Definition of the problem: The medical progress made in human reproduction and prenatal diagnosis is having an increasing effect on the responsibility of doctors concerning reproduction and birth. A faulty diagnosis or professional error is causing lawyers to be confronted with difficulties in which ethical views are involved. It is becoming clear that there will be difficulties if the courts have to rule on the question whether the doctor is under an obligation to pay maintenance following the birth (...) of an unwanted child or a child with genetic defects. Arguments and conclusion: First, the controversy about parental claims on maintenance as a result of an unwanted child (”wrongful birth”) is presented, and the ethical arguments against physician liability are critically discussed. Subsequently, the claims of a genetically defective child against the doctor (”wrongful life”) are dealt with. It should be stressed that it is unjust for the court to reject physician liability in this case. The intention is to point out that ethical judgements are improper and inadequate in both cases. (shrink)

“Wrongful birth” is a controversial malpractice action, which has arisen in the past two decades, secondary to an expanding knowledge of human genetics and the constitutionally protected access to abortion. Under the wrongful birth claim, parents of a child with a congenital illness or abnormality may bring suit against a physician who allegedly failed to provide appropriate prenatal counseling or information. Typically, the parents claim that they were inadequately warned of a potential problem in their child, (...) and that this paucity of timely information prevented them from avoiding the pregnancy or from obtaining an abortion. While these cases have arisen in a variety of clinical circumstances, a characteristic example is the obstetrician who fails to offer amniocentesis to a woman of advanced maternal age who subsequently gives birth to a child with Down syndrome. Since the parents were prevented from learning of the abnormality and therefore exercising the option to terminate the pregnancy, they may claim damages for themselves for the wrongful birth of the infant. (shrink)

The concept of wrongful birth, which is based on the premise that a person would have been better off never having been born, is a serious mat­ter for Catholic obstetricians, especially in the context of prenatal screening. This principle, in conjuncture with the belief that individuals with disabilities have a decreased quality of life, has been used to promote a eugenic mentality. Consequently, prenatal screening tests often are used to identify fetuses with disabilities, who subsequently are aborted. Not (...) only is this practice ethically reprehensible, but its presuppositions about quality of life find little support in the medical literature. In fact, in the case of Down syndrome, there is consider­able evidence to the contrary: individuals living with Down syndrome have a high quality of life and are accepted by their families. These data illuminate the discrepancy between how physicians portray Down syndrome to expect­ant parents and what the literature shows regarding this condition. (shrink)

Meier et al. describe a pilot study that developed METHAD, an AI-based Medical Ethics Advisor tool that draws on the principlism approach and was tested using text-book cases and clinical et...

Wrongful birth actions aim to compensate litigants who are negligently deprived by health professionals of their right to reproductive choice. Access to safe and legal abortion is integral to the action and wrongful birth claims in the United Kingdom have been facilitated by the Abortion Act 1967 (as amended). The recent Australian case CES v Superclinics (1995) 38 NSWLR 47 shows how judicial confusion about the legality of abortion can result in judges condoning medical negligence. The (...) Superclinics case also suggests that doctors are not required to provide pregnant women with the same standard of care as other patients. These developments show that law can become incoherent and health professionals can act negligently with impunity when reproductive choice does not have a secure legal foundation. (shrink)

On July 3, 1996, in Jones v. United States), the United States District Court for the Northern District of California held that plaintiffs in a wrongful birth action cannot recover costs or damages associated with the birth and upbringing of their daughter absent evidence of causation and proof to satisfy liability requirements. Plaintiffs scientific evidence regarding the alleged interaction between antibiotics and oral contraceptives did not satisfy the Daubertstandard, cert. denied,116 S. Ct. 189 )) for admissibility developed (...) by the Supreme Court. In addition, the plaintiffs failed to meet their burden of persuasion on duty of care and causation.On January 16, 1992, Karyn Jones went to a U.S. Army gynecologist, Dr. James Murphy, to obtain a prescription for birth control pills. (shrink)

The New Jersey Supreme Court has continually avoided making moral judgments about the value of life and emphasized that such decision making should be the province of the potential parents. Recently, in Acuna v. Turkish, the court elaborated on the limitations of the decision-making right of the potential parents, and its decision demonstrated that New Jersey courts were only willing to require physicians to disclose all relevant medical information, and not moral statements that had not been agreed upon by the (...) state's medical community, people, or legislature. Acuna might be read as a departure from the trend displayed by New Jersey courts in “wrongful birth” and “wrongful life” actions toward empowering potential parents to decide if they want to bring the pregnancy to term. However, the decision actually fits squarely within this trend in that the reluctance to expand the information to which potential parents are entitled from their physicians can be directly tied to the reluctance of the New Jersey Supreme Court to weigh in on the value of life in wrongful birth and wrongful life suits. (shrink)

This analysis scrutinises the rhetorical strategies used by judges in wrongful life and wrongful birth actions as evidence for the assertion that the judicial reading of public policy in such cases has undergone a significant shift which is likely to accelerate as genetic knowledge grows and health care resources shrink. The implications of the predicted move towards increased genetic testing of prospective parents are traversed in relation to feminist analyses of the impact of genetics on reproductive technology. (...) These are viewed as forming a nexus with the current social constructions of disability and the contemporary cultural preoccupation with risk, in a context of the increasing commercial importance of genetic information. It is argued that women cannot make free and informed choices about genetic testing and pregnancy unless legal and social mechanisms which protect those choices are in place. (shrink)

Dov Fox’s Birth Rights and Wrongs offers a largely compelling argument for expanding the scope of legal actions and remedies available to those whose reproductive choices are wrongfully frustrated by the actions of others. The dominant focus of the book is individuals who, due to the negligence and/or malice of medical professionals, suffer harms arising from reproduction imposed, denied, or confounded. A serious examination of these kinds of injuries is certainly appropriate given that medical professionals are increasingly involved in (...) individuals’ reproductive plans and that serious harms may arise when desired medical interventions are improperly implemented. I will not take issue with the general framework developed by Fox for addressing these kinds of harms. My focus here will be to show that Fox’s arguments have consequences for two kinds of cases that lie beyond the scope of those he explicitly acknowledges. The first is instances of reproductive wrongs that occur outside the confines of the patient/medical practitioner relationship. The second is claims made by children for harms suffered in virtue of being denied contact with their biological parents and/or access to identifying information about their biological parents. (shrink)

On December 7,1999, a divided Oklahoma Supreme Court held in Nealis v. Baird that a claim may be brought under Oklahoma's wrongful death statute on behalf of a nonviable fetus born alive. The decision represents a departure from the traditional notion that “viability”—the ability of a fetus to sustain life outside the womb with or without medical assistance—is the standard for wrongful death recovery. In replacing the “viability” standard with a “live birth” standard, the majority maintained that (...) live birth is the “unassailable point at which legal rights must be said to attach to the human person. “ By holding a nonviable fetus a legal “person” for the purpose of a wrongful death claim, the court's decision emphasizes the limited application of the United States Supreme Court's holding in Roe v. Wade that a fetus is not a person for the purposes of the Fourteenth Amendment. (shrink)

This paper discusses the issues of deciding to have a child with mental retardation, and of terminating a pregnancy when the future child is known to have the same disability. I discuss these problems by criticizing a utilitarian argument, namely, that one should act in a way that results in less suffering and less limited opportunity in the world. My argument is that future parents ought to assume a strong responsibility towards the well-being of their prospective children when they decide (...) to reproduce. The moral point in cases in which our acts affect the well-being of future children should be expressed strictly in terms of parents' culpability. Future children thus do not have current moral standing but presently living persons have current obligations to consider the presumable effects of their actions on future people. I will also argue that there are morally significant differences between 'selective contraception' and selective abortion. (shrink)

In 2014 Jennifer Cramblett, a white lesbian, filed a Complaint for Wrongful Birth alleging that the Midwest Sperm Bank mistakenly provided sperm from an African–American donor. In this article, we trace the complex and overlapping lines of legal and social inheritance that have conditioned not only the possibility of such a lawsuit, but also the legal language and arguments within the Complaint itself. First, we trace the racial politics of homonormativity, which set the conditions of possibility for an (...) out, white lesbian to bring this case forward. Second, we trace the inheritance of wrongful birth tort law, reviewing its prior race and disability-related uses, and its basis in feminist reproductive rights. Third, we trace how disability, race and sexuality interlock within the eugenic inheritance of both ‘wrongful birth’ and reproductive technologies. Finally, we follow traces of racial inheritance, namely, the loss of white property and proximity to whiteness. (shrink)

This article reports and analyses a ‘wrongful life’ lawsuit brought against a genetic counsellor who failed to refer a woman for prenatal genetic testing despite her pleas to do so; this resulted in the wrongful birth of a child with a genetic abnormality. As a result of negligence, the mother did not have a termination and the baby was born. This is an event that reveals the troublesome nature of prenatal genetic testing applications in medical practice in (...) Korea. The case presentation and critique illuminates how genetic research and its applications in practice influence human life and society. The central issues involved in the lawsuit are the discrepancies between present practice and the law, and lack of respect for the client’s request to make self-determined reproductive choices. The lawsuit is explored in terms of the ethical grounds for the court’s ruling, the responsibility of the genetic counsellor, the sociocultural impact of genetic testing in Korean society, and people’s ability to make informed choices about how this technology is applied in medical practice. (shrink)

I shall be concerned in this paper with some philosophical puzzles raised by so-called “wrongful life” suits. These legal actions are obviously of great interest to lawyers and physicians, but philosophers might have a kind of professional interest in them too, since in a remarkably large number of them, judges have complained that the issues are too abstruse for the courts and belong more properly to philosophers and theologians. The issues that elicit this judicial frustration are those that require (...) the application to border-line cases of such philosophically interesting concepts as acting, causing, and the one that especially interests me, harming. I first became interested in the concept of harming in my work on the moral limits of the criminal law, where I had to come to terms with John Stuart Mill's famous “harm principle”–the principle that it is always a good reason in support of a criminal prohibition, indeed, the only legitimate reason, that it will prevent harm to persons other than the actor. I could not very well criticize that principle until I decided what the word “harm” must mean in its formulation. I gave what I took to be the requisite analysis of harm in my book Harm to Others. Here I wish to improve that analysis, examine its implications for civil as well as criminal liability, and test it on conceptually hard cases, especially cases of prenatal harming, that is, cases in which the wrongful causative conduct occurs before the victim's birth, and the harmed state that is its upshot consists in being born in an impaired condition. (shrink)

Three years before his death, Michel Foucault delivered a series of lectures at the Catholic University of Louvain that until recently remained almost unknown. These lectures—which focus on the role of avowal, or confession, in the determination of truth and justice—provide the missing link between Foucault’s early work on madness, delinquency, and sexuality and his later explorations of subjectivity in Greek and Roman antiquity. Ranging broadly from Homer to the twentieth century, Foucault traces the early use of truth-telling in ancient (...) Greece and follows it through to practices of self-examination in monastic times. By the nineteenth century, the avowal of wrongdoing was no longer sufficient to satisfy the call for justice; there remained the question of who the \u201ccriminal\u201d was and what formative factors contributed to his wrong-doing. The call for psychiatric expertise marked the birth of the discipline of psychiatry in the nineteenth and twentieth centuries as well as its widespread recognition as the foundation of criminology and modern criminal justice. Published here for the first time, the 1981 lectures have been superbly translated by Stephen W. Sawyer and expertly edited and extensively annotated by Fabienne Brion and Bernard E. Harcourt. They are accompanied by two contemporaneous interviews with Foucault in which he elaborates on a number of the key themes. An essential companion to Discipline and Punish, Wrong-Doing, Truth-Telling will take its place as one of the most significant works of Foucault to appear in decades, and will be necessary reading for all those interested in his thought.  . (shrink)

What role does birth play in the debate about elective abortion? Does the wrongness of infanticide imply the wrongness of late-term abortion? In this paper, I argue that the same or similar factors that make birth morally significant with regard to abortion make meaningful viability morally significant due to the relatively arbitrary time of birth. I do this by considering the positions of Mary Anne Warren and José Luis Bermúdez who argue that birth is significant enough (...) that the wrongness of infanticide does not imply the wrongness of late-term abortion. On the basis of the relatively arbitrary timing of birth, I argue that meaningful viability is the point at which elective abortion is prima facie morally wrong. (shrink)

torts raise a number of interesting and perplexing philosophical issues. In a suit for ‘wrongful life’, the plaintiff (usually an infant) brings an action (usually against a physician) claiming that some negligent action has caused the plaintiff's life, say by not informing the parents of the likely prospect that their child would be born with severe defects. The most perplexing feature of this is that the plaintiff is claiming that he would have been better off if he had never (...) been born. A number of arguments have appeared which purport to show that ‘wrongful life’ claims should not be allowed, either because it is senseless to claim that one would be better off if one had not existed or that it is impossible to assess the extent to which someone has been damaged by being brought into existence. In our paper we rebut these arguments and suggest a procedure for determining damages in ‘wrongful life cases’. Keywords: ‘wrongful life’, ‘wrongful birth’, negligence, impaired existence, assessing damage * Professor Bell would like to express appreciation to the National Endowment for the Humanites for affording her the opportunity at an NEH Summer Seminar to do most of the background work for the preparation of this manuscript, and to the South Carolina Committee for the Humanities for funding that aided in continued work on this topic. CiteULike Connotea Del.icio.us What's this? (shrink)

A "wrongful life" suit is based on the purported tortious liability of a genetic counsellor towards an infant with hereditary defects, with the latter asserting that he or she would not have been born at all if not for the counsellor's negligence. This negligence allegedly lies in the failure on the part of the defendant adequately to advice the parents or to conduct properly the relevant testing and thereby prevent the child's conception or birth. This paper will offer (...) support for the thesis that it would be both feasible and desirable to endorse "wrongful life" compensation actions. The genetic counsellor owed a duty of due professional care to the impaired newborn who now claims that but for the counsellor's negligence, he or she would not have been born at all. The plaintiff's defective life constitutes a compensable injury. A sufficient causal link may exist between the plaintiff's injury and the defendant's breach of duty of due professional care and an appropriate measure of damages can be allocated to the disabled newborn. Sanctioning a "wrongful life" cause of action does not necessarily entail abandoning valuable constraints with regard to abortion and euthanasia. Nor does it inevitably lead to an uncontrolled slide down a "slippery slope". (shrink)

The issue of wrongful disability arises when parents face the choice whether to produce a child whose life will be unavoidably flawed by a serious disease or disorder (Down syndrome, for example, or Huntington’s disease) yet clearly worth living. The authors of From Chance to Choice claim, with certain restrictions, that the choice to produce such a child is morally wrong. They then argue that an intuitive moral approach––a “person-affecting” approach that pins wrongdoing to the harming of some existing (...) or future person––cannot account for that wrong since the choice to produce such a child cannot, under the logic of the nonidentity problem, harm that child. The authors propose that we supplement the person-affecting approach with an “impersonal” principle that takes the form of their well-known principle N. In this paper, I argue that the authors are mistaken to suppose that a plausibly articulated person-affecting approach cannot account for the wrong of wrongful disability. We can retain an intuitive, comparative, “worse for” account of harm and still identify serious harms imposed by the choice of wrongful disability. In particular, I argue that harm, both to the impaired child and to others, comes not in the form of that procreative choice’s procreative effect but rather in the form of its many distributive effects. I also argue that the rare, residual case in which a person-affecting approach would approve of the choice of wrongful disability does not function as a counterexample to that approach. As a separate matter, I address legal claims for wrongful disability, which are closely akin to claims for wrongful life. The legal claim is brought by the impaired child, not against the parents, but rather against health care providers whose negligent failure to diagnose or inform parents of an increased risk of a genetic or congenital impairment results in the birth of the impaired child. The authors’ treatment of the moral wrong that is done as impersonal in nature suggests that courts are correct to dismiss any such claim. Once we identify harm, however, the person-affecting approach can identify a clear foundation in the law for the wrongful disability claim. (shrink)

Is it wrong to bring children who will have serious diseases and disabilities into the world? In particular, is it unfair to them? The notion that existence itself can be an injury is the basis for a recent new tort known as "wrongful life" (Steinbock, 1986). This paper considers Feinberg's theory of harm as the basis for a claim of wrongful life, and concludes that rarely can the stringent conditions imposed by his analysis be met. Another basis for (...) maintaining that it is morally wrong to have children under extremely adverse conditions is suggested: a principle of parental responsibility. We also argue that having children under such conditions may be unfair to the children, even if they have not been (in Feinberg's sense) harmed. Finally, we consider when conditions are sufficiently awful that having children might be viewed as incompatible with being a good parent and unfair to the child. (shrink)

It is frequently argued that home birth is morally irresponsible because it involves the taking of risks on behalf of the fetus. Against this position, I argue three things. First, the fact that home birth involves risks does not necessarily entail that choosing or attending one is morally unacceptable, irresponsible or wrong. Second, parents have a prima facia prerogative to decide on behalf of their fetuses and children whether risks should be taken. While this prima facia prerogative can (...) be overridden, reasonable and widely accepted criteria for doing so are not met in the case of home birth. Third, since the current attitudes and behaviours of physicians with regard to home birth constitute a de facto morally and socially unjustifiable overriding of an informed parental decision, physician autonomy should be restricted so as to preserve the autonomy of the medical consumer. (shrink)

It is frequently argued that home birth is morally irresponsible because it involves the taking of risks on behalf of the fetus. Against this position, I argue three things. First, the fact that home birth involves risks does not necessarily entail that choosing or attending one is morally unacceptable, irresponsible or wrong. Second, parents have a prima facia prerogative to decide on behalf of their fetuses and children whether risks should be taken. While this prima facia prerogative can (...) be overridden, reasonable and widely accepted criteria for doing so are not met in the case of home birth. Third, since the current attitudes and behaviours of physicians with regard to home birth constitute a de facto morally and socially unjustifiable overriding of an informed parental decision, physician autonomy should be restricted so as to preserve the autonomy of the medical consumer. (shrink)

Three years before his death, Michel Foucault delivered a series of lectures at the Catholic University of Louvain that until recently remained almost unknown. These lectures—which focus on the role of avowal, or confession, in the determination of truth and justice—provide the missing link between Foucault’s early work on madness, delinquency, and sexuality and his later explorations of subjectivity in Greek and Roman antiquity. Ranging broadly from Homer to the twentieth century, Foucault traces the early use of truth-telling in ancient (...) Greece and follows it through to practices of self-examination in monastic times. By the nineteenth century, the avowal of wrongdoing was no longer sufficient to satisfy the call for justice; there remained the question of who the “criminal” was and what formative factors contributed to his wrong-doing. The call for psychiatric expertise marked the birth of the discipline of psychiatry in the nineteenth and twentieth centuries as well as its widespread recognition as the foundation of criminology and modern criminal justice. Published here for the first time, the 1981 lectures have been superbly translated by Stephen W. Sawyer and expertly edited and extensively annotated by Fabienne Brion and Bernard E. Harcourt. They are accompanied by two contemporaneous interviews with Foucault in which he elaborates on a number of the key themes. An essential companion to _Discipline and Punish_, _Wrong-Doing, Truth-Telling_ will take its place as one of the most significant works of Foucault to appear in decades, and will be necessary reading for all those interested in his thought. (shrink)

Our ambivalent attitudes toward the notion of ‘a life worth living’ present a philosophical puzzle: Why are we of two minds about the birth of a severely disabled child? Is the child’s life worth living or not worth living? Between these two apparently incompatible evaluative judgments, which is true? If one judgment is true and the other false, what makes us continue to find both evaluations appealing? Indeed, how can we manage to hold these inconsistent judgments simultaneously at all? (...) I critically examine two solutions to this puzzle: the hidden-indexical account and Velleman’s anti-realist account. I propose an alternative explanation which appeals to (a) state-given, as opposed to object-given, reasons for belief and (b) the distinction between belief and acceptance. I argue that (1) the fact that a severely disabled life is not worth living provides object-given reason to believe that that life is not worth living, but (2) after the birth of a severely disabled child, the psychological utility of positive evaluation gives us a state-given reason to believe that that child’s life is worth living, and a reason to accept that, in our relation with the child, her life is worth living. I conclude by drawing a practical lesson about wrongful life suits. (shrink)

In November 2018, Dr. He Jiankui announced the birth of two baby girls born through the use of in vitro fertilization technology and the use of the gene-editing tool CRISPR-Cas9. There has been nigh uniform international condemnation of the clinical trial for violating international norms governing genomic research, especially research in human embryos that has implications for the germline. At issue also is the question whether the parents and the clinical research team harmed, and therefore wronged, the two girls. (...) Here this question is engaged through application of the reasoning Derek Parfit has provided on the non-identity problem. One concludes that on this reasoning the parents are not morally culpable on that argument, although there is other reasoning that is to be considered to resist the Parfitian conclusion. (shrink)

The single most important intellectual event in my career in medical ethics occurred the day I realized that the Hippocratic ethic for medicine was not merely outdated and irrelevant but actually in conflict with all the dominant religious and secular moral traditions of our day. Whether one stood in any of the great modern religious traditions or in any of the camps of secular philosophy—the liberal tradition of political philosophy, Marxism, or more recent feminist or communitarian views—the Hippocratic ethic was (...) wrong, both metaethically and normatively. (shrink)

The notion of being a burden to others is mostly discussed in the context of care‐intensive diseases or end‐of‐life decisions. But the notion is also crucial in decision‐making at the beginning of life, namely regarding prenatal testing. Ever more sophisticated testing methods, especially non‐invasive prenatal testing (NIPT), allow the detection of genetic traits in the unborn child that may cause disabilities. A positive result often influences the decision of the pregnant women towards a termination of the pregnancy. Thus, critics claim (...) that these testing methods send a negative message to people with disabilities. At the core of this is what we call the burden assumption. This assumption claims that children with disabilities are necessarily a burden to others, especially to their parents and other family members. In this paper, we discuss what being a burden to others means in this context and how such an attitude can be avoided without restraining reproductive autonomy. A closer examination shows that the burden assumption is mostly based on misinformation and a false model of disability. Empirical studies as well as narrative evidence from parents who raise a child with disabilities show that the burden assumption is wrong. Raising a child with disabilities does not necessarily mean a decrease in the quality of life. We show how the burden assumption can be challenged through an advanced genetic counselling that combines empirical evidence with narratives from a first‐person perspective. (shrink)

In ‘Dilemma for Appeals to the Moral Significance of Birth’, we argued that a dilemma is faced by those who believe that birth is the event at which infanticide is ruled out. Those who reject the moral permissibility of infanticide by appeal to the moral significance of birth must either accept the moral permissibility of a late-term abortion for a non-therapeutic reason or not. If they accept it, they need to account for the strong intuition that her (...) decision is wrong as well as deny the underlying normative principle that killing a viable fetus requires good reason, and not wanting to care for the child when the child could be easily placed for adoption is not a good enough reason to abort. If they reject the moral permissibility of the late-term abortion, they need to explain why her decision is wrong. Doing so, however, will undermine their own project of denying infanticide by appeal to birth. Walter Veit argues that the dilemma relies too much on intuition and does not live up to biological continuity. We explain why his criticisms are unconvincing. (shrink)

The law sometimes permits what ordinary morality, or widely-shared notions of right and wrong, reproaches. Rights to Do Grave Wrong explores the relationship between law and common morality to clarify law's reliance on society's broad presumption that people will exercise their rights responsibly. More concretely, he argues that certain legal rights rest on tacit sociological assumptions as to who will exercise them, under what circumstances, and how frequently. Further, he argues that we depend on stigma and shame to reduce and (...) circumscribe the law's use. Some examples: though reneging on a debt is considered wrong, the law allows you to declare personal bankruptcy; international law allows museums to retain some masterworks looted from their rightful owners; in many countries abortion is permitted as a means of birth control. Using these examples and more, Osiel presents a "social scientific" analysis of law's interaction with social mores and the extent to which they limit our exercising rights to do wrong. The paradox he intends to elucidate is when and why it is appropriate for societies to champion de jure entitlements even as they successfully limit their de facto usage. (shrink)

Recent years have illustrated how the reproductive realm is continuously drawing the attention of medical and legal experts worldwide. The availability of technological services to facilitate reproduction has led to serious concerns over the right to reproduce, which no longer is determined as a private/personal matter. The growing technological options do implicate fundamental questions about human dignity and social welfare. There has been an increased demand for determining (a) the rights of prisoners, unmarried and homosexuals to such services, (b) concerns (...) over child’s information and health needs, (c) claims for wrongful birth and wrongful life, (d) the role of donors and physicians, (e) posthumous reproduction etc. In addition, the role of national and international law has been emphasized for an efficient system of functioning and delivery. This paper is an attempt to explore the pressing claims to reproductive choices, coupled with a marked increase in demand for legislative intervention in India. (shrink)

Two notable limitations exist on the use of personhood arguments in establishing moral status. Firstly, although the attribution of personhood may give us sufficient reason to grant something moral status, it is not a necessary condition. Secondly, even if a person is that which has the ‘highest’ moral status, this does not mean that any interests of a person are justifiable grounds to kill something that has a ‘lower’ moral status. Additional justification is needed to overcome a basic wrongness associated (...) with killing something possessing moral status. There are clear arguments already available in this regard in the case of a foetus that are not available in the case of a newborn infant. Hence, there is scope to consistently hold that abortion may be permissible but that after-birth abortion may not be permissible. (shrink)

Last year, Andreas Kalyvas and Ira Katznelson published a brief, bold book on a topic from which historians of political thought have tended to shy away, curiously enough—the relations between republicanism and liberalism as political ideologies in the age of the American and French Revolutions. Liberal Beginnings: Making a Republic for the Moderns is relentlessly polemical, blaming this neglect on the historians and theorists responsible for resurrecting the early modern republican tradition over the last few decades. Pocock, Skinner, Wood, Petit, (...) and more are assailed for having indulged in what Kalyvas and Katznelson call “republican nostalgia”—that is, for having wrongly presented republicanism as an alternative to modern liberalism, rather than its parent and precursor. Instead, the authors of Liberal Beginnings set out to show the ways in which republicanism evolved into liberalism, in and through the works of a set of leading thinkers—Smith, Ferguson, Paine, Madison, Staël, and Constant. Their story has a happy ending. Whatever was valuable and actual in republicanism was smoothly incorporated into early liberalism, for which they turn the dictionary inside out in search of approbative adjectives—“situated,” “thick,” “sturdy,” “confident,” “open,” “immanent,” “heterogeneous,” and “syncretic.” How persuasive is their account? Not a few readers will detect a hint of protesting too much in this kind of cheerleading. “Thick,” “sturdy,” and “confident” are surely not the first terms to spring to mind in regard to this gallery of thinkers, Staël and Constant least of all. It also seems clear that Kalyvas's and Katznelson's coverage of French thought, confined almost entirely to that pair, is too cursory to sustain their case. At one end, Montesquieu and Rousseau, the titans who together defined republicanism for the revolutionary generation, make only the most fleeting of appearances in Liberal Beginnings . At the other, Tocqueville, acknowledged on all sides as the master thinker of French liberalism, is missing altogether. Nevertheless, the attempt at treating anglophone and French thinkers within a single interpretative framework is in itself a virtually unprecedented feat, for which Kalyvas and Katznelson should be congratulated. For who could doubt that they are on exactly the right path in chasing their prey onto French soil? (shrink)

Aims The aim of this study was to examine if it is plausible to interpret the appearance of shame in a Swedish healthcare setting as a reaction to having one's honour wronged. Methods Using a questionnaire, we studied answers from a sample of long-term sick-listed patients who had experienced negative encounters (n=1628) and of these 64% also felt wronged. We used feeling wronged to examine emotional reactions such as feeling ashamed and made the assumption that feeling shame could be associated (...) with having one's honour wronged. In statistical analyses relative risks (RRs) were computed, adjusting for age, sex, disease-labelling, educational levels, as well as their 95% CI. Results Approximately half of those who had been wronged stated that they also felt shame and of those who felt shame, 93% (CI 91 to 95) felt that they had been wronged. The RR was 4.5 (CI 3.0 to 6.8) for shame when wronged. This can be compared with the other emotional reactions where the RRs were between 1.1 (CI 0.9 to 1.3)–1.4 (CI 1.2 to 1.7). We found no association between country of birth and feeling shame after having experienced negative encounters. Conclusions We found that the RR of feeling shame when wronged was significantly higher compared with other feelings. Along with theoretical considerations, and the specific types of negative encounters associated with shame, the results indicate that our research hypothesis might be plausible. We think that the results deserve to be used as point of departure for future research. (shrink)

Medical professionals routinely offer prenatal genetic testing services to their expecting patients. In theory, this testing helps expecting parents better prepare for the birth of their child: e.g., if the child will have a disability. In practice, however, such testing often leads to the termination of pregnancies that would produce a child who has a disability. Some bioethicists believe that in light of our society’s history of poor treatment of people who have disabilities, when expecting parents use prenatal testing (...) for selective abortion and when medical professionals promote the use of such testing, they express a disparaging message to and about extant disabled people: e.g., that disabled people’s lives are... (shrink)

In Handle with Care, novelist Jodi Picoult presents a heartbreaking case involving the question of wrongful birth. This essay examines Ronald M. Green's writings in the field of bioethics to see what wisdom they might bring to this case. I argue that Green's contributions to bioethics exemplify some of the best of ethical argumentation: attention to facts, discernment of morally relevant differences, enunciation and justification of principles, originality, and compassion. I then draw from his work three foci that (...) illuminate aspects of the dilemma presented by Picoult: the importance of parental love, the possibility that the dilemma might be reframed away from wrongful birth, and the need to shift our focus to questions of justice. While appreciating Green's contributions to bioethics, I also indicate several places of nuanced disagreement. (shrink)

This article seeks to interrogate the moment of queer theory's ‘birth’ out of French influences, or what is designated by the umbrella term ‘French Theory’. It specifically points to the operations of transformation and dislocation, subversion and perversion of French theoretical influences at work in two distinctive ‘pairings’ of French ‘progenitor’ and American queer ‘offspring’: Jacques Derrida with Eve Kosofsky Sedgwick and Jacques Lacan with Judith Butler.

It is recognised that Olympiodorus must have had a long career. He is still lecturing on Aristotle in the late 560s as we can deduce from the reference to a comet that appeared in 565ce (In Mete. 52.31), while he clearly learned his Platonism under Ammonius. His Commentary on Plato’s Gorgias, in which Ammonius rather than Proclus is seen as a figure of authority, is sometimes supposed to have been written in the late 520s. His date of birth may (...) presumably be placed within five years of 500 ce,1 though evidence is lacking. While it is hard to compare Platonic with Aristotelian commentaries, there are important differences among the commentaries on Plato that are best explained in terms of Olympiodorus’ growing maturity and his growing familiarity with, and appreciation of, the Athenian school. The pivotal role of Syrianus and Proclus will here be better appreciated, and the refinements of the last scholarch, Damascius, considered. (shrink)

This paper presents ethical dilemmas concerning the termination of pregnancy, the management of childbirth, and the withdrawal of life-support from infants in special care, for a small sample of British Pakistani Muslim parents of babies diagnosed with fatal abnormalities. Case studies illustrating these dilemmas are taken from a qualitative study of 66 families of Pakistani origin referred to a genetics clinic in Southern England. The paper shows how parents negotiated between the authoritative knowledge of their doctors, religious experts, and senior (...) family members in response to the ethical dilemmas they faced. There was little knowledge or open discussion of the view that Islam permits the termination of pregnancy for serious or fatal abnormality within 120 days and there was considerable disquiet over the idea of ending a pregnancy. For some parents, whether their newborn baby would draw breath was a main worry, with implications for the baby's Muslim identity and for the recognition of loss the parents would receive from family and community. This concern sometimes conflicted with doctors' concerns to minimize risk to future pregnancies by not performing a Caesarean delivery if a baby is sure to die. The paper also identifies parents' concerns and feelings of wrong-doing regarding the withdrawal of artificial life-support from infants with multiple abnormalities. The conclusion considers some of the implications of these observations for the counselling and support of Muslim parents following the pre- or neo-natal diagnosis of fatal abnormalities in their children. (shrink)

"Dancing with Absurdity" explores the limitations of knowledge and argues that neither reasoning nor direct observation can be trusted. Not only are they unreliable sources, they do not even justify assigning probabilities to claims about what we can know. This position, called radical skepticism, has intrigued philosophers since before the birth of Christ, yet nobody has been able to refute it. Fred Leavitt uses two unique methods of presentation. First, he supports abstract arguments with summaries of real-life examples from (...) many and varied fields, which make the arguments much more convincing and compelling. He cites more than 200 studies from psychology, mathematics, chaos theory, quantum mechanics, evolutionary theory, history, the corporate world, politics, the military, and current news reporting. Second, Leavitt's writing is user-friendly, even when dealing with complex issues. Whether answering the telephone, turning on the TV, talking with friends, or munching on an apple, we expect things to happen predictably. These expectations, paired with radical skepticism, exemplify cognitive dissonance at the highest level. Although certain of nothing, other than that we can be certain of nothing, it's certain that readers will come to be intrigued by the problem. (shrink)

In October of 2014, news outlets began reporting on a case of a lesbian couple suing a sperm bank for receiving the wrong donor's sperm.1 As the lawsuit Cramblett v. Midwest Sperm Bank alleged, not only did the couple receive the wrong donor's sperm but they had specifically chosen a white donor with blonde hair and blue eyes and the sperm they received had been from a black donor.2 Both women were white. The couple gave birth to a black/mixed-race (...) child in 2012 and claimed that their daughter's race posed particular challenges for their family, from facing prejudice in their nearly all white community to difficulties dealing with their daughter's hair. The couple sued for "wrongful birth" and "breach of warranty,"... (shrink)

To what extent should parents be able to choose the kind of child they have? The unfortunate phrase 'designer baby' has become familiar in debates surrounding reproduction. As a reference to current possibilities the term is misleading, but the phrase may indicate a societal concern of some kind about control and choice in the course of reproduction. Typically, people can choose whether to have a child. They may also have an interest in choosing, to some extent, the conditions under which (...) they do so, such as whether they have a child with a serious disability or disease. The purpose of this book is to explore the difficult and controversial question of the appropriate ethical and legal extent of reproductive autonomy in this context. The book examines ethical, legal and public policy issues in prenatal screening, prenatal diagnosis (PND), selective abortion and preimplantation genetic diagnosis (PGD). It explores the ethics of these selection practices and the ability of current ethical guidelines and legal mechanisms, including the law on selective abortion and wrongful birth, to deal with advances in genetic and other knowledge in these areas. Unlike in the United States, in England the relevant law is not inherently rights-based, but the impact of the Human Rights Act 1998 inevitably raises questions about the proper scope of reproductive autonomy in this context. The implications of the analysis are considered for the development of relevant law, public policy and ethical guidelines and will be of interest to academics in medical law and ethics, health professionals, lawyers, those working on public policy and students with an interest in these issues. (shrink)

At the intersection of law, feminism and philosophy, this book analyses the ways in which certain bodies and 'selves' continue to be treated as monstrous aberrations from the 'ideal' figure or norm. Employing contemporary feminist philosophy to rethink accepted legal ideas, the book is divided into three sections. The first focuses on the different relational ontologies of philosophers Adriana Cavarero and Christine Battersby - also considering their work via a third term: Spinoza. The second turns to diverse feminist engagements with (...) the social contract theorists. The third section employs insights from throughout the book to focus more explicitly on law - and, in particular privacy law and the so-called 'wrongful birth' cases. Bringing together more than twenty years of sustained reflection, this book offers an insightful account of how contemporary feminist philosophy can contribute to a richer understanding of law. It will be of enormous interest to scholars and students working in the areas of legal theory, feminist thought and philosophy. (shrink)

On March 30, 1995, the Supreme Court of Nevada, in Greco v. United States, determined that medical professionals who fail to make a timely diagnosis of gross and disabling fetal defects, thereby denying a pregnant woman her right to terminate a pregnancy, had acted negligently, and a malpractice claim could be brought against them. The court supported the plaintiff's claim of “wrongful birth,” but determined that the disabled child born to the plaintiff has no personal cause of action (...) for “wrongful life.” Sundi Greco, the plaintiff, alleged that her doctors at Nellis Air Force Base in Nevada failed to make a timely diagnosis of her son's physical defects and abnormalities before his birth. Their negligence denied her the opportunity to terminate her pregnancy, causing her damages attendant to the avoidable birth of a child with birth defects. On her child's behalf, Greco asserted that the physicians' negligence, and resultant denial of his mother's right to terminate the pregnancy, allowed him to be born into a “grossly abnormal life of pain and deprivation.”. (shrink)

Pietsch, Chelsea In a claim of negligence, plaintiffs must be able to prove that they have suffered some sort of damage or loss. Proving damage is usually a straightforward task which involves making a comparison between the plaintiff's position before and after the alleged negligence. However, what damage has been done if a doctor's negligence results in the conception and subsequent birth of a child? Is it ever possible to conceive of life as damage? These questions must ultimately be (...) addressed in wrongful birth claims where parents seek compensation for the conception and/or birth of a life that would not have existed but for the doctor's negligent advice or treatment. However, they are not as easy for judges to answer as you may think. Judges have a duty to resolve such matters - not with reference to vague notions of 'common sense' or 'community interests' - but in accordance with established law. However, what if there is no statute or precedent that speaks on the matter? How should judges resolve such 'novel' issues? Can judges rely on 'common sense' or arguments about 'community interests' in these limited circumstances? The question of whether or not a child may be categorised as damage for the purpose of satisfying a claim in negligence is such an issue. In this essay I acknowledge that, in the absence of guiding legal rules and principles, judges have no choice but to resolve novel questions on grounds of policy considerations. I suggest, however, that a distinction should be made between legal and public policy and that reliance on the former, not the latter, may be used to assert that children are blessings, not injuries. While it may be morally desirable for the issue to end there, this is not the case. Legal policy has also developed the notion of reproductive autonomy in such a way that suggests the opposite may also be true. In an attempt to resolve these conflicting values, I propose the damage in wrongful birth cases is not the conception and/or birth of a child but rather a doctor's infringement on their patient's reproductive autonomy, which warrants legal recognition in the form of compensation. (shrink)