Before you were born: a moral exploration of parental and societal responsibilities for the health of children-to-be

The aims of this dissertation are: · To identify and describe the views of parents and caregivers on the responsibilities for the health of children-to-be in general and the responsibility to prepare for pregnancy in particular. · To provide an ethical analysis of the justifiability of unreflective behavioral interventions (nudges) aimed at benefiting the health of children-to-be. · To provide an ethical analysis of the justifiability of the use of force in pregnancy related care by considering the case of the justifiability of forced cesareans. · To identify and present the demands of justice pertaining to the improvement and securing of the health of children-to-be

Incentives for Smoking Cessation During Pregnancy: An Ethical Framework

INTRODUCTION: Smoking during pregnancy increases the risk of morbidity and mortality of the mother and child. The inability of the unborn child to protect itself, raises the social and academic responsibility to protect the child from the harmful effects of smoking. Interventions including rewards (incentives) for lifestyle changes are an upcoming trend and can encourage women to quit smoking. However, these incentives can, as we will argue, also have negative consequences, for example the restriction of personal autonomy and encouragement of smoking to become eligible for participation. To prevent these negative consequences, we developed an ethical framework that enables to assess and address unwanted consequences of incentive-based interventions whereby moral permissibility can be evaluated. AIMS AND METHODS: The possible adverse consequences of incentives were identified through an extensive literature search. Subsequently, we developed ethical criteria to identify these consequences based on the biomedical ethical principles of Beauchamp and Childress. RESULTS: Our framework consists of 12 criteria. These criteria concern (1) effectiveness, (2) support of a healthy lifestyle, (3) motivational for the target population, (4) stimulating unhealthy behavior, (5) negative attitudes, (6) personal autonomy, (7) intrinsic motivation, (8