M.Sc. (Med.) (Bioethics and Health Law), Faculty of Health Sciences, University of the Witwatersrand, 2009 / This study set out to perform an ethical-legal analysis of the current practices across the seven public health centres in South Africa that perform feticide for congenital abnormalities. Ideally, such decisions need to be guided by multidisciplinary discussions with the parent(s) and the parties included in the team, e.g. Obstetricians, Neonatologists, Nursing, Genetics counsellors and Social Workers and following the ethical principles of beneficence and respect for autonomy. Prior to the study, it was unknown as to whether all seven centres were using multidisciplinary groups in the decision-making process and on what basis approvals were being granted for feticide. The objectives of the review were to assess the number of feticides performed, who made the decision to offer the feticide and for what ethical or clinical indications. The results showed that all public health facilities in South Africa differed in the criteria that were used in making the decision to offer feticide. The clinicians varied in terms of who was represented in the team that reviewed the cases of congenital abnormalities. An analysis of the literature, together with a review of the data received on the current practices, guided the development of an ethical guideline for this service as well as making recommendations as to how the law could be strengthened in order to protect both health workers and patients.

Purvi Patel is an Indian American woman who, in 2015, was the first U.S. citizen to be convicted under feticide statutes for allegedly attempting her own abortion. Though her 2015 conviction was overturned the same year, the feticide conviction was significant as a legal precedent as well as part of a larger trend criminalizing pregnant women of color. With an eye towards the greater pattern of the criminalization of other pregnant women of color (Boyd, 1999; Faludi, 1991; Humphries, 1999; Mahan, 1996; Roberts, 1997), in this thesis I employ a feminist legal studies methodology and the theoretical frameworks of intersectionality (Crenshaw, 1989, 1991) and Reproductive Justice (Ross and Solinger, 2017; Silliman et al., 2004) to analyze five pro-Patel briefs, two from Patel’s appellate lawyers and three from amici curiae. The four themes present are: fetal personhood; racialized gender; medical privacy and trust; and surveillance, knowledge, and legitimacy. I argue these briefs were not always consistent with the tenets of intersectionality and Reproductive Justice, even as the briefs may have been effective in convincing the Court of Appeals to overturn Patel’s conviction. I conclude with a discussion of the implications of Patel’s case for public health and law. I suggest that criminalization of abortion is harmful to public health and that the feticide mandate as it stands now does not do what it was intended to do, which is to protect the pregnant woman from harm.