Sylvia Burrow

Following decades of maltreatment of women in obstetric care, professional respect for maternal autonomy in obstetric decision making and care have become codified in global and national professional ethical guidelines. Yet, using the example of birth after cesarean, identifiable threats to maternal autonomy in obstetrics continue. This paper focuses on how current scientific knowledge and obstetric practice patterns factor into restricted maternal autonomy as evidenced in three representative maternal accounts obtained prior and subsequent to birth after cesarean. Short- and long-term remedies to improve the current state of restricted maternal autonomy in clinical practice surrounding decision making on birth after cesarean are provided.

Following decades of maltreatment of women in obstetric care, professional respect for maternal autonomy in obstetric decision making and care have become codified in global and national professional ethical guidelines. Yet, using the example of birth after cesarean, identifiable threats to maternal autonomy in obstetrics continue. This paper focuses on how current scientific knowledge and obstetric practice patterns factor into restricted maternal autonomy as evidenced in three representative maternal accounts obtained prior and subsequent to birth after cesarean. Short- and long-term remedies to improve the current state of restricted maternal autonomy in clinical practice surrounding decision making on birth after cesarean are provided.

The authors show that martial arts illustrate how ethical and aesthetic value intersect within and beyond sport. While they do not aim to provide a comprehensive analysis of martial arts in this paper, they do plan to draw parallels between sport and martial arts for the purpose of recognizing how martial arts practice may be both aesthetically pleasing and grounded in ethically relevant aims. The upshot of this paper is not wholly positive, however, since the authors draw attention to ethically repugnant practices connected to ideals of aesthetic beauty and other contentious sport practices as part of the analysis of the connection between aesthetic and ethical value. In light of those shared connections, martial arts might simply reinstate, rather than overcome, troublesome goals and values in sport.

The emergence of new forms of reproductive technology raise an increasingly complex array of social and ethical issues. Nevertheless, this paper focuses on commonplace reproductive technologies used during labor and birth such as ultrasound, fetal monitoring, episiotomy, epidurals, labor induction, amniotomy, and cesarean section. This paper maintains that social pressures increase women’s perceived need to such reproductive technologies and thus undermine women’s capacity to choose an elective cesarean or avoid an emergency cesarean. Routine, normalized use of technology interferes with the possibility of choosing use of technology where best suited through misdirecting laboring women to use technological resources whenever possible. This normalized use of technology decreases risk tolerance and increases dependence on technology for reassurance, which bears significant implications for self-trust and self-confidence. My account encourages women’s cultivation of autonomy as a capacity interconnected with our own attitudes and those of other persons; and as a function of cultivating trust and confidence in one’s body.

Cesarean delivery rates have been steadily increasing worldwide. In response, many countries have introduced target goals to reduce rates. But a focus on target goals fails to address practices embedded in standards of care that encourage, rather than discourage, cesarean sections. Obstetrical standards of care normalize use of technology, creating an imperative to use technology during labor and birth. A technological imperative is implicated in rising cesarean rates if physicians or patients fear refusing use of technology. Reproductive autonomy is at stake since a technological imperative undermines patients’ ability to choose cesareans or refuse use of technology increasing the likelihood of cesareans. To address practices driven by a technological imperative I outline three physician obligations that are attached to respecting patient autonomy. These moral obligations show that a focus on respect for autonomy may prove not only an ideal ethical response but also an achievable practical response to lowering cesarean rates.

Rawls's political constructivism in Political Liberalism maintains that the two principles of justice will be accepted and endorsed by persons who are both reasonable and rational. A Theory of Justice explains the motivation to endorse the political conception on the basis of a Kantian moral psychology. Both Leif Wenar and Brian Barry argue that despite Rawls's claims to the contrary, the later work still supposes a Kantian moral psychology. If so, political constructivism fails to account for stability in society among a plurality of reasonable conceptions of good. This paper draws on Rawls's distinction in Political Liberalism between the political and nonpolitical moral sell characterizing each citizens' moral identity in claiming that the two parts of the sell correlate to two sets of motivation, political and moral motivation. This account explains resolution of conflict in the agent in favor of the political conception without invoking a Kantian moral psychology.

Living in a culture of violence against women leads women to employ any number of avoidance and defensive strategies on a daily basis. Such strategies may be self protective but do little to counter women’s fear of violence. A pervasive fear of violence comes with a cost to integrity not addressed in moral philosophy. Restricting choice and action to avoid possibility of harm compromises the ability to stand for one’s commitments before others. If Calhoun is right that integrity is a matter of standing for one’s commitments then fear for safety undermines integrity. This paper extends Calhoun’s view through arguing that integrity further requires resiliency to protect one’s commitments. My account shows that self-defense training is a key source of this resiliency because it cultivates self-confidence. The practical point is that self-defense training directly counters fear and other passive responses to violence that undermine integrity. The theoretical significance is that violence against women is a social condition threatening integrity. Hence, integrity requires self-protection for more socially minded reasons than moral theorists have previously recognized.

Our position is that the threat and experience of violence that sex workers face is a crucial issue to address and should be considered in debates concerning the legalization of prostitution because even in countries where prostitution is legalized, prostitutes continue to experience violence. Our focus is to show that violence is crucially important to address because both the experience and the fear of physical, sexual or psychological harm erodes women ’s capacity to choose and act autonomously. We shall argue, then, that despite differences between inside and outside prostitution, all women in prostitution suffer unacceptable levels of violence ; hence, we conclude that all forms of prostitution continue to be morally problematic