The Future of Reproductive Autonomy

Just Reproduction: Reimagining Autonomy in Reproductive Medicine, special report, Hastings Center Report 47, no. 6 (2017): S6-S11.

6 Pages Posted: 29 Sep 2020 Last revised: 21 Dec 2021

See all articles by Josephine Johnston

Josephine Johnston

The Hastings Center

Rachel Zacharias

University of Pennsylvania Law School

Date Written: November 1, 2017

Abstract

In a project The Hastings Center is now running on the future of prenatal testing, we are encountering clear examples, both in established law and in the practices of individual providers, of failures to respect women's reproductive autonomy: when testing is not offered to certain demographics of women, for instance, or when the choices of women to terminate or continue pregnancies are prohibited or otherwise not supported. But this project also raises puzzles for reproductive autonomy. We have learned that some clinicians and patients do not discuss the fact that prenatal testing can lead to a decision about whether to terminate a pregnancy — they just don't talk about it. And while the decision whether to agree to prenatal screening and diagnostic testing is to be made with women's free and informed consent, many screening tests have been routinized in such a way that some women do not even recall agreeing to testing, while others feel that agreeing to testing is what their clinicians expect of them or that the testing is necessary to protect themselves and their families from the significant financial hardship of raising a child with a disability. In the face of these pressures, can one really say that women are freely choosing to undergo testing or are freely choosing to continue or terminate a pregnancy following receipt of test results? The reality of these pressures is requiring us to consider expanding the scope of our investigation beyond the clinical encounter to the broader context — to think harder about what reproductive autonomy means and how best to enhance it.

Suggested Citation

Johnston, Josephine and Zacharias, Rachel, The Future of Reproductive Autonomy (November 1, 2017). Just Reproduction: Reimagining Autonomy in Reproductive Medicine, special report, Hastings Center Report 47, no. 6 (2017): S6-S11., Available at SSRN: https://ssrn.com/abstract=3672713

Josephine Johnston

The Hastings Center ( email )

Garrison, NY 10524
United States

Rachel Zacharias (Contact Author)

University of Pennsylvania Law School ( email )

3501 Sansom St
Philadelphia, PA 19104
United States

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