If a pregnant woman refuses medical treatment needed by the fetus - for instance for religious reasons - or conducts some aspect of her life in a way which risks fetal harm, there may arise an instance of "maternal-fetal conflict". This is an unfortunate term, since pregant women are generally renowned for their self-sacrificing behaviour, but it may well reflect the reality of certain maternal choices and actions. Should a pregnant woman have the legal right to refuse medical treatment needed by the fetus, or should she owe it a legal duty of care which precludes her acting in ways which may harm it? Does the debate hinge simply upon the appropriateness, or otherwise, of legally compelling presumed moral obligations, or is it more complex than this? Indeed, what are a pregnant woman't moral obligations towards her fetus? In England and in some US states, courts have held that a pregnant woman has the right to refuse medical treatment needed by the fetus. In similar fashion, the idea of a general maternal legal duty of care toward the fetus has been rejected, most recently in Canada. The cases, however, leave the impression of an uncomfortable split between the ethics and the law, as if the problem were entirely one of not legally enforcing presumed moral duties. The effect is both puzzling and polarising: puzzling in that the cases leave unanswered - as largely they must - the huge question of a pregnant woman's moral rights and duties; polarising in that the cases leave troubling tensions about a pregnant woman's rights in the face of fetal harm or death. The tendency is to deny these by ever more strongly asserting a woman's rights. In turn this encourages a reaction in favour of fetal rights, one which is unlikely to attend to a woman's interests and difficulties in pregnancy. This could have serious legal repercussions for various instances of maternal-fetal conflict, including in those US states or other jurisdictions which have yet to address these issues. It might also increase the pressures on the issue of abortion. This book, which seeks a way between these polarised positions, tries to explain and justify a woman's moral and legal rights in pregnancy and, at the same time, to explore the extent of her moral duties toward the fetus. The aim is to resolve, as far as possible, the ethical, legal and social tensions which undoubtedly surround this area. Innovatively in work on this issue (and unusually in the field of medical law and ethics) the author adopts a joint philosophical and legal approach directed to issues both of principle and policy, revealing strong conceptual links between the ethics and the law. In addition to an ethical exploration of the maternal-fetal relationship, the author explores and analyses the relevant English, American, Canadian (and sometimes Australian) arguments from the law of treatment refusal, abortion, tort and rescue, as well as relevant jurisprudence from the European Court of Human Rights. This important book breaks new ground and will be of great interest to academics in law and philosophy, lawyers, health professionals, policy-makers and students of medical law and ethics. "It is rare to find a book which so skilfully combines legal and moral analysis of a controversial medical issue. Rosamund Scott has produced what is undoubtedly one of the finest pieces of medico-legal writing of recent years. This is a clever, human and immensely readable work." Alexander McCall Smith, Professor of Medical Law, University of Edinburgh "This book concerns one of the most personally agonizing and morally complex issues in medical ethics. It is a work of great philosophical sophistication, combining breadth of vision with acute sensitivity to the nuances of women's experiences. It will soon become the standard work in philosophical, legal and political debate on maternal-fetal conflicts." Roger Crisp, Uehiro Fellow and Tutor in Philosophy, St Anne's College, Oxford

To what extent should parents be able to choose the kind of child they have? The unfortunate phrase 'designer baby' has become familiar in debates surrounding reproduction. As a reference to current possibilities the term is misleading, but the phrase may indicate a societal concern of some kind about control and choice in the course of reproduction. Typically, people can choose whether to have a child. They may also have an interest in choosing, to some extent, the conditions under which they do so, such as whether they have a child with a serious disability or disease. The purpose of this book is to explore the difficult and controversial question of the appropriate ethical and legal extent of reproductive autonomy in this context. The book examines ethical, legal and public policy issues in prenatal screening, prenatal diagnosis (PND), selective abortion and preimplantation genetic diagnosis (PGD). It explores the ethics of these selection practices and the ability of current ethical guidelines and legal mechanisms, including the law on selective abortion and wrongful birth, to deal with advances in genetic and other knowledge in these areas. Unlike in the United States, in England the relevant law is not inherently rights-based, but the impact of the Human Rights Act 1998 inevitably raises questions about the proper scope of reproductive autonomy in this context. The implications of the analysis are considered for the development of relevant law, public policy and ethical guidelines and will be of interest to academics in medical law and ethics, health professionals, lawyers, those working on public policy and students with an interest in these issues.

The emergence of new empirical evidence and ethical debate about families created by assisted reproduction has called into question the current regulatory frameworks that govern reproductive donation in many countries. In this multidisciplinary book, social scientists, ethicists and lawyers offer fresh perspectives on the current challenges facing the regulation of reproductive donation and suggest possible ways forward. They address questions such as: what might people want to know about the circumstances of their conception? Should we limit the number of children donors can produce? Is it wrong to pay donors or to reward them with cut-price fertility treatments? Is overseas surrogacy exploitative of women from poor communities? Combining the latest empirical research with analysis of ethics, policy and legislation, the book focuses on the regulation of gamete and embryo donation and surrogacy at a time when more people are considering assisted reproduction and when new techniques and policies are underway.

The emergence of new empirical evidence and ethical debate about families created by assisted reproduction has called into question the current regulatory frameworks that govern reproductive donation in many countries. In this multidisciplinary book, social scientists, ethicists and lawyers offer fresh perspectives on the current challenges facing the regulation of reproductive donation and suggest possible ways forward. They address questions such as: what might people want to know about the circumstances of their conception? Should we limit the number of children donors can produce? Is it wrong to pay donors or to reward them with cut-price fertility treatments? Is overseas surrogacy exploitative of women from poor communities? Combining the latest empirical research with analysis of ethics, policy and legislation, the book focuses on the regulation of gamete and embryo donation and surrogacy at a time when more people are considering assisted reproduction and when new techniques and policies are underway.