This thesis is about potentiality theory and the right to life. It is an attempt to distil the potentiality position into its strongest incarnation in order to see what it has to offer. In Chapter I various attempts to discredit potentiality theory are examined. Particular emphasis is placed on Michael Tooley's defense of abortion and infanticide and his critique of potentiality theory. It is concluded that a well articulated potentiality position need not lead to any obvious absurdity, and can resist the charge of philosophical arbitrariness. Thus, the potentiality position is a legitimate contender in the right to life dispute. In Chapter II, we ask the question whether the potential to become a person is sufficient for the right to life, or is actual personhood necessary? Various attempted resolutions are considered and rejected. It is concluded that the issue is still quite debateable but that some support for the potentiality position can be found in a Rawls-type validation procedure. / Arts, Faculty of / Philosophy, Department of / Graduate

The study was motivated by studies which have revealed that teenage pregnancy, maternal mortality and unsafe abortion are high in Lesotho. The purpose of the study was to examine whether or not lack of access to emergency contraception as one of the essential forms of contraception could be the reason for the aforementioned health challenges facing adolescent girls in Lesotho. The study was a desktop review with content analysis of documents applicable to the health of adolescents and those relating to access to family planning services for adolescent girls. The woman question was used as a tool for ascertaining whether the health rights of adolescent girls are fulfilled by Lesotho. The legal framework relevant to access to emergency contraception was also scrutinised to ascertain whether they are compliant with human rights treaties ratified by Lesotho. The study is also a comparative analysis of Lesotho's policy frame with South Africa. From the analysis of the literature review, the study uncovered how religious, cultural practices and some areas of the laws relevant to access to emergency contraception for adolescents were not responsive to the female adolescent question, thereby perpetuating infringement of various human rights belonging to adolescent girls. The study also revealed that lack of political will and poor coordination and monitoring of policies, budgetary deficiencies and shortages in human resources are some of the factors inhibiting adolescent's realisation of their full access to family planning services. The study made recommendations which the Government of Lesotho could use to change the current state of access of adolescent girls to emergency contraception. / tm2017 / Centre for Human Rights / LLM / Unrestricted

Magister Curationis - MCur / The legislation of abortion in many countries, allowing women the right to decide to terminate pregnancy, has introduced an unfamiliar situation to the medical professionals, especially nurses and doctors who are the implementers of the legislation.

Background: Millions of women in the United States seek out an abortion each year and about one in three women will have obtained an abortion within her reproductive lifetime. Abortion affects millions of women and although it is a highly controversial subject, there is a universal concern for women’s health. Currently, mandatory data reporting services do not exist in the United States, making it difficult for researchers to comprehensively study the impact of abortion on women’s health. Methods: A review of the relevant legal and medical literature was completed in an attempt to present the physical, mental and psychosocial health effects of induced abortion on women. Results: Early pregnancy termination is safe for women relative to other common medical procedures, but is a risk factor for future pregnancy complications such as pre-term birth, placenta previa and low birth weight. Correlative studies have found increasing evidence that pregnancy termination is associated with psychological distress and may be related to increased substance abuse and other harmful behaviors. Legislature and social stigma surrounding abortion and non-marital pregnancy has noticeable effects on women’s mental health, sexual behavior, contraceptive use and relationships. Conclusion: Public discourse on abortion generally centers on a women’s right to choose versus a fetal right to life, however the aspect of women’s health should also be considered in the discussion. Future abortion legislation must be informed by the medical literature. Currently, there is no rigorous method of data collection for abortion statistics, which can make it difficult to study its effect. Policies vary so widely across the country, that it can be burdensome for women experiencing crisis pregnancies to make informed decisions for their health. There is evidence to suggest that there are negative long-term physical effects of previously induced abortions on subsequent pregnancies. Abortion can also have negative psychological impacts on women, which can be compounded by inadequate pre-abortion counseling. While some studies show no difference between long-term stress levels of women who chose abortion compared to women who carried unintended pregnancy to term, more research comparing the two outcomes could shed light on the issue. Abortion legality and practice may also have negative psychosocial effects on relationships, sexual behavior and perpetuate or be affected by stigmas. This project encourages the continuation of academic inquiry into all aspects of the effects of abortion on women’s health, particularly in the realms of mental and psychosocial impact where it is more difficult to establish a causative relationship between variables.

Please note: creative writing theses are permanently embargoed in OpenBU. No public access is forecasted for these. To request private access, please click on the locked Download file link and fill out the appropriate web form. / Play / 2031-01-01

Student Number : 0353470 - MA research report - School of Philosophy - Faculty of Humanities / The South African Choice on Termination of Pregnancy Act 92 of 1996 is regarded as one of the most liberal abortion laws in the world. It aims to uphold the rights of women as equal citizens, give effect to their rights to reproductive healthcare and redress past discriminatory legislation. Conscientious objection by healthcare providers to terminating pregnancies is also allowed in terms of the act. This research report considers the justification for the right of conscientious objection by the healthcare provider in the face of the conflicting claims of a pregnant woman seeking abortion. There are good reasons for a pregnant woman’s right to terminate pregnancy, just as they exist for the healthcare provider who objects, on grounds of conscience, to involvement in the process. I will attempt to balance these sets of rights, weigh priorities, and offer possible solutions. A focus on the unique value of each individual demands that each one be accorded dignity and respect. Thus ways of minimizing conflict are explored. Though compromise may be required, it is important that healthcare workers have the freedom to live their lives with integrity.

M.Med. in Community Health, Faculty of Health Sciences, University of the Witwatersrand, 2011 / Introduction Three public health interventions well known to decrease the risks associated with pregnancy and child birth are access to maternity care, family planning and contraception, and safe abortion. Worldwide, the African region has the highest case fatality rate associated with unsafe abortion 750 per 100 000, largely as a result of restrictive abortion laws. South Africa (SA) legalised abortion in 1996 with the “Choice on Termination of Pregnancy” (CTOP) Act. It sought to improve the quality and access to termination of pregnancy (TOP) services in SA. Since its enactment there has been a 91% decrease in deaths due to unsafe abortions. There have been some experienced challenges associated with the implementation of the Act, limited number of functional TOP facilities, prolonged waiting times, and negative attitudes of TOP providers to clients. After more than a decade of liberalised law in SA, what are TOP providers’ perceptions, clients’ experiences and the overall quality of TOP services? Main Aim The evaluation of TOP services in the urban Johannesburg Metropolitan Municipality (JHB), Gauteng Province, and two rural municipalities Bela-Bela Municipality, Limpopo Province and Mangaung Municipality, Free State Province. Methodology A mixed methods approach was adopted; both quantitative and qualitative data were collected in three sections. Included were all primary health care facilities offering first trimester TOPs in the Johannesburg Metropolitan, Mangaung, and Bela-Bela Municipalities. Section I the analysis of district health information management system (DHIS) data for JHB. Section II, TOP providers and TOP clients completed self-administered questionnaires. Section III the TOP clients from JHB were questioned again after eighteen months. Various parametric and non-parametric tests were conducted on the data, based on the data distribution. The statistical software used for quantitative data analyses was Stata release 10.0 and qualitative data MAXQDA release 10.0. Results The DHIS showed a 61% increase in TOP requests from 2006 to 2009 (Chi-square for trend; P=0.08). The number of first trimester procedures performed only addressed 40% of total requests in 2006 and 33% of total requests in 2009. Section II demonstrated that all the TOP providers reported not coping with their duties, only two (15%) providers were comfortable with administering TOPs. One hundred and fifty-two TOP clients were recruited into the study. The mean age was 26.00 (±6.03) years. One hundred and sixteen (76%) women were not using contraception. Clients from JHB had prolonged waiting times 14 days (IQR; 6-28) compared to Bela-Bela clients’ 3 days (IQR; 1-6) (Post-hoc Wilcoxon- Ranksum; P<0.0001). Hence clients from JHB had TOPs at later median gestational ages of 9 weeks (IQR; 8-11) and Bela-Bela clients at 7.5 weeks (IQR;4-8) (Post-hoc Wilcoxon Ranksum; P<0.0001). Knowledge of the CTOP Act exceeded seventy percent across all three municipalities (Pearson Chi-square; P=0.83). Section III identified that 39% (n=9) of interviewed clients experienced a TOP-related complication. The odds of experiencing a complication was decreased if client received a follow-up appointment (OR 0.12; 95% CI 0.02-1.51; P=0.02), if client was aware of the CTOP Act (OR 0.11; 95% CI 0.01-2.08; P=0.06), and clients that had attended Lenasia South CHC had odds of complication 8 times higher than clients who had presented to Bophelong clinic (OR 8.68; 95% CI 3.47 -21.7; P<0.0001). The qualitative analysis identified themes of an association with intra-procedural pain and perceived inadequate counselling with those reporting emotional distress. Discussion The prevalence of contraceptive use during the month of conception was low, and the majority of clients were unaware of the correct gestational age for termination of pregnancy according to the CTOP Act. This suggests that the pre-TOP services required strengthening. The TOP services in the public sector may not to be addressing the number of TOP requests; this affects the availability of the service. TOP providers in different South African settings report similar challenges associated with delivering TOP services. The clients from JHB are waiting longer for the TOP and hence having the abortion at later gestational ages which are associated with increased complications rates. The study estimated a complication rate of approximately 26 per 100 abortion clients, higher than acceptable global rates which approximate 3 per 100. The improvement of pre and post-TOP counselling was highlighted. Conclusion This study introduces the importance of passive surveillance in improving the quality of service delivery. Though this is only achieved when data collected are analysed and used to inform policy and service. The studies conducted in South Africa since the CTOP Act enactment has demonstrated various challenges and areas for improvement. These findings have ensured that issues of public health importance continue to be studied and relevant findings disseminated to stakeholders for and consideration and action where appropriate.

The following work presents the ongoing philosophical debate regarding the use of biotechnology to improve human capabilities and attempts to apply the insights drawn from these debates to the regulation of non-medical uses of reproductive technology. After presenting the criticisms towards a hardline approach that would ban all attempts to enhance humans, we evaluate various alternative frameworks and adopt a framework called Genetic Justice, which can be understood as an application of Rawlsian distributive justice to biological assets. After improving on this moral framework by incorporating various institutional considerations into it, we apply it to the evaluation of non-medical uses of a screening technique called preimplantation genetic diagnosis and propose recommendations for its regulation.

Prostaglandin E 2 vaginal suppositories are a highly effective method of second-trimester pregnancy termination. Management of a failed prostaglandin abortion must include a search for the cause of the failure. This case report is the first description of a failed prostaglandin abortion associated with placenta accreta.

Post-abortion support groups are a new sub-movement or strategy of the broader anti-abortion movement that provide support to women who understand their prior abortions as problematic. These groups construct abortion as a form of trauma that causes post-abortion syndrome (PAS), a broad array of negative mental health and behavioral problems similar to post-traumatic stress disorder. Although these claims are not substantiated by empirical evidence, claims that abortion causes PAS are increasingly featured in the public domain to bolster national anti-abortion claims that abortion represents a public health issue. A majority of PAS support groups are offered by crisis pregnancy centers (CPCs) affiliated with one of two national pregnancy resource centers whose approach to healing from abortion reflects the increased presence and influence of evangelical women in the CPC movement. The increased presence of evangelical women in the CPC movement is reflected in the growing influence of conservative Christian beliefs in the support services offered by CPCs in general and PAS groups specifically. This research examined a PAS group in Mississippi sponsored by an evangelical CPC affiliated with Care Net, a national pregnancy resource center, to understand the motivations of women who participate in a PAS group, how PAS group participation shapes participants’ understandings of abortion to conform to broader anti-abortion claims that abortion is a public health issue, and how PAS claims are diffused into the public domain. To discern the relationship between PAS groups and broader anti-abortion claims, I analyze state and national media coverage of the 2011 Mississippi political campaign in which voters overwhelmingly defeated a constitutional amendment to pass a personhood amendment to confer legal status to the fetus. Together these analyses show how evangelical groups are working through legislative and individual-level processes to shape the abortion debate and climate in contemporary American society.