Even if the fetus is not a person,abortion is immoral: The impairment argument

Much of the debate about the ethics of abortion has centered on whether the fetus is a person. In an attempt to sidestep this complex issue, I argue that, even if the fetus is not a person, abortion is immoral. To arrive at this conclusion, I argue that giving a fetus fetal alcohol syndrome is immoral, and that if this is so, then killing the fetus is immoral. Roughly, this is because killing the fetus impairs it more than giving it fetal alcohol syndrome. Since abortion (in most cases) amounts to killing the fetus, this means that abortion (in most cases) is immoral. I defend the premises of this argument against a plethora of objections, concluding that they either do not work, or commit their proponent to a controversial position.     

The impairment argument for the immorality of abortion: A reply

In his recent article Perry Hendricks presents what he calls the impairment argument to show that abortion is immoral. To do so, he argues that to give a fetus fetal alcohol syndrome is immoral. Because killing the fetus impairs it more than giving it fetal alcohol syndrome, Hendricks concludes that killing the fetus must also be immoral. Here, I claim that killing a fetus does not impair it in the way that giving it fetal alcohol syndrome does. By examining the reason why giving a fetus this condition is wrong, I conclude that the same reasoning, on common pro‐choice accounts, does not apply to killing the fetus. Accordingly, Hendricks's argument does not succeed in showing abortion is immoral.     

药械联合终止早孕的临床研究

目的：探讨药物联合负压吸宫术对哺乳期妊娠流产的有效性及安全性。方法：选择200例哺乳期早期妊娠妇女随即分为药械联合终止早孕组（药械联合组）和负压吸宫术终止早孕组（负压吸宫组）,比较两组间各临床指标。结果：药械联合组I级、II级、III级疼痛评价均较负压吸宫组明显降低（P〈0．05）。两组在完全流产率和不全流产率上差异均无统计学意义（P〉0．05）。药械联合组宫腔吸出组织量（2．48＋0．77）mL明显高于（12．11±4．23）mL（P〈0．05）。两组术后均无感染、闭经、器械性损伤和宫腔或宫颈粘连等并发症发生。结论：药械联合终止早孕有效、安全,疼痛及刮宫程度较轻。     

Avoiding the Personhood Issue: Abortion,Identity, and Marquis's ‘Future‐Like‐Ours’ Argument

One reason for the persistent appeal of Don Marquis' ‘future like ours’ argument (FLO) is that it seems to offer a way to approach the debate about the morality of abortion while sidestepping the difficult task of establishing whether the fetus is a person. This essay argues that in order to satisfactorily address both of the chief objections to FLO – the ‘identity objection’ and the ‘contraception objection’ – Marquis must take a controversial stand on what is most essential to being the kind of entity that an adult human being is. Such a stand amounts to a controversial account of personhood. To the extent that FLO's success depends on accepting such a controversial metaphysical view, one apparent attraction of FLO proves illusory.     

Polymicrogyria in fetal alcohol syndrome

BACKGROUND: Intrauterine exposure to alcohol may result in a distinct pattern of craniofacial abnormalities and central nervous system dysfunction, designated fetal alcohol syndrome (FAS). The spectrum of malformations of the brain associated with maternal alcohol abuse during pregnancy is much broader than the relatively uniform clinical phenotype of FAS. Among these malformations the most striking abnormalities involve the impairment of neuronal cell migration. However, polymicrogyria (PMG) has so far been reported only once in a human autopsy study of a child with FAS. CASE: A 16‐year‐old girl with confirmed maternal alcohol consumption during pregnancy and full phenotype of FAS presented after two generalized epileptic seizures for neurologic assessment. Cranial magnetic resonance imaging revealed bilateral PMG in the superior frontal gyrus with asymmetric distribution. History, clinical features, and genetic investigations provided no evidence for any of the known genetic or acquired causes of PMG. Therefore, we propose that prenatal alcohol exposure is the cause of PMG in this patient rather than a mere coincidence. CONCLUSION: Our observation represents only the second patient of PMG in FAS and confirms the phenotypic variability of cerebral malformations associated with maternal alcohol abuse during pregnancy. In patients with clinical features of FAS and neurologic deficits or seizures neuroimaging is recommended. Furthermore, FAS should be considered as a differential diagnosis for PMG. Birth Defects Research (Part A), 2010. © 2009 Wiley‐Liss, Inc.     

The effects of alcohol on fetal development

Prenatal exposure to alcohol has profound effects on many aspects of fetal development. Although alterations of somatic growth and specific minor malformations of facial structure are most characteristic, the effects of alcohol on brain development are most significant in that they lead to substantial problems with neurobehavioral development. Since the initial recognition of the fetal alcohol syndrome (FAS), a number of important observations have been made from studies involving both humans and animals. Of particular importance, a number of maternal risk factors have been identified, which may well be of relevance relative to the development of strategies for prevention of the FAS as well as intervention for those who have been affected. These include maternal age >30 years, ethnic group, lower socioeconomic status, having had a previously affected child, maternal under-nutrition, and genetic background. The purpose of this review is to discuss these issues as well as to set forth a number of questions that have not adequately been addressed relative to alcohol's effect on fetal development. Of particular importance is the critical need to identify the full spectrum of structural defects associated with the prenatal effects of alcohol as well as to establish a neurobehavioral phenotype. Appreciation of both of these issues is necessary to understand the full impact of alcohol on fetal development.     

Obesity Increases the Risk of Spontaneous Abortion during Infertility Treatment

Objective: This study examines the relationship between body mass and the risk of spontaneous abortion in a large cohort of patients who received infertility treatment. Research Methods and Procedures: This is a retrospective study using data on pregnancies (n = 2349) achieved after treatment in a tertiary medical center from 1987 to 1999. One pregnancy per subject was included, and the subjects were stratified into five body mass groups based on body mass index (BMI): underweight, <18.5 kg/m²; normal, 18.5 to 24.9 kg/m²; overweight, 25 to 29.9 kg/m²; obese, 30 to 34.9 kg/m²; and very obese, ≥35 kg/m². Logistical regression analysis was used. Results: The overall incidence of spontaneous abortion was 20% (476 of 2349). The effect of BMI on the risk of spontaneous abortion was significant after adjusting for several independent risk factors. Compared with the reference group (BMI 18.5 to 24.9 kg/m²), underweight women had a similar risk of spontaneous abortion, whereas there was progressive increase of risk in overweight, obese, and very obese groups (p < 0.05, p < 0.01, and p < 0.001, respectively). Discussion: Of all known risk factors for spontaneous abortion, the control of obesity has great significance because it is noninvasive, potentially modifiable, possibly amenable to low cost, and self‐manageable by patients. This study established a positive relationship between BMI and the risk of spontaneous abortion in women who became pregnant after assisted reproductive technology treatment.     

Bax/Bcl-2 mRNA在恒河猴药物流产胎盘中的表达

目的：通过检测重要的细胞凋亡调节因子Bax和Bcl-2的表达,探讨恒河猴胎盘细胞凋亡与药物流产的关系。方法：利用RT-PCR和原位杂交的方法检测恒河猴对照组和药物流产组(RU-486与AG诱导)胎盘中Bax和Bcl-2mRNA的表达。结果：Bax mRNA在流产胎盘中的表达量明显高于对照组胎盘。在胎盘绒毛滋养层细胞可见明显表达,基底层蜕膜细胞也有表达。Bcl-2mRNA在流产胎盘中的表达量明显低于对照组胎盘,表达部位与Bax类似。结论：RU-486和AG可能通过上调Bax mRNA和下调Bcl-2mRNA的表达,导致胎盘组织凋亡细胞的数量明显增加,从而影响胎盘的正常结构和功能,增加了流产的危险性。     

Violinists,demandingness, and the impairment argument against abortion

The ‘impairment argument’ against abortion developed by Perry Hendricks aims to derive the wrongness of abortion from the wrongness of causing foetal alcohol syndrome (FAS). Hendricks endorses an ‘impairment principle’, which states that, if it is wrong to inflict an impairment of a certain degree on an organism, then, ceteris paribus, it is also wrong to inflict a more severe impairment on that organism. Causing FAS is wrong in virtue of the impairment it inflicts. But abortion inflicts an even more severe impairment (death), and so, ceteris paribus, is also wrong. Notably, Hendricks thinks that this argument does not require the claim that the foetus is a person. Here, I respond to Hendricks by arguing that the ceteris paribus clause of the impairment principle is not met in ordinary cases of pregnancy. Carrying an unwanted pregnancy to term is much more burdensome than is refraining from excessive drinking for nine months. This provides a pro tanto justification for obtaining an abortion that does not apply to causing FAS. If the foetus is not a person, it seems fairly clear to me that this justification is strong enough to render abortion permissible. Hendricks is therefore incorrect in claiming that the impairment argument can go without claims concerning foetal personhood. If the foetus is a person, then whether burdensomeness justifies abortion depends on certain questions relating to Thomson’s famous violinist argument. I will not attempt to answer those. But anyone who is otherwise sympathetic to Thomson’s argument should not be moved by the impairment argument.     

妊娠早期流产的阴道超声影像表现及与血清瘦素、ADAM12、CA-125水平的相关性研究

摘要 目的：探讨妊娠早期流产的阴道超声影像表现及与血清瘦素、融合素 -α（ADAM12）、糖类抗原 -125（CA-125）的相关性。方法：选取 2017年 7月 -2020年 9月于我院就诊的 419例具有早期先兆流产征象的孕妇患者,按妊娠结局分为妊娠早期流产组（流产组,61例）和正常早期妊娠组（正常组,358例）。所有患者均进行阴道超声检查,观察卵黄囊的大小和形态。测定胎儿冠臀长（CRL）、胎囊直径（GSD）、卵黄囊直径（YSD）和胎心率（FHR）。同时检测患者血清瘦素、ADAM12、CA-125水平。采用 Spearman秩相关分析评价阴道超声影像学表现与血清瘦素、ADAM12、CA-125水平的相关性。结果：正常组孕妇超声影像表现可见孕囊形态饱满,孕周和胎芽大小相符,可清晰显示原始心管、卵黄囊和胎心波动。流产组孕妇部分超声影像表现可见卵黄囊过大、过小或未见显示,胎芽略小,卵囊位置位于宫腔中下段,孕囊外形稍欠规则,同时可见原始心管或胎心波动。流产组孕妇平均 CRL、GSD、FHR均显著低于正常组,差异均有统计学意义（P＜0.05）;流产组患者平均 YSD稍低于常组,差异有统计学意义（P＜0.05）。流产组孕妇各孕周 CRL、GSD、FHR均显著低于正常组,差异均有统计学意义（P＜0.05）;流产组患者第 6-7周 YSD高于正常组、第8-9周和第 10-11周 YSD低于正常组,差异均有统计学意义（P＜0.05）。流产组患者血清瘦素、ADAM12水平明显低于正常妊娠组,差异有统计学意义（P＜0.05）,流产组患者血清 CA-125水平明显高于正常妊娠组,差异有统计学意义（P＜0.05）。妊娠早期流产患者阴道超声参数 CRL、GSD、FHR与血清瘦素、ADAM12呈正相关（P＜0.05）,与 CA-125水平呈负相关（P＜0.05）。结论：妊娠早期阴道超声及血清瘦素、ADAM12、CA-125可作为早期流产的有效预测因素,阴道超声参数 CRL、GSD、FHR与血清瘦素、ADAM12、CA-125水平具有相关性,临床可通过测定这些指标以提高妊娠早期流产预测的准确性。     

胎儿稽留流产与染色体异常的关系及其影响因素分析

目的：探讨B超联合FISH实验室诊断技术分析胎儿稽留流产与染色体非整倍体关系并对其他影响因素进行综合分析。方法：采用FISH技术对广西267例B超诊断为稽留流产孕妇的胎儿绒毛组织行13,16,18,21,22,X,Y染色体数目检测,荧光显微镜下观察结果;采用SPSS13．0对相关数据进行统计分析。结果：267例稽留流产胎儿绒毛组织中,染色体数目异常95例,异常率35．6％,数目异常以三体最常见,其次为四体,少见部分单体;异常病例样本中存在多种染色体混合嵌合体现象,如混合嵌合三体（2n＋1／2n）,混合嵌合四体（2n＋2／2n）,混合嵌合单倍体、三体、四体（2n-1／2n＋l／2n＋2／2n）等;稽留流产与患者年龄、流产史、孕周具有显著相关性。结论：染色体数目异常与染色体混合嵌合均是稽留流产的重要原因,同时稽留流产发生与患者高龄、多次流产史、早期妊娠密切关系。     

自然流产患者TORCH检验的结果分析

目的:分析TORCH的检验结果,探讨TORCH感染对于自然流产患者的影响。方法:选取2010年1月到2013年12月来南京市第一医院检查的无自然流产史孕妇300例(对照组),并选择同期有自然流产史孕妇300例(观察组),使用ELISA检验法检测所有孕妇TORCH抗体,对比分析两组阳性率。结果:观察组血清中的风疹病毒(RV)、单纯疱疹病毒(HSV-Ⅱ)、巨细胞病毒(CMV)、弓形虫(TOX)的阳性率分别为12.00%、52.00%、27.67%、3.33%,明显高于对照组的2.00%、3.00%、2.67%、1.00%,差异有统计学意义(P0.05);观察组流产、死胎和早产的比率分别为37.67%、7%、11.67%,明显高于对照组的7.67%、0.33%、0.67%,差异有统计学意义(P0.05);观察组HSV-Ⅱ和CMV所致不良妊娠发生率分别为58.30%﹑59.04%,与RV、TOX所致不良妊娠发生率66.67%、50.00%比较,差异有统计学意义(P0.05)。结论:TORCH病原体或者病毒抗体阳性率的孕前检测对于预防自然流产有重要的临床意义。     

盐酸戊乙奎醚与丙泊酚联合用于无痛人工流产术的临床研究

目的:评价盐酸戊乙奎醚联合丙泊酚减轻人工流产术后疼痛的效果.方法:ASAⅠ-H级人工流产术患者100例,随机分为观察组和对照组.处理组先缓慢静脉注射盐酸戊乙奎醚注射剂1mg,30min后静脉注射丙泊酚2.5mg/kg;;对照组单独静脉注射丙泊酚2.5mg/kg.两组丙泊酚静注速率均为5mg/s.结果:处理组苏醒即刻苏醒后15min和30min宫缩痛的VAS评分分别为(3.13±0.15)、(2.02±0.11)和(0.87±0.09)分,明显低于对照组的(4.47± 0.35)、(3.54± 0.14)及(2.01±0.12)(P＜0.01).结论:盐酸戊乙奎醚联合丙泊酚镇痛能减轻人工流产术后的疼痛.     

孕酮，CA125及TNF-alpha水平与先兆流产的关系

目的：探讨孕酮,CA125 及TNF-alpha水平与先兆流产发生的关系。方法：选择2014 年2 月-2015 年2 月在我院诊断并接受治疗的先兆流产患者60 例,根据妊娠结局不同,将患者分为完成妊娠组和终止妊娠组。另选取同期顺利分娩的产妇作为对照组。比较三组研究对象血清孕酮,CA125 及TNF-琢水平。结果：先兆流产患者血清孕酮水平低于对照组,而CA125 及TNF-alpha水平高于对照组,差异具有统计学意义（P<0.05）;先兆流产终止妊娠组血清孕酮水平低于完成妊娠组,而CA125 及TNF-alpha水平高于完成妊娠组,差异具有统计学意义（P<0.05）。孕酮,CA125 及TNF-alpha水平是先兆流产发生的影响因素（P<0.05）。结论：孕酮水平低,CA125 及TNF-alpha水平高是先兆流产发生的危险因素。临床应给予高度重视,积极采取有效的保胎治疗,避免不良妊娠结局。     

Abortion by the tsetse fly Glossina palpalis palpalis after treatment with insecticides

Batches of wild-caught adult females of Glossina palpalis palpalis R.-D. were treated topically (0.36 l per fly) with different doses of 14 chemical insecticides in acetone and subsequent abortion (if any) and death of each fly were recorded. Control flies received acetone alone. No fly was fed after treatment. Abortion rates of treated fly-batches and the corresponding control batch were compared by Fisher's exact test. The rate of abortion for 274 control flies rose from 1.1% on day 1 to 6.3% on day 5, then declined to the last abortions on day 9. The increase of rate probably resulted from increasing period of starvation. Significantly increased rates of abortion of eggs or immature larvae, compared with the control, were only found with high doses of fenitrothion, propoxur, permethrin and dieldrin and with various doses of sumithrin, sumicidin and deltamethrin. Abortion was most frequent for the last three; synthetic pyrethroids. All significant rates were for rapid abortion, within 24 h after treatment, and many abortions for sumithrin, sumicidin and deltamethrin were within 60 min Pyrethroid-treated flies frequently showed rapid and prolonged knock-down. Especially for pyrethroids, many aborted eggs or larvae were covered with white, sticky fluid. It is suggested that insecticides caused high rates of abortion by general relaxation of maternal muscles, thus opening the vaginal sphincter, smoothing the uterine wall and allowing accumulated milk gland secretions to flow into the uterus. This reduced friction between contents and the uterine wall and the egg or larva escaped passively through the vaginal aperture.

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Résumé Les femelles de G. palpalis palpalis provenaient de captures de populations sauvages près d'Abuja au Nigéria. Les lots de mouches ont reçu des applications locales (0,36 l par mouche) de 14 insecticides chimiques à différentes doses. L'émission d'un oeuf ou d'une larve immature était considérée comme un avortement. Les témoins ont reçu de l'acétone. Les mouches n'ont pas été alimentées après traitement. Les résultats des différents lots ont été comparés par le test de Fisher. Pour 274 mouches traitées à l'acétone, le taux d'avortement croît de 1,1% le ler jour à 6,3% le 5e jour pour diminuer jusqu'au taux final le 9e jour, qui n'excède pas le taux naturel de 7%. On peut penser que le taux croissant est dû à la prolongation du jeûne et que l'acétone n'est pas un abortif. Les avortements se sont produits chez les mouches qui ont reçu chacun des 14 insecticides, les taux variant avec les doses, et pour la plupart des insecticides, augmentant avecle le temps depuis le traitement. Les taux d'avortement étaient particulièrement augmentés pour les lots traités avec des doses élevées de fénitrothion. propoxur ou perméthrine, et étaient très significativement augmentés chez ceux traités avec des doses très élevées de dieldrine ou différentes doses de sumithrine, sumicidine ou deltaméthrine: tous ces taux élevés étaient enrigstrés dans le jour après le traitement.Les avortements étaient particulièrement rapides, dans les 60 minutes, pour la sumithrine, la sumicidine et la delthaméthrine. Aucune mouche traitée à l'acétone ou à l'un des 11 autres produits n'a avorté dans les 60 minutes. Beaucoup de mouches traitées aux pyréthroïdes ont présenté un effrondement rapide et prolongé, suivant la dose. Beaucoup d'oeufs et de larves avortés après traitement aux pyréthroïdes étaient couverts d'un fluide blanc et visqueux. On peut estimer que les insecticides ont provoqué l'avortement par relâchement des muscles maternels, permettant l'ouverture du vagin, le déridement de la paroi utérine et la décharge dans l'utérus des secrétions de lait accumulées dans les glandes. Ceci a réduit la friction entre les parois de l'utérus et son contenu (oeuf ou larve) qui glissait à travers l'ouverture du vagin. Il est peu vraisemblable que les avortements induits par les insecticides puissent réduire les populations pendant les traitements.

     

不明原因复发性自然流产夫妇MTHFR C677T位点多态性分析

目的：分析不明原因复发性自然流产（URSA）夫妇与亚甲基四氢叶酸还原酶基因C677T（MTHFR C677T）位点多态性的关 联性研究。方法：采用聚合酶链式反应- 限制性片段长度多态性( PCR-RFLP)对URSA 组和对照组各50 对夫妇的外周血进行 MTHFR C677T 的位点多态性进行检测分析。结果：URSA 组MTHFR 基因677 位点的T/T、C/T+T/T 基因型的发生频率显著高于 对照组,差异具有统计学意义(P<0.05),而对照组MTHFR 基因677 位点的C/C 基因型发生频率显著高于URSA 组（P<0.05）,两 组MTHFR 基因677 位点的C/T 基因型比较无明显差异（P>0.05)。另外URSA 组等位基因T 明显高于C 的频率,且URSA 组等 位基因T 发生频率显著高于对照组,对照组等位基因C 发生频率显著高于USRA 组,差异均具有统计学意义（P<0.05）。结论： MTHFR C677T 位点的多态性与URSA 的发生密切相关,是该病的重要遗传风险因素。     

自然流产患者绒毛和蜕膜中ZEB1 的差异性表达及意义*

摘要目的：检测锌指结合蛋白（zinc finger E-box-binding protein ,ZEB1）在自然流产患者绒毛和蜕膜组织中的差异性表达。方法： 选取2010 年3 月到2011 年3 月在我院妇产科门诊进行人工流产的患者,分为正常人工流产（对照组50 例）和自然流产（实验组 50 例）两组,两组年龄和孕周间差异无统计学意义（P＞0.05）。用荧光实时定量PCR（qRT-PCR）技术检测在绒毛和蜕膜组织中 ZEB1 mRNA的表达量。结果：自然流产患者绒毛（0.835± 0.047）中ZEB1的表达量低于对照组（1.942± 0.095）,自然流产患者蜕 膜（0.65± 0.058）中ZEB1 的表达量低于对照组（1.13± 0.084）,差异具有统计学意义(P＜0.05)。结论：绒毛及蜕膜组织中ZEB1 的 异常表达可能参与自然流产的发生发展过程。     

The effect of infant fetal alcohol syndrome facial features on adoption preference

Infant facial characteristics may affect discriminative parental solicitude because they convey information about the health of the offspring. We examined the effect of Fetal Alcohol Syndrome (FAS) infant facial characteristics on hypothetical adoption preferences, ratings of attractiveness, and ratings of health. As expected, potential parents were more likely to adopt “normal” infants, and they rated the FAS infants as less attractive and less healthy. Cuteness/attractiveness was the best predictor of adoption likelihood. This study formed part of the first author’s undergraduate honors thesis at Queen’s University conducted under the supervision of the third author. This research was supported by an Ontario Mental Health Foundation Senior Research Fellowship and a research contract from the Kingston Providence Continuing Care Centre to the third author. Katherine L. Waller is a Ph.D. candidate in psychology at Queen’s University. Her research focuses on health psychology and behavior in close relationships. Anthony Volk is a Ph.D. candidate in psychology at Queen’s University. His research focuses on evolutionary psychology and parental investment. Vernon L. Quinsey is a professor of psychology and psychiatry at Queen’s University. His research focuses on forensic and evolutionary psychology.