Pregnancy, pain and pathology: a reply to Smajdor and Räsänen

J Med Ethics. 2024 May 15:jme-2024-109921. doi: 10.1136/jme-2024-109921. Online ahead of print.

Abstract

In their recent paper 'Is pregnancy a disease?', Anna Smajdor and Joona Räsänen argue in the affirmative, highlighting features shared by both pregnancy and paradigmatic diseases. In particular, they point to the harmful symptoms and side effects of pregnancy, and the provision of medical treatment to both pregnant patients and those aiming to avoid pregnancy. They consider both subjectivist and objectivist approaches taken by philosophers of health in defining disease, and point out that neither approach convincingly excludes pregnancy. Finally, they present a normative case for treating pregnancy as a disease, suggesting that this attitude could promote preventive provision of contraception and abortion, and encourage respect for (and better treatment of) patients' suffering during pregnancy. In this response, I challenge various parts of Smajdor and Räsänen's argument, and cast doubt on the normative benefits of their approach.

Keywords: Contraception; Pathology; Philosophy- Medical; Reproductive Medicine.