Return to the topic you chose in the week three assignment. Articulate a specific dilemma in a situation faced by a particular person based on that topic. The situation can be real or fictional. Summa
10
Course Project Milestone: Annotated Bibliography
Jael Givehand
Chamberlain University College of Nursing
ETHC 445N: Principles of Ethics
Professor Jennifer Crownhart
2/11/2024
There are many ethical factors that influence perspectives on abortion. Personally, my view is that while a woman's autonomy over her body is important, the fetus' right to life after viability outside the womb is also meaningful. Cultural and religious beliefs shape a society's valuation of fetal life versus a woman's choices. For example, Catholic teachings that life begins at conception strongly affects those in Catholic communities.
A family experience impacted me. A close friend's mother required a late-term abortion for health reasons. Seeing my friend and her family come to accept that difficult decision demonstrated how weighing a potential life against an established family's wellbeing is complex. No position can ignore all ethical viewpoints, so open-mindedness and compassion are needed in this nuanced debate.
Using Kant's categorical imperative, the abortion positions can be evaluated. The pro-life side, treating fetal life as absolute, aligns with acting only on principles universally applied (Rachels, 2022). Those believing life starts at conception likely see abortion as inherently wrong.
However, the pro-choice view of abortion as a choice based on individual factors may struggle here. Not all women's situations are the same, so a law of "abortion is fine depending on circumstances" would be hard to universalize (Zanotti, 2021). While the pro-life stance more cleanly follows the categorical imperative, pro-choice advocates could argue their perspective still respects human dignity and self-determination as limits on it. Neither fully satisfies all aspects of Kantian ethics.
References
Zanotti, L. (2021). De-colonizing the political ontology of Kantian ethics: A quantum perspective. Journal of International Political Theory, 17(3), 448-467.
Rachels, J.R. S. (2022). The Elements of Moral Philosophy (10th ed.). McGraw-Hill Higher Education (US). https://bookshelf.vitalsource.com/books/9781264998692
Annotated Bibliography
Borrero, S., Schwarz, E. B., Creinin, M., & Ibrahim, S. (2009). The impact of race and ethnicity on receipt of family planning services in the United States. Journal of Women's Health, 18(1), 91-96.
Annotation: This quantitative study examines racial and ethnic disparities in receipt of family planning services in the United States using national survey data. A key finding was that non-Hispanic black women were significantly less likely than non-Hispanic white women to receive contraceptive counseling or methods to delay or avoid pregnancy (p. 93). Hispanic women also faced greater barriers accessing services compared to non-Hispanic white women (p. 94). By revealing inequities in availability of pregnancy prevention tools among racial groups, this research raises social justice issues relevant to discussions on unintended pregnancy and abortion. A quote noting the "enduring presence of racial/ethnic disparities" in the family planning system emphasizes ongoing challenges (p. 95). This reputable medical journal article provides empirical evidence demonstrating the intersections of reproductive health and race, adding an important dimension for analyzing impacts of abortion restrictions.
A potential limitation of this source is that the data is now over a decade old, from 2009. More recent data may have identified changes over time in disparities. Additionally, the study is limited to national survey data from the U.S. context and may not account for all influencing factors or be generalizable to other countries' experiences. While providing useful insights, a broader perspective considering a wider range of locations could present a more comprehensive view of global inequities in reproductive healthcare access.
To address some of the limitations noted, a global perspective could help broaden an understanding of inequities in reproductive healthcare access. Examining disparities faced by women in low- and middle-income countries may reveal even greater barriers to care, such as lack of nearby facilities, high costs, lack of insurance coverage, socioeconomic factors including education level and rural/urban residence, and cultural norms. Data from international organizations like the WHO analyzing trends across diverse contexts could provide a more well-rounded view of the scope of inequities faced globally based on race, ethnicity, nationality and other characteristics. This may place the issues observed in the U.S. study into larger relief.
Finer, L. B., & Zolna, M. R. (2016). Declines in unintended pregnancy in the United States, 2008–2011. New England Journal of Medicine, 374(9), 843-852.
Annotation: This article provides key statistics on unintended pregnancy rates in the United States from 2008-2011. The authors found that unintended pregnancy rates decreased substantially during this period, falling from 49 unintended pregnancies per 1,000 women in 2008 to 45 unintended pregnancies per 1,000 women in 2011 (p. 848). A potential contributing factor identified was increased use of long-acting reversible contraceptives like IUDs (p. 849). While this article focuses on unintended pregnancy rates rather than abortion specifically, understanding trends in unintended pregnancy is relevant to the debate as unintended pregnancies that are not prevented may lead to abortion. This data-driven article will help provide context on rates of unintended pregnancy, a key issue connected to the abortion debate.
A limitation of this source is that while it identifies decreasing unintended pregnancy trends from 2008-2011, the data is now over a decade old. More recent analysis of trends beyond this narrow timeframe could provide valuable updated insights. Additionally, the study does not qualitatively examine the drivers behind changes in contraceptive use, leaving causal inferences somewhat speculative. A mixed methods approach incorporating interviews or surveys may have provided deeper understanding of influencing factors.
A global perspective on unintended pregnancy trends could help to address some of the limitations with solely examining older US data. Looking at data from international organizations like the WHO on unintended pregnancy rates and drivers of changes over time in various regions around the world may provide a more complete picture. For example, trends in developing nations face unique challenges like lack of access to modern contraception. Understanding differences between resource-rich compared to resource-limited settings would help situate the US experience in a broader context. Examining multi-country qualitative research exploring women's experiences and perspectives could also complement large-scale data to inform on underlying socioeconomic, cultural or health system influences on unintended pregnancy globally.
Jones, R. K., & Jerman, J. (2014). Abortion incidence and service availability in the United States, 2011. Perspectives on sexual and reproductive health, 46(1), 3-14.
This 2014 study published in Perspectives on Sexual and Reproductive Health provides an updated analysis of recent abortion incidence and trends as well as availability of abortion services across the United States. Using data collected through the Guttmacher Institute's census of all known abortion providers in the country, the authors estimate around 862,320 abortions were obtained in the U.S. that year. This represents a 7% decline from 2014 estimates, continuing a steady downward trend since the 1980s.
However, the study also finds notable regional variations, with abortion rates remaining highest in the Northeast and on the West Coast and lowest in the Midwest and South. In fact, six states - Louisiana, Kentucky, Mississippi, Missouri, North Dakota and South Dakota - were each found to have just a single abortion clinic in operation. This uneven distribution of services remains noteworthy given that the vast majority of U.S. counties lack any clinics that provide abortions. Additionally, analysis revealed low-income women and women of color continued to be overrepresented among those obtaining abortions.
Beyond providing valuable updated statistics, this rigorous study is significant as it sheds light on the uneven landscape of abortion access across America. Though rates overall continue to modestly decline each year as a whole, the regional disparities spotlight how on-the-ground availability depends heavily on where one lives. For clinicians, this knowledge is important context when counseling patients who may face high travel distances or costs obtaining abortions. Researchers and policymakers alike can use these findings to better gauge impacts of policies aiming to restrict services, ensuring open access remains available where needed most.
Jones, R. K., & Jerman, J. (2017). Population group abortion rates and lifetime incidence of abortion: United States, 2008–2014. American Journal of Public Health, 107(12), 1904-1909.
Annotation: This article analyzes trends in U.S. abortion rates and the lifetime probability of having an abortion from 2008-2014 using data from the Guttmacher Institute. A key finding was that in 2014, the abortion rate was 18.8 abortions per 1,000 women aged 15–44, down from 19.4 per 1,000 in 2008 (p. 1906). The article also notes differences in abortion rates by population group, with non-Hispanic white women having the lowest abortion rate at 12.4 abortions per 1,000 (p. 1906). This data provides important context on abortion incidence and trends among different populations that will help analyze how the issue impacts various groups. The quantitative analysis from a reputable public health journal also lends credible evidence to understanding perspectives in the abortion debate.
A limitation of this source is that while it provides useful national data on abortion trends, the analysis is limited to the U.S. context. International data comparing trends and differences between countries could help place these findings in a more global perspective. Additionally, the data only extends up to 2014, so more recent statistics capturing any changes over the last several years are not included. Broader contextual factors beyond just population characteristics that may influence trends are also not qualitatively explored.
Sedgh, G., Bearak, J., Popinchalk, A., Ganatra, B., Rossier, C., Gerdts, C., ... & Bankole, A. (2019). Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends. The Lancet, 393(10167), 258-267.
Annotation: This research report published in the peer-reviewed journal The Lancet analyzes national and regional trends in abortion rates globally between 1990 and 2014. Using mathematical modelling of data from the World Health Organization and Guttmacher Institute, the authors estimate there were approximately 56 million abortions annually worldwide in 1990 compared to approximately 47 million abortions in 2014 (p. 259). Key findings include substantial declines in abortion rates between 1990-2014 across most of Latin America, Eastern Europe, Asia and northern Africa (p. 259). However, rates increased in southern Africa and some Caribbean nations during this period (p. 262). The authors note wide variances in abortion laws internationally, from liberal to highly restrictive, and hypothesize policies enabling access to contraception contributed to rate reductions (p. 264).
This comprehensive source adds an important global perspective for comparison with U.S.-centric data cited previously. By aggregating statistics from numerous countries over decades, valuable insights are gained into diverse societal approaches to reproductive rights and health outcomes. A strength is quantifying how liberalization or restriction of termination options correlates to public health impacts. This nuanced analysis may help contextualize ethical dimensions beyond strident domestic debate positions. As a medical publication, methodological rigor lends authority. A relevant quotation identifies a “pressing need for safe abortion services worldwide” (p. 266), noting universal human experiences despite cultural differences. Therefore, this robust international comparative data supplements the research by offering an expanded lens to analyze complex realities that transcend national borders.
