As we re-imagine feminist bioethics, we might consider some of its traditional topics in different ways. While feminist bioethics is of course concerned with many issues beyond reproductive justice, reproductive justice remains a central topic of concern for feminist bioethics because control over reproduction is a key way that gendered power structures and gender oppression operate. The hot topic in reproductive justice is often abortion, but many of the same issues of control arise when it comes to prenatal and perinatal care as well as access to, and even involuntary imposition of, contraception.
Systems, and individuals wrapped up in those systems knowingly or unknowingly, may seek to preserve gender oppression and reproductive control, and to displace responsibility for reproductive health from systems onto individuals. Several of our panelists—one from the North American context and one from the Central American context—separately examine how rights of conscience, and especially conscientious objection, can be used in anti-feminist backlash against reproductive justice in order to preserve oppressive systems. Reproductive justice, however, can be supported by careful feminist methodological attention to the way these systems operate. For instance, two co-authors on our panel examine seemingly innocent clinical questions such as “who infected her?” to see how they can do great harm to bodies and families in reproductive care spaces in Brazil, displacing responsibility from the state and policy onto individuals and families. Another set of co-authors on our panel show how recent developments in Mexican jurisprudence have advanced reproductive justice in that nation using methods we might recognize as feminist, to evaluate the impact of policy and law that affect reproductive care and to preserve a secular right to have access to reproductive health care. Finally, one of our panelists combines the feminist methodology of attention to systems with the concept at the core of rights of conscience to examine how conscientious provision of reproductive health services can disrupt reproductively unjust social systems and policies, and can position feminist approaches to reproductive justice as deeply rooted in conscience and thus deserving of the same protections governments in the Americas often offer to conscientious objection.
The five presentations on this panel, developed by panelists from throughout the Americas, provide illustrations of how feminist bioethics tools can identify and undermine reproductive injustice, and helps us move towards reproductive justice.
The instrumentalization of Conscientious Objection in Healthcare Services as part of a Conservative Civil Disobedience Movement against Reproductive Rights in Latin America
Prof. Gabriela Arguedas-Ramírez | Universidad de Costa Rica | Costa Rica
For almost two decades, in several Latin-American countries, medical associations, private
hospitals and other healthcare-related institutions and organizations have been promoting an
orchestrated and systematic narrative regarding the concept of conscientious objection that
respond to a primary objective: to obstruct access to all forms of abortion, even therapeutic
abortion. The international social movement called “Salvemos las dos vidas” is an example of this strategy, as well as medical organizations self-denominated “Médicos por la Vida”, among others. The rhetorical and political transformation of the notion of conscientious objection, from an individual and exceptional resource intended to protect individuals from legal and professional obligations that go against one’s most morally profound convictions, to a legal mechanism used by politically organized groups of healthcare workers determined to impede women’s access to abortion requires close attention from the field of feminist bioethics.
In this paper I will argue that once the conscientious objection to perform a legal abortion is made as part of a pro-criminalization of abortion political strategy, then it is not legitimate (because is not meant to protect one’s conscious but to intervene in someone else’s moral-subjectivity) and it is ethically unacceptable. The instrumentalization of conscientious objection by conservative social movements against reproductive rights is not only a menace against women’s and non-binary people’s fundamental rights, but against the very foundations of medical ethics. Both healthcare institutions and public health authorities should resist such moves.
Who infected her? A moral question about grieving and anger
Dr. Arbel Griner | Princeton University | United States
Debora Diniz | University of Brasilia Law School; Brown University | Brazil
Maternal mortality rose as a central epidemic trend of covid-19 in Brazil. Black and brown pregnant and puerperal women are most affected, as are all who are not able to isolate, work and consume from home. In clinical interactions with such women and their families, a protocolar question is usually set by physicians: “how did she get infected?” It is motivated by a logic of contact tracing and isolation of the potentially ill. In private and familial spaces, however, that interpellation is recast, implying blame and responsibilization: “who infected her?”
The clinic thus mediates the encounter between the public and the private; the space where governmentality and the logics of accountability mold into ethics of care, and where the emotional regimen of stoicism breaks into grief. Drawing on interviews with families that lost pregnant and puerperal daughters, sisters and wives to Covid-19 in Brazil, this paper questions the confessional script of the clinic and argue that it becomes a central mechanism in the displacement of responsibility from the state and policy space to individuals and families. It will further make the case that the protocolar and stoic (therefore patriarchal) ethics of clinical encounters, run by physicians and medical staff, are recast in spaces of care in terms of blame and anger.
Rather than asking how helpful a set of questions might be in the management of health crises, we use feminist bioethics to ask how harmful it is to bodies and families traversed by biomedicine and science.
Conscientious objection and abortion rights: a feminist critique
Prof. Dr. Alison Jaggar | University of Colorado-Boulder (emerita professor) | United States
The right to conscientious objection is accorded considerable moral weight in the United States. It is often regarded as crucial to preserving individual liberty and setting limits on government power. In the US, the right to conscientious objection was initially invoked to justify noncompliance with military service obligations but today it is often raised in the context of health policy. For instance, some US citizens argue that the claims of individual conscience give them the moral right to refuse vaccination against covid-19. Arguments from individual conscience have also been used extensively to limit access to abortion in the US. This paper will consider how far the rights of individual conscience may legitimately influence public policy around abortion access.
Advances in the Sexual and Reproductive Rights of Women in Mexico in fit and start of Jurisprudence
Pauline Capdevielle | Instituto de Investigaciones Jurídicas | Mexico
Prof. Dr. María de Jesús Medina Arellano | Instituto de Investigaciones Jurídicas | Mexico
In Mexico, the Supreme Court of Justice of the Nation has recently made two decisions that will profoundly modify legal abortion in the country.
The first, dated September 7, 2021, resolved the Action of Unconstitutionality 148/2017 against various articles of the Penal Code of the state of Coahuila that provided prison sentences for women found guilty of the crime of abortion. The Court began its reasoning by mobilizing a gender perspective, that is, a methodological tool that makes it possible to judge from situations of gender disadvantages that generate discrimination and subordination. It also emphasized that the right to decide is a requirement of secularism, which is understood as a project of intellectual emancipation against the imposition of religious dogmas and beliefs.
The second case decided by the Court concerned the federal constitutionality of the local constitution of Sinaloa State, which protects life from the moment of conception to natural death. In this judgment, the Court re-emphasized the values of dignity, autonomy, human rights, equality, and democracy as sources of recognition of women and pregnant persons as subjects of law. This represents an historical move in the progression of women rights in Mexico, but it also implies possibilities of backlash by anti-rights lobbying on local legislatures. We will analyze those discourses and the ethical discussion in the judiciary from gender perspective.
Conscientious provision and reproductive rights: rights of conscience as feminist bioethics
Alison Reiheld | Southern Illinois University-Edwardsville | United States
Rights of conscience can be a feminist bioethics tool for intervening in reproductively unjust policies and systems, now, while working for systemic reform. Conscientious provision of abortion within the United States highlights the fact that reproductive justice is driven by conscience, and that personal commitments to reproductive justice may require resistance to unjust systems and policies. Such resistance existed in the United States prior to Roe v. Wade (1973), when states were permitted to make abortion illegal and yet some physicians and nurses provided safe but illegal abortion, and since Roe v. Wade as states prevented from criminalizing abortion have increasingly proposed and sometimes passed laws that make it more and more difficult for abortion providers to operate and for pregnant persons to access abortion. And yet, some clinicians strive to provide reproductive services, including abortion, despite this, precisely because their commitment to reproductive justice demands it. We can also see this in the work of clinicians to provide access to contraception, including sterilization, for persons who might otherwise be refused access because of dominant pronatalist cultural assumptions that preserving the possibility of reproduction—at least by certain people—is more desirable than a person’s reproductive liberty.
Providing reproductive health services in the face of systems that seek to control and limit reproductive liberty is a feminist bioethics tool for serving reproductive justice. Insofar as governments in the Americas, and in the U.S. in particular, protect conscientious objection, conscientious provision deserves the same protection and is a site of resistance.