A basic criticism of Perry Hendrick's "Even if the fetus is not a person, abortion is immoral: The Impairment Argument," is offered, namely that the reasons why intentionally causing fetal alcohol syndrome is wrong simply do not apply to fetuses and so the "Impairment Argument" against abortion fails.

The history of the fetal alcohol syndrome provides a microcosm in which to explore the larger ramifications of historical citations in biomedical publications. Though some historical references such as Biblical writings may hint at a rudimentary understanding of the relationship between maternal drinking and fetal development, no definitive case can be made for an understanding of FAS dating back hundreds of years. Authors who claim an impressive history for FAS misrepresent that history. The modern history of (...) FAS raises a question concerning citations of original discoveries. The first paper describing ethanol-induced damage to the fetus appeared in 1968 yet most researchers cite one of two papers from 1973. Both ancient citations and modern references to original discoveries pose difficult questions for the scientist. Both dilemmas may be solved by a better reading of the literature and a more judicious wording when writing about history. (shrink)

Infant facial characteristics may affect discriminative parental solicitude because they convey information about the health of the offspring. We examined the effect of Fetal Alcohol Syndrome (FAS) infant facial characteristics on hypothetical adoption preferences, ratings of attractiveness, and ratings of health. As expected, potential parents were more likely to adopt “normal” infants, and they rated the FAS infants as less attractive and less healthy. Cuteness/attractiveness was the best predictor of adoption likelihood.

A recent article argued for the immorality of abortion regardless of personhood status by comparing the impairment caused by fetal alcohol syndrome to the impairment caused by abortion. I argue that two of the premises in this argument fail and that, as such, one cannot reasonably attribute moral harms to abortion on the basis of the moral harms caused by fetal alcohol syndrome. The impairment argument relies on an inconsistent instantiation, which undermines the claim (...) that personhood is irrelevant, and it does not fulfill its own ceteris paribus clause, which demands that no additional benefit be gained from abortion that would not be gained from causing fetal alcohol syndrome. (shrink)

Both the medical model and the social model of disability have substantial drawbacks for the project of creating better lives for people with disabilities; the first denies the value of difference and the effects of discrimination, and the second denies any place for prevention and cure. Using fictional and non-fictional parental narratives of Fetal Alcohol Syndrome, this article argues that a third model–a morphological model of disability–can best help us think about respectfully and effectively intervening in disability.

In his recent article Perry Hendricks presents what he calls the impairment argument to show that abortion is immoral. To do so, he argues that to give a fetus fetal alcohol syndrome is immoral. Because killing the fetus impairs it more than giving it fetal alcohol syndrome, Hendricks concludes that killing the fetus must also be immoral. Here, I claim that killing a fetus does not impair it in the way that giving it (...) class='Hi'>fetal alcohol syndrome does. By examining the reason why giving a fetus this condition is wrong, I conclude that the same reasoning, on common pro‐choice accounts, does not apply to killing the fetus. Accordingly, Hendricks's argument does not succeed in showing abortion is immoral. (shrink)

Perry Hendricks has recently presented the impairment argument for the immorality of abortion, to which I responded and he has now replied. The argument is based on the premise that impairing a fetus with fetal alcohol syndrome is immoral, and on the principle that if impairing an organism is immoral, impairing it to a higher degree is also—the impairment principle. If abortion impairs a fetus to a higher degree, then this principle entails abortion is immoral. In my (...) reply, I argued that abortion does not impair an organism in the way fetal alcohol syndrome does, and showed that interest theorists can avoid the argument. Hendricks has responded to my criticisms by demonstrating how abortion does impair an organism. In this reply, I acknowledge Hendricks’ point, but proceed to criticise the application of the impairment principle to abortion, showing that it is invalid if we accept his explanation for why inflicting fetal alcohol syndrome is immoral. I also argue that counter-examples show the impairment principle itself to be dubitable, concluding that the impairment argument remains unpersuasive. (shrink)

The social politics of women’s alcohol use is controversial given current debates over maternal-fetal health, fetal alcohol syndrome, and debates about welfare. Exploring the early twentieth century intersections of Prohibition, birth control reform, and alcohol politics reveals the historical roots of current recommendations surrounding women, alcohol, and public assistance.

Recently, Perry Hendricks argued that abortion is immoral even if the fetus is not a person. He did so by arguing that causing a future child to suffer from fetal alcohol syndrome is wrong because it is an impairment, and an abortion would be an even more substantial impairment. Here I reply that the argument depends on ignoring relevant facts that are essential for moral decision‐making. Moreover, if we adapt the argument to consider these essential facts, then (...) the argument fails because it no longer applies to the case under consideration. (shrink)

Fetal alcohol syndrome , the most common avoidable human birth defect, is the extensive irreversible brain damage caused by heavy prenatal alcohol exposure. Following the discovery of FAS in 1973, a multidisciplinary research community began applying discipline-specific methods to investigate the mechanisms underlying FAS and its consequences for the victims’ cognition and social behavior. An academic biomathematician and statistician, since 1984 I have collaborated with one American research group studying this condition.

This book is an interdisciplinary contribution to bioethics, bringing together philosophers, sociologists and Science and Technology Studies researchers as a way of bridging the disciplinary divides that have opened up in the study of bioethics. Each discipline approaches the topic through its own lens providing either normative statements or empirical studies, and the distance between the disciplines is heightened not only by differences in approach, but also disagreements over the values, interpretations and problematics within bioethical research. In order to converse (...) across these divides, this volume includes contributions from several disciplines. The volume examines the sociological issues faced by interdisciplinary research in bioethics, the role of expertise, moral generalisations, distributed agency, and the importance of examining what is not being talked about. Other contributions try to take an interdisciplinary look at a range of specific situations, fetal alcohol syndrome in the media, citizen science, electronic cigarettes and bioethical issues in human geography. (shrink)

Perry Hendricks’ impairment argument for the immorality of abortion is based on two premises: first, impairing a fetus with fetal alcohol syndrome is immoral, and second, if impairing an organism to some degree is immoral, then ceteris paribus, impairing it to a higher degree is also immoral. He calls this the impairment principle. Since abortion impairs a fetus to a higher degree than FAS, it follows from these two premises that abortion is immoral. Critics have focussed on (...) the ceteris paribus clause of TIP, which requires that the relevant details surrounding each impairment be sufficiently similar. In this article, we show that the ceteris paribus clause is superfluous, and by replacing it with a more restrictive condition, the impairment argument is considerably strengthened. There are no data in this work. (shrink)

Blackshaw and Hendricks have recently developed and defended the impairment argument against abortion, arguing that the immorality of giving a child fetal alcohol syndrome (FAS) provides us with reason to believe that abortion is immoral. In this paper, we forward two criticisms of the impairment argument. First, we highlight that, as it currently stands, the argument is very weak and accomplishes very little. Second, we argue that Blackshaw and Hendricks are fundamentally mistaken about what makes giving a (...) child FAS immoral. Once we acknowledge this, it is clear that our intuitions about giving a child FAS provide no support for the supposed immorality of abortion. (shrink)

Much of the discussion surrounding the ethics of abortion has centered around the notion of personhood. This is because many philosophers hold that the morality of abortion is contingent on whether the fetus is a person - though, of course, some famous philosophers have rejected this thesis (e.g. Judith Thomson and Don Marquis). In this article, I construct a novel argument for the immorality of abortion based on the notion of impairment. This argument does not assume that the fetus is (...) a person - indeed, I concede (for the sake of argument) that the fetus is not a person - and hence the morality of abortion is not contingent on whether the fetus is a person. I finish by answering a plethora of objections to my argument, concluding that none of them are successful. (shrink)

In an article of this journal, Perry Hendricks makes a novel argument for the immorality of abortion. According to his impairment argument, abortion is immoral because: (a) it is wrong to impair a fetus to the nth degree, such as causing the fetus to have fetal alcohol syndrome (FAS); (b) it is wrong to impair a fetus to the n+1 degree (to cause the fetus to be more impaired than to have FAS); (c) killing the fetus impairs (...) the fetus to the n+1 degree (causes it to be more impaired than to have FAS); (d) abortion kills the fetus; (e) therefore, abortion is immoral. The impairment argument is a promising account for the wrongness of abortion because it does not rely on the controversial metaphysical premise that a fetus is a person. This article aims to show, that despite some immediate advantages over the rival theories of the immorality of abortion there is a reason to believe that the impairment argument is untenable. That is because there are goods that can be achieved by abortion but that cannot be achieved by impairing the fetus. (shrink)

It is far from obvious that outside of highly specialized domains such as commercial agriculture, the methodology of biometrics—quantitative comparisons over groups of organisms—should be of any use in today’s bioinformatically informed biological sciences. The methods in our biometric textbooks, such as regressions and principal components analysis, make assumptions of homogeneity that are incompatible with current understandings of the origins of developmental or evolutionary data in historically contingent processes, processes that might have come out otherwise; the appropriate statistical methods are (...) those suited to random walks, not normal distributions. A valid methodology would further require that especially close attention be paid to the difference between aspects of processes that are plastic, those that encode their own histories or biographies, and the very small fraction of quantifications that can usefully and realistically be modeled as varying by colored noise around a central tendency that itself has some quantitative meaning. This point of view—that only a vanishingly small fraction of the quantitative information borne by any living organism is worth quantifying—is illustrated by some data on a human birth defect, namely, fetal alcohol syndrome. In a suggestive metaphor, the biometrician is like the pilgrim in Friedrich’s painting Der Wanderer über dem Nebelmeer, uncertain as to whether to measure the mountains or the clouds. The mountains stand for contingent history, the clouds for the subset of the data most closely matching controlled experiments suitable for quantitative biometric summary. Biometrics applies to the clouds, not the mountains. The success of statistical methods comes at the expense of all the theories that we simultaneously hold to be true about the biological materials to which they both pertain. Biometrics is thus complementary to all of the emerging reductionist sciences of biological structure. (shrink)

Perry Hendricks’ original impairment argument for the immorality of abortion is based on the impairment principle (TIP): if impairing an organism to some degree is immoral, then ceteris paribus, impairing it to a higher degree is also immoral. Since abortion impairs a fetus to a higher degree than fetal alcohol syndrome (FAS) and giving a fetus FAS is immoral, it follows that abortion is immoral. Critics have argued that the ceteris paribus is not met for FAS and (...) abortion, and so we proposed the Modified Impairment Principle (MIP) to avoid these difficulties. Dustin Crummett has responded, arguing that MIP is open to various counterexamples which show it to be false. He also shows that MIP can generate moral dilemmas. Here, we propose a modification to MIP that resolves the issues Crummett raises. Additionally, Alex Gillham has criticized our appropriation of Don Marquis’ ‘future like ours’ reasoning about the wrongness of impairment. We show that his objections have minimal implications for our argument. (shrink)

Hendricks’ The Impairment Argument (TIA) claims that it is immoral to impair a fetus by causing it to have fetal alcohol syndrome (FAS). Since aborting a fetus impairs it to a greater degree than causing it to have FAS, then abortion is also immoral. In this article, I argue that TIA ought to be rejected. This is because TIA can only succeed if it explains why causing an organism to have FAS impairs it to a morally objectionable (...) degree, entails that abortion impairs an organism to a morally objectionable and greater degree than causing FAS, and satisfies The Impairment Principle’s ceteris paribus clause. In order to do all three things, TIA must presuppose some theory of well-being. Even then, no theory of well-being accomplishes all three tasks that TIA must in order to succeed. However, even if this is false and TIA can meet all three objectives by presupposing some theory of well-being, it would not do very much to advance the debate about the morality of abortion. As I argue, TIA would essentially restate well-established arguments against abortion based on whatever theory of well-being it must presuppose in order to be successful. (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)

In order for the so-called strengthened impairment argument to succeed, it must posit some reason R that causing fetal alcohol syndrome is immoral, one that also holds in cases of abortion. In formulating SIA, Blackshaw and Hendricks borrow from Don Marquis to claim that the reason R that causing FAS is immoral lies in the fact that it deprives an organism of a future like ours. I argue here that SIA fails to show that it is immoral (...) to cause FAS and abort fetuses that will not be born because it deprives them of an FLO. This is because fetuses that will not be born have no chance of having an FLO in the first place, so causing FAS for and aborting them cannot deprive them of one. I then consider three responses to my argument. I conclude that each fails. SIA does not accomplish its task of showing why it is immoral to impair fetuses that will not be born. Perhaps it can accomplish the task of showing why it is immoral to impair fetuses that will be born, but not without sacrificing at least some of its alleged significance. (shrink)

I argue here that the impairment principle requires clarification. It needs to explain what makes one impairment greater than another, otherwise we will be unable to make the comparisons it requires, the ones that enable us to determine whether b really is a greater impairment than a, and as a result, whether causing b is immoral because causing a is. I then develop two of what I think are the most natural accounts of what might make one impairment greater than (...) another. The quantitative understanding of greater impairment is problematic because it leaves the impairment principle vulnerable to counterexamples; just because impairment b impairs a larger number of abilities or the same number of abilities but for a longer period or to a higher degree does not mean that b is a greater impairment than a. The qualitative understanding of greater impairment is problematic because it does not explain examples of greater impairment used in the literature, means that an abortion is always a qualitatively more severe impairment than causing fetal alcohol syndrome regardless of how the organism is affected, and/or entails that lethal impairment is always greater than nonlethal impairment. (shrink)

The Internet has quickly gained popularity as a major source of health-related information, but its impact is unclear. Here, we investigate the extent to which advocacy websites for three neurodevelopmental disorders—cerebral palsy (CP), autism spectrum disorder (ASD) and fetal alcohol spectrum disorder (FASD)—inform stakeholders about treatment options, and discuss the ethical challenges inherent in providing such information online. We identified major advocacy websites for each disorder and assessed website accountability, the number, attributes, and accessibility of treatments described, and (...) the valence of treatment information. With the exception of FASD websites, we found that advocacy websites provide a plethora of information about a wide variety of readily available products and services. Treatment information is primarily targeted at families and is overwhelmingly encouraging, regardless of the type or conventionality of treatments. Many websites acknowledge corporate sponsors. While the majority do not overtly advertise or endorse specific brands, they also do not prominently display disclaimers about the nature and intent of treatment information. Thus, while advocacy websites are organized to serve as information clearinghouses, they implicitly appear to provide endorsement of selected treatments and services. We conclude with recommendations for new partnerships between government-funded health organizations, advocacy and investigators to make more transparent the role of online information in informing treatment options and improving the evaluation of information. (shrink)

Perry Hendricks’ original ‘impairment argument’ against abortion relied on ‘the impairment principle’ (TIP): ‘if it is immoral to impair an organism O to the nth degree, then,ceteris paribus, it is immoral to impair O to the n+1 degree.’ Since death is a bigger impairment than fetal alcohol syndrome (FAS), Hendricks reasons that, by TIP, if causing FAS is immoral, then,ceteris paribus, abortion is immoral. Several authors have argued that this conclusion is uninteresting, since theceteris paribusclause is not (...) satisfied in actual cases of abortion: women have reasons for wanting abortions which do not apply to drinking during pregnancy, so all else is not equal, and the conclusion is irrelevant to the morality of actual abortions. In a recent article in this journal, Hendricks and Bruce Blackshaw try to evade this criticism by replacing TIP with the ‘modified impairment principle’ (MIP): ‘if it is immoral to impair an organism O to the nth degree for reason R, then, provided R continues to hold (or is present), it is immoral to impair O to the n+1 degree.’ MIP allows us to derive theultima faciewrongness of abortion (not just itsceteris paribuswrongness) because MIP lacks aceteris paribusclause. But I argue that this lack also renders MIP false: MIP faces counterexamples and implausibly produces genuine moral dilemmas. Since the moral principle on which it relies is false, the modified impairment argument fails. I close by considering what a principle would need to do for the impairment argument to succeed. (shrink)

The impairment argument claims that abortion is immoral, because it results in a greater impairment to a fetus than other actions that are clearly immoral, such as inflicting fetal alcohol syndrome. Alex Gillham argues that the argument requires clarification of the meaning of greater impairment. He proposes two definitions, and points out the difficulties with each. In response, I argue that while the impairment argument’s definition of greater impairment is narrow in scope, it is sufficient for its (...) intended purpose. Broadening its scope to more controversial comparisons of impairment is likely to undermine the intuitive appeal of the impairment principle that the argument is based upon. (shrink)

Kyle van Oosterum and Emma Curran have recently argued that the impairment argument against abortion is weak and accomplishes little. They also claim that impairment fails to explain what makes giving a child fetal alcohol syndrome (FAS) immoral, which is an important premise of the argument. Here, I explain that the impairment argument is not as weak as they believe. Further, I argue that impairment offers a superior explanation for what makes giving a child FAS immoral than (...) their proposal based on creative beneficence. (shrink)

In his recent article “Even if the fetus is not a person, abortion is immoral: The Impairment Argument,” Perry Hendricks sets out to sidestep thorny metaphysical questions regarding human fetuses and present a new argument against abortion – if impairing a fetus with fetal alcohol syndrome is immoral, then killing the fetus is immoral. Hendricks takes inspiration from Judith Jarvis Thomson’s defense of abortion – that even if fetuses are persons with a right to life, the right (...) to life is not the right to use others, so it is acceptable to induce abortion. Together with Bruce Blackshaw, Hendricks set out to strengthen the impairment argument by appealing to Don Marquis’s future like ours (FLO) account of the wrongness of killing. Here I argue the impairment argument falls short in three ways. First, Hendricks and Blackshaw fail to assume fetuses aren’t persons, broadly construed. Second, they fail to show that impairing a fetus is immoral. Third, they overlook abortions that (merely) let the fetus die. Finally, I argue Thomson’s defense of abortion preempts the significance of the impairment argument; Thomson seems to show that even if killing a fetus is prima facie immoral, women still have the right to induce abortion. (shrink)

According to Hendricks Impairment Argument (IA), abortion is immoral because it impairs the fetus. Here, I argue it is not sufficient to show merely that abortion impairs, Hendricks must show that it harms the fetus. If the fetus is not numerically identical to the person it will become, then it isn't harmed by an abortion. But if the fetus is numerically identical to the person it will become, it is harmed by the deprivation of a future of value. However, taking (...) this route ultimately undermines the novelty of the impairment argument. (shrink)

According to Hendricks Impairment Argument (IA), abortion is immoral because it impairs the fetus. Here, I argue it is not sufficient to show merely that abortion impairs, Hendricks must show that it harms the fetus. If the fetus is not numerically identical to the person it will become, then it isn't harmed by an abortion. But if the fetus is numerically identical to the person it will become, it is harmed by the deprivation of a future of value. However, taking (...) this route ultimately undermines the novelty of the impairment argument. (shrink)

Could it be that if a fetus is not a person abortion is still immoral? One affirmative answer comes in the form of ‘The Impairment Argument’, which utilizes ‘The Impairment Principle’ to argue that abortion is immoral even if fetuses lack personhood. I argue ‘The Impairment Argument’ fails. It is not adequately defended from objections, and abortion is, in fact, a counterexample to the impairment principle. Furthermore, it explains neither what the wrong-making features of abortion are nor what features of (...) fetuses ground their supposed moral significance. By presupposing the fetus lacks personhood and providing no alternate account of the basis of fetuses’ moral significance, there is nothing to constitute abortion’s wrongness. Attempts to modify it fail for the same reasons. Thus, the impairment argument fails to show abortion is immoral. (shrink)

According to Hendricks Impairment Argument (IA), abortion is immoral because it impairs the fetus. Here I argue it is not sufficient to show merely that abortion impairs, Hendricks must show that it harms the fetus. If the fetus is not numerically identical to the person it will become, then it isn’t harmed by an abortion. But if the fetus is numerically identical to the person it will become, it is harmed by the deprivation of a future of value. However, taking (...) this route ultimately undermines the novelty of the impairment argument. (shrink)

Brussen, Kerri Anne On 29 November 2012, one of the Standing Committees of the Commonwealth House of Representatives released a report on the prevention, diagnosis and management of Fetal Alcohol Spectrum Disorders in Australia. This article explores the findings and recommendations of this report. The Commonwealth parliamentary committee noted that FASD is a serious health issue in Australia. It therefore called for a National Plan of Action, education for health professionals, and public awareness campaigns to encourage women not (...) to drink when pregnant or when planning a pregnancy. Other recommendations included better management of FASD within education, disability services, and the criminal justice system. (shrink)

Khalafzai, Rida Usman Harms of alcohol consumption are not limited to the consumer. For women, it poses a significant threat to their unborn child. This article discusses one type of alcohol-related harm to the fetus: the fetal alcohol spectrum disorders (FASD).

This book discusses and provides insight on the legal and ethical dilemmas of managing those with Fetal Alcohol Spectrum Disorder (FASD). This book provides a clear perspective for those clinicians and legal professionals who are working with those with this disorder, and correspondingly increases their understanding when arranging effective supports for this population. Historically, the primary focus on FASD has been on children. However, this is a lifelong disorder, and the implications of this disorder become even more prominent (...) and complex in adulthood. Those with this condition can struggle with impulsiveness, and a host of cognitive difficulties. This correspondingly impacts their independence and employability, and produces an elevated risk for homelessness and other residential issues, involvement in substance use, being exploited, development of behavioural issues, and subsequent legal difficulties. Their cognitive difficulties result in challenges for legal systems around the world to understand their issues, and to design appropriate remedial strategies, recommendations for treatments and supports, and even for understanding the failure of many of these individuals to be able to change their behaviours effectively. This produces various legal and ethical dilemmas, which are discussed in detail in this volume by 28 authors from Europe, New Zealand, and North America. These include discussions regarding the rights of the unborn child, the alcohol industry's duty to warn, whether small amounts of alcohol during pregnancy can be condoned, and even the current use of involuntary hospitalization for addicted mothers. Other chapters discuss the need for training on FASD for front line officers, use of lies during interrogation of those with FASD, medical and legal interventions for offenders with FASD, access to diagnostic services and follow-up supports, and whether FASD can be considered a mitigating factor for sentencing. Furthermore, caregivers also provide their stories regarding the daily dilemmas that are faced in raising those with FASD. (shrink)

The diagnosis of Fetal Alcohol Spectrum Disorders is embedded in a matrix of biological, social and ethical processes, making it an important topic for crossdisciplinary social and ethical research. This article reviews different branches of research relevant to understanding how FASD is identified and defined and outlines a framework for future social and ethical research in this area. We outline the character of scientific research into FASD, epidemiological discrepancies between reported patterns of maternal alcohol consumption during pregnancy (...) and the incidence of FASD, and the social and ethical considerations that may impact on who is, and is not, diagnosed. We highlight what further research investigating FASD diagnostic processes, as well as the multi-generational impacts of FASD, is needed. Important research priorities are to: 1) enumerate the variety of stakeholders involved in seeking FASD diagnoses; 2) understand the experiences and perspectives of mothers from different backgrounds who have consumed alcohol during pregnancy and their affected children; and 3) collect health histories of maternal alcohol consumption in families to determine the effect of FASD at sub-cultural and cultural levels. (shrink)

South Africa has the highest rate of foetal alcohol syndrome (FAS) in the world. The problem of alcohol abuse in pregnancy has very deep historical roots that are intertwined with the injustices of both apartheid and pre-apartheid colonialism. Much of the research that is being done in these communities is focused on identifying the epidemiological variables associated with these patterns of alcohol abuse. The underlying reasons as to why these patterns continue seem to remain largely obscured (...) from view. In this article, I apply the theory proposed by Powers and Faden of social justice as a ‘moral foundation for public health and health policy’ to the problem of FAS in South Africa. The objective of this application is two-fold: first, to critically explore the additional insights and alternative perspectives to the problem of FAS that this approach may provide and second, to assess the utility of the theory when applied directly to a specific public health problem. I conclude by noting that although this approach could result in the kind of ‘public health scope creep’ that has been criticized by various authors, it does provide fresh insights to the problem of FAS in South Africa. (shrink)

A diagnosis of Fetal Alcohol Spectrum Disorder ascribes cause to developmental disability; however, there are logical issues in causation with ethical implications. This article focuses on the use of fallacious logic in FASD, focusing on the Canadian Guidelines for diagnosis, and knowledge translation issues from science to practice. The clinician’s logical fallacy is an ethical issue of veracity in the clinician–patient relationship; this then leads to issues of nonmaleficence, because the diagnosis in turn blames the mother for her (...) child’s difficulties. Suggestions for revised diagnostic practices that avoid allusions to causation and responsibility are discussed. (shrink)

This book discusses how to deal ethically with people with Fetal Alcohol Spectrum Disorder in the police, courts and correctional services. Ethical and legal issues associated with the deficits of individuals with a brain disorders such as FASD are surfacing more and more frequently in criminal proceedings. People with FASD often have not been diagnosed and rarely exhibit any visible evidence of the disorder. It has been argued that this invisible disability puts them in a disadvantaged position in (...) the justice system, since the awareness of this condition is limited. The need to identify and to address FASD more effectively and the many ethical issues this raises within the context of the law is increasingly acknowledged within judicial and legislative branches, as well as in government departments, agencies and community programs that provide services to those with FASD and their caretakers and families. This is the first book to give to elaborate on ethical and legal issues of FASD. (shrink)

Fetal alcohol spectrum disorders is an umbrella term covering several conditions for which alcohol consumption during pregnancy is taken to play a causal role. The benefit of individuals being identified with a condition within FASD remains controversial. The objective of the present study was to identify ethical aspects and consequences of diagnostics, interventions, and family support in relation to FASD. Ethical aspects relating to diagnostics, interventions, and family support regarding FASD were compiled and discussed, drawing on a (...) series of discussions with experts in the field, published literature, and medical ethicists. Several advantages and disadvantages in regards of obtaining a diagnosis or description of the condition were identified. For instance, it provides an explanation and potential preparedness for not yet encountered difficulties, which may play an essential role in acquiring much needed help and support from health care, school, and the social services. There are no interventions specifically evaluated for FASD conditions, but training programs and family support for conditions with symptoms overlapping with FASD, e.g. ADHD, autism, and intellectual disability, are likely to be relevant. Stigmatization, blame, and guilt are potential downsides. There might also be unfortunate prioritization if individuals with equal needs are treated differently depending on whether or not they meet the criteria for a specific condition. The value for the concerned individuals of obtaining a FASD-related description of their condition – for instance, in terms of wellbeing – is not established. Nor is it established that allocating resources based on whether individuals fulfil FASD-related criteria is justified, compared to allocations directed to the most prominent specific needs. (shrink)

Contexte : L’ensemble des troubles causés par l’alcoolisation fœtale (ETCAF), un diagnostic complexe qui comprend une vaste gamme de troubles neurodéveloppementaux, résulte de l’exposition à l’alcool dans l’utérus. L’ETCAF demeure mal compris par les Canadiens, ce qui pourrait contribuer à la stigmatisation dont souffrent les personnes atteintes d’ETCAF et les femmes qui consomment de l’alcool pendant leur grossesse. Méthodes : Pour mieux comprendre comment l’information sur l’ETCAF est présentée dans la sphère publique, nous avons analysé le contenu de 286 articles (...) tirés de dix grands journaux canadiens de langue anglaise (2002-2015). Nous avons utilisé le codage inductif pour établir une grille de codage à partir des données, puis nous avons appliqué de façon itérative des codes identifiés sur l’échantillon, en vérifiant la fiabilité intercodeurs. Résultats : Nous avons identifié six grands thèmes liés au contenu cliniques et scientifiques des médias : 1) prévalence de l‘ETCAF et de la consommation d’alcool chez les femmes ; 2) recherche en lien avec l’ETCAF ; 3) diagnostic d’ETCAF ; 4) traitement de l’ETCAF et de l’abus de substances par les mères ; 5) incapacités primaires associés à l’ETCAF ; et 6) effets de l’alcool pendant la grossesse. Discussion : Dans le cadre de ces six thèmes, nous examinons trois types d’exagération et de fausse représentation qui ont des conséquences sur le plan éthique : 1) l’exagération des taux d’ETCAF dans les communautés autochtones ; 2) la contradiction entre les articles sur les effets de l’exposition prénatale à l’alcool ; et 3) l’information scientifiquement exacte qui néglige le contexte social de la consommation et de l’abus d’alcool par les femmes. Respectivement, ces représentations pourraient mener à des croyances stéréotypées préjudiciables au sujet des peuples autochtones, pourraient créer de la confusion quant aux choix sains pendant la grossesse et risqueraient d’enflammer inutilement les débats sur des questions délicates concernant les choix des femmes. (shrink)

Stigma can influence the prevention and identification of fetal alcohol spectrum disorder, a leading cause of developmental delay in North America. Understanding the effects of public health practices and policies on stigma is imperative. We reviewed social science and biomedical literatures to understand the nature of stigma in FASD and its relevance from an ethics standpoint in matters of health practices and policies. We propose a descriptive model of stigma in FASD and note current knowledge gaps; discuss the (...) ethical implications of stigma based on two distinct criteria ; and describe two cases and the concerns associated with inadvertent stigmatization by public health initiatives for FASD. We recommend further empirical and ethical analyses to examine whether public health policies and practices inadvertently stigmatize and impact the success of public health initiatives and programs for FASD. (shrink)

Fetal alcohol spectrum disorder is a multifaceted disability, characterized not only by brain- and body-based challenges, but also high rates of environmental adversity, lifelong difficulties with daily living, and distinct sociocultural considerations. FASD is one of the most common neurodevelopmental disabilities in the Western world and associated with significant social and economic costs. It is important to understand the complexities of FASD and the ways in which FASD requires unique consideration in research, practice, and policy. In this article, (...) we discuss our perspectives on factors that distinguish FASD from other disabilities in terms of complexity, co-occurrence, and magnitude. We provide an overview of select literature related to FASD as a socially rooted disability with intergenerational impacts and multiple layers of stigma. These social issues are intertwined with notable experiences of adversity across the lifespan and high rates of co-occurring health concerns for individuals with FASD, all of which present unique challenges for individuals, caregivers, families, service providers, and policy makers. Understanding these factors is the first step in developing and implementing specialized initiatives in support of positive outcomes for individuals with FASD and their families. Future directions are proposed for advancing research, practice, and policy, and responding to the unique complexities of FASD. (shrink)

Alcohol consumption during pregnancy can lead to fetal alcohol spectrum disorders. FASD is a spectrum of structural, functional, and neurodevelopmental problems with often lifelong implications, affecting communities worldwide. It is a leading preventable form of intellectual disabilities and therefore warrants effective prevention approaches. However, well-intended FASD prevention can increase stigmatization of individuals with FASD, women who consume or have consumed alcohol during pregnancy, and non-biological parents and guardians of individuals with FASD. This narrative review surveyed the (...) literature on stigmatization related to FASD. Public stigma appears to be the most common form of stigma studied. Less is known about FASD-related self-stigma, stigma by association, and structural stigma. Accordingly, the current literature on FASD-related stigma does not appear to provide sufficient guidance for effectively reducing FASD-related stigma. However, lessons can be learned from other related health topics and the use of a systematic approach for the development of health promotion programs, namely Intervention Mapping. (shrink)

BackgroundPrenatal and early postnatal choline supplementation reduces cognitive and behavioral deficits in animal models of Fetal Alcohol Spectrum Disorder. In a previously published 9-month clinical trial of choline supplementation in children with FASD, we reported that postnatal choline was associated with improved performance on a hippocampal-dependent recognition memory task. The current paper describes the neurophysiological correlates of that memory performance for trial completers.MethodsChildren with FASD who were enrolled in a clinical trial of choline supplementation were followed for 9 (...) months. Delayed recall on a 9-step elicited imitation task served as the behavioral measure of recognition memory. Neurophysiological correlates of memory were assessed via event-related potentials.ResultsDelayed recall on EI was correlated with two ERP components commonly associated with recognition memory in young children: middle latency negative component and positive slow wave. No significant ERP differences were observed between the choline and placebo groups at the conclusion of the trial.ConclusionAlthough the small sample size limits the ability to draw clear conclusions about the treatment effect of choline on ERP, the results suggest a relationship between memory performance and underlying neurophysiological status in FASD. This trial was registered.1. (shrink)

Prenatal alcohol exposure interferes with neurodevelopment. The brain is particularly susceptible to the adverse consequences of prenatal alcohol exposure, and numerous studies have documented changes to brain anatomy and function, as well as consequences for cognition, behavior, and mental health. Studies in typically developing individuals have shown that the brain undergoes dynamic developmental processes over an individual’s lifespan. Furthermore, magnetic resonance imaging studies in other neurodevelopmental and psychiatric disorders have shown that their developmental trajectories differ from the typical (...) pattern. Therefore, to understand long-term clinical outcomes of fetal alcohol spectrum disorders, it is necessary to investigate changes in neurodevelopmental trajectories in this population. Here we review studies that have used MRI to evaluate changes in brain structure and function over time via cross-sectional or longitudinal methods in individuals with PAE. Research demonstrates that individuals with PAE have atypical cortical and white matter microstructural developmental trajectories through childhood and adolescence. More research is needed to understand how factors such as sex and postnatal experiences may further mediate these trajectories. Furthermore, nothing is known about the trajectories beyond young adulthood. (shrink)

Alcoholism is endemic in Nigeria’s traditional religion and society. This abuse is especially common at New Yam festivals, Ekpe, Ekpo and Nmanwu masquerades festivals, burial rituals, birth, marriage and naming ceremonies. Some claim that this is driven by specific beliefs and activities in African culture, such as beliefs in ancestors, libation, hospitality and entertaining guests and strangers and the desire to maintain the cultural traditions of the ancestors. Alcohol abuse has generated major health and social issues for abusers, their (...) families and society, plunging families, towns and tribes into crises and conflicts that bring economic and political retrogression. This research studied how the African traditional religion encourages alcohol misuse and how to decrease it for national development. This study was on Nigeria’s South-South region. The study uses qualitative and ethnographic research methodologies, including key informants, in-depth and focus group interviews and the reward deficiency syndrome as a theoretical framework. Although African Traditional Religion (ATR) supports alcohol usage, greed, a lack of self-control, peer pressure, indiscipline and lack of moral upbringing led to alcohol misuse, which harms the person, family, community and country as a whole. Education and enlightenment are a remedy to free alcoholics and utilise them for national integration and development.Contribution: Some say Africans drink a lot because their religious heritage promotes drinking, leading to abuse. However, peer pressure, selfishness, a lack of self-control, bad parenting and not religion push persons with reward deficiency syndrome into alcoholism, according to this research. (shrink)