Joan C. Callahan

(1946 - 2019)

Multiple gestations, or multifetal pregnancies,raise a number of significant policy questionsconcerning the well being of women and the wellbeing of the children fetuses might become.Important questions for feminists pertain notonly to multifetal pregnancy itself, but alsoto the medical interventions associated withthese pregnancies. In this paper, we addressthe questions of how many embryos should betransferred in assisted reproduction, how manyfetuses should remain in a multiple gestation,who should make these decisions, and the needto protect women from overexposure to exogenoushormones. Although we focus on assistedreproduction in the United States, we believethat our suggestions are applicable to othercountries where the technology is comparable.

Among fundamental, widely shared values, there are two which often come into conflict, creating a serious moral dilemma, viz., the value of individual well-being and the value of individual self-direction. These values issue in two fundamental moral principles, one which prescribes the protection of others from harm, and one which proscribes interfering with a person's right to direct his own life and actions. When an individual is doing or choosing something which subjects him to harm or significant risk of harm, the question of paternalistic interference arises.Since John Stuart Mill's On Liberty, there have been a number of attempts to say when such protective interference with adults is morally acceptable.