Catherine Mills

In recent years, a number of US states have adopted laws that require pregnant women to have an ultrasound examination, and be shown images of their foetus, prior to undergoing a pregnancy termination. In this paper, I examine one of the basic presumptions of these laws: that seeing one’s foetus changes the ways in which one might act in regard to it, particularly in terms of the decision to terminate the pregnancy or not. I argue that mandatory ultrasound laws compel women into a position of moral spectatorship and require them to recognise the foetus as a being for whom they are responsible, particularly through empathic responses to ultrasound images. The approach I propose extends the project of a bioethics of the image and highlights the need for a critical analysis of the political mobilization of empathy in discussions of abortion.

In this article, I consider recent debates on the notion of procreative liberty, to argue that reproductive freedom can be understood as a form of positive freedom—that is, the freedom to make oneself according to various ethical and aesthetic principles or values. To make this argument, I draw on Michel Foucault’s later work on ethics. Both adopting and adapting Foucault’s notion of ethics as a practice of the self and of liberty, I argue that reproductive autonomy requires enactment to gain meaning within the life contexts of prospective parents. Thus, I propose a shift away from the standard negative model of freedom that sees it solely as a matter of noninterference or nonimpedance, a view advocated by major commentators such as John Harris and John Robertson. Instead, reproduction should be understood as a deeply personal project of self-making that integrates both negative and positive freedom

Issues in reproductive ethics, such as the capacity of parents to ‘choose children’, present challenges to philosophical ideas of freedom, responsibility and harm. This book responds to these challenges by proposing a new framework for thinking about the ethics of reproduction that emphasizes the ways that social norms affect decisions about who is born. The book provides clear and thorough discussions of some of the dominant problems in reproductive ethics - human enhancement and the notion of the normal, reproductive liberty and procreative beneficence, the principle of harm and discrimination against disability - while also proposing new ways of addressing these. The author draws upon the work of Michel Foucault, especially his discussions of biopolitics and norms, and later work on ethics, alongside feminist theorists of embodiment to argue for a new bioethics that is responsive to social norms, human vulnerability and the relational context of freedom and responsibility. This is done through compelling discussions of new technologies and practices, including the debate on liberal eugenics and human enhancement, the deliberate selection of disabilities, PGD and obstetric ultrasound.

In lieu of an abstract, here is a brief excerpt of the content:Making Fetal PersonsFetal Homicide, Ultrasound, and the Normative Significance of BirthCatherine MillsIn early 2012, the then attorney general of Western Australia, Christian Porter, announced plans to introduce fetal homicide laws that would “create a new offence of causing death or grievous bodily harm to an unborn child through an unlawful assault on its mother” (Porter 2012). While well established in the United States, fetal homicide laws are only beginning to take shape in Australia.1 The proposed law would mean that if an offender assaulted a woman and thereby caused the death of the fetus she was gestating, the courts would be required to impose a sentence of life imprisonment in all but exceptional circumstances—equivalent to the penalty for murder. While the proposed fetal homicide law is said to give appropriate recognition to the grief and suffering of the woman involved—and while it may help to do that—this is certainly not all it would do.2 For it would also give existence to a new legal subject in Western Australia, that is, the “unborn child”: currently, under Western Australian law a child is only legally capable of being murdered when already external to the mother’s body. Thus, the woman’s body constitutes a kind of “natural” basis for a legal boundary—one that the proposed law transgresses and perhaps obliterates, at the same time as it purports to recognize the trauma associated with the transgression and obliteration of that boundary by another.Fetal homicide laws thus traverse difficult territory in the maternal-fetal relationship, in which actions against one person come to constitute a crime against another. Significantly, these laws are typically formulated to provide legal protection for pregnant women against the intrusions of a third party against [End Page 88] their person. However, it may be that they can also be interpreted more generally to provide legal protection for the fetus against others. So construed, such laws open up a danger for pregnant women themselves, insofar as their actions threaten the life and well-being of the fetus they carry. One recent example of the exploitation of this ambiguity in fetal homicide laws is the case of Bei Bei Shuai, a young woman of Chinese descent who faced felony charges of murder in Indiana after a failed suicide attempt resulted in the death of the thirty three week old fetus she was gestating (Pilkington 2011, 2012). If a woman’s actions against herself, leading to the death of her fetus, can be legally construed as murder, where does this leave the law on abortion? The Western Australian attorney general insisted that the proposed law would not affect laws on abortion in any way, since it would not encroach on a woman’s right to make decisions about her pregnancy (Porter 2012). But a woman’s decisional rights in regards to her pregnancy are at best an unstable dividing line; at worst, it is precisely her decision to terminate a pregnancy—that is, to intentionally bring about the death of the fetus—that substantiates a murder charge. Indeed, at the crux of the Shuai case was her suicide note, in which she apparently stated her intent to kill her fetus.This ambiguity between abortion and fetal homicide has been the topic of much discussion in legal literature, and it raises significant questions that bear further investigation. For one, it raises in a particularly pointed way questions about the moral and legal significance of birth, and the bearing it has on the status of the fetus. Birth has historically been significant in establishing personhood, but this reliance on birth is challenged by the shift to treating the fetus as a person for the purposes of some areas of the law. The further question then arises of whether that status must remain consistent across domains of the law, such as those addressed to the death of a fetus at the hands of a third party, and those on abortion. While these questions have been well canvassed in legal discussions, we might also consider the impact that technologies such as obstetric ultrasound have on notions of fetal life and personhood. Advances in medical technologies appear...

The practice of terminating a pregnancy following the diagnosis of a fetal abnormality raises questions about notions of bodily normality and the ways these shape ethical decision-making. This is particularly the case with terminations done on the basis of ostensibly minor morphological anomalies, such as cleft lip and isolated malformations of the limbs or digits. In this paper, I examine a recent case of selective termination after a morphology ultrasound scan revealed the fetus to be missing a hand . Using the work of Georges Canguilhem, I show that a person with acheiria could be considered normal. Further, I show that this case reveals a kind of “undecidability” in the significance of fetal sex/gender and disability in termination. From this, I consider the conceptual interaction of disability with sex/gender, to argue that the ethics of disability termination are not as distinct from those of sex/gender selection as is commonly supposed

The Routledge Handbook of Feminist Bioethics is an outstanding resource for anyone with an interest in feminist bioethics, with chapters covering topics from justice and power to the climate crisis. Comprising 42 chapters by emerging and established scholars, the volume is divided into six parts: Foundations of Feminist Bioethics Identity and Identifications Science, Technology and Research Health and Social Care Reproduction and Making Families Widening the Scope of Feminist Bioethics The volume is essential reading for anyone with an interest in bioethics or feminist philosophy, and will prove an invaluable resource for scholars, teachers, and advanced students.

Giorgio Agamben has gained widespread popularity in recent years for his rethinking of radical politics and his approach to metaphysics and language. However, the extraordinary breadth of historical, legal and philosophical sources which contribute to the complexity and depth of Agamben's thinking can also make his work intimidating. Covering the full range of Agamben's work, this critical introduction outlines Agamben's key concerns: metaphysics, language and potentiality, aesthetics and poetics, sovereignty, law and biopolitics, ethics and testimony, and his powerful vision of post-historical humanity. Highlighting the novelty of Agamben's approach while also situating it in relation to the work of other continental thinkers, "The Philosophy of Agamben" presents a clear and engaging introduction to the work of this original and influential thinker

In this paper I will argue for the ethical and political virtue of a form of critique associated with the work of Michel Foucault. Foucault’s tryptich of essays on critique---namely ”What is Critique?’ ”What is Revolution?’ and ”What is Enlightenment?’---develop a formulation of critique understood as an attitude or disposition, a kind of relation that one bears to oneself and to the actuality of the present. I suggest that this critical attitude goes hand in hand with a mode of intellectual practice realized rhetorically in the form of the interrogative and methodologically in ”problematology’. But, in addition to highlighting the habitus of critique suggested by Foucault, I also want to consider the entanglement of this critical enterprise in the conditions of the present that it attempts to diagnose. Specifically, I ask, in what way is a critical enterprise in the interrogative mood itself imbricated in the trope of interrogation that fills so much of our current political and public landscape?

In debates on infanticide, including the recent defence of so-called ‘after-birth abortion’, philosophers generally treat the term ‘the person’ as descriptive, such that statements claiming that something is a person can be considered true or false, depending on the characteristics of that thing. This obscures important aspects of its usage. J L Austen identified a subset of speech acts as performative, in that they do things in their very declaration or utterance. They do not simply describe states of affairs or things, but perform the act they ostensibly describe. ‘I promise’ or ‘I apologise’ may be taken as paradigmatic. Performative speech acts are not judged according to their truth-value, but their …

Recent animal research suggests that it may soon be possible to support the human fetus in an artificial uterine environment for part of a pregnancy. A technique of extending gestation in this way (“ectogestation”) could be offered to parents of extremely premature infants (EPIs) to improve outcomes for their child. The use of artificial uteruses for ectogestation could generate ethical questions because of the technology’s potential impact on the point of “viability”—loosely defined as the stage of pregnancy beyond which the fetus may survive external to the womb. Several medical decisions during the perinatal period are based on the gestation at which infants are considered viable, for example decisions about newborn resuscitation and abortion, and ectogestation has the potential to impact on these. Despite these possible implications, there is little existing evidence or analysis of how this technology would affect medical practice. In this paper, we combine empirical data with ethical analysis. We report a survey of 91 practicing Australian obstetricians and neonatologists; we aimed to assess their conceptual understanding of “viability,” and what ethical consequences they envisage arising from improved survival of EPIs. We also assess what the ethical implications of extending gestation should be for newborn and obstetric care. We analyze the concept of viability and argue that while ectogestation might have implications for the permissibility of neonatal life‐prolonging treatment at extremely early gestation, it should not necessarily have implications for abortion policy. We compare our ethical findings with the results of the survey.

In June 2019 Victoria became the first state in Australia to permit “voluntary assisted dying”, with its governance detailed in the Voluntary Assisted Dying Act 2017. While taking lead from the regulation of medically assisted death practices in other parts of the world, Victoria’s legislation nevertheless remains distinct. The law in Victoria only makes VAD available to persons determined to be “already dying”: it is expressly limited to those medically prognosed to die “within weeks or months.” In this article, we discuss the emergence of the Victorian legislation across key formative documents. We show how, in devising VAD exclusively for those “already at the end of their lives”, the Victorian state mobilizes the medico-legal category of the already dying. We argue that this category functions to negotiate a path between what are seen as the unacceptable alternatives of violent suicide on the one hand, and an unlimited right to die on the other. Further, we argue that the category of the already dying operates to make medical practitioners the gatekeepers of this new life-ending choice and effectively limits the realization of autonomy at the end of life.

In order to avoid the implication that ‘mitochondrial replacement techniques’ (MRT) would produce ‘three parent babies’, discourses around these techniques typically dismiss the contribution of the mitochondria to genetic parenthood and personal identity. According to many participants in debates about MRT, ‘real parenthood’ is a matter of contributing nuclear DNA, which in turn implies that men and women make the same contribution to the embryo. Even when the importance of the mitochondria is acknowledged, an emphasis on mitochondrial DNA still has the effect of valorizing the role of DNA (and thus the paternal contribution to conception) at the expense of the role played by the cytoplasm of the oocyte in the development of the embryo and placenta, and that of the mother’s body in gestation. In this way, discourses around MRT falsely imply that what men and women contribute to reproduction and parenthood is the same—nuclear DNA—and thus erase the distinctive contribution that women make to conception. The potential of MRT to reconfigure relationships between the sexes in the service of patriarchal norms is perhaps one of the most significant things about it and should, we argue, be counted in the discussion of the ethical and policy implications of legitimating these procedures.

This paper argues that social contexts of inequality are crucial to understanding the ethics of gestational harm and responsibility. Recent debates on gestational harm have largely ignored the social context of gestators, including contexts of inequality and injustice. This can reinforce existing social injustices arising from colonialism, socio‐economic inequality and racism, for example, through increased regulation of maternal behaviour. To demonstrate this, I focus on the related notions of the ‘future child’ and an obligation of easy rescue, which have been used to discuss the ethics of gestational harm in the context of alcohol consumption during gestation and foetal alcohol spectrum disorder (FASD). I use a feminist perspective to evaluate these ideas and conclude that anyone concerned with remediation of social injustice has good reason to be suspicious of the notion of the future child in the context of gestational harm.