in tandem with progress in 'mind' research. (shrink)

Appealing to reason rather than religious belief, this book is the most comprehensive case against the choice of abortion yet published. _The Ethics of Abortion_ critically evaluates all the major grounds for denying fetal personhood, including the views of those who defend not only abortion but also infanticide. It also provides several justifications for the conclusion that all human beings, including those in utero, should be respected as persons. This book also critiques the view that abortion is not wrong even (...) if the human fetus is a person. _The Ethics of Abortion_ examines hard cases for those who are prolife, such as abortion in cases of rape or in order to save the mother’s life, as well as hard cases for defenders of abortion, such as sex selection abortion and the rationale for being “personally opposed” but publically supportive of abortion. It concludes with a discussion of whether artificial wombs might end the abortion debate. Answering the arguments of defenders of abortion, this book provides reasoned justification for the view that all intentional abortions are morally wrong and that doctors and nurses who object to abortion should not be forced to act against their consciences. (shrink)

In 2017, a Philadelphia research team revealed the closest thing to an artificial womb the world had ever seen. The ‘biobag’, if as successful as early animal testing suggests, will change the face of neonatal intensive care. At present, premature neonates born earlier than 22 weeks have no hope of survival. For some time, there have been no significant improvements in mortality rates or incidences of long-term complications for preterms at the viability threshold. Artificial womb technology, that might change these (...) odds, is eagerly anticipated for clinical application. We need to understand whether AWT is an extension of current intensive care or something entirely new. This question is central to determining when and how the biobag should be used on human subjects. This paper examines the science behind AWT and advances two principal claims. First, AWT is conceptually different from conventional intensive care. Identifying why AWT should be understood as distinct demonstrates how it raises different ethico-legal questions. Second, these questions should be formulated without the ‘human being growing in the AW’ being described with inherently value laden terminology. The ‘human being in an AW’ is neither a fetus nor a baby, and the ethical tethers associated with these terms could perpetuate misunderstanding and confusion. Thus, the term ‘gestateling’ should be adopted to refer to this new product of human reproduction: a developing human being gestating ex utero. While this paper does not attempt to solve all the ethical problems associated with AWT, it makes important clarifications that will enable better formulation of relevant ethical questions for future exploration. (shrink)

This paper suggests that medically the term a 'human being' should be defined by the presence of an active human brain. The brain is the only unique and irreplaceable organ in the human body, as the orchestrator of all organ systems and the seat of personality. Thus, the presence or absence of brain life truly defines the presence or absence of human life in the medical sense. When viewed in this way, human life may be seen as a continuous spectrum (...) between the onset of brain life in utero (eight weeks gestation), until the occurrence of brain death. At any point human tissue or organ systems may be present, but without the presence of a functional human brain, these do not constitute a 'human being', at least in a medical sense. The implications of this theory for various ethical concerns such as in vitro fertilisation and abortion are discussed. This theory is the most consistent possible for the definition of a human being with no contradictions inherent. However, having a good theory of definition of a 'human being' does not necessarily solve the ethical problems discussed herein. (shrink)

Rhythm is key to language acquisition. Across languages, rhythmic features highlight fundamental linguistic elements of the sound stream and structural relations among them. A sensitivity to rhythmic features, which begins in utero, is evident at birth. What is less clear is whether rhythm supports infants' earliest links between language and cognition. Prior evidence has documented that for infants as young as 3 and 4 months, listening to their native language supports the core cognitive capacity of object categorization. This precocious link (...) is initially part of a broader template: listening to a non-native language from the same rhythmic class as and to vocalizations of non-human primates provide English-acquiring infants the same cognitive advantage as does listening to their native language. Here, we implement a machine-learning approach to ask whether there are acoustic properties, available on the surface of these vocalizations, that permit infants' to identify which vocalizations are candidate links to cognition. We provided the model with a robust sample of vocalizations that, from the vantage point of English-acquiring 4-month-olds, either support object categorization or fail to do so. We assess whether supervised ML classification models can distinguish those vocalizations that support cognition from those that do not, and which class of acoustic features best support that classification. Our analysis reveals that principal components derived from rhythm-relevant acoustic features were among the most robust in supporting the classification. Classifications performed using temporal envelope components were also robust. These new findings provide in principle evidence that infants' earliest links between vocalizations and cognition may be subserved by their perceptual sensitivity to rhythmic and spectral elements available on the surface of these vocalizations, and that these may guide infants' identification of candidate links to cognition. (shrink)

Both many critics of abortion and many defenders of abortion have suggested that artificial wombs could end the abortion debate. If the fetus is removed from the uterus, women have an end to an unwanted pregnancy. If the living fetus is then put in an artificial uterus for ectogenesis, there is no termination of the life of the fetus. Joona Räsänen challenges this view in his article, Ectogenesis, abortion and a right to the death of the fetus. Räsänen provides three (...) arguments for a right to secure the death of the human being in utero, namely the ‘right not to become a biological parent argument’, the ‘right to genetic privacy argument’, and the ‘right to property argument’. This article critiques these three arguments for a right to the death of the fetus. (shrink)

La aplicación de la versión tradicional –estructurada en cuatro partes– de la doctrina católica del doble efecto a dos casos de conflicto materno-fetal –la histerectomía en el caso de cáncer de útero, y la craneotomía en el caso de parto obstruido–, ha originado cierta confusión entre los partidarios de las versiones –estructuradas en dos partes contemporáneas– del doble efecto. Aunque la craneotomía, no la histerectomía, fue prohibida de acuerdo a la DDE tradicional, pocos partidarios de las versiones contemporáneas de (...) la DDE consideran que estos casos sean significativamente diferentes. ¿La aplicación tradicional de la DDE a estos dos casos puede entenderse? Si así es, ¿esta aplicación sorprendente puede arrojar luz a los debates contemporáneos sobre el doble efecto? Este artículo trata estas dos preguntas. Se divide en tres apartados: en el apartado I se ofrece una panorámica sobre la génesis histórica –en la casuística católica romana– de las versiones de la DDE articuladas en cuatro partes; en el apartado II se discute las aplicaciones habituales de la DDE tradicional en cuatro partes a una serie de casos, y se presta una atención particular al análisis ortodoxo de los dos procedimientos de aborto terapéutico mencionados, la histerectomía y la craneotomía. Tras exponer tres concepciones de la acción intencional, la tomista, la davidsoniana y la goldmaniana, se muestra que desde ninguna de ellas esos casos pueden distinguirse en virtud de la intención; en el apartado III se lleva a cabo un análisis de lo que se denomina el principio de prioridad causal, que da sentido a la aplicación tradicional de la DDE a estos y otros casos. El artículo concluye explicando por qué se pensó que las tres primeras condiciones de la DDE tradicional, que se reducen a una en las versiones modernas del doble efecto, estaban relacionadas pese a ser diferentes. Por último, sugiero que los desafíos que propiciaron el desarrollo del principio de prioridad causal aclaran otros desafíos similares que deben ser afrontados por cualquier versión moderna adecuada del doble efecto. (shrink)

This essay has two purposes. The first is to argue that our moral duties towards human embryos should be assessed in light of the Golden Rule by asking the normative question, “how would I want to be treated if I were an embryo?” Some reject the proposition “I was an embryo” on the basis that embryos should not be recognized as persons. This essay replies to five common arguments denying the personhood of human embryos: (1) that early human embryos lack (...) ontological individuation; (2) that they are members of the species Homo sapiens but not yet human persons; (3) that the argument for personhood commits the “heap argument” fallacy; (4) that since human procreation in nature is inefficient, human embryos cannot be persons; and (5) the “burning building” scenario proves that all arguments for personhood are irrational or inconsistent. The second purpose is to set forth and criticize in light of the normative judgement defended in part one the present legal situation of cryo-preserved embryos in the U.S. The essay ends by proposing legislative reforms to protect ex utero human embryos. (shrink)

The Tennessee Supreme Court's decision in Davis v. Davis, a case that raises the question of how to allocate frozen embryos in the event of divorce, addresses many of the legal issues posed by in vitro fertilization. The decision considers the interests of the progenitors as well as of the children who may result. For example, the court held that gamete providers' discretion regarding the disposition of embryos can be limited only when their decisions would harm the children who might (...) be born. The court also made clear that efforts to seek genetic parenthood are protected only when accompanied by a desire to raise the resulting children, a conclusion that also affects other reproductive technologies. In addition to elaborating an analytic framework, the court set guidelines for resolving disputes when the couples had made no prior agreements, including holding that while the embryos are ex-utero the desire to avoid genetic parenthood almost always trumps the wish to become a parent. The well-reasoned analysis in Davis v. Davis should help shape legal and ethical discussion regarding the use of in vitro fertilization for many years to come. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Contradiction and Legislation Regarding the Right to LifeKevin L. Flannery, S.J.Unborn Human Life and Fundamental Rights: Leading Constitutional Cases under Scrutiny. Edited by Pilar Zambrano and William Saunders, with concluding reflections by John Finnis. Berlin: Peter Lang, 2019.The most fundamental principle of law is the principle of non-contradiction. This is Thomas Aquinas's position in the seminal article on the natural law, Summa theologiae I-II, question 94, article 2, where, (...) citing Aristotle, he formulates the principle as, "One should not simultaneously affirm and negate." Lafter in the same article, Thomas offers a practical formulation of the same principle, "Good is to be done and pursued and evil avoided"; but in law, since it is contained in propositions (airmations and negations) as distinct from ideas regarding the pursuit of goods, the prior formulation is the more immediately relevant of the two.The book under review is important in that, by going through the legal history regarding abortion and related issues in a number of different countries—the United States, Canada, Italy, Spain, Poland, Ireland (Eire), Costa Rica, Argentina, Chile, Mexico, and Peru—it causes to emerge any number of times the realization that legislation and judicial decisions in favor of abortion "rights" invariably infect a legal system with contradictions and inconsistencies of various sorts. The present essay is, therefore, not your typical book review. Its objective is simply to list some of the legal contradictions and inconsistencies identified by the book's various authors as they describe the legal status of the unborn in their respective nations. [End Page 1323]William Saunders's very clear and comprehensive first chapter is entitled, "Judicial Interference in the Protection of Human Life in the United States: Actions and Consequences." In it, he describes, among other things, the Human Cloning Prohibition Act passed by the U.S. House of Representatives in 2003, which prohibited "any person or entity, public or private" from performing human cloning (23). He speaks also of a bill proposed in the U.S. Senate once the Human Cloning Prohibition Act had passed in the House of Representatives. This Senate bill (which was entitle, "The Human Cloning Ban and Stem Cell Research Protection Act") would have prohibited "any person or other legal entity" from conducting human cloning, even while allowing nuclear transplantation, which it defines as "transferring the nucleus of a human somatic cell into an oocyte from which the nucleus... ha[s] been... removed or rendered inert." The problem here, as Saunders explains, is that this latter definition "is the very definition of cloning" (25). In other words, in the same year, two pieces of legislation were considered in the Congress of the United States, both purporting to ban human cloning, one of which would have permitted what the other described (correctly) as human cloning and so prohibited.In the second chapter, "Whither United States Abortion Law?" by Gerard V. Bradley, discussed, among other things, is the inconsistency between the United States Supreme Court's pro-abortion decision Roe v. Wade and various laws, both state and federal, prohibiting feticide. Bradley says of the 2004 federal Unborn Victims of Violence Act that, "in pertinent part it says that 'whoever' 'causes the death of or bodily injury to,' a 'child who is in utero' is guilty of an offense apart from any accompanying offense against the woman carrying the child." The penalty for such an act is the same as would be imposed if the act were inflicted upon the unborn child's mother: if, for instance, the mother was killed. "A child in utero," reports Bradley, "is defined as a member of the species homo sapiens, at any stage of development, who is carried in the womb'" (37).The problem here is that prosecutable under this law are acts identical with those performed legally by abortionists. Bradley mentions two cases in which a woman's male partner—in one case the woman's husband—effected by stealth the abortion of her child. In one case, the male purchased abortion pills and affixed to their container a pharmacy label indicating that it contained a common antibiotic; in the other, the husband obtained the same type of... (shrink)

Entrevista al doctor Gonzalo Herranz, profesor emérito de la Facultad de Medicina de la Universidad de Navarra. Cómo se forman los gemelos en el útero de la madre es una incógnita. No existe ninguna hipótesis que haya sido científicamente comprobada y, aun así, con el paso del tiempo una de las teorías que intentaba aproximarse a este hecho ha acabado por imponerse. Esta considera que los gemelos monozigóticos, aquellos que se generan a partir de un solo óvulo y un (...) solo espermatozoide, son fruto de la escisión de un embrión único en dos, y que esta división se produce en algún momento a lo largo de los catorce días que siguen a la fecundación. Sin embargo, el doctor Gonzalo Herranz, ha dedicado los últimos años de su vida a la investigación de este pequeño milagro de la embriología y ha propuesto una nueva teoría. (shrink)

Dr Boyle is right in drawing attention to the apparent inconsistency between laws that allow a fetus in utero to be aborted at the mother’s will but give the law’s full protection to a newborn infant, perhaps of the same gestation as the aborted fetus. It makes no difference how disabled the infant is, or how poor the prognosis. The reason for the inconsistency is that the two stages of the infant’s development—before birth and after birth—are governed by different legal (...) principles.While a fetus is in utero, the applicable laws are the criminal law of abortion and the civil law of battery, which here focuses on the mother’s direction alone. As Dr Boyle says, the law on abortion in the UK—and also in Australia—enables an abortion to be lawfully performed if continuing the pregnancy would present a real risk to the mother’s life, or her physical and mental health; and, additionally, in some jurisdictions like the UK, for serious fetal abnormality: see Abortion Act 1967 ,1 which includes risks to “existing children” as well as to the mother.2 Recent changes to the criminal law in the Australian Capital Territory and Western Australia have gone further and abortion is now lawful in those jurisdictions, simply on the informed request of the mother.3In jurisdictions that do not have a specific provision allowing abortion on the grounds of fetal abnormality, doctors have inferred that having a child with a serious abnormality would constitute a threat to the mother’s life or health, again focussing on the mother. The concept of harm to the mother’s health has been interpreted by the courts to include harm during pregnancy and delivery and also after the birth.4 This might take account of difficulties in raising …. (shrink)

The World Health Organisation recently listed air pollution as the most significant threat to human health. Air pollution comprises particulate matter (PM), metals, black carbon and gases such as ozone (O3), nitrogen dioxide (NO2) and carbon monoxide (CO). In addition to respiratory and cardiovascular disease, PM exposure is linked with increased risk of neurodegeneration as well as neurodevelopmental impairments. Critically, studies suggest that PM crosses the placenta, making direct in utero exposure a reality. Rodent models reveal that neuroinflammation, neurotransmitter imbalance (...) and oxidative stress are triggered following gestational/early life exposure to PM, and may be exacerbated by concomitant mitochondrial dysfunction. Gestational PM exposure (potentiated by mitochondrial impairment in the metabolically active neonatal brain) not only impacts neurodevelopment but may sensitise the brain to subsequent cognitive impairment. Having reviewed this field, we conclude that strategies are urgently required to reduce exposure to PM during this sensitive developmental period. (shrink)

Feticide, the practice of terminating the life of an otherwise viable fetus in utero, has become an increasingly common practice in obstetric centres around the globe, a concomitant of antenatal screening technologies. This paper examines this expanding practice in light of the concept of human dignity. Although it is assumed from the outset that even viable human fetuses are not persons and as such do not enjoy full membership in the moral community, it is argued that the fact that these (...) are nevertheless human fetuses affords them prima facie moral status. Thus even those who accept a liberal position with regard to therapeutic abortion, should be concerned about these more recent developments. Indeed, how we treat viable human fetuses has implications for our prospective treatment of other human non-persons and could undermine the common human dignity we all share. (shrink)

To better understand ethical issues involved in the field of human genetics and promote debate within the scientific community, the author surveyed scientists who engage in human genetics research about the pros, cons, and ethical implications of genetic testing. This study contributes systematic data on attitudes of scientific experts. The survey finds respondents are highly supportive of voluntary testing and the right to know one's genetic heritage. The majority consider in utero testing and consequent pregnancy termination acceptable for cases involving (...) likelihood of serious disease but disapprove for genetic reasons they consider arbitrary, leaving a gray area of distinguishing between treatment of disorders and enhancement still to be resolved. While safeguarding patient confidentiality versus protecting at-risk third parties presents a dilemma, preserving privacy from misuse by institutional third parties garners strong consensus for legislation against discrimination. Finally, a call is made for greater genetic literacy. (shrink)

An article by Mark Repenshek and a letter by Edward Delaquil published recently in The National Catholic Bioethics Quarterly underscore the urgent need for further moral and magisterial clarification regarding a number of highly complex and difficult bioethical issues. These involve ex utero therapeutic genomic interventions, the practice of in vitro fertilization and embryo transfer, and the ongoing debate over the morality of embryo adoption to help resolve the “absurd” fate of countless, cryopreserved human embryos. This essay critiques and argues (...) against the use of therapeutic IVF, helps clarify why embryo transfer and embryo adoption do not violate the sacred bond of marriage, and uses key magisterial passages from both Donum vitae and the Catechism of the Catholic Church to defend the practice of embryo transfer. National Catholic Bioethics Quarterly 14.2 : 227–234. (shrink)

O texto consiste em uma resenha da obra Retrotopia, de Zygmunt Bauman, publicada pela Editora Zahar em 2017. A obra percorre os labirintos da história da utopia e chega a retrotopia, cujo surgimento se dá devido ao divórcio, cada vez mais acentuado, entre poder e política, e o desencanto com ideias, ideais e promessas de futuro. [...]. O autor Zygmunt Bauman, sociólogo e filósofo polonês, tornou-se um dos mais importantes analistas de temas hodiernos, dedicando sua vida ao estudo da condição (...) humana. Sua formação e trajetória docente na Universidade de Varsóvia e na Universidade de Leeds, bem como sua vasta produção acadêmica, colocam-no na vanguarda dos intelectuais contemporâneos e caracterizam-no como um dos grandes pensadores da contemporaneidade. Se para alguns ele é o conhecedor perspicaz, para outros é um ingênuo pessimista. Contudo, sua produção acadêmica possui ampla aceitação no campo das ciências sociais, nas ciências da educação, sobretudo nos estudos norteados pela perspectiva pós-estruturalista. A partir de um diálogo com a “Utopia” de Thomas More, o autor tece seus argumentos na interlocução com diversos pensadores e com as diferentes situações cotidianas noticiadas nos principais jornais do mundo. Ele sistematiza conceitos, pressupostos, posicionamentos e críticas em uma obra densa, disposta em seis seções: a introdução, denominada de “A era da nostalgia”; o primeiro capítulo “De volta a Hobbes?”; seguido por “De volta às tribos”; “De volta à desigualdade”; “De volta ao útero”; e um epílogo, intitulado “olhando adiante, para variar”. Essas seções constituem uma espécie de inventário, que articula sentimentos e práticas retrotopianos, materializados no Lebenswelt dos sujeitos imersos na moderna sociedade líquida. [...]. Essa epidemia global de nostalgia de que fala o autor, em vez de consolidar o futuro como ethos de esperanças e expectativas, torna-o um invólucro de medo e pesadelos. É desse cenário complexo que emerge a retrotopia como um “novo” ciclo da história da utopia, substituindo o vigor do tempo incerto que está por vir, por tentativas conscientes de iteração com aspectos bem-sucedidos do passado, projetando-os como futuro, na fantasia de harmonizar segurança com liberdade. Embora não se trate de “retorno direto a um modo de vida antes praticado”, a suposta estabilidade, o pseudorresguardo no que passou, e a ilusória faculdade de controlar o que pode acontecer, causam um distanciamento entre poder e política, destituindo a soberania do Estado e das agências capazes de regular/prover a vida social. Ao denotar que os sujeitos contemporâneos duvidam da capacidade do Estado, e de qualquer instituição, de levar as coisas a cabo e de escolher entre aquelas que devem ser feitas, o autor revela o desmonte do coletivo como uma instância política de poder e a redução da vida social à capacidade de consumir, exacerbando o âmbito pessoal como responsável pela busca das melhorias de vida. [...]. (shrink)

The authors focus on IVF technology to raise profound and disturbing questions about potentiality in the context of ex utero embryo. They explore different meanings of such notion. They suggest that the notion of potential is relatively clear in the context of naturally occuring process of pregnancy. But a laboratory embryo follows no “natural course”. It cannot become a person without the deliberate human act to transferring it to a uterus. They also connect the notion of potential with that of (...) “possibility” noticing that the possibilities of becoming a person of an ex utero and an in utero embryo are very different. (shrink)

In lieu of an abstract, here is a brief excerpt of the content: Five Poems DEBORAH WARREN Bugonia hic vero subitum dictu mirabile monstrum aspiciunt, liquefacta boum per viscera toto stridere apes utero et ruptis effervere costis. —Vergil, Georgics IV The covert’s dark, but Aristaeus sees —beyond it, in the oleandered meadow, walking to her wedding with her maids— Eurydice, as sweet as early windfall apples to the gods of the bitter dead. She runs, from shifting shade to sun to (...) shade until, in a shock of sudden sun, she sways, blinded, blundering into an adder’s kiss, and while the bridegroom waits by the bridal bed, she waits to be undressed by worms instead. But Aristaeus pays for the assault. The mead-gods visit on his apiaries wax-moth, mites, foulbrood and chalk-disease until an oracle orders a hekatomb: after nine days the myrtle-nymphs perform a miracle, and out of the carcases crawl fat new sun-furred drones to work the comb, a gift of the mead-gods who, with the poet, praise the teams of bright collaborating bees as little Romans—parvos Quirites. arion 27.1 spring/summer 2019 And what about Eurydice? The swarm goes humming on, a small Rome in a hive. The story’s not about Eurydice’s second chance, or whether she’ll survive. Eurydice’s a minor character; she’s only one girl, sui generis. Besides, no cattle-trick exists for her. The gods can let the apiaries thrive and armies—even empires—endure; one girl’s more complicated to replace. 44 five poems The Tithonus Club We can begin our visit with the Day Room where, in wheelchairs, some with canes or walkers, members sit: a fraternity so ancient that the confrères mostly ignore each other (club tradition). The dues are paid in decades; no one has an outstanding balance—Sir? Whoa, steady, there! Sit down... yes. Here’s your blanket. The badge of membership—the club regalia? Laminated ceremonial bracelets bear the motto Do Not Resuscitate (legend which, in practice, is seldom honored). Eleven-thirty, gentlemen; lunch is served, and now a little toast while the television mesmerizes the aides: Messieurs, your health! Deborah Warren 45 Aphrodite at the Old-Age Home —for Aphrodite Kalogeris “Honey,” the night nurse said to Aphrodite, “let me fix your bib. Look, Aphrodite! Here’s your juice and crackers, Aphrodite! “She doesn’t speak a blessed word of English,” the night nurse told us, “but she understands as good as if we spoke to her in Greek.” Aphrodite’s ears were as grotesque as the pore-coarse nose that bloomed across her face, but she heard her name: When Aphrodite rose and, beatific, dreamed across the room, traversing a happiness none of us could hear, she spoke a language older than herself but still her own—a dialect of beauty able to translate the fetid air. 46 five poems Climbing Etna We’d see the lava, nights, from the town square, as if the sun—an egg of fire—broke at dusk, threading its incandescent yolk down a mountain hanging in black air. Every night we’d scan the dark horizon looking for those streaks, and every night they took a while to find, however bright: Etna, it seemed, had spent the evening rising off the earth, to hover even higher, as if the mountain meant not to be found. And then, today, we ran the flows to ground, climbing up to the rolling burns of fire— closer, into the shimmering air and hiss that glanced up from the thick and red-flecked river —until our soles were smoking. But the lava sang, inside the mountain: Come, discover the fire’s origin and genesis; more—the heart of the world, in its enceinte of blind white heat. Seeing the lava course wasn’t enough, or watching the rock decant the sun; what brought us up here was the force— the hot loins—of a lightning god as dark as thunder; and, like Eve, like Semele, we wanted to approach. But there’s a spark, a jewel older than geology: stop shy of it—of finding the fire’s source, of closing in on what you shouldn’t see. Deborah Warren 47 Human Sucking strength... (shrink)

_Background:_ Preterm infants are still at an increased risk for suboptimal neurodevelopmental outcomes when compared with term born infants. The development of a child born preterm can be jeopardized by suboptimal conditions during pregnancy, in addition to the suboptimal growth environment postnatally compared to the normal in utero environment. This review summarizes the literature on the role of chorioamnionitis, placental insufficiency, and maternal smoking on the developmental outcomes of preterm infants. _Methods:_ A systematic database search was performed to identify all (...) original articles published on or before September 12, 2018 that evaluated the impact of clinical or histological chorioamnionitis, abnormal prenatal fetal and placental blood flow, and prenatal smoking exposure on the neuropsychological and cognitive outcomes of preterm infants. We identified a total of 54 studies. Thirty five original articles evaluated the effects of clinical or histological chorioamnionitis; 15 studies evaluated the effects of abnormal blood flow patterns; and four studies evaluated the effects of maternal smoking during pregnancy. _Results:_ The studies on prenatal risk factors showed conflicting results about the impact on the neurodevelopment of preterm infants. The majority of the studies did not show that chorioamnionitis poses a direct risk to the development of preterm infants. The role of abnormal prenatal placental and fetal blood flow on the development of preterm infants remained inconclusive because the sample sizes were often small and methodological problems complicated the interpretation of the data. Maternal smoking during pregnancy was assessed only in one cohort which showed that maternal smoking is a risk for suboptimal cognitive and neuropsychological development in preterm infants. _Conclusions:_ This review summarizes the data on several prenatal risk factors which play a role in the developmental outcomes of preterm infants. To optimize the developmental outcomes, we need to first optimize the fetal wellbeing before birth. More research that extends from the fetal life to long-term developmental outcomes is needed. (shrink)

A simple definition of consciousness is sensory awareness of the body, the self, and the world. The fetus may be aware of the body, for example by perceiving pain. It reacts to touch, smell, and sound, and shows facial expressions responding to exter- nal stimuli. However, these reactions are probably preprogrammed and have a subcortical nonconscious origin. Furthermore, the fetus is almost continuously asleep and unconscious partially due to endog- enous sedation. Conversely, the newborn infant can be awake, exhibit sensory (...) awareness, and process memorized mental representations. It is also able to differentiate between self and nonself touch, express emotions, and show signs of shared feelings. Yet, it is unreflective, present oriented, and makes little reference to concept of him/herself. Newborn infants display features characteristic of what may be referred to as basic consciousness and they still have to undergo considerable maturation to reach the level of adult consciousness. The preterm infant, ex utero, may open its eyes and establish minimal eye contact with its mother. It also shows avoidance reactions to harmful stimuli. However, the thalamocortical connections are not yet fully established, which is why it can only reach a minimal level of consciousness. (shrink)

In this article I want to ask what we should do, either collectively or individually, if we could identify by genetic and family profding the 12% of the male population likely to commit almost half the violent crime in our society. What if we could identify some individuals in that 12% not only at birth, but in utero, or before implantation? I will explain the source of these figures later; for now, I will use them only to provide a concrete (...) example of the kind of predictive claims we can expect to be made with some frequency, and some scientific credibility, over the next generation. I will adopt an outlook that one commentator has called “pragmatic optimism,” but which could also be called technological optimism - the belief that a science or technology will achieve many or most of its advertised goals. My optimism will be directed towards human behavioral genetics, the source of predictions like the one I just offered; I will assume that this controversial discipline will achieve a substantial pan of its scientific ambition to identlfy genetic differences among individuals that help predict and possibly explain future behavior, psychological health, and cognitive skill. This optimism is very limited -it concerns the scientific success of behavioral genetics, not the social value of that success. (shrink)

In a recent publication, I argued that there is a conceptual difference between artificial womb (AW) technology, capable of facilitating gestation ex utero, and neonatal intensive care, providing incubation to neonates born prematurely. One of the reasons I provided for this distinction was that the subjects of each process are different entities. The subject of the process of gestation ex utero is a unique human entity: a ‘gestateling’, rather than a fetus or a newborn preterm neonate. Nick Colgrove wrote a (...) response to my paper, claiming that my distinction between the subject of an AW and a newborn (in intensive care) was false. He claims that I have not accounted for the proper definition of ‘birth’ and that gestatelings are not a distinct product of human reproduction. Further, Colgrove posits that even if I can successfully distinguish gestatelings from preterms, such a distinction is morally irrelevant because the entities would have the same moral status. In this paper, I address the three challenges raised and defend the claim that gestatelings are unique entities. Moreover, I argue that moral status should not be considered ipso facto determinative in the debate about AWs. (shrink)

The possibilities of non-invasive prenatal testing (NIPT) are expanding, and the use of NIPT for adult-onset conditions may become widely available in the near future. If parents use NIPT to test for these conditions, and the pregnancy is continued, they will have information about the child’s genetic predisposition from birth. In this paper, we argue that prospective parents should be able to access NIPT for an adult-onset condition, even when they have no intention to terminate the pregnancy. We begin by (...) outlining the arguments against testing in such a situation, which generally apply the same considerations that apply in the predictive testing of a minor to the fetus in utero. We then contend, firstly, that there are important practical considerations that support availability of testing for prospective parents regardless of their stated intentions. Secondly, we object to the ethical equation of a fetus in utero with a minor. We base our analysis on a view of pregnancy that conceptualises the fetus as a part of the gestational parent, as opposed to the more common ‘container’ model of pregnancy. We suggest that fetal information is best conceptualised as shared information between the gestational parent and future child. Thus, it should be approached in similar ways as other kinds of shared information (such as genetic information with implications for family members), where a person has a claim over their own information, but should be encouraged to consider the interests of other relevant parties. (shrink)

English law is unambiguous that legal personality, and with it all legal rights and protections, is assigned at birth. This rule is regarded as a bright line that is easily and consistently applied. The time has come, however, for the rule to be revisited. This article demonstrates that advances in fetal surgery and (anticipated) artificial wombs do not marry with traditional conceptions of birth and being alive in law. These technologies introduce the possibility of ex utero gestation, and/or temporary existence (...) ex utero, and consequently developing human beings that are novel to the law. Importantly, therefore, the concepts of birth and born alive no longer distinguish between human beings deserving of legal protection in the way originally intended. Thus, there is a need for reform, for a new approach to determining the legal significance of birth and what being legally alive actually encompasses. Investigating the law of birth is of crucial importance, because of the implications of affording or denying the subjects of new reproductive technologies rights and protections. A determination of the legal status of the subject of fetal surgery or an artificial womb will determine what can and cannot be done to each entity. Moreover, the status afforded to these entities will drastically impact on the freedoms of pregnant women. (shrink)

This essay briefly describes a few of the problems associated with using personhood language to defend the right to life of the pre‐implantation embryo. Arguing that an immaterial soul explains the personal identity of an embryo is problematic for many people because there is no apparent spiritual activity in the unborn. While some scholars argue that the embryo has the potential to act as an adult person and thus should be protected from harm, others contend that potentiality alone is insufficient (...) reason to ascribe special moral worth to the embryo in utero. For Thomas Aquinas, the soul is not only the life‐principle that organizes the human body, but it is also that by which the human being thinks and wills. By making suitable corrections to Aristotle's hylomorphic depiction of the soul–body relation, I suggest that a rational soul must be present from the moment of conception and that it is at the service of the person. What is of critical importance here is to accept that a human being is present from the moment of conception, something the vast majority of embryologists maintain, notwithstanding the inveiglement of those who state that the pre‐implantation blastocyst is simply a disorganized clump of cells. (shrink)

Court-ordered caesarean sections against the explicit wishes of the pregnant woman have been criticised as violations of the woman's fundamental right to autonomy and to the inviolability of the person--particularly, so it is argued, because the fetus in utero is not yet a person. This paper examines the logic of this position and argues that once the fetus has passed a certain stage of neurological development it is a person, and that then the whole issue becomes one of balancing of (...) rights: the right-to-life of the fetal person against the right to autonomy and inviolability of the woman; and that the fetal right usually wins. (shrink)