The Medical Nonnecessity of In Vitro Fertilization

Debate has raged in Canada recently over whether in vitro fertilization (IVF) should be funded through public health insurance. Such a move would require that the provinces classify IVF as a medically necessary service. In this paper, I defend the position I have taken publicly—especially in Ontario, my own province—that IVF is not medically necessary. I contend that, by funding IVF on grounds of medical necessity, governments like Ontario\u27s violate their commitments to equality and fairness, and cause harm. They do the last by suggesting that the lives of people who forgo procreation, and perhaps have children in other ways (e.g., through adoption), will be stunted

Morally Justifying Oncofertility Research

Is research aimed at preserving the fertility of cancer patients morally justified? A satisfying answer to this question is missing from the literature on oncofertility. Rather than providing an answer, which is impossible to do in a short space, this chapter explains what it would take to provide such justification

Harm or Mere Inconvenience? Denying Women Emergency Contraception

This paper addresses the likely impact on women of being denied emergency contraception (EC) by pharmacists who conscientiously refuse to provide it. A common view—defended by Elizabeth Fenton and Loren Lomasky, among others—is that these refusals inconvenience rather than harm women so long as the women can easily get EC somewhere else nearby. I argue from a feminist perspective that the refusals harm women even when they can easily get EC somewhere else nearby

Morally Justifying Oncofertility Science

Is research aimed at preserving the fertility of cancer patients morally justified? A satisfying answer to this question is missing from the literature on oncofertility. Rather than provide an answer, which is impossible to do in a short space, this paper explains what it would take to provide such justification

Referral in the Wake of Conscientious Objection to Abortion

Currently, the preferred accommodation for conscientious objection to abortion in medicine is to allow the objector to refuse to accede to the patient\u27s request so long as the objector refers the patient to a physician who performs abortions. The referral part of this arrangement is controversial, however. Pro-life advocates claim that referrals make objectors complicit in the performance of acts that they, the objectors, find morally offensive. McLeod argues that the referral requirement is justifiable, although not in the way that people usually assume

Self-Trust and Reproductive Autonomy

In this thesis. I give a theory of the nature of self-trust and an explanation of its role in autonomous decision-making. We tend to think of trust as essentially interpersonal which casts doubt on the coherence of the concept of self-trust. Drawing on patients\u27 experiences in reproductive medicine. I argue that self-trust is a meaningful as well as a useful concept. I provide autobiographical sketches of a number of women\u27s experiences. supplemented by my own observations made while doing a clinical practicum in reproductive medicine, to illustrate that what many women feel toward themselves in a variety of reproductive health care contexts is analogous to what we feel toward others when we trust and distrust them. I ground my theory of self-trust in an account of interpersonal trust, in which I draw on a number of theories of trust in ethics, especially those of Annette Baier and Karen Jones. The paradigm of trust in those theories is interpersonal, and I describe how self-trust and that paradigm are both alike and unlike one another in the following areas: what it is that we trust about ourselves/others when we are trusting, what kind of mental attitude trust is, and what constitute legitimate grounds for trusting. I use my theory of the nature of self-trust to understand the relation between autonomy and self-trust. I give a feminist analysis of that relation by showing how oppression can be a barrier to self-trust and hence, to autonomy. Lastly. I discuss the practical implications of the value of self-trust for the duty of health care providers to respect women\u27s reproductive autonomy

Licensing Parents in International Contract Pregnancies

The Hague Conference on Private International Law currently has a Parentage/Surrogacy Project, which evaluates the legal status of children in cross‐border situations, including situations involving international contract pregnancy (or ‘surrogacy’). Should a convention (or other legal instrument) focusing on international contract pregnancy emerge from this project, it will need to be consistent with the Hague convention on Intercountry Adoption. The latter convention prohibits adoptions unless, among other things, ‘the competent authorities of the receiving State have determined that the prospective adoptive parents are eligible and suited to adopt’ (Article 5a). Included in it, therefore, is a parental vetting or licensing requirement. In our view, a similar requirement must also appear in any Hague Convention on international contract pregnancy if the two conventions are to be ethically consistent with one another. In particular, there should be a licensing requirement in such a convention for at least some of the prospective parents in contract pregnancy arrangements. We consider several arguments against this conclusion, and argue that none of them is successful

Linking nursing pain assessment, decisionmaking and documentation.

A clinical nurse specialist’s (CNS) experience in the development and implementation of a pain assessment and treatment flowsheet (PATF) to enhance the nursing assessment, decision-making, and documentation of pain on a palliative care unit in a community hospital is described in this article. Members of the palliative care interdisciplinary team use the PATF for clinical decision-making in the day-to-day management of patients’ pain. The PATF is undergoing revision and re-implementation to promote the utilization of the tool beyond the specialty of palliative care and into the general patient population