A Problem of Self-Ownership for Reproductive Justice

Clinicians' criteria for fetal moral status: viability and relationality, not sentience

The antiabortion movement is increasingly using ostensibly scientific measurements such as 'fetal heartbeat' and 'fetal pain' to provide 'objective' evidence of the moral status of fetuses. However, there is little knowledge on how clinicians conceptualise and operationalise the moral status of fetuses. We interviewed obstetrician/gynaecologists and neonatologists on this topic since their practice regularly includes clinical management of entities of the same gestational age. Contrary to our expectations, there was consensus among clinicians about conceptions of moral status regardless of specialty. First, clinicians tended to take a gradualist approach to moral status during pregnancy as they developed and viewed viability, the ability to live outside of the uterus, as morally significant. Second, in contrast to 'fetal pain' laws and philosophical discussions about the ethical salience of sentience, the clinicians in our study did not consider the ability to feel pain as a morally relevant factor in moral status determinations. Third, during previability and perviability, clinicians viewed moral status as a personal value decision, which should be made by pregnant people and parents of neonates.

Family Care Relationships in Reproductive Justice

The Roe v. Wade case, which legally supported abortion in the U.S., was overturned in 2022, and the international conversation about reproductive justice gained momentum as a result. Reproductive justice is a concept that advocates reproductive freedom (the freedom to have/not have children and the freedom to raise children in a healthy environment) for all couples and individuals. This paper introduces the family care relationship in reproductive justice and presents a concept of reproductive justice. By incorporating family care relationships in the concept of reproduction, the complexity and uniqueness of the reproductive choice process are preserved. Family care relationships are well suited for focusing on family-centered societies and the processes leading to abortion care, and autonomous decision-making in reproductive choice can be strengthened. It is important to explore appropriate support methods from the dynamism of the caring network, advocate for positive freedom, and settle the decision-making power in a moderated position, even with some abandonment of individualism.

Age-not sex or gender-makes the case of Ellie Anderson Complex

In 'The Complex Case of Ellie Anderson', Joona Rasanen and Anna Smajdor raise several ethical questions about the case. One question asks, but does not answer, whether Ellie faced discrimination for being transgender when her mother was not allowed access to Ellie's sperm following her death. In raising the question, the authors imply anti-trans bias may have influenced this determination. However, this inference is not supported by current ethical and legal guidance for posthumous use of gametes, with which Ellie's case is consistent. We consider the authors' responses to their other ethical queries, and how their suggestions for what options might have been available to Ellie and her family are instructive for addressing attempts in the USA and UK to restrict minors' access to gender-affirming medical treatment, including puberty-blocking therapy.