Operating on the Fetus

Abstract

The advent of fetal surgery is analyzed in terms of its implications for the moral status of the fetus, its bearing on the abortion debate, and its effect on the nature of the physician patient relationship. Three types of therapeutic contracts are posited: the "gynecological," in which the pregnant woman is considered the primary patient; the "pediatric," in which the focus is on the fetus; and the "obstetrical," in which the woman and fetus have a shared interest in treatment. It is concluded that the possibility of fetal therapy does not preclude the "gynecological" and "obstetrical" contracts as moral options.This essay argues the need for making distinctions between facts, values as subject matter (values as facts), value judgements, and world views when addressing the goals and methods of sexuality education. Facts are defined as empirically verifiable, but yesterday's facts, after new observations, can become today's myths. The study of a plurality of behaviors, historical contexts, and social standards in sexuality education makes values a portion of the factual base which the educator must consider and incorporate. Value judgments are personal and subjective, and underlie the selection and treatment of facts in a curriculum. The question is how to incorporate value judgment fairly. Value judgments often reflect world views--coherent bodies of belief which contain fundamental conceptions of self, society, and the purpose of existence. Since a world view is assumed to constitute reality, it is generally not questioned or articulated. The Shornack and Shornack/Scales debate on sex education exemplifies a conflict stemming less from factual sources than from fundamentally divergent world views. Examining such a debate reveals how each side has an opportunity to see its own unreflected assumptions about reality by noting the different metaphysical basis behind the other's argument. As with educati on in general, sexuality education should aim to develop skills of critical inquiry, to understand the hidden assumptions behind values and motivations, and to consider how authority in matters of sex is established and changes. Value judgments are an inevitable part of sex education, but a fair presentation of a plurality of viewpoints can help students begin to think critically about their own assumptions and to make efforts to forge their own point of view. This should be the primary goal shared by all sexuality educators, regardless of their own specific value judgments or world views.