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)

Introduction: Motherese, or emotional infant directed speech, is the specific form of speech used by parents to address their infants. The prosody of IDS has affective properties, expresses caregiver involvement, is a marker of caregiver-infant interaction quality. IDS prosodic characteristics can be detected with automatic analysis. We aimed to explore whether pregnant women “speak” to their unborn baby, whether they use motherese while speaking and whether anxio-depressive or obstetrical status impacts speaking to the fetus.Participants and Methods: We conducted an observational (...) study of pregnant women with gestational ages from 26 to 38 weeks. Women were recruited in a university hospital department of obstetrics. Thirty-five women agreed to participate in the study, and 26 audio records were exploitable. We collected obstetrical and sociodemographic data, pregnancy outcomes, anxiety and depressive status using the Covy and Raskin Scales, and life events using the Sensations During Pregnancy and Life Event Questionnaire. Each participant was left alone with an audio recorder with a recommendation to feel free to speak to her fetus as she would have done at home. The recording was stopped after 3 min. Audio recordings were analyzed by two methods: psycholinguist experts' annotation and computational objective automatic analyses.Results: Most mothers reported speaking to their fetuses. We found a correlation between maternal first perceptions of fetal movements and the start of mother's speaking to fetus. Motherese prosody was detected with both annotation and automatic analysis with a significant correlation between the two methods. In this exploratory study, motherese use was not associated with maternal anxiodepressive or obstetrical status. However, the more future mothers were depressed, the less they spoke with their fetuses during the recording.Conclusion: Fetal directed speech can be detected during pregnancy, and it contains a period of prosody that shares the same characteristics of motherese that can be described as prenatal motherese or emotional fetal-directed speech. This means that pregnant women start using motherese much earlier than expected. FDS seems to be correlated with maternal first perceptions of fetal movements and depression scores. However, more research is needed to confirm these exploratory results. (shrink)

Ectogenesis, or “artificial womb technology,” has been heralded by some, such as prominent feminist Shulamith Firestone, as a way to liberate women. In this chapter, we challenge this view by offering an alternative analysis of the technology as relying upon and perpetuating a problematic model of pregnancy which, rather than liberating women, serves to devalue them. We look to metaphysics as the abstract study of reality to elucidate how the entities in a pregnancy are related to one another. We consider (...) two models of the metaphysics of pregnancy: (1) the Parthood Model, whereby the fetus is a part of what/who gestates it; and (2) and the Fetal Container Model, whereby the gestator is a container for the fetus. We suggest that under the assumption of the Fetal Container Model, we are more likely to think that any container will suffice for gestation, even an artificial one. In contrast, under the assumption of the Parthood Model, we are less likely to treat the gestator as interchangeable or replaceable, given the parthood relationship between gestator and fetus. This chapter argues that ectogenesis is conceptually linked to the Fetal Container Model and advocates a more cautious approach in promoting ectogenesis as a tool for women’s liberation. (shrink)

The intrusive state has long viewed women as fetal containers. TheDobbsdecision goes further, essentially causing women to vanish when fetuses are abstracted from their relationships to pregnant persons. The ways in which women are first controlled and then made invisible are clearly connected with the move from obedience to omission that has historically affected black Americans. When personal decisionmaking and participation in democracy are regarded as threats, those threatened restrict decisional freedom and political power, deepening structural injustices relating (...) to sex, race, and poverty. Fear ofDobbshas health effects on conditions unrelated to pregnancy and connects with erasures of human value that are not health-related. We reaffirm solidarity as a countering influence. Taking account of the richly relational context in which issues like abortion and political representation arise should lead to better, more meaningful policies, making so many people impossible to unsee. (shrink)

The purpose of this commentary on James Nelson's article [1] is to advocate introducing the ethics of care into the arena of gestational conflict. Too often the debate gets stalled in a maternal versus fetal rights headlock. Interventionists stress fetal over maternal rights: they believe education, post-birth prosecution or pre-birth seizure of pregnant women may be permissible. In contrast to interventionists, other philosophers stress that favoring fetal rights treats women like fetal containers. I question whether (...) we should really consider issues of moral/parental obligations to children in terms of rights. Rather, the language of care should guide moral conduct vis-a-vis children/fetuses. The particularity of each woman's story — the particulars of her human relationships — inform her story. An individual's ability to care is largely a function of whether community cares for her. We must care for others to enable them to care for themselves and their loved ones — born or unborn. (shrink)

This chapter contains sections titled: Fetal Personhood: From Wrongful Interference to Positive Responsibilities The Sanctity of Life: Respect Revisited.

This chapter contains sections titled: The Arguments for the Freedom to Choose Fetal Life and Humanity The Argument from Fetal Potential Abortion and Fetal Development Making Abortion Difficult to Obtain Ideological Bases of the Abortion Debate Conclusion References.

This chapter contains sections titled: Abortion and Mother‐Fetus Conflict Moral Obligations to the Unborn The Obstetrical Cases: Forced Cesareans Fetal Surgery Conclusion References Further reading.

Feminist bioethicists of a variety of persuasions discuss the 2013 case of Marlise Munoz, a pregnant woman whose medical care was in dispute after she became brain dead.

De Marco and colleagues claim that the standard account of invasiveness as commonly encountered ‘…does not capture all uses of the term in relation to medical interventions1 ’. This is open to challenge. Their first example is ‘non-invasive prenatal testing’. Because it involves puncturing the skin to obtain blood, De Marco et al take this as an example of how an incision or insertion is not sufficient to make an intervention invasive; here is a procedure that involves an incision, but (...) it is regarded as non-invasive. However, this ignores the context, and the term should really be understood in reference to the fetus. It is hard to believe healthcare professionals regard taking blood to measure, for example, ferritin levels as invasive but taking blood to look for fragments of fetal DNA as not. If anyone uses the term thinking it is not invasive to the mother, the solution would be to call it invasive, not redefine what is invasive. De Marco and colleagues’ second example is describing electroconvulsive therapy (ECT) as invasive. However, this is not borne out by their referenced papers. The first cited source is about non-invasive brain stimulation2 and only contains a single sentence about ECT. This sentence may suggest that their view is that ECT …. (shrink)

Males are selectively afflicted with the neurodevelopmental and psychiatric disorders of childhood, a broad and virtually ubiquitous phenomenon that has not received proper attention in the biological study of sex differences. The previous literature has alluded to psychosocial differences, genetic factors and elements pertaining to male “complexity” and relative immaturity, but these are not deemed an adequate explanation for selective male affliction. The structure of sex differences in neurodevelopmental disorders is hypothesized to contain these elements: Males are more frequently afflicted, (...) females more severely; disorders arising in females are largely mediated by the genotype; in males, by a genotype by environment interaction; complications of pregnancy and delivery occur more frequently with male births; such complications are decisive and influence subsequent development. We hypothesize that there is something about the male fetus that evokes an inhospitable uterine environment. This “evocative principle” is hypothesized to relate to the relative antigenicity of the male fetus, which may induce a state of maternal immunoreactivity, leading either directly or indirectly to fetal damage. The immunoreactive theory thus constructed is borrowed from studies of sex ratios and is the only explanation consistent with negative parity effects in the occurrence of pregnancy complications and certain neurodevelopmental disorders. Although the theory is necessarily speculative, it is heuristic and hypotheses derived from it are proposed; some are confirmed in the existing literature and by the authors' research. (shrink)

BackgroundGenetics and genomics research (GGR) is increasingly being conducted around the world; yet, researchers and research oversight entities in many countries have struggled with ethical challenges. A range of ethics and regulatory issues need to be addressed through comprehensive policy frameworks that integrate with local environments. While important efforts have been made to enhance understanding and awareness of ethical dimensions of GGR in Africa, including through the H3Africa initiative, there remains a need for in-depth policy review, at a country-level, to (...) inform and stimulate local policy development and revision on the continent.MethodsTo identify and characterize existing ethics-related guidelines and laws applicable to GGR across much of Africa, we conducted a scoping review of English language policy documents identified through databases, repositories, and web searches. Thirty-six documents were included and coded using a framework that contained a range of themes across five analytical categories: (1) respect, (2) beneficence, (3) justice, (4) independent oversight, and (5) bans and prohibitions. Data analysis software (NVivo 12) was used to organize, code, and tabulate information according to document characteristics and topics. Illustrative examples of policy requirements were selected for inclusion.ResultsDocuments that met inclusion criteria spanned 20 years; published between 1996 and 2018, with the majority (58%) published after 2009. About two-thirds were denoted as “guidelines,” and slightly more than half were non-exclusive to GGR. Very few (six) country-level documents identified were specific to GGR. Requirements related to the principle of “respect” appeared most often across all documents, relative to other principles and processes. The most commonly stated ban was on reproductive cloning. Other prohibitions applied to germline editing, undue inducements in research, sample use for commercial purposes, employee mandatory DNA testing, fetal sex selection, stem cell use, eugenics, and research without public health benefits.ConclusionsEnforceable policies that are indispensable to the ethical conduct and review of GGR are either deficient or missing in many African countries. Existing international, GGR-specific ethics guidelines can be used to inform GGR policy development at a country-level, in conjunction with insight from country specific ethics committees and other local stakeholders. (shrink)

Information on the factors influencing parents’ decision-making process following a lethal, life-limiting or severely debilitating prenatal diagnosis remains deficient. A comprehensive systematic review and meta-synthesis was conducted to explore the influencing factors for parents considering termination or continuation of pregnancy following identification of lethal, life-limiting or severely debilitating fetal abnormalities. Electronic searches of 13 databases were conducted. These searches were supplemented by hand-searching Google Scholar and bibliographies and citation tracing. Thomas and Harden’s thematic synthesis method was used to synthesise (...) data from identified studies. Twenty-four papers were identified and reviewed, but two papers were removed following quality assessment. Three main themes were identified through systematic synthesis. Theme 1, entitled ‘all life is precious’, described parents’ perception of the importance of the fetus’ life, a fatalistic view of their situation alongside moral implications as well as the implications decisions would have on their own life, in consideration of previous life experiences. Theme 2 contained two sub-themes which considered the parent’s own imagined future and the influence of other people’s experiences. Finally, Theme 3 presented three sub-themes which may influence their parental decision-making: These described parental consideration of the quality of life for their unborn child, the possibility of waiting to try for another pregnancy, and their own responsibilities and commitments. The first review to fully explore parental decision-making process following lethal, life-limiting, or severely debilitating prenatal diagnosis provided novel findings and insight into which factors influenced parents’ decision-making process. This comprehensive and systematic review provides greater understanding of the factors influential on decision-making, such as hope, morality and potential implications on their own and other’s quality of life, will enable professionals to facilitate supported decision-making, including greater knowledge of the variables likely to influence parental choices. (shrink)

Background: While employers are increasingly considering and implementing COVID-19 vaccination requirements, little is known about the reasons offered by employees seeking religious exemptions.Methods: We conducted a mixed methods analysis of all the requests for religious exemptions submitted during the initial implementation of a COVID-19 vaccination requirement at a single academic medical center in the United States.Results: Five hundred sixty-five (3.4%) employees requested religious exemptions. At least 305 (54.0%) requesters had job titles suggesting that they had direct patient contact. Four hundred (...) ninety-nine (88.3%) of requesters self-identified as Christian, of whom 120 (21.2%) identified as Roman Catholic. Requesters offered 0 to 8 (mean 2.7) categories of reasons for their request. The most frequently stated reasons pertained to the use of fetal cell lines in vaccine development and manufacturing (382, 67.6%), interest in maintaining purity (221, 39.1%), or belief in divine healing (172, 30.4%). Some requesters also volunteered evidence of the sincerity of their beliefs including examples of their religious practices (116, 20.5%), other practices (66, 11.7%), and emotional states (32, 5.7%). One hundred fifty-two applications (26.9%) contained text copied without attribution, primarily from sample religious exemption request letters available on the Internet.Conclusions: Most requesters focused on the use of fetal cell lines in the development or manufacturing of the vaccines as the justification for their request. The development of vaccines that are not reliant on fetal cell lines may increase vaccination rates. Understanding reasons for religious exemption requests may inform vaccine education and vaccination policies. (shrink)

Each year in the UK there are approximately 250,000 miscarriages, 3,000 stillbirths and 3,000 terminations following a diagnosis of fetal-abnormality. This paper draws from original empirical research into the experience of pregnancy loss and the accompanying decisionmaking processes. A key finding is that there is considerable variation across England in the range of options that are offered for disposal of pregnancy remains and the ways in which information around disposal are communicated. This analysis seeks to outline the key features (...) of what constitutes effective communication in this context, where effective communication is taken to mean that patients are provided with the key information necessary, in an appropriate manner, so that they are fully able to make a decision. A primary source of evidence includes interviews with the bereaved and pregnancy-loss support workers, in order to understand how the options available, and associated necessary procedures, are communicated. In addition, patient information leaflets are also analyzed as they offer an important tool for information delivery at a difficult and emotionally charged time. Following this, an overview is provided of the information that these leaflets should contain, along with guidance on effective presentation of this information. (shrink)

Objective The study evaluated patient informed consent (IC) for the Quad screen and examined differences in IC between test acceptors and test refusers. A multidimensional model of IC was used. Methods Women seeking prenatal care at nine obstetrics clinics in a large Midwestern city completed surveys between February and December 2006. Surveys contained measures for three dimensions of IC: intention, understanding and controlling influence. Results 56.2% of women did not meet criteria for all three of our dimensions of IC and (...) therefore failed to give it. The failure rate was higher among women who choose to screen (72.6%) than women who choose not screen (50%) (p < 0.001). Women who met all criteria for IC were over three times less likley to choose to screen (or = 0.32, CI 0.17–0.62 ( p < 0.01)) than women who did not meet criteria for IC. Conclusion The decision to screen for fetal anomalies is less of a deliberated action than the decision not to screen. Women who lack a fundamental understanding of the purpose and nature of the screen may be operating on the belief that the screen is part of standard care and presents no need to deliberate. (shrink)

The central concern of this article is whether early induction of labor for an anencephalic fetus can ever be morally justified, particularly by a Catholic healthcare ethics committee. By revisiting and refining arguments in articles by Drane (1992) and Bole (1992) published in this journal, a revised argument – consistent with the Catholic moral tradition – can seemingly be constructed that a Catholic healthcare ethics committee might use to justify early induction of labor in some pregnancies involving an anencephalic fetus. (...) Such a revised argument depends upon two central claims; first, that the anencephalic fetus in question is necessarily in the process of dying when early induction of labor occurs, and second, that the fetus is judged to be undergoing extraordinary or disproportionate means of preserving their life as a result of receiving ongoing maternal support of a mother’s womb. The revised argument developed in this article aims to utilize the doctrine of double effect in conjunction with these two central claims to justify early induction of labor for anencephalic fetal persons in some circumstances. Unfortunately, the revised argument – if successful – would be at odds with a stance taken in the United States Conference of Catholic Bishops (USCCB) 1996 statement “Moral Principles Concerning Infants with Anencephaly.” However, there is reason to believe the revised argument offered in this article is well aligned with other guidance from the USCCB, contained in the publication _Ethical and Religious Directives for Catholic Healthcare Services_ (2018). This article concludes by noting some important limitations of the argument and offering hope that consideration of the argument ultimately helps to strengthen the Catholic moral tradition. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 25.2 (2001) 335-346 [Access article in PDF] Aesthetic Incunabula Ellen Dissanayake Incunabula n. pl. (f. L swaddling clothes, cradle): Early stages of development of a thing.Over the past thirty years, developmental psychologists have discovered remarkable cognitive abilities in young infants. Before these investigations, common pediatric wisdom accepted that apart from a few innate "reflexes"--for crying, suckling, clinging, startling--babies were pretty much tabulae rasae for their elders (...) to inscribe as they (and their cultures) decreed. Today, however, it is well established that newborns come into the world with decided preferences and motivations, so that one can speak intelligently of "neonatal" (or even "fetal") psychology. 1The demonstrable existence of inherent psychological capacities in newborns and infants has important implications for twenty-first-century literary theory, which--also over the past thirty years--has operated under the theoretical assumption that all knowledge and experience are mediated by culture and that there is therefore no "natural" psychological or emotional experience. Yet if, as infant psychology confirms, babies in every culture show the same or similar cognitive abilities and preferences and the same or similar motivations and emotional responses, it is necessary to modify the dogmatic assertion that all experience, including literary response, is socially constructed. Rather, adult psychology and experience grow from and build upon inborn motives and preferences. Literary theorists can no longer ignore contemporary knowledge in psychobiology, ethology, and evolutionary psychology that directly pertains to conceptualizing their subject.The innate capacities of newborns predispose them specifically for social and emotional interaction with others, not simply for soliciting [End Page 335] their physical care. For example, newborns prefer human faces to any other sight (high-contrast colors, cartoon characters, cute stuffed animals) and human voices to any other sound (soft music, tinkling bells, The Chipmunks). 2 They can imitate face, mouth, and hand movements and respond appropriately to another person's emotional expressions of sadness, fear, and surprise. 3 At birth, infants can estimate and anticipate intervals of time and temporal sequences and remember these temporal patterns, categorizing them both in time and space and in terms of affect and arousal. 4 By six weeks of age, these perceptual and cognitive abilities of normal infants permit them to engage with adult partners in complex communicative interchanges--the playful behavior that is commonly or colloquially called "babytalk."Babytalk is not the trival or inane pastime that it might superficially seem but, rather, a cradle in which nascent psychosocial capacities can emerge and be developed. Interestingly for literary theory, babytalk achieves these effects through fundamentally aesthetic means. Adult-infant engagements are noteworthy for their use of stylization (formalization or simplification), repetition, exaggeration, and elaboration in visual, vocal, and gestural modalities. I call these "aesthetic incunabula"--that is, sources (or early developmental stages) of the operations used by artists in all media to attract attention and to provoke and manipulate emotional response. The existence of sensitivities to such features in the first months of life suggests that humans are born with natural (innate, universal) predispositions for aesthetic engagement from which cultures and individuals can go on to create their myriad elaborated forms of artistic expression.Although babytalk varies in minor details among individuals and cultures, it can be described in all instances as a multimedia performance. That is, it contains not only "talk" (or the characteristic high-pitched, undulant, breathy, patterned, repetitive vocalizations with pauses called "motherese," "parentese," or "infant-directed speech"). Along with the utterances are peculiarly stereotyped, repetitive, and exaggerated facial expressions (such as widened eyes, uplifted eyebrows, sustained open mouth, and smiles), head movements (e.g., distinct bobs backwards, slow rhythmic nods, movement toward and away from the baby), and gestures (such as touching, stroking, and rhythmic pats) to which infants respond with their own vocal sounds and face and body movements and, in many societies, sustained mutual gaze.Babytalk is not only a performance, but a duet that incorporates both synchrony of behavior and alternation (or turn-taking)--activities that [End Page 336] are made possible by the infant's remarkable inborn sensitivity to temporal sequence and pattern. Microanalyses of videotaped interactions (at 24... (shrink)

continent. 1.2 (2011): 141-144. This January, while preparing a new course, Robert Seydel was struck and killed by an unexpected heart attack. He was a critically under-appreciated artist and one of the most beloved and admired professors at Hampshire College. At the time of his passing, Seydel was on the brink of a major artistic and career milestone. His Book of Ruth was being prepared for publication by Siglio Press. His publisher describes the book as: “an alchemical assemblage that composes (...) the life of his alter ego, Ruth Greisman— spinster, Sunday painter, and friend to Joseph Cornell and Marcel Duchamp. Through collages, drawings, and journal entries from Ruth’s imagined life, Seydel invokes her interior world in novelistic rhythms.” This convergence of his professional triumph with the tragedy of his death makes now a particularly appropriate time to think about Robert Seydel and his work. This feature contains a selection of excerpts from Book of Ruth (courtesy of Siglio Press) alongside a pair of texts remembering him and giving critical and biographical insights into his art and his person. These texts, from a former student and a colleague respectively, were originally prepared for Seydel's memorial at Hampshire College and have since been revised for publication in continent. For more information on Book of Ruth, please visit the book's page at the Siglio Press website. —Ben Segal draughty R. * Lauren van Haaften-Schick 2011 “The most apt way to order Smithson's library is with the conjunction 'and'; science and religion; modernism and mass culture; what is present and what is missing.” —Alexander Alberro, 248 Robert Seydel's classes on collage and collecting immersed his students in a curious world of cabinets, oddities, exhaustive archives and obscure histories, explored always with critical rigor and a sincere eye for wonder. His office was a compendium of the ancient, mythic, potential and unworldy, where seemingly unrelated references were endlessly pulled, piled and fused in an ecstatic dance of hyper-annotation. The small room and all its contents overflowed with notes tucked in every margin and corner. Books coated the walls like a switchboard, anxious and humming, waiting for infinite links to be activated. William Blake's books of Job and Urizen summoned Greek mythology and the animal as metaphor, leading to 19th century cryptozoology and the cave paintings at Lascaux, Gaston Bachelard's description of the bird in his garden and Robert Rauschenberg's Canyon . Tracking archetypes and following tangential threads, new revelations and ancient narratives were compiled and ordered to form a new text, a bibliography as assemblage, portrait and poem. Robert's library—one of his many collections—is a portrait, an “artifact, collage of time, a token and remnant” (Seydel, 2007) He is humming with it still. The imagination of this room—of Robert—breathes through the pages of Book of Ruth, as every decision and detail unfolds to a cosmos. Allegory, invention, personal and art histories are entangled and leveled, rendering lived, perceived and absorbed experiences indistinguishable. Anonymous scraps discovered on the street or studio floor, careful clippings and drawn figures are chosen and animated through serendipitous destruction and whimsical, delicate positioning. A precise vocabulary of characters and terms erupts and collapses as personas and passers-by wave and whisper, “Every figure reveals aspects of the total form, which is open and green” (Seydel, 2007). The initials R.S. repeat, a nod to Robert's true family tree and further complicating identification. Robt, Robert's sometimes alter-ego, appears in myriad forms as a trickster “half-wit,” mercurial and skittish, or soft and worn thin. Saul is a solemn tinkerer, parsing the world and sometimes blind. Ruth, the speaker of the book, records and translates all, her voice wavering between poetic verse and a cryptic half-speech as complex as it is sparse. The rhythm of frayed edges sets time - the weight of the world and the lightness of paper. Robert wrote of his process, “Material is essential; scuffings carry history, which wanders throughout” (Seydel, 2007). Collectors, assemblers, sway between careful movements of selection and placement as they pull from the found world, mediating calculated and unconscious association to form a lexicon of gestures, symbols and allusion, the “artifacts of a life... the refuse and rejecta of days” (Seydel, 2007). These assembled fragments shift and chatter, at home in their homelessness, actors performing in their own lives, populating an invented world of similar orphans. Such accumulated, severed parts carry the injury of their cutting and retain the evidence of their source, binding loss to creation in a symbiosis of trauma and repair. Mourning and remembrance are deeply embedded in the histories and acts of such practices. Grievance, acceptance, and the fragility of life are conveyed in the 18th century allegorical arrangements of fetal specimens by Frederik Ruysch. A certain melancholy reverence colors Joseph Cornell's intimately tactile assemblages rendering the universe tangible in miniature, or made in devotion to unrequited loves. Preserved in stasis, these ghosts and idols are kept in a purgatory where fact and fiction, past and present are irrelevant distinctions. Catalogued and contained, the subject of loss is transferred to an artifact. Every thread, scrap and letter may be glued, gathered and placed in a museum, a tomb, a box, a page, ripe and open for possession. Holding on to grief and reveling in disrepair, we opt to be haunted. Forever unbalanced and in flux, the sublime of collage is its resolve to irresolution. For Robert, “Art, as creation and as sign of primary Imagination, is not objects but a state, a kind of fluid” (Seydel, 2007) Reflecting on his work, life, and death, I am drawn to my library and the myriad titles acquired through his inspiration. There is Daniel Spoerri's An Anecdoted Topography of Chance , Susan Stewart's On Longing , various Borges, Barthes, Perec, and especially Life: A User's Manual , which concludes that the perfect puzzle will have no solution. I think of the drawers of miscellaneous swallowed objects at the Mutter Museum, Ray Johnson coding the every day in riddles, Wallace Berman twisting tongues, and Susan Hiller laying every detail to bear. Collectors and makers working in endless cycles of observation, ingestion and display. Every gesture informs and is defined by others, every space is shaped by that which surrounds and fills it, the knot has an inner logic, the gigantic is not so different from the miniature, there is a world in every detail, and “All art is collage” (Seydel, 2011) These thoughts have molded my life, my art, and all the minutia that keep the two so profoundly intertwined; There is no difference between life and what we do with our time. “I write my life. I make me up.” What a gift to share this secret way of knowing the world, and to leave this knowledge for us to do with what we please. “Art begins in admiration” (Seydel, 2011) Lauren van Haaften-Schick is a curator, writer and artist based in New York. Upcoming curatorial projects include "Cancelled" at the Center for Book Arts, and "The Spirit of the Signal" at Nicole Klagsbrun Gallery, New York. Recent activities include the workshops "Market, Alternative" and "Alternative Art Economies" at Trade School and Momenta Art, and the e-flux Time/Store, New York. She is the founding director of two arts spaces in Northampton, MA and Philadelphia, PA. She received a BA in Art History and Studio Art from Hampshire college in 2006. Sura Levine on Robert Seydel If early on in his time at Hampshire College I was officially his “mentor,” Robert Seydel quickly became one of my great teachers. Over the years we talked about everything, from art, music, collage, and poetry, to campus politics, this latter far too often. It was always a sublime pleasure, if all too rarely done, to enter his apartment to look at his work in progress, to peruse his bookshelves where, inevitably, there were always new treats to examine. And, while he was working on his Book of Ruth , I was given the opportunity over the course of many meals at the Korean and other restaurants, to talk with him about image and poem ordering. To see how he thought through each comma, each juxtaposition across the gutters of the Book, was to watch a brilliant curator at work. Each day, I walk past his wonderful collaged portrait of Ruth, purchased, after much haggling, as a birthday present, a couple of years ago. And each day, I think how lucky I am to have known Robert as he produced this magnum opus. One of my greatest pleasures in 24 years at the College was to teach “The Collector” with Robert. One of my greatest regrets is that the magic we created together in the classroom will not, and cannot, be duplicated. Its various incarnations, its utter intelligence and magic, were all so deeply Robert’s. His was a mind that put poetry, philosophy, history of science, and history together with art, and art together with music. His intellect and eye were unparalleled. He introduced us to so many artists. He shared his fascination with the cabinets of curiosity of Aldrovandi, of Seba, and Peter the Great’s collection of fetal anomalies, as well as the Museum of Jurassic Technology in Los Angeles. Robert knew them all and so many more. He was a walking encyclopedia, his home a great archive. Arcane knowledge, perhaps, but oh so important for another of Robert’s heroes, the mid-20th century Belgian artist Marcel Broodthaers, whose name he invariably mispronounced as “Broadthayers.” In speaking his name, Robert would always look in my direction in a panic, and then he go on and maul it. I absolutely loved his various mispronunciations of French names and terms! “The Collector” was always filled with talented young artists, art historians, philosophers and writers who all came to understand the wondrous obsessions of the figure of the collector. Students in this course created dazzling projects each term. He always moved while looking and speaking. He read deeply, and commented on everyone’s work with wonderful generosity. Robert always found something to praise even in the least developed of projects. Robert inspired and mentored all of his students into making work that far exceeded their expectations—and ours. For those of you who were lucky enough to have been touched by or to have had an evaluation written by Robert, savor it, keep it, reread it, and share it. He loved working with you all; it is somehow fitting that he died while prepping yet another new course. Robert, it’s almost impossible to speak of you in the past tense, even though you left us a month ago. No doubt, if you knew about our gatherings and celebrations of you, you would be embarrassed that we are making a fuss over you; you always placed the focus on others rather than on yourself. This trait is exactly why so many people miss you now. We’re here to love you publicly as we all did privately for the eleven years you were among us. Robert, my very dear friend, you were an extraordinary artist—you were my brother of choice. My heart broke when yours did. I miss you profoundly. —Sura Levine, February 26, 2011 Sura Levine is a professor of art history at Hampshire College. Her field of specialty is 19th century Belgian and French art, particularly realism and impressionism. Having worked in museums for a number of years both prior to coming to the College, and, as guest curator and co-author of exhibition catalogues, she became particularly interested in the history of museum and trends in collecting. It was because of their shared interests that she and Robert Seydel developed their course, The Collector, which they co-taught for many years. (shrink)

Polyclonal antibodies raised against the human erythrocyte nucleoside transporter were used to investigate the distribution of the nucleoside transporters in the placenta. Immunoblots of brush-border membranes isolated from the human syncytiotrophoblast revealed a cross-reactive species that co-migrated with the erythrocyte nucleoside transporter as a broad band of apparent M(r) 55,000. In contrast, no labelling was detected in basal membranes containing a similar number of equilibrative nucleoside transporters as assessed by nitrobenzylthioinosine (NBMPR)-binding. The absence of cross-reactive epitopes in basal membranes and (...) their presence in brush-border membranes was confirmed by confocal immunofluorescence microscopy. The results suggest that at least two isoforms of the NBMPR-sensitive nucleoside transporter are present in the human placenta. The lumenal surfaces of fetal capillaries, small placental vessels and umbilical vein ware also strongly labelled by the antibody, a finding that suggests that the high fetal-placental adenosine uptake previously reported is due to endothelial transporters. (shrink)

The genetic interaction between mother and fetus during pregnancy is discussed, focusing on teratogenic alleles that act in the mother to alter fetal development and contribute to a neurodevelopmental disorder. For these alleles, the mother is the genetic patient. Teratogenic alleles interact with modifying and specificity alleles that act in the fetus and with environmental factors. Based on examples of the model, two candidate mechanisms emerge as contributors to neurodevelopmental disorders, folate‐homocysteine pathways and immune/inflammatory mechanisms. Both, acting in mothers, (...) affect fetal development and contain many polymorphic genes. These two systems interact with each other. Common functional polymorphisms of mild effect in these two systems of interacting genes are good candidates for teratogenic alleles. The presence of teratogenic alleles complicates gene identification for neurodevelopmental disorders. However, using the special methods required to identify teratogenic alleles is important because this could lead to new approaches to prevention and improved therapy of these disorders. BioEssays 25:464–477, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Private Bioethics Forums:Counterpoint to Government BodiesCynthia B. Cohen (bio) and Elizabeth Leibold McCloskey (bio)Ethical issues associated with reproductive technologies quickly gain public attention. The front pages of newspapers have featured stories about grandmothers giving birth to their own grandchildren, couples "renting" wombs from surrogates, and researchers prepared to transplant fetal ovaries into women unable to produce viable eggs. With each new and bolder foray into reproductive realms, the (...) question of whether to set limits on the use of such technologies surfaces. An ancillary debate inevitably ensues about the proper forum for discussing and deciding such limits. The recent announcement of human embryo splitting or cloning research is no exception to this pattern. Articles in both the popular press and academic circles in the wake of the reported research contain lamentations about the absence of a national ethics body that could address the ethical issues raised by the cloning experiment. This research also breathed new life into congressional calls to create a government bioethics commission.1At times, it appears that the substantive questions raised by a procedure like cloning are subsumed under the debate about whether this ethics group or that should be convened to study the matter. But the forum in which options are discussed is as crucial to the development of sound ethical thought and public policy as are the conclusions themselves. Thus, we address the question of whether a private, as opposed to a public, bioethics body provides a distinctively useful forum for reaching an understanding of issues such as cloning that have significant ethical and public policy implications.A 1993 Office of Technology Assessment report, in which the authors suggest that a new federal bioethics commission might be useful, has helped to frame recent discussions about the value of government-sponsored bioethics bodies (Office of Technology Assessment 1993). To most people, the question of whether a national forum for bioethics is needed is synonymous with the question of whether a new federal body should be convened. Yet the existence of the National Advisory Board on Ethics in Reproduction (NABER) suggests that the scope of the question should be broadened. [End Page 283]NABER was born in 1992, in part as a response to an Institute of Medicine report on infertility. That document endorsed the formation of a nongovernment body to develop guidelines for assisted reproductive measures and fetal research in the event that a government body was not forthcoming (Institute of Medicine 1989). NABER, which was founded by the American College of Obstetricians and Gynecologists and the American Fertility Society, now functions wholly independently of those groups and is supported by private foundations including the Ford, Greenwall, and Josiah Macy, Jr., Foundations and the Walter and Elise Haas Fund. NABER has issued a report on ethical issues related to the use of fetal tissue (Cohen and Jonsen 1993), is about to publish a report and background papers on oocyte donation, and presents a report on human cloning in this issue of the Kennedy Institute of Ethics Journal. In addition, it has developed a protocol for NABER review of research proposals from federal agencies subject to federal guidelines on the use of human subjects in research.Thus, in function and form, NABER was envisioned as a substitute for a government body, and it now functions in a manner similar to several types of government bioethics groups. Like the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (National Commission) and the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (President's Commission), NABER functions primarily through the publication of reports intended for a broad audience of practitioners, patients, policymakers, and the general public. Just as the Ethics Advisory Board of the late 1970s examined ethical issues related to specific protocols or types of research as they arose, NABER's purposes include scrutinizing the ethics of various research efforts in the reproductive area.NABER also parallels past government bodies in form. Like these groups, NABER is a multidisciplinary board that meets regularly and is supplemented by consultants and staff who provide research and writing for the board. Its members are nationally recognized in... (shrink)

This article is written in response to the idea that selective termination may be eugenic. It points out that a mixture of motives and goals may inform screening programmes and selective termination for fetal abnormality without the intention being “eugenic”. The paper locates modern genetics within the tradition of humanist medicine by suggesting that parents who choose to terminate a pregnancy because of fetal abnormalities are not making moral judgments about those who are living with these abnormalities already. (...) Rather they are making judgments about their own lives and the lives of their children in relation to this genetic disorder. It concludes by introducing several caveats about the counselling that parents receive after the results of the testing and suggests that counselling inevitably contains a directive element because of the nature of the information covered. (shrink)

‘Law’ said Mr Justice Windeyer of the High Court of Australia, ‘marches with science, but to the rear, and limping a little’. Nowhere is this limping more apparent than in respect of the attempts to keep up with medical science. The media is full of reports of the use of fetal ova to create new life, of the transplant of animal parts into human bodies, of tests involving the consumption of radioactive materials by human subjects. The law's response to (...) these problems has been notable most often by its absence. To some extent, the failure of the law to come to grips with developments is not entirely its own fault. Sometimes the advances made possible by science can only be forseen by those with a scientific background. At other times, however, the law fails by not being flexible enough to be able to create new categories of legal obligations. It tries instead to pigeon-hole radically new ideas within centuries-old categorisations. As anyone who has had experience with packing a large number of outsized objects into a too small suitcase will tell you, squeezing things into inappropriately shaped containers takes time. This is one of the problems apparent in the doctrine of consent; the area of law which attempts to regulate the provision of medical services by a practitioner to a patient. (shrink)

Explore the nature of our material world in a unique sourcebook, conceived by the Dalai Lama, collecting the scientific observations found in classical Buddhist treatises. Under the visionary supervision of His Holiness the Dalai Lama, Science and Philosophy in the Indian Buddhist Classics brings together classical Buddhist explorations of the nature of our material world and the human mind and puts them into context for the modern reader. It is the Dalai Lama’s view that the explorations by the great masters (...) of northern India in the first millennium CE still have much that is of interest today, whether we are Buddhist or not. Volume 1, The Physical World, explores of the nature of our material world—from the macroscopic to the microscopic. It begins with an overview of the many frameworks, such as the so-called five aggregates, that Buddhist thinkers have used to examine the nature and scope of reality. Topics include sources of knowledge, the scope of reason, the nature and constituents of the material world, theories of the atom, the nature of time, the formation of the universe, and the evolution of life, including a detailed explanation of the early Buddhist theories on fetal development. The volume even contains a brief presentation on early theories about the structure and function of the brain and the role of microorganisms inside the human body. The book weaves together passages from the works of great Buddhist thinkers like Asanga, Vasubandhu, Nagarjuna, Dignaga, and Dharmakirti. Each of the major topics is introduced by Thupten Jinpa, the Dalai Lama’s principal English-language translator and founder of the Institute of Tibetan Classics. (shrink)

Cognitive deficits were produced in rats by different methods of damaging the brain: chronic ingestion of alcohol, causing widespread damage to diffuse cholinergic and aminergic projection systems; lesions (by local injection of the excitotoxins, ibotenate, quisqualate, and AMPA) of the nuclei of origin of the forebrain cholinergic projection system (FCPS), which innervates the neocortex and hippocampal formation; transient cerebral ischaemia, producing focal damage especially in the CA1 pyramidal cells of the dorsal hippocampus; and lesions (by local injection of the neurotoxin, (...) colchicine) of the granule cells of the dentate gyrus. Following chronic alcohol or lesions of the FCPS, transplants of cholinergically rich fetal brain tissue into the terminal areas (neocortex and/or hippocampus) restored performance almost to control levels, with a time course consistent with growth of the transplants and integration with host tissue; transplants of cholinergically poor fetal tissue (hippocampus) were without effect, as were transplants of cholinergically rich tissue into the region containing the nuclei of origin of the FCPS. Grafts of primary cells enriched in glia and cultured neuroblastoma cells into the terminal areas of the FCPS were equally effective, suggesting that there are multiple mechanisms by which neural transplants can restore cognitive function following diffuse cholinergic damage. In contrast, after ischaemia- or neurotoxin-induced damage to CA1 or dentate granule cells respectively, cholinergically rich fetal transplants into the damaged hippocampal formation were ineffective in restoring performance. After ischaemic damage, however, performance was restored by suspension grafts of CA1 cells but not by transplants containing CA3 pyramidal cells or granule cells; and after colchicine damage it was restored by solid grafts containing granule but not CA1 pyramidal cells. Furthermore, electrophysiological evidence has demonstrated functional, graft type-specific host-graft functional neuronal connectivity. Thus, restoration of cognitive function by neural transplants is possible after damage to either diffuse (cholinergic) or point-to-point (intrahippocampal) forebrain systems, but the transplant must be appropriate to the damage to be repaired. Because the different types of brain damage studied provide analogues of human alcoholic dementia, Alzheimer's disease, and heart attack, these results are encouraging with regard to the eventual application of neural transplant surgery to the treatment of cognitive deficits in humans. (shrink)

The apolipoprotein E gene plays an important role in the pathogenesis of Alzheimer's disease , and amyloid plaque comprised mostly of the amyloid-beta peptide ) is one of the major hallmarks of AD. However, the relationship between these two important molecules is poorly understood. We examined how A treatment affects APOE expression in cultured cells and tested the role of the transcription factor NF-B in APOE gene regulation. To delineate NF-B's role, we have characterized a 1098 nucleotide segment containing the (...) 5'-flanking region of the human APOE gene . Sequence analysis of this region suggests the presence of two potential NF-B elements. To demonstrate promoter activity, the region was cloned upstream of a promoterless luciferase gene. This segment was able to drive expression of luciferase in transient transfections of human fetal glial cells. Promoter activity was stimulated twofold by A treatment. Pretreatment with double-stranded DNA decoy oligonucleotides against NF-B reduced A stimulation. Deletion and mutagenetic analyses demonstrated that the distal NF-B element was functional and showed a strong DNA-protein complex band in gel shift analysis, similar to that from control NF-B consensus element. An anti-inflammatory and anti-NF-B drug, sodium salicylate, significantly blocked A-induced APOE promoter function. Our data provide evidence that upregulation of APOE by A in astroglial cells is mediated by an NF-B-element present in the 5'-flanking region of the APOE gene. (shrink)

This chapter contains sections titled: Pregnancy: Before and After McFall, Shimp, and Thomson's Ailing Violinist Pro‐Choice Does Not Mean Pro‐Abortion Notes.

Neural fetal tissue transplantation offers promise as a treatment for devasting neurologic conditions such as Parkinson's disease. Two types of issues arise from this procedure: those associated with the use of fetuses, and those associated with the use of neural tissue. The former issues have been examined in many forums; the latter have not. This paper reviews issues and arguments raised by the use of fetal tissue in general, but focuses on the implications of the use of neural (...) tissue for basic concepts of personnood and personal identity. (shrink)

Fetal pain has long been a contentious issue, in large part because fetal pain is often cited as a reason to restrict access to termination of pregnancy or abortion. We have divergent views regarding the morality of abortion, but have come together to address the evidence for fetal pain. Most reports on the possibility of fetal pain have focused on developmental neuroscience. Reports often suggest that the cortex and intact thalamocortical tracts are necessary for pain experience. (...) Given that the cortex only becomes functional and the tracts only develop after 24 weeks, many reports rule out fetal pain until the final trimester. Here, more recent evidence calling into question the necessity of the cortex for pain and demonstrating functional thalamic connectivity into the subplate is used to argue that the neuroscience cannot definitively rule out fetal pain before 24 weeks. We consider the possibility that the mere experience of pain, without the capacity for self reflection, is morally significant. We believe that fetal pain does not have to be equivalent to a mature adult human experience to matter morally, and so fetal pain might be considered as part of a humane approach to abortion. (shrink)

The presence of fetal cells has been associated with both positive and negative effects on maternal health. These paradoxical effects may be due to the fact that maternal and offspring fitness interests are aligned in certain domains and conflicting in others, which may have led to the evolution of fetal microchimeric phenotypes that can manipulate maternal tissues. We use cooperation and conflict theory to generate testable predictions about domains in which fetal microchimerism may enhance maternal health and (...) those in which it may be detrimental. This framework suggests that fetal cells may function both to contribute to maternal somatic maintenance (e.g. wound healing) and to manipulate maternal physiology to enhance resource transmission to offspring (e.g. enhancing milk production). In this review, we use an evolutionary framework to make testable predictions about the role of fetal microchimerism in lactation, thyroid function, autoimmune disease, cancer and maternal emotional, and psychological health.Also watch the Video Abstract. (shrink)

The question of whether a fetus can experience pain is an immense challenge. The issue demands consideration of the physical and psychological basis of being and the relation between the two. At the center of this debate is the question of how it is that we are conscious, a question that has inspired the writing of some of our most brilliant contemporary philosophers and scientists, with one commentary suggesting surrender. In my earlier review I attempted to draw together the various (...) strands of thinking that had attacked the question of fetal pain and relate them back to the bigger question of consciousness. In their vituperative response, Benatar and Benatar bite off my finger before looking to where I am pointing. I will examine each of their criticisms and attempt to redirect the readers' interest towards examining the subjectivity of pain and the mediating links between physiology and experience. (shrink)

Several factors related to fetal risk render it more or less acceptable in justifying constraints on the behavior of pregnant women. Risk is an unavoidable part of pregnancy and childbirth, one that women must balance against other vital personal and family interests. Two particular issues relate to the fairness of claims that pregnant women are never entitled to put their fetuses at risk: relative risks and relatives' risks. The former have been used—often spuriously—to advance arguments against activities, such as (...) home birth, that may incur risk; the latter implicate the nature of relationships in determining the acceptability of coercing or precluding activities. Motivated reasoning by clinicians and judges leads to inaccurate risk assessments, and judgments based on false claims to objectivity. Such judgments undermine the moral and legal standing of pregnant women and do not advance the interests of fetuses, pregnant women, families, or states. (shrink)

Abstract:Open neural tube defects or myelomeningoceles are a common congenital condition caused by failure of closure of the neural tube early in gestation, leading to a number of neurologic sequelae including paralysis, hindbrain herniation, hydrocephalus and neurogenic bowel and bladder dysfunction. Traditionally, the condition was treated by closure of the defect postnatally but a recently completed randomized controlled trial of prenatal versus postnatal closure demonstrated improved neurologic outcomes in the prenatal closure group. Fetal surgery, or more precisely maternal-fetal (...) surgery, raises a number of ethical issues that we address including who the patient is, informed consent, surgical innovation and equipoise as well maternal assumption of risk. As the procedure becomes more widely adopted into practice, we suggest close monitoring of new fetal surgery centers, in order to ensure that the positive results of the trial are maintained without increased risk to both the mother and fetus. (shrink)

Trafficking and persistence of fetal microchimeric cells (fMCs) and circulating extracellular vesicles (EVs) have been observed in animals and humans, but their consequences in the maternal body and their mechanistic contributions to maternal physiology and pathophysiology are not yet fully defined. Fetal cells and EVs may help remodel maternal organs after pregnancy‐associated changes, but the cell types and EV cargos reaching the mother in preterm pregnancies after exposure to various risk factors can be distinct from term pregnancies. As (...) preterm delivery‐associated maternal complications are rising, revisiting this topic and formulating scientific questions for future research to reduce the risk of maternal morbidities are timely. Epidemiological studies report maternal cardiovascular risk as one of the major complications after preterm delivery. This paper suggests a potential link between fMCs and circulating EVs and adverse maternal cardiovascular outcomes post‐pregnancies, the underlying mechanisms, consequences, and methods for and how this link might be assessed. (shrink)

Fetal reduction is the practice of reducing the number of fetuses in a multiple pregnancy, such as quadruplets, to a twin or singleton pregnancy. Use of assisted reproductive technologies increases the likelihood of multiple pregnancies, and many fetal reductions are done after in vitro fertilisation and embryo transfer, either because of social or health-related reasons. In this paper, I apply Joe Horton’s all or nothing problem to the ethics of fetal reduction in the case of a twin (...) pregnancy. I argue that in the case of a twin pregnancy, there are two intuitively plausible claims: abortion is morally permissible, and it is morally wrong to abort just one of the fetuses. But since we should choose morally permissible acts rather than impermissible ones, the two claims lead to another highly implausible claim: the woman ought to abort both fetuses rather than only one. Yet, this does not seem right. A plausible moral theory cannot advocate such a pro-death view. Or can it? I suggest ways to solve this problem and draw implications for each solution. There are no data in this work. (shrink)

Pregnancy involves puzzling aversions to nutritious foods. Although studies generally support the hypotheses that such aversions are evolved mechanisms to protect the fetus from toxins and/or pathogens, other factors, such as resource scarcity and psychological distress, have not been investigated as often. In addition, many studies have focused on populations with high-quality diets and low infectious disease burden, conditions that diverge from the putative evolutionary environment favoring fetal protection mechanisms. This study tests the fetal protection, resource scarcity, and (...) psychological distress hypotheses of food aversions in a resource-constrained population with high infectious disease burden. The role of culture is also explored. In the first of two studies in Tamil Nadu, India, we investigated cultural explanations of pregnancy diet among non-pregnant women (N = 54). In the second study, we conducted structured interviews with pregnant women (N = 94) to determine their cravings and aversions, resource scarcity, indices of pathogen exposure, immune activation, psychological distress, and emic causes of aversions. Study 1 found that fruits were the most commonly reported food that pregnant women should avoid because of their harmful effects on infants. Study 2 found modest support for the fetal protection hypothesis for food aversions. It also found that pregnant women most commonly avoided fruits as well as “black” and “hot” foods. Aversions were primarily acquired through learning and focused on protecting the infant from harm. Our findings provide modest support for the fetal protection hypothesis and surprisingly strong support for the influence of cultural norms and learning on dietary aversions in pregnancy. (shrink)

As the range of conditions for which we can test prenatally expands, society and the medical profession need to develop guidelines about which tests ought to be offered and which ought not to be. Notions of fetal privacy and confidentiality can help to define limits to what parents may reasonably learn about their future child.

In coming decades, fetal medicine may become a routine part of reproductive care. The measures pregnant women now take to protect fetal health are largely generic, like restricting their diets and using supplements. Relatively few interventions are based on specific conditions revealed by ultrasound or genetic testing. A recent finding, though, may herald a dramatic rise in “personalized” fetal medicine: certain drugs already approved by the Food and Drug Administration can apparently boost neural growth in fetuses with (...) Down syndrome, improving cognitive functioning in the future child. Many more condition‐specific findings are likely in the near future. But as commentators have frequently observed about prenatal testing, technologies that appear to increase reproductive options also complicate and constrain them. (shrink)

In the summer of 1998, the Wisconsin State legislature amended its child protection laws. Under new child abuse provisions, Wisconsin judges can confine pregnant women who abuse alcohol or drugs for the duration of their pregnancies. South Dakota enacted similar legislation almost simultaneously. The South Dakota statute requires mandatory drug and alcohol treatment for pregnant women who abuse those substances and classifies such activity as child abuse. In addition, the South Dakota legislation gives relatives the power to commit pregnant women (...) involuntarily for two days; a court order can place the pregnant women in custody for up to nine months. These recent legislative “successes” follow scores of failed attempts by legislators in other states to establish fetal protection laws aimed at women who use and abuse drugs and alcohol during pregnancy. (shrink)

This essay critiques feminist treatments of maternal-fetal "relationality" that unwittingly replicate features of Western individualism (for example, the Cartesian division between the asocial body and the social-cognitive person, or the conflation of social and biological birth). I argue for a more reflexive perspective on relationality that would acknowledge how we produce persons through our actions and rhetoric. Personhood and relationality can be better analyzed as dynamic, negotiated qualities realized through social practice.

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

Maternal–fetal surgery (MFS) encompasses a range of innovative procedures aiming to treat fetal illnesses and anomalies during pregnancy. Their development and gradual introduction into healthcare raise important ethical issues concerning respect for pregnant women’s bodily integrity and autonomy. This paper asks what kind of ethical framework should be employed to best regulate the practice of MFS without eroding the hard-won rights of pregnant women. I examine some existing models conceptualising the relationship between a pregnant woman and the fetus (...) to determine what kind of framework is the most adequate for MFS, and conclude that an ecosystem or maternal–fetal dyad model is best suited for upholding women’s autonomy. However, I suggest that an appropriate framework needs to incorporate some notion of fetal patienthood, albeit a very limited one, in order to be consistent with the views of healthcare providers and their pregnant patients. I argue that such an ethical framework is both theoretically sound and fundamentally respectful of women’s autonomy, and is thus best suited to protect women from coercion or undue paternalism when deciding whether to undergo MFS. (shrink)

In the summer of 1998, the Wisconsin State legislature amended its child protection laws. Under new child abuse provisions, Wisconsin judges can confine pregnant women who abuse alcohol or drugs for the duration of their pregnancies. South Dakota enacted similar legislation almost simultaneously. The South Dakota statute requires mandatory drug and alcohol treatment for pregnant women who abuse those substances and classifies such activity as child abuse. In addition, the South Dakota legislation gives relatives the power to commit pregnant women (...) involuntarily for two days; a court order can place the pregnant women in custody for up to nine months. These recent legislative “successes” follow scores of failed attempts by legislators in other states to establish fetal protection laws aimed at women who use and abuse drugs and alcohol during pregnancy. (shrink)

Discussions of reproductive responsibility generally draw heavily upon the principles of nonmaleficence and beneficence. However, these principles are typically only applied to women due to the incorrect belief that only women can cause fetal harm. The cultural perception that women are likely to cause fetal and child harm is reflected in numerous social norms, policies, and laws. Conversely, there is little public discussion of men and fetal and child harm, which implies that men do not (or cannot) (...) cause such harm. My goal in this paper is to begin to fill the void in the academic literature about men’s reproductive responsibility by highlighting the health-related, economic, and social harms men can cause to potential fetuses and children and then examining what it would mean to hold them responsible for preventing these harms. Applying the principles of nonmaleficence and beneficence to men, I conclude that men have a moral duty to use contraception if their behavior—past, current, or future—could harm the potential fetuses and children who result from their unprotected sexual behavior. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Making Fetal PersonsFetal Homicide, Ultrasound, and the Normative Significance of BirthCatherine MillsIn early 2012, the then attorney general of Western Australia, Christian Porter, announced plans to introduce fetal homicide laws that would “create a new offence of causing death or grievous bodily harm to an unborn child through an unlawful assault on its mother” (Porter 2012). While well established in the United States, fetal homicide laws (...) are only beginning to take shape in Australia.1 The proposed law would mean that if an offender assaulted a woman and thereby caused the death of the fetus she was gestating, the courts would be required to impose a sentence of life imprisonment in all but exceptional circumstances—equivalent to the penalty for murder. While the proposed fetal homicide law is said to give appropriate recognition to the grief and suffering of the woman involved—and while it may help to do that—this is certainly not all it would do.2 For it would also give existence to a new legal subject in Western Australia, that is, the “unborn child”: currently, under Western Australian law a child is only legally capable of being murdered when already external to the mother’s body. Thus, the woman’s body constitutes a kind of “natural” basis for a legal boundary—one that the proposed law transgresses and perhaps obliterates, at the same time as it purports to recognize the trauma associated with the transgression and obliteration of that boundary by another.Fetal homicide laws thus traverse difficult territory in the maternal-fetal relationship, in which actions against one person come to constitute a crime against another. Significantly, these laws are typically formulated to provide legal protection for pregnant women against the intrusions of a third party against [End Page 88] their person. However, it may be that they can also be interpreted more generally to provide legal protection for the fetus against others. So construed, such laws open up a danger for pregnant women themselves, insofar as their actions threaten the life and well-being of the fetus they carry. One recent example of the exploitation of this ambiguity in fetal homicide laws is the case of Bei Bei Shuai, a young woman of Chinese descent who faced felony charges of murder in Indiana after a failed suicide attempt resulted in the death of the thirty three week old fetus she was gestating (Pilkington 2011, 2012). If a woman’s actions against herself, leading to the death of her fetus, can be legally construed as murder, where does this leave the law on abortion? The Western Australian attorney general insisted that the proposed law would not affect laws on abortion in any way, since it would not encroach on a woman’s right to make decisions about her pregnancy (Porter 2012). But a woman’s decisional rights in regards to her pregnancy are at best an unstable dividing line; at worst, it is precisely her decision to terminate a pregnancy—that is, to intentionally bring about the death of the fetus—that substantiates a murder charge. Indeed, at the crux of the Shuai case was her suicide note, in which she apparently stated her intent to kill her fetus.This ambiguity between abortion and fetal homicide has been the topic of much discussion in legal literature, and it raises significant questions that bear further investigation. For one, it raises in a particularly pointed way questions about the moral and legal significance of birth, and the bearing it has on the status of the fetus. Birth has historically been significant in establishing personhood, but this reliance on birth is challenged by the shift to treating the fetus as a person for the purposes of some areas of the law. The further question then arises of whether that status must remain consistent across domains of the law, such as those addressed to the death of a fetus at the hands of a third party, and those on abortion. While these questions have been well canvassed in legal discussions, we might also consider the impact that technologies such as obstetric ultrasound have on notions of fetal life and personhood. Advances in medical technologies appear... (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)