Between relational autonomy and trust. On the moral meaning of the family in reproduc-tive medicine and obstetrics (13 to 15. July 2011)

The Workshop was divided into three parts, which will be further explained below.

Part I: Medicalization and moral claims.
The starting point of the workshop is the observation of a growing medicalization of human re-production and birth. This medicalization also generates moral claims: There are risks to be avoided or to be eradicated and in turn responsibilities to be taken towards the (desired or un-born) child. Because of medical progress, more decisions can be made concerning reproduction and child birth. These decisions have to be made „correctly“. The process of social and political norm setting defines what makes a „good mother“ and a „good father“. By regulating the poten-tials of the body and bodily functions kinship relations gain a new moral quality because “good parents” are defining themselves on the basis of their decisions in minimizing the risks for the (desired or unborn) child. PID, PND, Sectio Caesarea, but also breast feeding or allergy prophy-laxis are examples for techniques of medical origin or with medical background but they are also, health policy related techniques which shape moral conceptions about “responsible parenthood” in society. In view of the development of (new) reproductive technologies, the legislator has to decide whether and how far access to medical assistance must, should or may be regulated or prohibited in view of safeguarding other legitimate interests. In addition the law has to define which relations between persons amount to family relations in the legal sense, which persons even outside these family ties should have rights or responsibilities towards other persons similar to positions of members of the legal family. The law operates on the borderline of social-political conceptions of family and ethical considerations on the family.

Part II: Surrogate motherhood and same-sex families.
If the interrelation of the biological link and the social family becomes flexible, social, political and legal norms might be disturbed. This can work in two directions: Either the biological structure of the family can be expanded. Surrogate motherhood is considered as the most common example alongside with AID (artificial insemination by donor). Or: the concept of family can be expanded towards solely social relationships. Same-sex couples with children might be taken as an exam-ple with especially “unusual” family relations – not easy to align with existing norms. This can either result in the expansion of social, political or legal norm setting practices: a process which would not affect the existing conceptions of the moral quality of the family. Conversely, surrogate motherhood and same-sex families could also be the starting point of questioning the moral quality of the family as commonly understood, because in those practices the disentanglement of biological link and social relationship becomes visible.

Part III: Relational autonomy and trust.
Enquiring the common moral understanding of the family critically from a philosophical-ethical point of view will be the subject matter of the last part of the workshop. The discussion will con-centrate on two topics. Firstly, in the above mentioned situations, the notion of autonomy in par-enthood is reduced to decision making or free choice. Such notion of autonomy ignores dimen-sions of relationality and dependencies on others, as well as aspects of recognition. Secondly, moral responsibility in parenthood is reduced to risk avoidance. In the alternative, a notion of responsibility can put a certain stance towards other persons characterized by trust. The moral quality of the family would be newly identified in an expanded notion of relational autonomy and in trust.

Der Workshop was initiated by Fellow Dr. Susanne Braune and Prof. Dr. Claudia Wiesemann and Dr. Katharina Beir (Department of Medical Ethics and History of Medicine at the University Medical Center Goettingen)