When to Say “No”? Reproductive Justice, Disability Ethics, and Obstetric Violence

Janice Firn – University of Michigan Center for Bioethics & Social Sciences in Medicine (CBSSM)

Abstract: Reproductive Justice (RJ) centers the idea that women have the right to have children or not, and that these children have the right to be parented in safe and healthy environments. RJ emphasizes listening to diverse voices in order to incorporate human rights and an awareness of the intersectionality of women’s identities into the conversation. Black women have shaped this movement and due to the movement’s intersectional nature, it has come to include discussions that amplify the voices of queer women, women living in poverty, and those living with disability, to name a few.

For women with disabilities, the current discourse addresses improving access to assisted reproductive technologies (ART) and considerations of supportive parenting for those with additional needs. However, this emphasis leaves ill-defined how to proceed in situations where ART risks being a violation of bodily integrity. In this case-based presentation, we will engage the audience in discussion around how healthcare professionals make decisions about ART for people with disabilities, balancing their right to conceive and parent children while also not indiscriminately performing medical procedures that could cause serious harm to those who cannot provide consent for such care. We will examine the fraught history of eugenics and how this history has shaped RJ for people with disability. Lastly, we will propose a framework that addresses the merits of bodily integrity, considerations and conditions for assent and ability to parent, and how we can promote access while avoiding contributing to obstetric violence.

Keywords: reproductive justice, disability ethics