New Release Books by Carolyn McLeod

In Conscience in Reproductive Health Care, Carolyn McLeod responds to a growing worldwide trend of health care professionals conscientiously refusing to provide abortions and similar reproductive health services in countries where these services are legal and professionally accepted. She argues that conscientious objectors in health care should have to prioritize the interests of patients in receiving care over their own interest in acting on their conscience. McLeod defends this ''prioritizing approach'' to conscientious objection over the more popular ''compromise approach'' in bioethics-without downplaying the importance of health care professionals having a conscience or the moral complexity of their conscientious refusals. She begins with a description of what is at stake for the main parties to the conflicts generated by conscientious refusals in reproductive health care: the objector and the patient. Her central argument for the prioritizing approach is that health care professionals who are charged with gatekeeping access to services such as abortions are fiduciaries for their patients and for the public they are licensed to serve. As such, they have a duty of loyalty to these beneficiaries and must give primacy to their interests in gaining access to care. McLeod provides insights into ethical issues extending beyond the question of conscientious refusal, including the value of conscience and the fundamental moral nature of the relationships health care professionals have with current and prospective patients.

A study of the importance of self-trust for women''s autonomy in reproductive health. The power of new medical technologies, the cultural authority of physicians, and the gendered power dynamics of many patient-physician relationships can all inhibit women''s reproductive freedom. Often these factors interfere with women''s ability to trust themselves to choose and act in ways that are consistent with their own goals and values. In this book Carolyn McLeod introduces to the reproductive ethics literature the idea that in reproductive health care women''s self-trust can be undermined in ways that threaten their autonomy. Understanding the importance of self-trust for autonomy, McLeod argues, is crucial to understanding the limits on women''s reproductive freedom. McLeod brings feminist insights in philosophical moral psychology to reproductive ethics, and to health-care ethics more broadly. She identifies the social environments in which self-trust is formed and encouraged. She also shows how women''s experiences of reproductive health care can enrich our understanding of self-trust and autonomy as philosophical concepts. The book''s theoretical components are grounded in women''s concrete experiences. The cases discussed, which involve miscarriage, infertility treatment, and prenatal diagnosis, show that what many women feel toward themselves in reproductive contexts is analogous to what we feel toward others when we trust or distrust them. McLeod also discusses what health-care providers can do to minimize the barriers to women''s self-trust in reproductive health care, and why they have a duty to do so as part of their larger duty to respect patient autonomy.