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Autonomy and its limitations in artificial reproduction.

We have examined the concept of autonomy and some of its limitations. The choice between comprehensive and paternalistically modified information giving is not necessarily easy and the competence of a patient to comprehend and give informed consent in medically complex issues may be limited. In extreme cases, such as mentally defective persons, the consent-giver is unarguably incompetent to directly exercise autonomy and a substitute consent-giver or decision-maker is required. In most circumstances decision-making should be devolved to patients as much as possible, notwithstanding the faulty heuristics frequently displayed. This is not only because autonomy is an important principle in its own right but because an internally inconsistent decision is still likely to be closer to an individual's theoretical ideal decision than a decision based on a substitute decision-maker's values. We can see from the examples discussed that there are many instances where principles, guidelines, rules or laws propounded for the benefit of one party may restrain autonomy, beneficence and justice done to another. We would not wish to see anarchy occur in any branch of medicine but is there evidence that restricting the autonomy of the parties involved will necessarily prevent that? We argue that restraint on the autonomy of individuals in reproductive medicine should be kept to a minimum and that society is strongest where individuals have the greatest freedom to follow their personal beliefs.

Advisory Committees↗

Reproduction trends and the emergence of moral panic.

Are we witnessing a moral panic or a moral evaluation in the responses to the new reproductive technologies? Locating women in reproductive technology is a particularly powerful way into a discussion of values and consequences, intended or unintended. Twelve areas are isolated for discussion beginning with issues of definition and location: What is reproductive and genetic engineering? and How does human reproduction fit into bio-technological developments generally? Next issues are raised about how the new developments are being shaped ideologically and how they are being promoted by the state. A series of legal issues affecting women, men, children, embryos and fetuses follow. The focus then shifts to the way women are ideologically constructed: Why is there an assumption that woman = mother, and mother = heterosexual married or stable cohabiting woman?--and socially controlled: Why assume technological change in human reproductive processes means the basic subordination of women to men will not alter? The usefulness of the new technologies in relieving involuntary childlessness is then queried which leads on to a questioning of whether these developments are qualitatively different from other technologies used in human reproduction. Futuristic concerns such as the importance of the male pregnancy and the social consequences of fully medicalising human reproduction are raised. The last area to be considered is protest by women and suggested alternative approaches to increase the social visibility and recognition of the needs and interest of women in the current and potential use of the new medical and scientific developments.

Female↗

Warnock's law.

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Child↗