Carolyn McLeod

Public attention on embryo research has never been greater. Modern reproductive medicine technology and the use of embryos to generate stem cells ensure that this will continue to be a topic of debate and research across many disciplines. This multidisciplinary book explores the concept of a 'healthy' embryo, its implications on the health of children and adults, and how perceptions of what constitutes child and adult health influence the concept of embryo 'health'. The concept of human embryo health is considered from preconception to pre-implantation genetic diagnosis to recent foetal surgical approaches. Burgeoning capacities in both genetic and reproductive science and their clinical implications have catalysed the necessity to explore the concept of a 'healthy' embryo. The authors are from five countries and 13 disciplines in the social sciences, humanities, biological sciences and medicine, ensuring that the book has a broad coverage and approach.

Philosophical theories about parental licensing tend to pay insufficient attention to forms of discrimination that may be inherent in, or result from, a system of parental licensing. By situating these theories in relation to the status quo on parental licensing, we aim to show how many of them reinforce what philosophers have called “biologism”: the privileging of families formed through biological reproduction over families formed in other ways. Much of our discussion focuses on biologism, although we also touch on other forms of discrimination that parental licensing can cause or exacerbate, such as classism, sexism, homophobia, racism, and ableism. We firmly believe that any adequate proposal in favour of parental licensing must take worries about discrimination seriously. Unfortunately, most philosophical proposals fail to do so.

I want to get both personal and philosophical in this piece. I want to reflect on how my relationship with Sue Sherwin has fostered my own relational autonomy. At the same time, I want to discuss what theories of relational autonomy, like Sue's, add to the bioethics literature on autonomy. With this second objective, I hope to begin clearing up some confusion that I see in this literature about the nature of relational autonomy.Sue was my PhD supervisor, but more than that, she has been my mentor and my role model. I doubt I would still be part of the discipline of philosophy if it weren't for Sue. I came to Dalhousie University as a PhD student in 1995 with a burning love for philosophy but an intense dislike for...

Conscience in Reproductive Health Care responds to the growing worldwide trend of health care professionals conscientiously refusing to provide abortions and similar reproductive health services in countries where these services are legal and professionally accepted. Carolyn McLeod argues that conscientious objectors in health care should prioritize the interests of patients in receiving care over their own interest in acting on their conscience. She defends this "prioritizing approach" to conscientious objection over the more popular "compromise approach" without downplaying the importance of health care professionals having a conscience or the moral complexity of their conscientious refusals. McLeod's central argument is that health care professionals who are gatekeepers of services such as abortions are fiduciaries for their patients and for the public they are licensed to serve. As such, they owe a duty of loyalty to these beneficiaries and should give primacy to their beneficiaries' interests in accessing care. This conclusion is informed by what McLeod believes is morally at stake for the main parties to the conflicts generated by conscientious refusals: the objector and the patient. What is at stake, according to McLeod, depends on the relevant socio-political context, but typically includes the objector's integrity and the patient's interest in avoiding harm.

To a large extent, what we do and the circumstances we find ourselves in are beyond our control. Yet this fact presents a problem for the common view that we can be held responsible only for what we have direct control over. If we have control over very little, if anything at all, then to what extent can we be held responsible? A typical response by feminist philosophers is to accept the absence of control—or in other words, the presence of luck—but to insist that responsibility remains often enough. According to this view, where there is luck, there can also be responsibility. At the same time, feminists accept, of course, that where there is luck, there may not be responsibility. In general, like other philosophers, feminists have a complicated understanding of the relationship between luck and responsibility. In this chapter, we aim to describe how their understanding flows out of their feminist commitments and also what avenues there are for future research on luck and responsibility in feminist philosophy. Avenues that concern luck without responsibility are our central concern.

With the cure rate for many pediatric malignancies now between 70% and 90%, infertility becomes an increasingly important issue. Strategies for preserving fertility in girls and adolescent women occur in two distinct phases. The first phase includes oophorectomy and cryopreservation of ovarian cortex slices or individual oocytes; ultrasound-guided needle aspiration of oocytes, with or without in vitro maturation, followed by cryopreservation; and ovarian autografting to a distant site. The second phase occurs if the woman chooses to pursue pregnancy, and includes IVM of the oocytes, followed by in vitro fertilization and transfer of any created embryos to the woman's uterus. For ovarian autografting, the woman would undergo menotropin ovarian stimulation and retrieval of matured oocytes. The ethical challenges with each of these phases are many of fertility preservation and include issues of informed choice. The lack of proven benefit with these strategies and the associated potential physical and psychological harms require careful attention to the key elements of informed choice, which include decisional capacity, disclosure, understanding and voluntariness, and to the benefits of in-depth counseling to promote free and informed choice at a time that is emotionally difficult for the decision makers.

At the 2022 Central American Philosophical Association meeting, there was an Author-Meets-Critics session on Carolyn McLeod’s book, Conscience in Reproductive Health Care: Prioritizing Patient Interests. The event was organized and chaired by Heather Stewart and sponsored by the APA Committee on the Status of Women and Kate Norlock, chair of that committee. There were four speakers, including McLeod and three “critics”: Javiera Perez Gomez, Alison Reinheld, and Jennifer Parks, who were all generous enough to provide McLeod with their comments beforehand. The sessions occurred over Zoom even though some speakers were present in person at the conference. McLeod kicked things off by providing a summary of her book, which was then followed by critical comments by the critics in the order in which they’re named above. McLeod responded to their remarks and then Stewart led a Q&A session with our small but lively and intelligent audience. The content of what was said has been reproduced here.

The reproductive rights of women have been a central topic in feminist bioethics. The focus has been predominantly on the right not to reproduce, and so not to be subject to pronatalist social forces that make motherhood compulsory for women. That is the case despite many women and other members of marginalized groups experiencing anti-natalism, or in other words, social pressure to avoid biological reproduction. For these groups, the right to reproduce is as important, if not more important, than the right not to reproduce. This chapter concentrates on the right to reproduce and considers what form it should take in feminist bioethics. The main claim of the chapter is that feminists should ground the right in the need to protect marginalized groups from anti-natalism.