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Understanding Health Inequalities and JusticeBridging Perspectives for New Conversations$
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Mara Buchbinder, Michele Rivkin-Fish, and Rebecca Walker

Print publication date: 2016

Print ISBN-13: 9781469630359

Published to North Carolina Scholarship Online: May 2017

DOI: 10.5149/northcarolina/9781469630359.001.0001

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PRINTED FROM UNIVERSITY OF NORTH CAROLINA PRESS SCHOLARSHIP ONLINE (www.northcarolina.universitypressscholarship.com). (c) Copyright University of North Carolina Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in NCSO for personal use.date: 20 October 2021

Chasing Virtue, Enforcing Virtue

Chasing Virtue, Enforcing Virtue

Social Justice and Conceptions of Risk in Pregnancy

(p.160) 6 Chasing Virtue, Enforcing Virtue
Understanding Health Inequalities and Justice

Debra DeBruin

Anne Drapkin Lyerly

Joan Liaschenko

Mary Faith Marshall

University of North Carolina Press

Judgments about risk of harm raise issues of profound moral significance. This chapter criticizes prevailing assumptions about risk management in pregnancy. While bioethicists tend to focus on beneficence when analyzing issues of risk, beneficence does not exhaust the moral significance of risk and judgments about risk also raise issues of social justice. The chapter begins by highlighting criteria for adequate understanding of social justice as transcending the distribution of harms and benefits standardly thought to constitute justice. The chapter then considers how culture shapes the normative significance of risk: how we think about risk, what measures we feel justified taking to manage risks, whose interests are promoted by various approaches to risk, whom we hold responsible and for what. Moving beyond criticism, reforms of cultural attitudes toward pregnancy and its management are proposed and recent claims that “fetal origins” research provides a basis for such reform are assessed. This chapter argues that recognition of the significance of social determinants of health plays a critical role in transforming the management of risk in pregnancy. Overall, the analysis engages foundational philosophical questions about the nature of social justice in concert with attention to cultural context.

Keywords:   Risk management, Pregnancy, Social Justice, Cultural attitudes, Fetal origins, Social determinants

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