Ostetricia 6a Lezione

Sesta lezione

Etica del feto e del neonato

La mamma adolescente

Caratteristiche delle “teenage mothers”

Dati da una ricerca canadese (1997)

“Motherhood at adolescence reduces the chances of pursuing one’s studies and getting a job and increases the risk of becoming a single parent and living in poverty. There is an increase in abortions and repeated abortions among young

women. However, the number of births among young women under age 20 is also higher”.

PREGNANT TEENS AND TEENAGE MOTHERS: A STATISTICAL PORTRAIT

Gouvernement du Québec Ministère de l’Éducation, 2001 http://www.mels.gouv.qc.ca/cond-fem/publications/portrait-24-a.pdf

Professional visionProfessional visionGoodwin, Charles (1994). "Professional Vision." American Anthropologist, 96(3): 606-633.

http://www.sscnet.ucla.edu/clic/cgoodwin/94prof_vis.pdf

La visione professionale (VP) è condivisa da una comunità di pratica(*) e dà luogo ad una mutua costituzione di attori, cose e comunità.

Infatti l'abilità professionale non è individuale, ma collettiva...

La VP consiste in tre fasi:

• Codifica

• Messa in evidenza

• Produzione di una rappresentazione materiale ed articolata

(*) vedi 5a lezione

Produrre rappresentazioni materiali ed articolate

“Resoconti visuali prodotti da tomografia computerizzata, ultrasuoni, scansioni PET ed immagini prodotte da risonanza magnetica non sono istantanee fotografiche della realtà, ma rappresentazioni di strutture e

funzioni metaboliche elaborate matematicamente”. (Hogle, 2008, p.847)

Hogle, L. 2008 “Emerging Medical Technologies” in (a cura di) Hackett, E. ed altri The Handbook of Science and Technology Studies, 3a ed., MIT Press, Cambridge (MA), pp.841-873.

Le immagini ad ultrasuoni sono entrate nell'esperienza e nella trajectory della gravidanza“Queste immagini sono usate anche in pubblicità e nelle campagne anti

aborto […] sono decontestualizzate, inquadrando l'autonomia del feto e quindi la sua personalità e creando l'immagine del feto come paziente e quindi della madre come grembo e incubatrice” (Burri & Dumit, 2008, p.307)

Burri, R.V.; Dumit, J. 2008 “Social Studies of Scientific Imaging and Visualization” in (a cura di) Hackett, E. ed altri The Handbook of Science and Technology Studies, 3a ed., MIT Press, Cambridge (MA), pp.297-317.

Immagini tratte da http://www.ob-ultrasound.net/frames.htm

http://www.phisick.com/a4rollholzhauer.htm

“Gli apparati non sono preesistenti o entità fisse; sono essi stessi costituiti attraverso particolari pratiche che sono

perpetuamente aperte a ri-arrangiamenti, ri-articulazioni, ad altre ri-elaborazioni. Questo è parte della creatività e difficoltà del fare scienza: avere la strumentazione che

funzioni in un particolare modo per un particolare intento”.(Barad, 2007, p.203)

da “Inseparabili” (1988) regia di David Cronenberg

“...nell'ultrasonografia ostetrica, il trasduttore piezo elettrico è un dispositivo prostetico per creare e ricreare i margini (inclusi quelli tra natura e cultura, umano e non umano, vivo e non vivo, visibile ed invisibile, autonomo ed indipendente, sé ed altro,...).” (Barad, 2007, p.201).

Barad, K. 2007 Meeting the Universe Halfway, Duke Press, Durham.

Il trasduttore piezo elettrico

Karen BaradPh.D. in theoretical particle physics.

Professor of Feminist Studies, Philosophy, and History of Consciousness at the University of California, Santa Cruz.

“I trasduttori piezo elettrici si materializzano (e sono iterativamente ri-materializzati) in intra-azioni con una moltitudine di pratiche, incluse quelle che includono necessità mediche; restrizioni progettuali (incluse quelle legali, economiche, biomediche, fisiche e di ingegneria); fattori di mercato; temi politici; altri progetti di R & D che usano simili materiali; il background specialistico dell'ingegnere e dello scienziato che hanno progettato il cristallo e l'ambiente di lavoro della ditta o del laboratorio; gli ambienti specifici dell'ospedale o della clinica dove la tecnologia è utilizzata; la recettività della tecnologia da parte della comunità medica e del paziente; costrizioni legali, economiche, culturali, religiose, politiche e spaziali sui suoi usi....”

(Barad, 2007, pp.203-204)

Ultrasonografia 3D

“Le immagini sono così naturali che portano l'osservatore a pensare che la rappresentazione dell'oggetto è isomorfica con l'oggetto stesso; l'immagine

sembra essere proprio quello che vedremmo con i nostri occhi, ma anche meglio”. (Barad, 2007, p.220)

Il “bimbo perfetto”: il problema etico relativo alla diagnosi (pre) fetale

“Despite all of medicine's advances--in genetic testing, prenatal diagnosis, and treatment--little headway has been made, from a statistical point of view, in preventing the majority of birth defects, notes Dr. Stephen Brown, co-director of the division of clinical genetics, assistant professor of obstetrics and gynecology, and director of the DNA diagnostic laboratory. "For a given individual, these advances can make all the difference in the world, but from a population or epidemiological point of view, we have not made major advances against preventing the majority of birth defects." Instead, he says, what has changed is American attitudes toward birth.[...]

"The advances in technology have been the source of a lot of enthusiasm, but what has really changed in the last 20 years is attitudes toward pregnancy," he says. "The average prospective parents in 1997 think it's their right to have a perfect baby and that [physicians] can tell if they're going to have a perfect baby. But by and large, we cannot." One of the most difficult genetic counseling issues medical professionals face, he says, is getting people to understand that having a baby always entails the risk of birth defects and mental retardation”.

FOURTH IN A SERIES By Devera Pine - Ethics in Medicine: Fetal Diagnosis and Treatment in P&S Journal: Spring 1997, Vol.17, No.2

http://www.cumc.columbia.edu/news/journal/journal-o/archives/jour_v17n2_0021.html

Monica Casperdirector of Women’s and Gender Studies and the associate professor of sociology at Vanderbilt University

1) Etica della chirurgia fetale.

2) Problematizzare le categorie di genere con il fenomeno dei nati intersex.

Etica della chirurgia fetale

"Fetal surgery has been seen largely as a pediatric issue, not a matter of women's health".

“We love medical miracles in this culture--especially at both ends of life".

"We're able to construct these tools that allow us to do amazing things, and medicine has done a very good job of promoting the idea that we can save lives this way. But with each of these 'medical miracles,' there is a downside."

Fetal surgeons view the fetus as the patient, but does that mean the fetus is a person, asks Casper. What about the woman's role as patient? Could mothers be forced to undergo the procedure against their will? Like interventions at the end of life, does it make sense to try to save the life of an impaired fetus at all costs, financial and otherwise? What if the best surgical outcome is a severely disabled infant?

http://review.ucsc.edu/winter.99/miracle_or_menace.html

Le politiche della normalizzazione del genere alla nascita

Genital Fixations by Monica J. Casper and Courtney Muse on March 16, 2006

http://nsrc.sfsu.edu/article/genital_fixations_intersex

“The term "intersex" refers to conditions in which an individual’s anatomy—specifically genitalia but also other characteristics such as chromosomes and internal sexual/reproductive anatomy—is defined as “ambiguous” or atypical for that person’s sex, or in which there is a specific type of endocrinological deficiency or imbalance. Anatomical dissimilarity may appear at birth (and may even be diagnosed before birth), but also can sometimes appear later in a person’s life, for example at puberty. There is considerable variation among definitions of intersex used by doctors, scientists, and laypersons. The intersex patient rights movement and feminist scholars have advanced the idea that intersex, like other concepts related to sex and gender, is constructed and contested. That is, while intersex conditions may be based in “nature” through the actions of genes and hormones, our understanding of the significance of these conditions is social, cultural, and political”.

[…]

“We suggest that not treating fetuses with atypical genitalia is a viable clinical option, and, moreover, that it is a deeply moral approach to the enduring “problem” of anatomical differences”.

My Life as an Intersexualby Max Beck

http://www.pbs.org/wgbh/nova/gender/beck.html

When I was born, the doctors couldn't tell my parents what I was: They couldn't tell if I was a boy or a girl.

[…]

"Feed the baby every two hours, burp well after feeding, and raise it female."

[…]

What was I? The doctors and surgeons assured me I was a girl, that I just wasn't yet "finished." I don't think they gave a thought to what that statement would mean to me and my developing gender identity, my developing sense of self. The doctors who told me I was an "unfinished girl" were so focused on the lie—so invested in selling me "girl"—that I doubt they ever considered the effect a word like "unfinished" would have on me.