This document discusses several topics related to fetal and neonatal ethics: 1) It examines the characteristics of teenage mothers based on Canadian research, noting increased risks of poverty and single parenthood. 2) It discusses the professional vision of medical imaging techniques and how they produce articulated representations rather than photographs of reality. 3) It problematizes the categories of gender through the phenomenon of intersex births and policies of normalizing gender through early surgery.

1. Sesta lezione
Etica del feto e del neonato

2. La mamma adolescente

3. 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

4. Professional vision
Goodw in, Charles (1994). "Professional Vision." A merican A nthropologist, 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

5. 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.

6. 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)
Immagini tratte da http://www.ob-ultrasound.net/frames.htm
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.

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

8. Il trasduttore piezo elettrico
“...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.

9. Karen Barad
Ph.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)

10. 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)

11. 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

12. Monica Casper
director 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.

13. Etica della chirurgia fetale
http://review.ucsc.edu/winter.99/miracle_or_menace.html
"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?

14. 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”.

15. My Life as an Intersexual
by 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.