I have argued that because human sexual reproduction inevitably involves the creation and destruction of embryos, it is a problematic activity for those who believe that the embryo is “one of us.” Or, if it is not a problematic activity, then neither is the creation and destruction of embryos for a purpose of comparable moral seriousness—the development of lifesaving therapy, for example. I assume that, whereas it is possible for the very first act of unprotected intercourse to result (...) in a live human baby, and hence not in a given case cause any embryo loss, this is a rare event and that, statistically, for every live birth from three to five embryos must be created only to die. For dramatic effect, I assume that five is a reasonable figure, giving each embryo a 20% chance of survival; however, nothing in the argument depends on any specific figures being correct. a. (shrink)

Sexual reproduction is a composite, not a singular, phenomenon and as such can be subdivided into a number of componentsi.e. fusion, recombination, fission, and the male-female phenomenon. These components can evolve independently, though any evolutionary change in one component is likely to influence the future evolution of the other components. The ambiguity that surrounds the term ‘sex’ due to a failure to recognise the composite nature of sexual reproduction has led to considerable confusion in past discussions (...) of the evolution of the phenomenon. This paper considers the possible chronological interaction of the components of sexual reproduction both with each other and with the sequence of selective pressures that seem likely to have acted. This chronological approach is used to consider: the origin of sexual reproduction; the evolution of sexual reproduction in the common ancestor of the procaryotes and eucaryotes; the modification of the ancestral system in the procaryote line following the procaryote-eucaryote dichotomy; and the modification of the ancestral system in the eucaryote line up to the origin of the male-female phenomenon.It is suggested that the fusion and recombination of the first living organisms were chronological continuations of the fusion and recombination of complex organic molecules that led up to the origin of life. The evolution of the third major component of sexual reproductioni.e. fission , by definition coincided with the origin of life. Initial selection on the components of sexual reproduction are likely to have been related to the optimum manifestations of size, complexity, diversity, multiplication, and distribution. Resultant early evolutionary trends are likely to have been: selective fusion between more-similar organisms; increase in number of fissions per fusion; and less recombination.The procaryote-eucaryote dichotomy is argued to have evolved in response to the increasing cellular problems of packing and replicating an increasing amount of hereditary material. The evolution of a single circular hereditary organelle in the procaryote line is argued to have led to the loss of total fusion and the specialisation of individuals into either donors or recipients. The donor-recipient phenomenon of procaryotes is directly analogous to the male-female phenomenon of eucaryotes and leads to parallel evolution due to sexual selection in both groups. In the eucaryote line the ancestral mechanism of sexual reproduction is argued to have persisted through, but to have been greatly modified by, the evolution of complex machinery for the handling of multiple hereditary organelles at cell division and reduction division. The evolutionary modification of the ancestral system of sexual reproduction is suggested to have led in eucaryotes to the evolution of: the species phenomenon; allelic recombination; and the male-female phenomenon. (shrink)

The dynamics of populations of self-replicating, hierarchically structured individuals, exposedto accidents which destroy their sub-units, is analyzed mathematically, specifically with regardto the roles of redundancy and sexual repair. The following points emerge from this analysis:0 A population of individuals with redundant sub-structure has no intrinsic steady-statepoint; it tends to either zero or infinity depending on a critical accident rate α c . Increased redundancy renders populations less accident prone initially, but populationdecline is steeper if a is greater than a (...) fixed value α d . Periodic, sexual repair at system-specific intervals prevents continuous decline and stabilizesthe population insofar as it will now oscillate between two fixed population levels. The stabilizing sexual interval increases with increased complexity provided this is accom-panied by appropriate levels of redundancy. The model closely simulates the dynamics of heterosis effects. Repair fitness is a population fitness: the chance of an individual being repaired is a functionof the statistical make-up of the population as a whole at that particular period. Populationsliving at α > α c either engage in sexual repair at the appropriate time or they die out. The mathematical properties of the model illustrate mechanisms which possibly played arole in the evolution of a mortal soma in relation to sexual reproduction. (shrink)

There is evidence that asexual reproduction has a long-term disadvantage when compared to sexual reproduction. This disadvantage is usually assumed to arise from the more efficient incorporation of advantageous mutations by sexual populations. We consider here the effect on asexual and sexual populations of changes in the fitness of harmful mutations. It is shown that the re-establishment of equilibrium following environmental change is generally faster in sexual populations, and that the mutational load experienced by (...) the sexual population can be significantly less during this period than that experienced by an asexual one. Changes in the fitness of harmful mutations may therefore impose a greater long-term disadvantage on asexual populations than those which are sexual. (shrink)

Fertility clinicians participate in non-sexual reproductive projects by providing assisted reproductive technology (ART) to those hoping to reproduce, in support of their reproductive goals. In most countries where ART is available, the state regulates ART as a form of medical treatment. The predominant position in the reproductive rights literature frames the clinician’s role as medical technician, and the state as a third party with limited rights to interfere. These roles broadly align with established functions of clinician and state in (...) Western liberal democracies, where doctors have duties to provide safe, beneficial and legal healthcare to all who seek it. Recognised state responsibilities include safeguarding equitable access to medical services and protecting and promoting reproductive liberty.I argue against this normative moral framing of clinician and state involvement in non-sexual reproduction, suggesting that clinician and state join the non-sexual reproductive project at the point of triggering conception. Begetting a child is more than just the provision and regulation of healthcare; it generates rights and confers responsibilities on all who join this morally significant project. All who collaborate have the right to join or refuse to join the project. I suggest this is intuitively understood in the sexual realm, but not in the non-sexual realm. My key substantive claim is that non-sexual reproduction is a pluralist pursuit that morally implicates more than the genetic and gestational contributors. I find that while the moral basis of a clinician or the state’s right to refuse to join the ART project is the same as for those providing gestational or genetic input, the reasons that morally underpin their refusal differs. (shrink)

This paper reconnects the personal and the biological by extending the reach of parental causality. First, it argues that the reproductive act is profitably understood in personal terms as an “invitation” to new life and that the egg and sperm are “ambassadors” or “delegates,” because they represent the potential mother and father and are naturally endowed with causal powers to bring about motherhood and fatherhood, two of the most significant roles a person may have. Second, it argues that even though (...) God alone can create a spiritual soul, the human parents are not just the causes of their child’s body; they are the secondary causes of the whole child. In this way, God acts as a kind of “sponsor” who enables the acceptance of the invitation issued by the parents, and he accepts it on behalf of the new human person that comes to be thanks to their invitation. (shrink)

Adolescents and youth in South Africa comprise about 30% of the total population. This phenomenon is referred to as a youth bubble. Research shows that 52% of young people have had full penetrative sex by age 17, and yet 35% of teenagers who have sex say they only sometimes wear a condom, while 32% who have sex say they never wear a condom. Furthermore, studies show that more than half (52%) of parents of teenagers and youth are unaware of their (...) children’s sexual experiences. This situation is insignificantly different between the youth who frequently attend church and those who do not go to church. Responses by churches to the situation have ranged from denialism and hence only maintaining an abstinence stance to superficial youth sexuality discussions that only scratch on the surface. Data indicate that many adolescents seldom have an opportunity to discuss issues of sexual and reproductive health with a caring, knowledgeable adult and are often confronted with unresponsive health services. In response to the situation, there is growing awareness of the important role that religious communities play in adolescents and youth sexual health. The National Adolescent Sexual and Reproductive Health and Rights Framework Strategy (2014–2019) encourage parents and faith-based organisations to bridge this gap by empowering adolescents and youth regarding sexuality issues. The fourth priority of the strategy advocates for a strengthening and scaling up of community networks aimed at supporting adolescents. The churches, however, are caught in a dilemma where on the one hand they have to uphold (teaching) the biblical moral values of abstinence and at the same time respond to the realities of youth who are engaging in sex. With the church being a subsystem of society, a question that is posed is: how should a constructive engagement between church and society regarding youth sexual reproductive health be done? A practical theological response of the church to adolescents and youth sexual reproductive health (AYSRH) that is dialectic and juxtaposes the church and its distinctive values and at the same time practically responding to realities of the needs of adolescents and youth is proposed. In such a model, an engagement that upholds the sacredness of the church while observing the public role of the church as a community institution is advanced. (shrink)

Horizontal gene transfer in the form of long DNA fragments has changed our view of bacterial evolution. Recently, we discovered that such processes may also occur with the massive amounts of short and damaged DNA in the environment, and even with truly ancient DNA. Although it presently remains unclear how often it takes place in nature, horizontal gene transfer of short and damaged DNA opens up the possibility for genetic exchange across distinct species in both time and space. In this (...) essay, we speculate on the potential evolutionary consequences of this phenomenon. We argue that it may challenge basic assumptions in evolutionary theory; that it may have distant origins in life's history; and that horizontal gene transfer should be viewed as an evolutionary strategy not only preceding but causally underpinning the evolution of sexual reproduction. (shrink)

The theory is presented that the sexual process is a repair mechanism which maintains redundancy within the sub-structure of hierarchical, self-reproducing organisms. In order to keep the problems within mathematically tractable limits , a simple model is introduced: a wheel with 6 spokes, 3 of them vital and 3 redundant, symbolizes the individual . Random accidents destroy spokes; the wheels replicate at regular cycles and engage periodically in pairing and repair phases during which missing spokes are copy-reproduced along the (...) intact spokes of the partner wheel.The hierarchical structure of such a system is analysed and an ‘autonomous unit’ is defined: this is the unit of minimal hierarchical complexity which is capable of perpetuating autonomously all higher and all lower levels of the hierarchy; this is the central unit of selection.Four basic, physical parameters are isolated which determine the essential features of any eucaryotic life cycle: 1. The number of levels of the hierarchy ; 2. the relation between the phases of replication and repair ; 3. the duration of potential repair ; 4. the position of the sexual partners within the hierarchy .The evaluation of fitness components is considered in relation to trends of reproductive patterns in evolution. (shrink)

The group selection controversy largely focuses on altruism (e.g., Wilson 1983; Lloyd 2001; Shavit 2004; Okasha 2006, 173ff; Borrello 2010; Leigh 2010; Rosas 2010; Hamilton and Dimond in press). Multilevel selection theory is a resolution of this controversy. Whereas kin selection partitions inclusive fitness into direct and indirect components (via influencing the replication of copies of genes in other individuals), multilevel selection considers within-group and between-group components of fitness (Gardner et al. 2011; Lion et al. 2011). Two scenarios of multilevel (...) selection are often distinguished (Damuth and Heisler 1988; Okasha 2006; Pigliucci 2010): (1) group structure only divides individual fitnesses into within- and between-group components (MLS1); and, (2) groups get their own component of fitness and also, in most definitions, a group-level adaptation (MLS2). (shrink)

In any given society, rights are said to co-exist. When rights, however, begin to conflict, a balance must be sought. In few fields has the ability of governments to accommodate two conflicting sets of rights been so controversial as it has in the case of conscientious objection in reproductive health care. Today, states have an obligation under international law to protect the right to the freedom of thought, conscience, and religion of medical providers. They also, however, have an obligation to (...) protect right to the highest attainable standard of health and other fundamental rights of women. Considering the extent to which CO has been invoked in the context of reproductive health care, international law recognizes limits to its use. Over the years, human rights bodies have sought to develop guidelines around CO in order to ensure the protection of women’s basic rights. While some state practices have shown to be consistent with guidelines established at the international level, some countries have struggled to provide an effective balance so as to protect women’s fundamental rights. Taking the example of countries in Latin America and Europe, this article provides an overview of the different ways states have sought to regulate CO in the medical context and the various difficulties ensued. (shrink)

Sexual and reproductive health is a challenge worldwide, and much progress is needed to reach the relevant UN Sustainable Development Goals. This paper presents cross-sectional data collected in Sierra Leone on sexual and gender-based violence, family planning, child, early and forced marriage, and female genital mutilation using an innovative method of measurement: situational judgment tests, as a subset of questions within a larger survey tool. For the SJTs, respondents saw hypothetical scenarios on these themes and had to indicate (...) how they would react. The objective is to give an impression of beliefs and norms on specific behaviors, which provide insights for social and behavior change interventions. Data was collected by enumerators traveling to villages randomly selected in six districts of the country. The sample is composed of 566 respondents. Results show that FGM in particular seem to be a priority topic, in comparison to the other topics for which the norms seem to be stronger against those practices. Age differences emerged and suggest priority groups to be targeted. In terms of validity of the measurement methods, situational judgment test answers correlated positively with other items in the survey, but the magnitude of the association is often small, and sometimes not significant. Thus, more studies are needed to further explore the validity of this measure by comparing against a reference value. Using SJTs could complement other data collection tools to perform community assessment, and orient the direction of the program in its planning phase. (shrink)

How can ethnic boundaries survive in contexts of legal racial equality and institutionalized ethnic mixing? Constructivist theories of ethnicity have long emphasized the fluidity, rather than the durability, of ethnic boundaries. But the fact that ethnic boundaries often endure—and even thrive—in putatively non-ethnic political contexts suggests the need for sustained attention to the problem of boundary persistence. Based on an ethnographic study of ethnic boundaries in the Turkish case, this article argues that the regulation of the domain of sexuality and (...) marriage can play a critical role in reproducing boundaries when political institutions neither acknowledge nor aid in the survival of ethnic diversity. Ultimately, the data provide substantial evidence that the transmission and internalization of informal rules of inter-ethnic sexual conduct are central to boundary maintenance. (shrink)

For years, the sexual and reproductive health of women with intellectual and developmental disability or disabilities has been insufficiently addressed by institutions and family members due to a lack of information, training, and, sometimes, religious issues. In this context, contraceptive digital pills can enhance the sexual and reproductive control of this population group. Digital pills could help to improve adherence to treatments aimed to prevent unwanted pregnancies, as well as allowing women and their caregivers to exert better drug (...) intake control. However, there are some ethical risks to consider that may outweigh these benefits. This study sets out to explore the ethical considerations that should be taken into account in the case of a potential roll‐out of contraceptive digital pills as a way of improving the sexual and reproductive health of these women. (shrink)

Asylum-seeking and refugee women (ASRW) are population groups characterized by diverse social, economic and legal backgrounds as well as diverse needs. Their backgrounds of forced migration have a profound impact on their overall health, including their sexual and reproductive health (SRH). In Europe, the SRH needs of ASRW are usually more pressing than those of the host country population. In the context of refugee health, it is important to distinguish between asylum seekers and statutory refugees, as asylum seekers have (...) distinct needs and often limited rights in their host country. Yet both groups face many barriers in accessing national health services. This article addresses the issue of entitlements to health services for asylum-seeking women in Europe, and highlights the wide range of difficulties of both asylum-seeking and refugee women in accessing (sexual and reproductive) health services. (shrink)

Violations of women’s sexual and reproductive health and rights are frequent all over the world. Women’s sexual and reproductive health is related to multiple human rights. The term ‘rights-based’ has become increasingly linked to the concept of a more comprehensive approach to sexual and reproductive rights of women around the globe. The rights-based perspective is derived from the treaties, pacts and other international commitments that recognize and reinforce human rights, including the sexual and reproductive rights of (...) women. We conducted an extensive review of the guidelines, frameworks, research reports and published articles that have been cited as informing the rights-based approach. The findings of the review highlights what is meant by sexual and reproductive health and rights by the stakeholders, why this matter is important, and what can be done. It demands more partnerships with human rights, women’s and other civil society organizations, increased number of successful national policies, initiatives and/or legislative changes, increased budget and other resources at national and/or local community level, mass communication and engagement of men to promote and advance women’s sexual and reproductive health and rights. Achievement of gender equality is very crucial, because it is a human right that advances women’s empowerment; and is interlinked with sexual and reproductive health and rights. (shrink)

While sexual violence should not be the prerequisite for legal abortion, expanding definitions of abuse to include reproductive coercion can open avenues of access to abortion following the Dobbs decision. Understanding the increased danger and compounding challenges of intimate partner violence can inform legislative initiatives, healthcare responses, and movements for reproductive justice.

Claims concerning the death of the nation-state are often accompanied by postnationalist arguments that emphasize the potential of human rights to contest nation-bounded conceptualizations of membership. Conversely, arguments focusing on the continuing importance of state-bounded social citizenship rights undermine such postnationalist claims. To assess these claims, this article turns to the Irish state and its prohibition of abortion except in cases where the life of the pregnant woman is in danger. The authors focus their analysis on four legal cases that (...) unfolded between 1992 and 2010. These cases reflect how specific women’s social location within interconnected power hierarchies of nationality, gender, class, race/ethnicity positioned them differently vis-a-vis the Irish state, international and supranational bodies. Furthermore, the transnational, in the form of immigration, non-governmental organizations and the Catholic Church, plays an important role in structuring the context within which these cases unfold. Rather than showing that the international, supranational and transnational are conduits for the declining power of the nation-state, this article finds that in the increasingly dense legal-political field there is room for all of these forces. (shrink)

What kind of rhetoric frames French reproductive policy debate? Who does such policies exclude? Through an examination of the “American import” of gender studies, along with an analysis of France’s Catholic heritage and secular politics, I argue that an unwavering belief in sexual difference as the foundation of French society defines the productive reproductive citizen. Sylviane Agacinski is perhaps the most vocal public philosopher who has framed the terms of reproductive policy debate in France, building an oppositional platform to (...) reproductive technology around anthropological assertions of sexual difference. This paper engages with Agacinski to examine rhetorical claims of sexual difference and how such claims delayed passage of France’s revised bioethics legislation that extends access of assisted reproductive technology (ART) to “all women.” Though the “PMA pour toutes” [ART for all women] legislation was eventually passed, such rhetoric motivated the explicit exclusion of all trans person from its extension, thus hardly permitting ART to all women. (shrink)

What is sex and why is it important? Does marriage have a basic rationale? How should couples manage their fertility, and when and how should pregnancy be achieved? How should we respond to 'embryo adoption', teenage pregnancy, population growth, HIV/AIDS and other STIs, same-sex attraction? This collection of original essays looks at these and other pivotal issues in reproductive and sexual ethics, from the perspectives of philosophy, theology, psychology and economic science.

Explores the conceptual schema underlying our understanding of reproductive technologies.

Introducción: El embarazo, aborto, las infecciones de transmisión sexual incluido el Virus de Inmuno Deficiencia Humana, se han convertido en problemas sanitarios de mayor vulnerabilidad en jóvenes. Objetivo: Describir las conductas de riesgo y prevalencia de problemas sexuales y reproductivos de estudiantes universitarios. Método: Investigación descriptiva, el universo estuvo constituido por alumnos de dos grupos de segundo semestre; el grupo de estudio conformado por la totalidad de estudiantes de la Facultad de Salud Pública ; y el control seleccionado mediante (...) una muestra aleatoria de estudiantes del resto de las facultades, se realizó esta selección con el propósito de valorar la homogeneidad de las variables entre los grupos. Resultados: Existe homogeneidad en la mayoría de conductas de riesgo y problemas sexuales en los grupos, en consecuencia estas variables no están influenciadas por la pertenencia a la Facultad de Salud Pública. Se evidencian conductas de riesgo como: inicio temprano de relaciones sexuales, múltiples parejas, infidelidad, relaciones sexuales ligadas al consumo de sustancias, dificultades con el uso de métodos anticonceptivos o de protección; se encontró prevalencia de problemas como: experiencia de embarazos, la mayoría no planeados, abortos inducidos y presencia de infecciones de transmisión sexual. Conclusiones: Existe vulnerabilidad en la salud sexual y reproductiva de los jóvenes universitarios independientemente de la formación que reciben, por tanto, emerge la necesidad de buscar alternativas integrales de promoción, prevención y educación sexual integral. Introduction: Pregnancy, abortion, sexually transmitted infections including Human Immunodeficiency Virus, have become a health problem of more vulnerable in young people. Objective: To describe risk behaviors and prevalence of sexual and reproductive problems of university. Method: Descriptive study, the universe consisted of students from two groups of second semester; the study group is conformed by students of the Public Health Faculty ; and control selected by a random sample of students from other faculties, in order to assess the homogeneity of the variables between groups. Results: Homogeneity exists in most risk behaviors and sexual problems in groups, therefore these variables are not influenced by membership in the Public Health Faculty. Risk behaviors as evidence: early initiation of sexual activity, multiple partners, infidelity, sexual relationship linked to substance consumption, which prevails alcohol, together with the non-use or inappropriate use of contraception or protection; experience of pregnancy, most unplanned, induced abortions and the presence of sexually transmitted infections: prevalence of problems as found. Conclusions: There is vulnerability in sexual and reproductive health of young students regardless of their training, thus emerges the need to find alternatives comprehensive promotion, prevention and comprehensive sex education. (shrink)

There is increasing interest in the need to address the ethical dilemmas related to the engagement of adolescents in sexual and reproductive health research. Research projects, including those that address issues related to STIs and HIV, adverse pregnancy outcomes, violence, and mental health, must be designed and implemented to address the needs of adolescents. Decisions on when an individual has adequate capacity to give consent for research most commonly use age as a surrogate rather than directly assessing capacity to (...) understand the issues and make an informed decision on whether to participate in research or not. There is a perception that adolescents participating in research are more likely to be coerced and may therefore not fully comprehend the risk they may be taking when engaging in research. This paper examines the various ethical issues that may impact stakeholders' decision making when considering engaging adolescents in SRH research in Nigeria. It makes a case for lowering the age of consent for adolescents. While some experts believe it is possible to extrapolate relevant information from adult research, studies on ethical aspects of adolescents' participation in research are still needed, especially in the field of sexual and reproductive health where there are often differences in knowledge, attitudes and practices compared to adults. The particular challenges of applying the fundamental principles of research ethics to adolescent research, especially research about sex and sexuality, will only become clear if more studies are conducted. (shrink)

The decision of the House of Lords in Gillick v West Norfolk Area Health Authority carved out a safe space for competent minors to confidentially access sexual and reproductive health care and advice in the UK. Ireland is one of the few common law jurisdictions that has not endorsed Gillick or a similar mature minor doctrine, nor has it securely legislated for the right to consent of those aged 16 and 17 years. The legal lacuna created by this deficiency (...) has left young persons in Ireland seeking sexual and reproductive healthcare, and the clinicians who provide this, in a challenging place. While this void has been partially filled with policy statements by bodies such as the Irish College of General Practitioners and the Health Service Executive, nonetheless the legal shortcomings leave both a sense of insecurity, and real world difficulties for adolescents seeking to access to sexual and reproductive healthcare. (shrink)

This article explores how cross-cultural research on sexual and reproductive rights can be vulnerable to ethnocentrism, and in what way ethnocentrism can be reduced in such research. Against the background of feminist debate on equality and difference, it discusses how the concepts of sexual and reproductive rights, within the parameters of development discourse, can reinforce hierarchical dichotomies of North–South, modern–traditional and actor–structure, and undervalue southern women's agency. An analytical framework that combines the entitlement approach and the three-dimensional model (...) of gender is proposed to diminish ethnocentrism and counter homogenization and generalization. This framework aims at balancing agency, actor and structure, and allowing for differences, heterogeneity and contradictions. (shrink)

The years since the rise of gay liberation in 1969 have seen remarkable changes in the realm of sexuality. Lesbians and gay men have won important rights and attained a cultural visibility that would have been impossible to imagine even thirty years ago. Yet these rights are limited, and apply only to specific sections of those who face exclusion, discrimination or violence on the basis of their queerness in the realm of gender and/or sexuality.

This study’s objective was to understand Colombian adolescents’ experiences and preferences regarding access to sexual and reproductive health services (SRHS), either alone or accompanied. A mixed-method approach was used, involving a survey of 812 participants aged eleven to twenty-four years old and forty-five semi-structured interviews with participants aged fourteen to twenty-three. Previous research shows that adolescents prefer privacy when accessing SRHS and often do not want their parents involved. Such findings align with the longstanding tendency to frame the ethical (...) principle of autonomy as based on independence in decision-making. However, the present study shows that such a conceptualization and application of autonomy does not adequately explain Colombian adolescent participants’ preferences regarding access to SRHS. Participants shared a variety of preferences to access SRHS, with the majority of participants attaching great importance to having their parents involved, to varying degrees. What emerges is a more complex and non-homogenous conceptualization of autonomy that is not inherently grounded in independence from parental involvement in access to care. We thus argue that when developing policies involving adolescents, policymakers and health professionals should adopt a nuanced “relational autonomy” approach to better respect the myriad of preferences that Colombian (and other) adolescents may have regarding their access to SRHS. (shrink)

The devastating COVID-19 pandemic and its accompanying containment measures brought exceptional challenges to the health delivery system, and in particular, women’s sexual and reproductive healthcare (hereafter referred to as SRH). The re-routing of health resources and funding to mitigate the effects of the pandemic obstructed the provision of essential SRH services for women and girls. Coupled with the incessant socio-cultural and patriarchal norms and gender inequalities, the COVID-19 pandemic aggravated the pre-existing SRH disproportions already affecting women. By adopting a (...) qualitative approach and drawing on the experiences of women from three high density suburbs in Harare. Firstly, the study sought to explore the implications of the COVID-19 pandemic on SRH for women and girls. Secondly, the research sought to determine key drivers that affect women’s SRH in the context of COVID-19. Participant responses indicated that the COVID-19 lockdown containment measures which confined spouses to the home setting for prolonged periods of time, which is in contrast to the norm, exposed women to SRH related challenges. Participants cited that (i) bruised male ego due to lack of employment as a result of downscaling of companies resulting from COVID-19 containment measures resulted in men asserting their masculinities through heightened sexual intercourse, (ii) restraint of movement resulted in limited time for men to visit their small houses and side-chicks or side dish (euphemisms for illicit sexual relations) therefore resulting in frequent and unprotected sex with their spouses, giving rise to unplanned pregnancies and increased exposure to STIs due to limited access to SRH services and, (iii) increased intimate partner violence (IPV) and sexual abuse. Therefore, the research sought to explore the response of religious leaders and faith-based actors to providing psycho-social support and safe spaces as ways of addressing intersectional injustices giving rise to SRH challenges for women and girls.Contribution: The intersecting crises of the COVID-19 pandemic have extensively hindered progress towards the promotion of women’s SRH. Relating to sustainable development goal 3 (SDG3), the article acknowledges the trust and respect of religious leaders within communities as change agents who can encourage shifts in behaviour, beliefs and practices in ways that promote holistic SRH for women. (shrink)

There are conceptual and ethical challenges to defining adolescents’ autonomy to access health care, and these can lead to health care norms and practices that could be maladjusted to the needs and preferences of adolescents. Particularly sensitive is access to sexual and reproductive health care services (SRHS). Yet, while there has been substantial conceptual work to conceptualize autonomy (e.g., as independence), there is a lack of empirical research that documents the perceptions of adolescents regarding on how they access or (...) wish to access health care services. The main objectives of this research were to (a) understand how adolescents in Colombia interpret the concept of “autonomy,” (b) describe how these adolescents articulate their autonomy (i.e., preferences) in accessing SRHS, and (c) analyze the ethical issues emerging from these data. Forty-five semi-structured interviews were conducted with participants aged 14 to 23 years old in the Departments of Antioquia and Valle del Cauca in Colombia. Our study showed that participants’ understanding of autonomy was context-based and highly dependent on personal experiences, and these influenced their choice in how to access SRHS. Seen through the ethical lens of a reproductive justice framework, our results highlight the unequal opportunities for adolescents in terms of autonomy to access SRHS. (shrink)

There are no technologies at the present time that would allow parents to select the sexual orientation of their children. But what if there were? Some commentators believe that parents should be able to use those techniques so long as they are effective and safe. Others believe that these techniques are unethical because of the dangers they pose to homosexual men and women in general. Both sides point to motives and consequences when trying to analyse the ethics of this (...) question. These arguments are reviewed, and it is concluded that opponents of these technologies have not shown good reason why the law or policy should override parental choice in this matter. In general, therefore, if technologies become available to choose the sexual orientation of children, parents should be allowed to use them, provided they are safe and disrupt no interest of the child. This use will, at the very least, protect homosexual children from parents who do not want them, but it will also allow parents who want homosexual children to make that choice as well. (shrink)

The predominant position in the reproductive rights literature argues that access to assisted reproductive technologies (ART) forms part of an individual’s right to reproduce. On this reasoning, refusal of treatment by clinicians (via provision) violates a hopeful parent’s reproductive right and discriminates against the infertile. I reject these views and suggest they wrongly contort what reproductive freedom entitles individuals to do and demand of others. I suggest these views find their origin, at least in part, in the way we define (...) “reproduction” itself. This paper critically analyses two widely accepted definitions of human reproduction and demonstrates that both are fundamentally flawed. While the process of reproduction includes the biological acts of begetting and bearing a child, I argue that it does not extend to include rearing. This reworked definition has little impact in the realm of sexual reproduction. However, it has significant ethical implications for the formulation and assignment of reproductive rights and responsibilities in the non-sexual realm in two important ways. First, a claim to access ART where one has an intention to rear a child (but does not beget or bear) cannot be grounded in reproductive rights. Second, lacking an intention to rear does not extinguish the reproductive rights and responsibilities for those who collaborate in the process. I conclude that clinicians collaborate in non-sexual reproduction at the point of triggering conception (begetting) and therefore have the right to refuse to be involved in non-sexual reproduction, in some instances, as do all reproductive collaborators. (shrink)

O conceito freudiano de "impulso", ou "instinto" (Trieb), é reconhecidamente um dos conceitos mais fundamentais da psicanálise. No entanto, seu sentido ainda é objeto de controvérsia. Originalmente definido por Freud em um sentido biológico ou quase biológico, sua recepção em muitas das diversas tradições pós-freudianas tendeu, frequentemente, a recusar essa filiação epistemológica inicial. Um dos sinais dessa reorientação doutrinária é a recusa da tradução de "Trieb" por "instinto" e a preferência pelo neologismo "pulsão", de origem francesa e comum na literatura (...) psicanalítica escrita em várias das línguas neolatinas, inclusive em português. O objetivo deste artigo é criticar essa tendência. Para tanto, são examinados os principais argumentos normalmente apresentados contra uma visão biológica do Trieb freudiano, a saber, 1) a alternativa terminológica entre os termos alemães "Trieb" e "Instinkt" e o modo como estes são utilizados por Freud; 2) a crítica freudiana de uma redução da sexualidade humana à função reprodutiva; 3) o conceito de "Todestrieb" ("instinto de morte" ou "pulsão de morte") formulado por Freud por volta de 1920 e central na etapa final de seu pensamento. Procura-se argumentar que essas formulações não impedem uma interpretação biológica do conceito de "Trieb". Essa interpretação, por sua vez, abre uma via de diálogo entre a psicanálise e a biologia, a qual é também enfática e explicitamente defendida por Freud. Esta primeira parte do trabalho introduz a questão e também aborda o problema da relação entre sexualidade e reprodução na psicanálise e na biologia. Uma segunda parte, a ser publicada em uma próxima edição de Scientiae Studia, será dedicada ao problema da agressividade e da autodestrutividade nessas duas áreas do conhecimento. Freud's concept of "drive" or "instinct" ("Trieb") has been widely acknowledged as one of the most fundamental concepts of psychoanalysis. However, its meaning is still a matter of controversy. It was originally defined by Freud in a biological or quasi-biological sense, but its reception in many different post-Freudian traditions has often tended to reject this early epistemological affiliation. One sign of this theoretical reorientation has been to refuse the translation of "Trieb" as "instinct" and to favor instead the neologism "pulsion" ("drive"), which has French origins and became common in the psychoanalytic literature written in many neo-Latin languages, including Portuguese. The objective of this paper is to criticize this trend. For that, the main arguments usually presented against a biological view of Freud's "Trieb" are discussed, namely: (1) the terminological alternative between the German words "Trieb" and "Instinkt" and how these terms are employed by Freud; (2) Freud's critique of the reduction of human sexuality to the reproductive function; (3) the concept of "Todestrieb" ("death instinct" or "death drive"), formulated by Freud around 1920 and central in the last stage of his thought. It is argued that these formulations do not preclude a biological interpretation of the concept of "Trieb". Such interpretation, in turn, opens the way for dialogue between psychoanalysis and biology, a dialogue which was also emphatically and explicitly supported by Freud. This first part of the paper is an introduction to this issue, and approaches the problem of the relationship between sexuality and reproduction in psychoanalysis and biology. A second part will be published in a forthcoming issue of Scientiae Studia; it will be dedicated to the problem of aggression and self-destructiveness in these two fields of knowledge. (shrink)

Objective Our study sought to (1) describe the practices and preferences of Colombian adolescents in accessing sexual and reproductive health services: accompanied versus alone; (2) compare actual practices with stated preferences; and (3) determine age and gender differences regarding the practice and these stated preferences. -/- Methods 812 participants aged 11–24 years old answered a survey in two Profamilia clinics in the cities of Medellin and Cali in Colombia. A cross-sectional analysis was performed to compare participants’ answers based on (...) the variables of gender and age. -/- Results A quarter of participants visited the clinic alone (25.4%). Females were more likely to go alone in comparison to males (26.3% vs 14.1%; p = 0.031), and older participants went alone more often than younger participants (p < 0.001). Most participants – 72.7% (95 %CI: 69.3–75.9) – expressed a preference in being accompanied to the clinic, and more than 90% had their preferences met. The preferences of older participants were, however, less likely to be met than those of younger participants (p < 0.001), notably, because they predominantly wanted to be accompanied. -/- Conclusion Contemporary public health and bioethics literature advocates in favor of developing health services that better meet the preferences of adolescents. The present research highlights an apparent blind spot related to the role that others (e.g., parents, friends, partners) can or should play in accompanying adolescent patients when they access sexual and reproductive health services. Respecting adolescents’ preferences, and hence their autonomy, is not simply a matter of ensuring freedom from constraints (e.g., their right and ability to go alone). Rather, it should also consider the liberty to choose whether to be accompanied when accessing SHRS and by whom. (shrink)

Sexual Orientation as Symbolic Capital and as the "Object" of Symbolic Violence Sexual orientation is currently understood to be an innate disposition. Heterosexually oriented people are perceived to be in the majority and homosexually oriented people as the minority. Using Pierre Bourdieu's concepts of symbolic power, symbolic violence and symbolic capital, this paper aims to show how symbolic power and symbolic violence contribute to determining which sexual orientation is associated with the majority and minority populations, and establish (...) what role is played by the symbolic capital derived from sexual orientation. (shrink)

There is an increasing recognition internationally of the critical impact of communication within healthcare. The link between ineffective communication, patient dissatisfaction and critical incidents is well established. Family Planning New South Wales has sought to address patient-centred care and communication in its policy platform. This article reports on research conducted within FPNSW, which analysed the discourse features that constituted effective doctor–patient1 communication in sexual and reproductive health consultations. The principal aim of the research was to understand how effectively messages (...) were conveyed and received and to what degree patients were active participants in their own sexual healthcare. Analysed consultations were characterised by extremely high levels of communicative competence on the part of the doctors who integrated medical expertise with the development of interpersonal relationships with patients, thus positioning patients as active contributors to the consultations and to decisions about their ongoing treatment. The detailed linguistic analysis identified characteristic features of patient-centred communication that are essential to patient-centred care. These interactions demonstrate that communicating care is just as important as delivering care and involves a drawing together of the medical and the interpersonal in consultations. The article details strategies for interweaving medical knowledge and establishing rapport that can inform practitioner communication practices across different healthcare contexts. (shrink)

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

In much of the discourse of evolutionary theory, reproduction is treated as an autonomous function of the individual organism — even in discussions of sexually reproducing organisms. In this paper, I examine some of the functions and consequences of such manifestly peculiar language. In particular, I suggest that it provides crucial support for the central project of evolutionary theory — namely that of locating causal efficacy in intrinsic properties of the individual organism. Furthermore, I argue that the language of (...) individual reproduction is maintained by certain methodological conventions that both obscure many of the problems it generates and serve to actively impede attempts to redress those difficulties that can be identified. Finally, I suggest that inclusion of the complexities introduced by sexual reproduction — in both language and methodology — may radically undermine the individualist focus of evolutionary theory. (shrink)