Ethics, Technology and Pregnant Bodies

Rapid and dramatic new breakthroughs in medicine, genetics and technology, and, quickly changing ethical and legal conceptions of women’s, infants’, and fetal bodies have raised complicated and sensitive new issues in reproductive ethics.

Is a pregnant woman morally obligated to accept medical treatment for her fetus?
What kind of moral responsibilities does the pregnant woman have towards her fetus, in terms of preventative health measures? Can she be forced to stop drinking alcohol? Does she have a moral duty to submit herself to prenatal testing? Are doctors dealing with two patients (the pregnant woman and the fetus) or is there just a woman who is pregnant? Is there a maternal-fetal conflict, and if so: in what situations and whose interests prevail?

Expertisecentrum Ethiek in de Zorg (UMCG) and Studium Generale organize a series of three public lectures around the theme Ethics, Technology and Pregant Bodies. Three experts will zoom in on the influence of technology upon  childbirth, upon the inclusion of pregnant women in research, and on the (re)making of the unborn patient.This series is made possible by an Extra Emancipation/Women's Studies Activities
Grant Application of the University of Groningen.

Technology and Childbirth
Rebecca Kukla

Date: Monday 23 February 2009

Scientists are currently developing techniques for growing fresh human eggs from deep frozen tissue. When this procedure is perfected, we will be able to remove specific tissue from girls as young as six months old, and store it for later use in reproduction. Surely this emerging technology will have many salutary uses. However, it also has the potential to transform female children and even infants into reproductive medicine patients. This shift needs to be situated within a larger cultural trend: women's health care is increasingly being transformed into reproductive health care. New federal guidelines in the United States explicitly urge that all of women's primary care be treated as 'preconception care', since "the average woman of reproductive age encounters the medical system 3.8 times per year and any of these occasions may be a woman's last before she becomes pregnant.” This transformation in women's health care attends complex ethical and political questions. It extends the reproductive age of woman and girls back as far as infancy.

Rebecca Kukla is Professor of Philosophy and Obstetrics and Gynecology at the University of South Florida, where she is also a core faculty member in the Medical Humanities and Bioethics graduate program. She writes on public health ethics, medical epistemology, and the culture of reproduction and motherhood. Her publications include Mass Hysteria: Medicine, Culture, and Mothers' Bodies (Rowman and Littlefield 2005).


The Second Wave
Inclusion of Pregnant Women in Research
Anne Drapkin Lyerly

Date: Monday 30 March 2009

Traditionally, a lot of clinical research in medical science focuses on men and non-pregnant women. There has been much progress on the inclusion of non-pregnant women in research, recently, but thoughtful discussion about including pregnant women has lagged behind - of course not to the advantage of pregnant women and the fetuses they carry. After the inclusion of non-pregnant women it is time for a second wave: the responsible inclusion of pregnant women in research.
Dr. Lyerly will outline the resulting knowledge gaps of current approaches and their costs. She will highlight reasons why - ethically - we are obliged to include pregnant women in clinical research. Eventually, she will describe the challenges of developing an adequate ethical framework that specifies suitable justifications for excluding pregnant women from research.

Anne Drapkin Lyerly is Associate Professor in the Department of Obstetrics and in the Trent Center for Bioethics, Humanities, and History of Medicine at Duke University. A practicing obstetrician/gynecologist and bioethicist, she undertakes ethical and empirical inquiry into issues in women’s reproductive health. Her current research projects address fertility patients’ attitudes about cryopreserved embryos, preferences and values around childbirth practices, and ethics and policy considerations around the inclusion of pregnant women in research.

 
Fetal Surgery
The making of the (un)born Patient
Monica  Casper

Date: Wednesday 27 May 2009

Surgeons have operated on fetuses for almost three decades, since a team in San Francisco first removed the ‘unborn patient’ from the womb for intervention. Not all fetuses survived surgery, and indeed mortality rates for fetuses have been high, while pregnant women have been at risk. Fetal surgery has shifted from operations performed only for lethal conditions, to surgery for spina bifida and other non-fatal conditions. Throughout its history, it has been accompanied by glowing media coverage emphasizing the ‘miraculous’ nature of interventions and celebrating tiny, fragile fetal patients. Pregnant women are routinely erased in these stories. With few exceptions, there has been little critical analysis of fetal surgery.
This talk will recount this history and situate fetal surgery in the current cultural, economic, and geopolitical context, including the irony of society’s continued embrace of fetal surgery at the same time that infant mortality rates in the U.S. and developing nations have increased.

Monica J. Casper is Professor of Social and Behavioral Sciences and Women’s Studies, and Director of Humanities, Arts, and Cultural Studies, at Arizona State University’s New College of Interdisciplinary Arts and Sciences. Her research and teaching interests include biopolitics, women’s and children’s health, feminist science and technology studies, trauma studies, and environmental studies. She is author of The Making of the Unborn Patient: A Social Anatomy of Fetal Surgery (Rutgers University Press, 1998), co-author of Missing Bodies: The Politics of Visibility (NYU Press, 2009), and editor of Synthetic Planet: Chemical Politics and the Hazards of Modern Life (Routledge, 2003). With Lisa Jean Moore, she co-edits the new NYU Press book series Biopolitics: Medicine, Technoscience, and Health in the 21st Century.