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Twin pregnancy, fetal reduction and the 'all or nothing problem’
  1. Joona Räsänen1,2
  1. 1Department of Philosophy, Classics, History of Art and Ideas, University of Oslo, Oslo, Norway
  2. 2Faculty of Social Sciences, Tampere University, Tampere, Finland
  1. Correspondence to Mr Joona Räsänen, Department of Philosophy, Classics, History of Art and Ideas, University of Oslo, Oslo 0315, Norway; joona.rasanen{at}ifikk.uio.no

Abstract

Fetal reduction is the practice of reducing the number of fetuses in a multiple pregnancy, such as quadruplets, to a twin or singleton pregnancy. Use of assisted reproductive technologies increases the likelihood of multiple pregnancies, and many fetal reductions are done after in vitro fertilisation and embryo transfer, either because of social or health-related reasons. In this paper, I apply Joe Horton’s all or nothing problem to the ethics of fetal reduction in the case of a twin pregnancy. I argue that in the case of a twin pregnancy, there are two intuitively plausible claims: (1) abortion is morally permissible, and (2) it is morally wrong to abort just one of the fetuses. But since we should choose morally permissible acts rather than impermissible ones, the two claims lead to another highly implausible claim: the woman ought to abort both fetuses rather than only one. Yet, this does not seem right. A plausible moral theory cannot advocate such a pro-death view. Or can it? I suggest ways to solve this problem and draw implications for each solution.

  • abortion
  • embryos and fetuses
  • ethics
  • reproductive medicine
  • artificial insemination and surrogacy
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Footnotes

  • Contributors JR is the sole author of this work.

  • Funding This study was funded by UiO Life Science Convergence Project: epigenetics and bioethics of human embryonic development.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.

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