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Romanis EC, Begović D, Brazier MR, Mullock AK. Reviewing the womb. JOURNAL OF MEDICAL ETHICS 2020; 47:medethics-2020-106160. [PMID: 32727855 PMCID: PMC8639904 DOI: 10.1136/medethics-2020-106160] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/19/2020] [Accepted: 06/08/2020] [Indexed: 05/20/2023]
Abstract
Throughout most of human history women have been defined by their biological role in reproduction, seen first and foremost as gestators, which has led to the reproductive system being subjected to outside interference. The womb was perceived as dangerous and an object which husbands, doctors and the state had a legitimate interest in controlling. In this article, we consider how notions of conflict surrounding the womb have endured over time. We demonstrate how concerns seemingly generated by the invisibility of reproduction and the inaccessibility of the womb have translated into similar arguments for controlling women, as technology increases the accessibility of the female body and the womb. Developments in reproductive medicine, from in vitro fertilisation (IVF) to surrogacy, have enabled women and men who would otherwise have been childless to become parents. Uterus transplants and 'artificial wombs' could provide additional alternatives to natural gestation. An era of 'womb technology' dawns. Some argue that such technology providing an alternative to 'natural' gestation could be a source of liberation for female persons because reproduction will no longer be something necessarily confined to the female body. 'Womb technology', however, also has the potential to exacerbate the labelling of the female body as a source of danger and an 'imperfect' site of gestation, thus replaying rudimentary and regressive arguments about controlling female behaviour. We argue that pernicious narratives about control, conflict and the womb must be addressed in the face of these technological developments.
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Affiliation(s)
- Elizabeth Chloe Romanis
- Centre for Social Ethics and Policy, Department of Law, University of Manchester, Manchester, UK
| | - Dunja Begović
- Centre for Social Ethics and Policy, Department of Law, University of Manchester, Manchester, UK
| | - Margot R Brazier
- Centre for Social Ethics and Policy, Department of Law, University of Manchester, Manchester, UK
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Making Politics Visible: Discourses on Gender and Race in the Problematisation of Sex-Selective Abortion. FEMINIST REVIEW 2018. [DOI: 10.1057/s41305-018-0137-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This paper examines the problematisation of sex-selective abortion (SSA) in UK parliamentary debates on Fiona Bruce's Abortion (Sex-Selection) Bill 2014–15 and on the subsequent proposed amendment to the Serious Crime Bill 2014–15. On the basis of close textual analysis, we argue that a discursive framing of SSA as a form of cultural oppression of minority women in need of protection underpinned Bruce's Bill; in contrast, by highlighting issues more commonly articulated in defence of women's reproductive rights, the second set of debates displaced this framing in favour of a broader understanding, drawing on postcolonial feminist critiques, of how socio-economic factors constrain all women in this regard. We argue that the problematisation of SSA explains the original cross-party support for, and subsequent defeat of, the policies proposed to restrict SSA. Our analysis also highlights the central role of ideology in the policy process, thus making politics visible in policymaking.
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Korngiebel DM, McMullen CK, Amendola LM, Berg JS, Davis JV, Gilmore MJ, Harding CO, Himes P, Jarvik GP, Kauffman TL, Kennedy KA, Simpson DK, Leo MC, Lynch FL, Quigley DI, Reiss JA, Richards CS, Rope AF, Schneider JL, Goddard KAB, Wilfond BS. Generating a taxonomy for genetic conditions relevant to reproductive planning. Am J Med Genet A 2016; 170:565-73. [PMID: 26889673 DOI: 10.1002/ajmg.a.37513] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 10/22/2015] [Indexed: 01/20/2023]
Abstract
As genome or exome sequencing (hereafter genome-scale sequencing) becomes more integrated into standard care, carrier testing is an important possible application. Carrier testing using genome-scale sequencing can identify a large number of conditions, but choosing which conditions/genes to evaluate as well as which results to disclose can be complicated. Carrier testing generally occurs in the context of reproductive decision-making and involves patient values in a way that other types of genetic testing may not. The Kaiser Permanente Clinical Sequencing Exploratory Research program is conducting a randomized clinical trial of preconception carrier testing that allows participants to select their preferences for results from among broad descriptive categories rather than selecting individual conditions. This paper describes (1) the criteria developed by the research team, the return of results committee (RORC), and stakeholders for defining the categories; (2) the process of refining the categories based on input from patient focus groups and validation through a patient survey; and (3) how the RORC then assigned specific gene-condition pairs to taxonomy categories being piloted in the trial. The development of four categories (serious, moderate/mild, unpredictable, late onset) for sharing results allows patients to select results based on their values without separately deciding their interest in knowing their carrier status for hundreds of conditions. A fifth category, lifespan limiting, was always shared. The lessons learned may be applicable in other results disclosure situations, such as incidental findings.
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Affiliation(s)
- Diane M Korngiebel
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington
| | - Carmit K McMullen
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Laura M Amendola
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington
| | - Jonathan S Berg
- Department of Genetics, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - James V Davis
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Marian J Gilmore
- Department of Medical Genetics, Kaiser Permanente Northwest, Portland, Oregon
| | - Cary O Harding
- Molecular and Medical Genetics, Oregon Health and Science University, Portland, Oregon
| | - Patricia Himes
- Department of Medical Genetics, Kaiser Permanente Northwest, Portland, Oregon
| | - Gail P Jarvik
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington
| | - Tia L Kauffman
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Kathleen A Kennedy
- Department of Perinatal Services, Kaiser Permanente Northwest, Portland, Oregon
| | | | - Michael C Leo
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Frances L Lynch
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Denise I Quigley
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Jacob A Reiss
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - C Sue Richards
- Molecular and Medical Genetics, Oregon Health and Science University, Portland, Oregon
| | - Alan F Rope
- Department of Medical Genetics, Kaiser Permanente Northwest, Portland, Oregon
| | | | | | - Benjamin S Wilfond
- Treuman Katz Center for Pediatrics Bioethics, Seattle Children's Research Institute, Seattle, Washington.,Division of Bioethics, Department of Pediatrics, University of Washington, Seattle, Washington
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