Journal articles on the topic 'Prenatal legal protection'

This article examines protection rights under the United Nations Convention on the Rights of the Child 1989 (crc) and assesses the extent to which such protection rights are afforded to prenatal children in Ireland in the context of prenatal exposure to alcohol. It follows on from the article, “Overstepping the Mark?” (Broughton, 2016: 687–717) in which the author demonstrates the possibilities for the application of the crc to prenatal children. Within the context of protection rights under the crc, this article examines Irish law and policy on protecting children from prenatal alcohol exposure, through the lenses of both child protection and public policy. The central thesis of the article is that although Irish law has the potential to offer prenatal children crc protection rights from this type of harm, legal interpretation has hindered this potential and legal clarity is now necessary to bolster policy and practice, in the best interest of children.

In the context of the active development of the areas defined by the Concept of Predictive, Preventive and Personalized Medicine, genodiagnostics, applied at the stage of family planning, is of particular importance. The introduction of preimplantation and prenatal genodiagnostics poses not only ethical but also legal problems. Of particular importance are the problems of protecting genetic information obtained using these methods from unauthorized use, which actualizes the need to improve the current regulatory framework for determining and specifying the conditions for carrying out such genodiagnostics. Purpose: to identify actual legal problems arising from the use of genetic information obtained by methods of preimplantation and prenatal genetic diagnosis, to determine the best ways of their solution as well as the main directions of further technological development and improvement of national legislation in the field of genetic diagnosis. Methods: the authors apply empirical methods of comparison, description, interpretation; theoretical methods of formal and dialectical logic; specific scientific methods: legal-dogmatic and interpretation of legal norms. Results: the analysis of the current legislation regulating preimplantation and prenatal genetic diagnosis in the Russian Federation reveals a number of pressing legal problems arising from the use of genetic information obtained in diagnostics. It is established that the current legislation does not take into account the specifics of genetic information and cannot provide effective protection against its illegal use in genetic diagnostics. General directions of improving national legislation in order to overcome problems related to the observance of human rights in the use of methods of preimplantation and prenatal genetic diagnostics are outlined.

AbstractDevelopments in legal and medical practice in the Netherlands give rise to questions regarding the legal position of the unborn child. This article provides an overview of these developments and argues — in view of developments in other countries — that current Dutch legislation regarding the unborn child is not up to date. In effect, the article challenges the idea that the actual legal protection of the unborn child under positive Dutch law can be considered proportionate, even sufficient. To support this view the author will show that abortion is not the only matter in which clarity as to the legal protection of the viable unborn child is required. This signalisation provides good cause to reconsider the Dutch perspective on the matter, thus offering a point of reference to countries with a similar interpretation of what constitutes an appropriate legal protection of the unborn child.

Current ethical and legal issues with regard to abortion, prenatal genetic testing and managing pregnancy are discussed in this paper. These problems are considered from the legal theory point of view as well as from the standpoint of the Serbian Law, the European Convention for the Protection of Human Rights and Fundamental Freedoms, European Court of Human Rights, legal regulations of several EU countries, the USA, Japan, and their judicial practice. First, the pregnancy termination standards that exist in Serbia are introduced. Then the following issues are explained separately: the pro life and pro choice approaches to abortion; abortion according to the legal approach as a way of survival; the moral and legal status of the fetus; prenatal genetic testing, and finally matters regarding managing pregnancy today. Moral and legal principals of autonomy, namely freedom of choice of the individual, privacy and self-determination give women the right to terminate unwanted pregnancies. In addition, the basic question is whether the right of the woman to abortion clashes with the rights of others. Firstly, with the right of the "fetus to life". Secondly, with the right of the state to intervene in the interest of protecting "the life of the fetus". Third, with the rights of the woman?s partner. The fetus has the moral right to life, but less in relation to the same right of the woman as well as in relation to her right to control her life and her physical and moral integrity. On the other hand, the value of the life of the fetus increases morally and legally with the maturity of gestation; from the third trimester, the interest of the state prevails in the protection of the "life of the fetus" except when the life or health of the pregnant woman are at risk. As regards the rights of the woman?s partner, namely the husband?s opinion, there is no legal significance. The law does not request his participation in the decision on abortion because the decision is exclusively brought by the pregnant woman. Critics of prenatal genetic testing claim that the woman?s autonomous choice is seriously prejudiced, as the women are pressured first with genetic testing and then with abortion, if the test is positive. However, there are views that many parents are left to bring their decisions in a vacuum because the physicians do not discuss all possible available options with them out of fear that they will be perceived as orders. Genetic counseling has an aim to facilitate informed reproductive decisions. Rigid application of policies on non-directive genetic counseling make pregnant women and families unaware of the nature and consequences of the genetic state which could affect the future child. If the real goal is an informed choice then it is the obligation of the physician-specialist to inform the parents with the facts and familiarize them with the true state. Managing pregnancies today medicalizes and pathologizes all pregnancies, and not only the risky ones. Since these techniques are becoming a routine part of medicalized pregnancy managing, pregnant women find it difficult to resist undertaking such technologies or to refuse them. Thus the question on how much these technologies offer sensible choices is imposed. Generally speaking, it is stated that women are becoming observers rather than active participants in giving birth to a new life. Attempts of legal control over a pregnant woman for the protection of "the life of the fetus" violate the woman?s human rights in democratic societies.

The topicality of the article is due to the strategy of transition to personalized medicine in Russia, based, among other things, on technologies of preimplantation and prenatal genetic diagnostics. The purpose of the article is to analyze the main directions of ethical and legal support for the development of these technologies. The work is based on the study of relevant international regulations, foreign and Russian legislation using the methods of legal-dogmatic and philosophical-legal analysis. The article substantiates the need for a clearer distinction between legal and moral-religious approaches to regulating relations in applying these technologies. The task is to find legal structures that can take into account the moral aspects of the problem without replacing legal regulation with an appeal to moral and religious values and norms. An example of this approach is the development of a legal regime for manipulations with embryo in vitro, in which the necessary legal protection of the embryo is provided by recognizing its special ontological status as a constitutional value of the common good. From these positions, the author identifies a range of issues that should form the organizational and legal context necessary to ensure adequate guarantees of human rights in the field of application of the considered genetic technologies. The legal regulation of this range of issues should be fixed in a special federal law on genetic testing.

AbstractThe national abortion debate, rising drug use and homelessness, and the return to conservatism intersect in the trend which increasingly recognizes fetal rights, often at the expense of women's rights. Pregnant women, as never before, are faced with criminal charges and physical invasions in the name of protection of fetuses. This Note examines the sociological forces creating these situations and suggests better solutions. The Note cautions against the future fear that private parties will claim a legal right to interfere with a pregnant woman's behavior, and illustrates the need to prevent it.

Through the statement of the Bioethics Commission of the State Rheinland-Pfalz (EK-RhPf) and the draft guidelines for the use of PGD of the Federal Medical Association (REP-BÄK) the debate about PGD in Germany is clearly headed towards an introduction of the technique. Both papers fail to deal adequately with some of the most important medical facts as well as legal and ethical aspects: embryo destruction in the course of diagnostic procedures or necessary research; the initiation of a trial pregnancy conditional on the results of prenatal diagnosis – a practice which contradicts the aims usually stated in favour of PGD; diagnostic indications intended to restrict the use of the technique are impractical in the light of previous experience with prenatal diagnosis. The REPBÄK tries to squeeze PGD techniques, procedures and aims into the existing guidelines for IVF despite profound differences. If PGD is to be introduced then these half-hearted would-be-solutions must be replaced by a clear and complete presentation of the facts as well as the moral problems and legal consequences including the abandonment of embryo protection as we know it. Society needs complete information, honest ethical discussion and legal security for a decision: PGD – yes or no!

Advances in fetal medicine have expanded opportunities for protection of fetal health and intrauterine management of an increasing number of fetal disorders. The legal rights and duties of parents to provide necessary medical treatment for the child may extend to the prenatal period. Resolution of the conflict between the rights of the fetus to be born healthy and the pregnant woman's right of privacy is difficult and controversial. It is suggested that intrusion into a woman's individual fundamental rights for the potential benefit of her fetus should be permissible only in narrowly defined circumstances.

The purpose of this study is primarily to analyse the jurisprudence of the Polish Constitutional Tribunal regarding the compliance with constitutional norms of the conditions for the admissibility of termination of pregnancy (abortion). The Constitution of the Republic of Poland provides every person with legal protection of life. Although its provisions do not explicitly specify that it is about the legal protection of life from conception to natural death, this type of interpretation seems to be adopted by the Constitutional Tribunal, which results in subsequent judgments on the assessment of compliance with this constitutional model of the conditions for the admissibility of abortion in Poland. In its jurisprudence, the Constitutional Tribunal first drew attention to the constitutional guarantees for the protection of human life at every stage of its development, and thus questioned the admissibility of termination of pregnancy due to difficult living conditions or the difficult personal situation of a pregnant woman, as well as in the case when prenatal examinations or other medical conditions indicate a high probability of severe and irreversible impairment of the fetus or an incurable disease threatening its life. In this context, however, it is worth noting that abortion is permissible when a high probability of severe and irreversible impairment of the fetus or an incurable disease threatening its life simultaneously poses a substantial risk to the life and health of the mother. The analysis of the jurisprudence of the Constitutional Tribunal therefore allows to formulate a conclusion on the conservative and restrictive approach of this body regarding the conditions for the admissibility of abortion in Poland and the recognition of the legal protection of life as a cardinal constitutional value of the Polish legal system.

The desire to prevent prenatal and preconceptual harm has led to a call for more legal protection for unborn and future children. This Article analyzes the way in which the Dutch legal system has responded to this call by identifying and critically scrutinizing two strategies employed in this response. First, to protect the unborn child from maternal harm, the concept of legal personality has been expanded to include the unborn child, albeit only the viable fetus. This strategy is criticized because its measures are presented as if they follow directly from the existing legal framework, whereas these measures are in fact based on several obscured assumptions and, therefore, bring to bear a new perspective on the concept of legal personality. The second strategy is applied to the future child. Instead of expanding an existing category, a new category is created to offer the future child a place within the law. The future child is addressed as the subject of legal relevant interests instead of rights. Although this strategy seems promising, it still faces difficulties when applied to the future child, which presumably has an interest in non-existence.

Along with numerous ethical and legal questions prompted by advancements in technology, there is a strong call for protection of “persons” in a broad sense. This Article discusses how such developments emerge in China. Chinese courts are often confronted with disputes concerning prenatal injuries, the disposition of frozen embryos, and infringements on the reputation of the deceased. After examining these cases, their underlying tensions, and the upcoming Chinese Civil Code, this Article reflects on the evolving concept of a natural person within the Chinese civil law context. The Article further asks how law deals with new problems while at the same time maintaining stability and coherence when viewed against a rapidly evolving biotechnological background.

The purpose of this paper is to attempt to classify the practice of international bodies that is significant for understanding the legal features of the use of genetic technologies as well as to provide a brief overview of some of the ECtHR cases that are key to identifying the general trends in human rights protection in the use of genetic technologies. The author provides an analysis of the ECtHR cases, which reveal some aspects of informed consent in medical activities and also addresses the more specific issue of prenatal genetic testing. The conclusion is drawn that it is advisable to classify cases of international bodies on the application of genetic technologies into two main categories: cases concerning particular issues of the application of genetic technologies and cases containing fundamental legal positions on the application of medical technologies, including genetic ones. It is necessary to consider both categories of cases in order to clarify the official interpretation of international norms and principles for the protection of human rights in the area at issue. For example, the analysis of practice in a broad category of medical cases provides insight into how the ECtHR discusses the principle of informed consent through the interpretation of the right to privacy enshrined in article 8 of the ECHR. However, a narrow focus on cases directly arising from the application of genetic technologies allows the inference of general requirements for legal regulation and human rights in subject areas such as genetic testing.

The countries of the European Union have decided to share a peaceful future based on common values. However, there are still disputes over the understanding of the most fundamental issues related to the protection of human rights, including protection of the right to life. The author shows that the source of European culture is Christian. However, it is not the only source of shaping the values of Europe. As an example, she cites the differentiation of constitutional legal regulations or controversies related to the jurisprudence of the ECHR. She analyzes the judgment of the Polish Constitutional Tribunal declaring the unconstitutionality of the provisions allowing abortion if prenatal tests or other medical conditions indicate a high probability of a severe and irreversible fetal impairment or an incurable life-threatening disease. This judgment caused enormous opposition from a part of the society. This problem proves that a compromise has not yet been made on the issue of abortion. It is, therefore, difficult to claim that human rights protected in the European Union are given universal meaning.

INTRODUCTION: Primary health care is a fundamental element in protecting the health of the children’s population. This article presents a literature review on the problems of providing medical care to children of the first month of life. One of the main stages in an integrated approach to observation of children is the antenatal protection of the fetus, which is provided primarily by childrens clinics through prenatal patronage. To date, at this stage, there is still lack of coordination in the work of womens clinics and childrens clinics. After the discharge of newborns, prenatal care is replaced by home care for newborns, which is realized by both a doctor and a district nurse and represents a complete system with an integrated approach to appropriate examinations. Observance of the frequency of both prenatal and primary patronages, which is regulated by the federal normative acts, is ensured by the professional level of district pediatricians and district nurses, as well as by the appropriate provision of the primary link with personnel. Lack of specialists in medical organizations providing primary health care to children is reflected in the increased burden on the medical and nursing staff. According to the research conducted in different regions of the Russian Federation, the number of population attached to a health locality, often significantly exceeds the recommended standard of 800 people per one locality. All this leads to non-standardized loads on the staff, and has a significant impact on the quality of medical care provided. This, in turn, leads to dissatisfaction of the patients legal representatives with the availability, quality and completeness of the medical care provided. CONCLUSION: The presented information, based on the data of the literature review devoted to the quality of medical care for children of the first month of life in childrens polyclinics, is aimed at optimizing the conditions for improving affordable and high-quality medical care, improving the health of the child population, reducing infant mortality.

: The nerve growth factor (NGF) belongs to the family of neurotrophic factors. Initially discovered as a signaling molecule involved in the survival, protection, differentiation, and proliferation of sympathetic and peripheral sensory neurons, it also participates in the regulation of the immune system and endocrine system. NGF biological activity is due to the binding of two classes of receptors: the tropomyosin-related kinase A (TrkA) and the low-affinity NGF pan-neurotrophin receptor p75. Alcohol Use Disorders (AUD) are one of the most frequent mental disorders in developed countries, characterized by heavy drinking, despite the negative effects of alcohol on brain development and cognitive functions that cause individual’s work, medical, legal, educational, and social life problems. In addition, alcohol consumption during pregnancy disrupts the development of the fetal brain causing a wide range of neurobehavioral outcomes collectively known as fetal alcohol spectrum disorders (FASD). The rationale of this review is to describe crucial findings on the role of NGF in humans and animals, when exposed to prenatal, chronic alcohol consumption, and on binge drinking.

The article analyzes the problems of protecting the rights of children in the USA, which developed at the end of the 19th and the beginning of the 20th centuries. It was established that by the end of the 19th century. the question of protecting children has never been raised anywhere in the world. The considered case of Mary Ellen McCormack, who suffered brutal abuse from her adoptive parents, and with the help of Elbridge Jerry's lawyer, was transferred to the US Supreme Court. It was established that this precedent became the first documented case of child abuse in the history of the United States of America, and in the world as a whole. Tracing the history of the formation of the New York Society for the Prevention of Cruelty to Children "NYSPCC", which became the first organization in the world to protect the interests of children. His activities, which consisted in the legal protection of children, their material support and violation of their rights and interests, were considered. Particularly shocking were the persistent abuses in private kindergartens and homes where children were kept in unlivable conditions, while the guardians received the costs of child support from the state. It was emphasized that the establishment of the New York Society for the Prevention of Cruelty to Children "NYSPCC" was the key to changes in this area. His activities prompted the rapid formation of other societies in the United States and the adoption of the first normative legal acts that guaranteed the rights of children and provided a mechanism for their protection. Gradually, there was a transformation of public consciousness, which took over responsibility for the protection of minor children. Examines the creation of state departments of welfare, social services, health, and labor, which opened in all states, as well as the Federal Children's Bureau, which was established in 1912. It became the first national government office in the world, whose powers focused on ensuring better well­being of children and their mothers. The field of activity of the Bureau was studied, which developed a whole set of measures, which consisted in the introduction of prenatal care for women, helped them in the birth of a child, the establishment of specialized children's clinics, the introduction of the institute of patronage nurses, certified milk stations for the children's year, and raising awareness among women mothers about the measures . and the need for proper child care to address high infant mortality. Another area of activity of the Children's Bureau was the control over the use of child labor, as well as educational activities - the publication of books that highlighted contemporary problems in the field of violation of children's rights. The work of the bureau also affected legislative initiatives. Thus, the Keating-Owen Act of 1916, which prohibited the labor of minors, as well as the Sheppard- Towner Act of 1921, which allocated federal subsidies to state programs for the protection of motherhood and childhood, were analyzed. The following were subject to state funding: training of midwives, educational work with parents, opening of health centers, parenting courses, introduction of standards and the procedure for licensing maternity homes, collection of data on maternal and child mortality. The prescriptions of the Law on Social Security of 1935, which provided for the financing of a program to help dependent children, low-income families, and the creation of a child care service, which was authorized to supervise the maintenance of children's rights, were studied.

Resumen:El presente trabajo es un análisis de cómo ha evolucionado la protección del no nacido en España desde la aprobación de la Constitución de 1978. Se centra, en particular en el estudio de la legislación y de la jurisprudencia constitucional sobre dos temas especialmente relevantes y controvertidos: la regulación del aborto, de un lado, y de la fecundación in vitro y uso de embriones, sus tejidos y órganos, de otro. Tanto el legislador como la doctrina del Tribunal Constitucional se han inclinado por una protección gradualista de la vida humana en formación que deja abiertos muchos interrogantes desde la perspectiva del derecho a la vida (art. 15 CE) y la dignidad humana (art. 10.1 CE)Summary:1. The Introduction Of Abortion In Spain And The STC 53/1985: a) From Criminalization To Decriminalization In Certain Circumstances; b) STC 53/1985: i) Right To Life And Prenatal Life; ii) The Life Of The Unborn As A Constitutional Interest; iii) The Constitutionality Of The Indication System; iv) The Conditions For The Constitutionality Of Decriminalization; c) The New Regulation. 2. From The «Indication System» To The «System Of Deadlines»: Organic Law 2/2010 Of 3 March On Sexual And Reproductive Health And Voluntary Termination Of Pregnancy: a) The Evolution Of Abortion In Spain Under The 1985 Act;b) The Arguments For The Reform And The Context Of The New Regulation;c) The New Regulation. 3. An Open Debate: a) The Conditions For The Constitutionality Of Decriminalization; b) The Failed Reform Of The Act. 4. The Weak Protection Of The Embryo In The Legislation On In Vitro Fertilization And The Use Of Embryonic Organs And Tissues, And The SSTC 212/1996 And 116/1999: a) Act 35/1988 On Assisted Reproduction Techniques, And Act 42/1988 On Donation And Use Of Human Embryos And Fetuses And Their Cells, Tissues And Organs; b) Negation Of The Right To Life Of The Embryo And Consequences For Its Consideration As A Constitutionally Protected Legal Interest: i) The Embryo Does Not Hold The Right To Life; ii) Two New Categories:Pre-Embryos And Non-Viable Embryos And Their Legal Relevance; iii) Surplus Embryos; iv) The Absence Of Any Criminal Protection; v) A Weak Concept Of Dignity. 5. Legislative Evolution; 6. A Model For The Gradual (Dis)Protection Of Unborn Human Life.Abstract:This paper analyzes the evolution of the protection of the unborn human life in Spain since the enactment of the 1978 Constitution. It focuses, in particular, on the study of the laws and the constitutional jurisprudence on two relevant matters: the regulation of abortion; and the in vitro fertilization, the use of embryos their tissues and organs. The legislator and the decisions of the Constitutional Court have opted for gradualist protection of the embryo that leaves many questions open from the perspective of the right to life (Article 15 SC) and human dignity (Article 10.1 SC).

The right to life is a fundamental right, the legal basis for all other human rights. Recognition and proper protection at the state level of this most important right is a prerequisite for the enjoyment of other rights. However, do we respect each life, regardless of any personal characteristics? The history of humanity shows that the caste/class approach to the formation of society is one of humanity's most brutal inventions. The categorization of people into more critical and less critical in many cases led to antihuman practices, such as slavery or serfdom, and atrocious crimes ranging from rape to murder. Scientific and social progress must have pushed aside such medieval approaches, but the results of this study indicate that social neglection just shifted from those who have stood for their rights for hundreds of years to those who cannot - to the unborn. In this study, we demonstrate the historical development of embryology, medicine, biology, psychology, and other sciences in order to understand the exact point of the beginning of human life. Scientists in the United States of the mid-19th century were found to be the leading opponents of artificial termination of pregnancy and believed that most abortionists carry vestiges of outdated dogmatic views on the nature of human life, including its beginning and prenatal development. We present that, despite the achievements of science, the society press the legalization of the murder of the unborn, the primary reason for which is the irresponsible attitude to sexual life. This study presents the positions of modern scientists on the prenatal development of the child; data on the old and the new paradigms in embryology in the context of the relationships between mother and child; the results of the psychological research on the impact of abortion scenario in the family system on the health of offspring; and other data indicating that a child before birth is not just a material clot of cells, but a full-fledged subject, person and participant of social life.

Child protection is a constitutional right to realize human rights even though it is aimed at child offenders. The problem of saving culture (deviant culture) is still a major consideration as a cause of the emergence of bad behavior by children. Psycholegal approach found that crime committed by children is influenced by the process of imitation. Incorrect socialization in this imitation process, or exposure to violations of the law, is obtained from the family or social environment around children during prenatal, Christmas, adolesencence until adulthood. Starting from the wrong socialization process and the inability to understand the law in childhood. become one of the triggers of crime. The juvenile justice system model with a psycholegal approach requires diversion by strengthening the legal substance, namely (a) right to as soon as possible without delay by a free/impartial judiciary, (b) standardization of parents/supervisors who are monitored, (c) revitalization of roles Bapas as the oversight body diversion. (d) the elimination of stigmatization and (e) respect for children's privacy rights.Perlindungan anak merupakan hak konstitusional untuk mewujudkan hak asasi manusia meskipun itu ditujukan bagi anak pelaku kejahatan. Masalah sub-budaya menyimpan (deviant culture) masih menjadi pertimbangan utama sebagai penyebab munculnya perilaku jahat oleh anak. Pendekatan psikolegal menemukan bahwa kejahatan yang dilakukan anak dipengaruhi proses peniruan. Sosialisasi yang salah pada proses peniruan ini, atau terpaparnya tindak pelanggaran hukum, didapat dari keluarga atau lingkungan sosial di sekitar anak semasa prenatal, natal, adolesencence hingga dewasa.. Bertitik tolak dari proses sosialisasi yang salah serta ketidakmampuan memahami hukum di masa kanak-kanak ini menjadi salah satu pemicu munculnya kejahatan. Model sistem peradilan anak dengan pendekatan psikolegal menghendaki diversi dengan penguatan substansi hukum, yaitu (a) hak untuk sesegera mungkin tanpa penundaan oleh badan pengadilan yang bebas/tidak memihak, (b) standarisasi orang tua/pengampu yang terpantau, (c) revitalisasi peran Bapas sebagai badan pengawas diversi. (d) penghapusan stigmasi dan (e) penghargaan terhadap hak privasi anak.

Recognizing the importance of the state’s special protection of the prenatal stage of human development, most countries establish strict control over the research of the human embryo. One way to argue the limitations of embryo research is its moral status as a potential human being and representative of the human species. In the insufficient study of the moral status of the embryo, the article identifies approaches to its understanding and formulates its main features. The paper also examines the theoretical question that is at the heart of practical and professional ethics: by what criteria is the embryo attributed to have the moral status? The answer to this question reveals the importance of moral considerations regarding the proper handling of the embryos as well as the importance of the moral duty of others to treat an unborn child with respect. Some ways of understanding the principle of respect are examined separately. The moral significance, value, and respect for the embryo are all prerequisites for establishing the limits of acceptable and unacceptable behaviour during the research on human embryos. This article highlights the problem of conflict of interests of the embryo as the one with moral status, with the interests of society to continue embryonic research due to the potential for usefulness for a huge number of people suffering from various diseases. Such conflict can be resolved through the establishment of ethical principles, which can be used to describe the limits of research on human embryos in the international and national guidelines for such research. Given the generality of such principles, it is also important to establish a national specialized committee on the ethics of research on human embryos. Despite the results of the study, the article emphasizes the need for more detailed and deeper participation of representatives of legal, bioethical, embryological science, and the public in conversation. Key words: moral significance, value, respect, moral obligations, legal status.

The article considers the crime of the so-called prenatal injury, which is stipulated in Article 157a of the Polish Criminal Code. The question of the possibility of unpunished interference of the mother in the body of her unborn child is undoubtedly an important and controversial aspect of modern criminal law, especially in the context of the principles of protecting human life and health. The article also touches on philosophical and legal subjects, namely the moment when a person is created and subsequently protected by the state and law. Finally, the article answers the question whether the current legal status should be maintained and how it could possibly be revised.

Background Neonatologists, legal experts and ethicists extensively discuss the ethical challenges of decision-making when a child is born at the limit of viability. The voices of parents are less heard in this discussion. In Norway, parents are actively shielded from the burden of decision-making responsibility. In an era of increasing patient autonomy, is this position still defendable? Research question In this article, we discuss the role of parents in neonatal decision-making, based on the following research question: Should parents decide whether to provide lifesaving treatment when their child is born at the limit of viability? Research design We conducted eight interviews with 12 parents, 4 individuals and 4 couples, all having experienced prenatal counselling at the limit of viability. The interviews took place at different university locations in Norway in the years 2014–2018. Ethical considerations All study participants gave their written informed consent. The Regional Committee for Medical Research Ethics approved the study. Findings We identified six main themes in parents’ responses to the research question. Parents (1) experienced an emotional turmoil confronted with birth at the border of viability, (2) emphasized the importance of being involved in decision-making, (3) described and reflected on the need to balance the parental instinct of saving, (4) were concerned about the dilemmas involved in protecting the family, (5) were worried about the burden of overwhelming responsibility and (6) called for guideline relief. Conclusion The perceived parental instinct of saving the life of their child makes it hard for parents to step away from a call for ‘everything to be done’. Involvement of an interprofessional periviability team drawing on the experiences and viewpoints of nurses and neonatologists in decision-making is needed to protect both infants and parents against undue parental push for treatment and enable parents to make good decisions regarding their child.

This research aims to discuss the statutory regulations of halal certification. The study was performed through literature studies, especially on primary, secondary, and tertiary legal materials that describe legal protections for consumers and consideration of the halal certification. This study showed that micro and small enterprises’ food products are easy to verify about the halal food products, as long as the organization that assists the enterprises are legal entities. Micro and small enterprises (MSEs) should only make a statement letter of the halalness of a product that is verified and get assistance by Islamic social organizations or religious institutions that are legal entities and/or universities, government agencies, or business entities as long as they are partners with legal Islamic community organizations or Islamic religious institutions. However, regulations related to the halal statement of micro and small enterprise actors must still be reviewed and given special attention and supervision. In Indonesia, with the majority of the Muslim community, the guarantee of the halalness of a product and/or service is crucial. For this reason, the enactment of the Halal Product Guarantee Law is a form of state protection for Muslim consumers in Indonesia.___ References Books with an author: Amiruddin, A., & Asikin, Z. (2018). Pengantar Metode Penelitian Hukum. Jakarta: Raja Grafindo Persada. Aswirna, P., & Febriyanti, S. (2018). Pengabdian Berbasis Kebijakan Peningkatan Pemahaman Masyarakat tentang Pentingnya Mengkonsumsi Produk Halal bagi Pemuka Agama Islam Kota Padang. Padang: UIN Imam Bonjol. Barkatullah, A. H. (2008). Hukum Perlindungan Konsumen: Kajian Teoritis dan Perkembangan Pemikiran. Bandung: Nusa Media. Marzuki, P. M. (2005). Penelitian Hukum. Jakarta: Kencana Prenada. Rahardjo, S. (2003). Sisi-Sisi Lain dari Hukum di Indonesia. Jakarta: Kompas. Saebani, B. A. (2009). Metode Penelitian Hukum. Jakarta: Pustaka Setia. Shidarta, S. (2004). Hukum Perlindungan Konsumen Indonesia. Jakarta: Grasindo. Utsman, S. (2014). Metodologi Penelitian Hukum Progresif: Pengembaraan Permasalahan Penelitian Hukum Aplikasi Mudah Membuat Proposal Penelitian Hukum. Yogyakarta: Pustaka Pelajar. Journal articles: Ab Talib, M. S., & Mohd Johan, M. R. (2012). Issues in Halal Packaging: a Conceptual Paper. International Business and Management, 5(2), 94-98. Abd Rahman, A., Asrarhaghighi, E., & Ab Rahman, S. (2015). Consumers and Halal Cosmetic Products: Knowledge, Religiosity, Attitude and Intention. Journal of Islamic Marketing, 6(1), 148-163. Agustina, Y., Pratikto, H., Churiyah, M., & Dharma, B. A. (2019). Pentingnya Penyuluhan Sertifikasi Jaminan Produk Halal Untuk Usaha Kecil Menengah (UKM). Jurnal Graha Pengabdian, 1(2), 139-150. Ahmad, A., Pransisto, J., & Syahril, M. A. F. (2023). Perlindungan Hukum terhadap Konsumen Dalam Transaksi E-Commerce. Jurnal Litigasi Amsir, 10(3), 322-332. Anugrah, K. (2017). Potensi Pengembangan Wisata Halal Dalam Perspektif Dukungan Ketersediaan Restoran Halal Lokal (Non Waralaba) di Kota Gorontalo. Jurnal Pariwisata Pesona, 2(2), 1-12. Djakfar, I., & Isnaliana, I. (2021). Model Pendampingan Pengurusan Sertifikasi Produk Makanan Halal bagi UMKM dalam Mendukung Banda Aceh Menjadi Kota Wisata Halal. Wikrama Parahita: Jurnal Pengabdian Masyarakat, 5(1), 80-88. Erfan, M., Pransisto, J., & Syahril, M. A. F. (2023). Perlindungan Hukum Bagi Konsumen dari Peredaran Makanan Kedaluwarsa. Jurnal Litigasi Amsir, 10(2), 194-207. Faridah, H. D. (2019). Sertifikasi Halal di Indonesia: Sejarah, Perkembangan, dan Implementasi. Journal of Halal Product and Research, 2(2), 68-78. Fathoni, M. A. (2020). Potret Industri Halal Indonesia: Peluang dan Tantangan. Jurnal Ilmiah Ekonomi Islam, 6(3), 428-435. Giyanti, I., & Indriastiningsih, E. (2019). Effect of SME Food Entrepreneurs Knowledge on Halal Certification for Certified Awareness Using Partial Least Square. Jurnal Teknik Industri, 20(2), 140-151. Hartati, R. (2019). Peran Negara Dalam Pelaksanaan Jaminan Produk Halal. ADIL: Jurnal Hukum, 10(1). Ilyas, M. (2017). Sertifikasi dan Labelisasi Produk Halal Perspektif Maslahat. Jurnal Al-Qadau: Peradilan Dan Hukum Keluarga Islam, 4(2), 357-376. Izzuddin, A. (2018). Pengaruh Label Halal, Kesadaran Halal dan Bahan Makanan terhadap Minat Beli Makanan Kuliner. Jurnal Penelitian Ipteks, 3(2), 100-114. Jopie Gilalo, J., Sulistiyono, A., & Harahap, B. (2020). Tinjauan Yuridis dalam Bukti Hukum Konsumen dalam Makanan Halal. Jurnal Ilmiah Living Law, 12(1), 26-40. Kawata, Y., Htay, S. N. N., & Salman, A. S. (2018). Non-Muslims’ Acceptance of Imported Products with Halal Logo: a Case Study of Malaysia and Japan. Journal of Islamic Marketing, 9(1), 191-203. Khairunnisa, H., Lubis, D., & Hasanah, Q. (2020). Kenaikan Omzet UMKM Makanan dan Minuman di Kota Bogor Pasca Sertifikasi Halal. Al-Muzara’ah, 8(2), 109-127. Langvinienė, N., & Daunoravičiūtė, I. (2015). Factors influencing the success of business model in the hospitality service industry. Procedia-Social and Behavioral Sciences, 213, 902-910. Mawaddah, F. (2020). Constraints And Challenges of Halal Product Guarantee in the Syariate Area. SHIBGHAH: Journal of Muslim Societies, 2(1), 91-112. Mutmainah, L. L. (2018). The Role of Religiosity, Halal Awareness, Halal Certification, and Food Ingredients on Purchase Intention of Halal Food. Ihtifaz: Journal of Islamic Economics, Finance, and Banking, 1(1), 33-50. Pujiono, A., Setyawati, R. F., & Idris, I. (2018). Strategi Pengembangan UMKM Halal di Jawa Tengah Dalam Menghadapi Persaingan Global. Indonesia Journal of Halal, 1(1), 1-7. Purwanda, S., & Wulandari, A. S. R. (2023). Socio-Legal Studies: Methodical Implications of Legal Development in Indonesia. Al-'Adl, 16(2), 152-163. Rahmawati, I. N., & Rukiyah, L. (2014). Win-Win Solution Sengketa Konsumen. Jakarta: Pustaka Yustisia. See also Kasim, A., & Heridah, A. (2020). The Region Governance Review of Barru Regency to Actualize Good and Clean Governments. Amsir Law Journal, 1(2), 61-69. Widayat, W., Sulardjaka, S., Al-Baarri, A. N., & Nurjannah, R. (2020). Pendampingan Sertifikasi Halal pada UMKM Hanum Food (Halal Certification Support in UMKM Hanum Food). Indonesia Journal of Halal, 3(1), 83-87. Yusoff, S. Z., Adzharuddin, N. A., & Bolong, J. (2014). Faktor Pencetus Perilaku Pencarian Maklumat Produk Halal Dalam Kalangan Keluarga Islam. Global Media Journal, 3(2), 69-82.

The main purpose of screening is to identify infants with sickle cell anemia so that appropriate health care might be given to such infants. The following four types of legal issues will be considered: the extent to which existing state newborn screening laws can accommodate sickle cell anemia, the malpractice concerns related to sickle cell anemia screening, the need for protection of the confidentiality of the data collected by such testing, and the legal issues raised by discrimination against sickle cell carriers. These legal issues cannot be considered in a vacuum, however. Attention must be given to the history of sickle cell screening laws in this country. When state laws mandating sickle cell anemia screening were passed in the early 1970s, they were aimed at giving people information that was helpful for making reproductive choices. Two carriers who were married, for example, had a 25% risk of giving birth to a child with sickle cell anemia. However, because there were no health care measures that could be taken to cure an affected fetus or even to safely diagnose the condition prenatally, the only potential effect of the law was to deter such couples from having children altogether, a tactic criticized as genocidal. Moreover, the early laws lacked provisions for counseling and, thus, fostered misunderstanding and anxiety. The information collected by screening programs apparently also served as a basis for discrimination against people with sickle cell trait. The issues presented by sickle cell anemia screening of newborns are somewhat different because screening is not for the primary purpose of changing reproductive behavior but rather to identify infants who then can be treated.

Efforts to overcome and eradicate narcotics crimes require community participation, especially in reporting narcotics crimes. Some people don't want to report knowing that there is a narcotic crime. The problem of this research is whether the factors that cause crime do not report the existence of narcotic crime and how our efforts to deal with crime against crime not reporting narcotic crime. This research uses normative juridical and empirical juridical approaches. Data collection procedures were carried out using literature and field studies; the data were analyzed qualitatively to obtain conclusions and suggestions. An example of a crime not reporting the existence of a narcotics crime with permanent legal force is in Decision Number: 522/Pid.Sus/2022/PN Tjk with the defendant Ali Amarsyah Bin Misran being imprisoned for 8 (eight) months because it was proven legally and convincingly committing the crime of Article 114 of the Narcotics Law. The results of the research and discussion show that: Factors that lead to crimes not reporting narcotics crimes consist of the community does not want to deal with legal issues because they are considered to be a hassle for themselves, the community being afraid of the perpetrators of criminal acts and their syndicates which have the potential to threaten the safety of their lives if known reporting narcotics crimes and the lack of public understanding of the legal protection they will get if they report narcotics crimes to law enforcement. Efforts to overcome crime by not reporting the existence of narcotics crimes non-prenatally are by conducting counseling on legal awareness to the public so that people are willing to become reporters of narcotics crimes and provide security and safety guarantees for reporters. Penal efforts are carried out by a process of inquiry and investigation. Investigators take action in matters and according to the manner regulated in this law to seek and collect evidence with that evidence to shed light on the crime that occurred and to find suspects who have not reported a narcotics crime.

Hak Merek merupakan hak eksklusif yang diberikan oleh negara kepada pemilik merek. Berdasarkan Pasal 499 KUH Perdata, pada intinya menyatakan bahwa benda merupakan segala sesuatu yang dapat menjadi obyek hak milik bisa di jaminkan maupun dialihkan. Maka dari itu, isu hukum dalam penulisan ini yaitu bagaimana bentuk perlindungan dan kepastian hukum kedepan bagi pemegang hak merek yang sesuai dengan karakteristik hak merek. Tujuan penelitian ini adalah menemukan hak merek sebagai hak alamiah atau hak hukum yang sesuai dengan karakteristik hak merek. Hasil penelitian ini Karakteristik hak merek yaitu hak eksklusif yang diberikan oleh Negara kepada pemilik merek yang terdaftar dalam jangka waktu tertentu serta dapat dialihkan dengan membuat surat perjanjian atau lisensi kepada orang lain untuk menggunakannya, selanjutnya merek dalam hukum kebendaan yang melekat untuk dinikmati serta bisa dilihkan dengan jaminan, namun pada standart itu belum ada kepastian hukumya apabila debitor mengalami kredit macet, maka dibutuhkan perlindungan oleh negara berupa peraturan perundangan bersifat preventif yang dilakukan melalui pendaftaran merek. Kata Kunci: Hak Kekayaan Intelektual, Hak Merek, Perlindungan Hak Merek Trademark right are exclusive rights granted by the state to brand owners, based on Article 499 of the Civil Code, in essence it states that objects are anything that can become objects of property. Therefore, the legal issues in this writing are, what forms of future legal protection and certainty for trademark rights holders are appropriate with trademark rights characteristics. The purpose of this study is to find trademark rights as natural rights or legal rights that are in accordance with the characteristics of trademark rights. The results of this research are the characteristics of trademark rights, namely the exclusive rights granted by the State to trademark owners who are registered for a certain period of time and can be transferred by making a letter of agreement or license to another person to use it, then the mark in material law is inherent to be enjoyed and can be changed by guarantee, but at this standard there is no legal certainty if the debtor has bad credit, then protection by the state is needed in the form of preventive legislation which is carried out through trademark registration. Keywords: Intellectual Property, Brand Rights, Brand Right Protection REFERENCES Agung Sudjatmiko, Perlindungan Hukum Hak Atas Merek, Yuridika, Vo. 15, No. 5, September – Agustus, 2000. Ari Wibowo, Penerapan Prinsip Itikad Baik dan Daya Pembeda Dalam Pendaftaran Merek Dagang yang Bersifat Keterangan Barang Berdasarkan Undang-Undang Nomor 15 Tahun 2001 Tentang Merek, Junal Privat Law, Vol. VII, 2015. Asri Jayanto, Dewi, Kajian Yuridis Terhadap Merek Sebagai Jaminan Pada Lembaga Perbankan, Jurnal Ilmu Hukum, Vol. 32, No. 3, 2017. Budi Agus Riswandi dan M. Syamsudin. 1997. Hak Kekayaan Intelektual dan Budaya Hukum. Bandung: Citra Aditya Bakti. Caroline, Berkatini. 2017. Pengualifikasian Merek Sebagai Benda Berdasarkan Kitab Undang-Undang Hukum Perdata Untuk Dapat Dijadikan Objek Jaminan, Tesis. Bandung: Universitas Katolik Parahyangan. Fajar Nurcahya Dwi Putra, Perlindungan Hukum Bagi Pemegang Hak Atas Merek Terhadao Perbuatan Pelanggaran Merek, Jurnal Ilmu Hukum, ISSN: 08538964. Gania Balqiz, Wizna, Perlindungan Merek Sebagai Hak Kekayaan Intelektual: Studi di Kota Semarang, Indonesia, Jurnal of Judicial Review, ISSN 1907-6479, 2021. Hery Firmansyah. 2013. Perlindungan Hukum Terhadap Merek” Panduan Memahami Dasar-Dasar Hukum Penggunaan dan Perlindungan Merek. Yogyakarta: Medpress Digital. I Ketut Markeling. 2016. Bahan Kuliah Hukum Perdata (Pokok Bahasan: Hukum Benda). Denpasar: Universitas Udayana. Khoirul Hidayah, Kajian Hukum Islam Terhadap Hak Merek Sebagai Obyek Dalam Perjanjian Rahn, Jurnal Syariah dan Hukum, Vol. 6, No. 1, 2014. Muhammada Djumhana dan R. Djubaedillah. 2009. Hak Milik Intelektual, Sejarah, Teori dan Prakteknya di Indonesia. Bandung: Citra Aditya bakti. Nur Aisyah, Lindatin Dwiatin, Kasmawati dengan Judul Penelitian Penyelesaian Sengketa Kepemilikan Merek Dagang Antara Perusahaan dan Direktur, Fakultas Hukum, Pactum Law Journal Volume 1, No 01 (2017). OK Saidin. 2015. Aspek Hukum Hak Kekayaan Intelektual. Jakarta: Raja Grafindo Persada. Peter Mahmud Marzuki. 2014. Penelitian Hukum. Jakarta: Kencana Prenada Media Group. R Murjiyanto, Konsep Kepemilikan Hak Atas Merek di Indonesia (Studi Pergeseran Sistem Deklaratif ke Dalam Sistem Konstitutif), Jurnal Hukum Ius Quia Iustum, Vo. 24, No. 2, 2017. Raden Suryodiningrat. 2017. Pengantar Ilmu Hukum Merek. Jakarta: Pradnya Paramita. Ruslam, Surianto. 2009. Mendesaian Logo. Jakarta: Gramedia Pustaka Utama. Satjipto Raharjo. 2000. Ilmu Hukum. Bandung: Citra Aditya Bakti. Sudargo Gautama. 2016. Hak Merek Dagang Menurut Perjanjian TRIPs-GATT dan Undang-Undang Merek Republik Indonesia. Bandung: Citra Aditya Bakti. Sulastri, Perlindungan Hukum Terhadap Merek, Jurnal Yuridis, Vol. 5, No. 1, 2018. Tommy Hendra Purwaka. 2017. Perlindungan Merek. Jakarta: Yayasan Obor Indonesia.

Akta perkawinan membuktikan bahwa status pasangan dan anak-anak mereka adalah sah, dan bahwa anak-anak tersebut adalah ahli waris yang sah dan telah diberikan status konklusif sebagai warga negara Indonesia, menjadi sangat penting. Rumusan masalah dalam penelitian ini adalah: “Bagaimana tingkat kesadaran hukum masyarakat tentang akta perkawinan di Desa Gelang Kecamata Sumberbaru Jember?” Penelitian ini menggunakan tiga teknik penelitian yang digunakan dalam penelitian ini: wawancara, observasi, dan wawancara. Metode observasi adalah metode penyelidikan dengan cara mengamati secara langsung di lapangan. Lokasi sasaran adalah Desa Gelang. Kesadaran masyarakat relatif tinggi di Desa Gelang RT 02 RW 06 Kecamatan Sumberbaru Kabupaten Jember yang memiliki akta kawin.Hal ini terbukti dari jumlah kepala keluarga yang memiliki akte perkawinan yaitu sebanyak 100 pasangan, sedangkan yang tidak memiliki yaitu sebanyak 8 pasangan. Penyebab di Desa Gelang RT 02 RW 06 Kecamatan Sumberbaru Jember tidak memiliki dan tidak mengurus kepemilikan akta perkawinanan adalah ketidak tahuan masyarakat atas pentingnya kepemilikan akta perkawinan, dan adanya perkawinanan siri atau perkawinan dibawah umur. Kata kunci : Kesadaran Hukum, Akta Perkawinan, Perlindungan Hukum A marriage certificate proving that the status of the spouses and their children is legal, and that the children are legal heirs and have been granted conclusive status as Indonesian citizens, is very important. The formulation of the problem in this research is: "What is the level of public legal awareness regarding marriage certificates in the Village of Gelang Kecamata Sumberbaru Jember?". The purpose of this study was to determine the legal awareness of the community in the ownership of marriage certificates. The study used three research techniques, namely interviews, observation, and interview methods. The method of observation is done to find out through direct observation in the field. The place that is used as an object is the community in the Bracelet Village. Community awareness in the village of Bracelet RT 02 RW 06 Sumberbaru District, Jember Regency in the ownership of marriage certificates is relatively high. This is evident from the number of heads of families who have a marriage certificate as many as 100 couples, while those who do not have as many as 8 couples. The cause in Bracelet Village, RT 02 RW 06, Sumberbaru District, Jember, does not have and does not take care of ownership of a marriage certificate is the public's ignorance of the importance of having a marriage certificate, and the existence of siri marriages or underage marriages. Keywords: Legal Awareness, Marriage Certificate, Legal Protection REFERENCES Abdul Rahman Ghozali, Fiqih Munakahat, 2010, Kencana prenada Media, Jakarta. Adhim Fauzil, mohammad, dkk. Perkawinan memuliakan Sunnah, 2017, Yogyakarta: Pro-U Media Azhar Basir, Hukum Perkawinan, 2018, Gama UPI, Yogyakarta Chuzaimah T. Yanggo, A. Hafiz Anshary, et al, Problematika Hukum Islam Kontemporer (1), 1996, Pusaka Firdaus, Jakarta. Faqih, dkk, 2009, Perkawinan Usia Dini dan dampaknya, Sumedang: Universitas Padjajaran. Hamid Sarong , Hukum Perkawinan Islam Di Indonesia, 2015, Global Education Institute, Banda Aceh. Lexy, Moleong, 2003, Metodologi Penelitian Kualitatif, Bandung: Rosda Karya. Muntamah, dkk, Perkawinan Dini di Indonesia, 2019, Semarang: Universitas Negeri Semarang. M.yahya Harahap, Informasi Materi Kompilasi Hukum Islam: Mem-positifkan abstraksi hukum islam, mimbar hukum no. 5, 1992 Neng Hilda Febriyanti, Kesadran Hukum Masyarakat Tehadap Perkawinan diBawah Umur Ditinjau dari Undang-UndangNo. 16 Tahun 2019 Tentang Perubahan Undang-Undang No. 1 Tahun 1974 Tentang Perkawinan, 2021, Jurnal Pendidikan Pancasila dan Kewarganegaraan- Universitas Banten Jaya : PROPATRIA ol. 4, No. 1 Sayyid Muhammad ibn ‘Alwi al-maliki al-hasani, Seni Berkeluarga Islami, membongkar segudang problematikan kehidupan rumah tangga berikut solusinya, 2004, nuqthoh, Yogyakarta. Umar Haris Sanjaya, Hukum Perkawinan Islam di Indonesia, 2017, Yogyakarata: Grama medika. Soetojo Prawirohamidjojo, 2012, Pluralisme Dalam Perundang-Undangan Perkawinan Di Indonesia, Airlangga University Press, Surabaya. Soemiyati, Hukum Perkawinan Islam dan Undang-Undang Perkawinan, 1999, cetakan ke-4, Liberty Yogyakarta. Suharsimi Arikunto, 2009, Metodologi Penelitian Pendidikan, Jakarta: Bumi Aksara. Undang-Undang Dasar 1945 Undang-Undang No. 1 Tahun 1974 Tentang Perkawinan Undang-Undang No. 16 Tahun 2019 Tentang Perubahan Atas Undang-Undang No 1 Tahun 1974 Tentang Perkawinan Undang-Undang Nomor 23 Tahun 2002 tentang Perlindungan Anak Kompilasi Hukum Islam Budi Prasetyo, “Analisis Akibat Hukum Dari Perkawinan Di bawah Tangan” dalam jurnal Ilmiah Serat Acitya Vol 7 no. 1 Tahun 2018, http://jurnal.untagsmg.ac.id/index.php/sa/article/view/715 Enik Isnaeni, “Perkawinan Siri Dalam Perspektif Hukum Islam, Hukum Positif dan Hak Asasi Manusia”, dalam Jurnal Independent Unisla Vol. 2 no. 1 Tahun 2014, http://jurnalhukum.unisla.ac.id/index.php/independent/article/view/18/0 Addin Daniar Syamdan, “ Aspek Hukum Perkawinan Sirri Dan Akibat Hukumnya” oleh Addin Daniar Syamdan dalam Jurnal Notarius Vol. 12 No. 1 Tahun 2019. https://ejournal.undip.ac.id/index.php/notarius/article/download/28897/16735

Kekerasan seksual telah menjadi perhatian banyak pihak. Pemerintah maupun penegak hukum juga mmberi atensi serius sehingga kebiri kimia dijadikan alternatif hukuman untuk pelaku kejahatan seksual tersebut. Artikel ini menganalisis tentang kebijakan pidana tindakan kebiri kimia terhadap pelaku kejahatan seksual berulang pada anak di Indonesia. Teori kebijakan pidana yang dikemukakan Marc Ancel dan teori tujuan pemidanaan Herbert L. Packer dijadikan landasan dalam membahas persoalan ini. Artikel ini adalah penelitian hukum normatif atau studi kepustakaan/studi dokumen. Kajian dilakukan terhadap regulasi negara yang tertulis maupun bahan-bahan hukum lain, serta literatur yang memiliki kesesuaian dengan topik yang tengah dibahas. Kesimpulan penelitian ini menunjukkan, Undang-Undang nomor 17 Tahun 2016 Tentang Penetapan Peraturan Pemerintah Pengganti Undang-Undang Nomor 1 Tahun 2016 Tentang Perubahan Kedua Atas Undang-Undang Nomor 23 Tahun 2002 Tentang Perlindungan Anak Menjadi Undang-Undang dan Peraturan Pemerintah Nomor 70 Tahun 2020, mengenai kebiri kimian, selayaknya “ditinjau ulang kembali” untuk mendapatkan suatu formulasi pemidanaan yang lebih humanis serta tidak merendahkan martabat manusia. Kata Kunci: Kebijakan Pidana, Kekerasan Seksual Anak, Kebiri Kimia Sexual violence has become a concern of many parties. Especially if the victims are children. The government and judiciary are also giving serious attention to. Thus, chemical castration is used as an alternative punishment for the perpetrators of these sexual crimes. This article analyzes the criminal policy of chemical castration against perpetrators of repeated sexual crimes against children in Indonesia. The theory of criminal policy proposed by Marc Ancel and the theory of the purpose of punishment by Herbert L. Packer are used as the basis for discussing this issue. This article is a normative legal research or literature study/document study. Studies are conducted on written state regulations and other legal materials, as well as literature that is relevant to the topic being discussed. The conclusion of this study shows that Law Number 17 of 2016 concerning the Stipulation of Government Regulations in Lieu of Law Number 1 of 2016 concerning the Second Amendment to Law Number 23 of 2002 concerning Child Protection to become Laws and Government Regulations Number 70 of 2020, regarding chemical castration, it should be "re-examined" to obtain a formulation of punishment that is more humane and does not demean human dignity. Keywords: Criminal Policy, Child Sexual Violence, Chemical Castration REFERENCES Ancel, Marc. Social Defence: A Modern Approach to Criminal Problems. London: Psychology Press, 1998. Arief, Barda Nawawi. Beberapa Aspek Kebijakan Penegakan Dan Pengembangan Hukum Pidana. Bandung: Citra Aditya Bakti, 1998. ———. Bunga Rampai Kebijakan Hukum Pidana, Perkembangan Penyusunan Konsep KUHP Baru. Jakarta: Kencana Prenada Media Group, 2011. ———. Kebijakan Legislatif Dalam Penanggulangan Kejahatan Dengan Pidana Penjara. Semarang: Universitas Diponegoro, 1994. ———. Masalah Penegakan Hukum Dan Kebijakan Hukum Pidana Dalam Penanggulangan Kejahatan. Jakarta: Kencana Prenada Media Group, 2018. Bentham, Jeremy. The Collected Works of Jeremy Bentham: An Introduction to the Principles of Morals and Legislation. Oxford: Clarendon Press, 1996. Ibipurwo, Guruh Tio, Yusuf Adi Wibowo, and Joko Setiawan. “Pencegahan Pengulangan Kekerasan Seksual Melalui Rehabilitasi Pelaku Dalam Perspektif Keadilan Restoratif.” Jurnal Hukum Respublica 21, no. 2 (2022): 155–78. Ibrahim, Johnny. Teori & Metodologi Penelitian Hukum Normatif. Malang: Bayumedia Publishing, 2007. Jamaluddin, Madiasa Ablisar, Marlina, and Edy Ikhsan. “Hukuman Kebiri Kimia Bagi Pelaku Kejahatan Seksual Terhadap Anak Berdasarkan Ketentuan Undang-Undang Nomor 17 Tahun 2016.” USU Law Journal 7, no. 6 (2019): 84–92. Jayus, Jaja Ahmad. “Pembangunan Hukum Dan Keadilan Harus Sesuai Di Era Revolusi Industri 4.0.” In The 2nd International Conference on Law, Governance and Social Justice (ICoLGaS). Banyumas: Fakultas Hukum Universitas Jenderal Soedirman, 2020. Kementerian Koordinator Bidang Pembangunan Manusia dan Kebudayaan. “N.” https://www.kemenkopmk.go.id, 2020. https://www.kemenkopmk.go.id/anak-sebagai-penentu-masa-depan-indonesia. Listiawatie, Liliana, and I. Dewa Made Suartha. “Penjatuhan Hukuman Kebiri Kepada Para Pelaku Kejahatan Seksual Terhadap Anak Dibawah Umur.” Kertha Wicara 6 (2017): 1–15. Mahmodin, Mohammad Mahfud. Politik Hukum Di Indonesia. Jakarta: LP3ES, 1998. Mardiya, Nuzul Qur’aini. “Penerapan Hukuman Kebiri Kimia Bagi Pelaku Kekerasan Seksual.” Jurnal Konstitusi 14, no. 1 (2017): 213–33. Marpaung, Leden. Tindak Pidana Korupsi, Pemberantasan Dan Pencegahan. Jakarta: Djambatan, 2001. Marzuki, Peter Mahmud. Pengantar Hukum. Jakarta: Kencana, 2017. Monica, Made Sugi Hartono, and Ni Putu Rai Yuliartini. “Sanksi Kebiri Kimia Dalam Tindak Pidana Pencabulan Anak Berdasarkan Undang-Undang Nomor 17 Tahun 2016 Tentang Perlindungan Anak Ditinjau Dari Tujuan Pemidanaan Dan Perspektif Hak Asasi Manusia (HAM).” Jurnal Komunitas Yustisia 4, no. 2 (2021): 564–75. Muladi. Lembaga Pidana Bersyarat. Bandung: PT Alumni, 2002. Muladi, and Barda Nawawi Arief. Teori-Teori Dan Kebijakan Pidana. Bandung: PT Alumni, 2010. Napitupulu, Erasmus. “PP Kebiri Kimia, Diyakini Bisa Jadi Efek Jera Dan Kritik Soal Perlindungan Korban.” Kompas.Com, 2020. https://nasional.kompas.com/read/2021/01/05/08513071/pp-kebiri-kimia-diyakini-bisa-jadi-efek-jera-dan-kritik-soal-perlindungan?page=all. Packer, Herbert L. The Limits of the Criminal Sanction. California: Standford University Press, 1968. Pemerintah Indonesia. “Peraturan Pemerintah 70/2020 Tentang Tata Cara Pelaksanaan Tindakan Kebiri Kimia, Pemasangan Alat Pendeteksi Elektronik, Rehabilitasi, Dan Pengumuman Identitas Pelaku Kekerasan Seksual Terhadap Anak.” Jakarta, 2020. Prodjodikoro, Wirjono. Asas Asas Hukum Pidana. Bandung: Eresco, 1981. Purnama, Dharmawan A. “Apa Arti Pedofilia Dan Dampaknya Pada Korban? Begini Penjelasan Dokter.” Kompas.Com, 2021. https://health.kompas.com/read/2021/09/12/190100568/apa-arti-pedofilia-dan-dampaknya-pada-korban-begini-penjelasan-dokter?page=all. Rahardjo, Satjipto. Ilmu Hukum. Bandung: Citra Aditya Bakti, 1991. Reid, Sue Titus. Criminal Justice, Procedur and Issues. New York: West Publising Company, 1987. Satrio, Ariedwi. “Jokowi Teken PP Nomor 70 Tahun 2020, Predator Seksual Dihukum Kebiri.” INews, 2021. https://www.inews.id/news/nasional/jokowi-teken-pp-nomor-70-tahun-2020-predator-seksual-dihukum-kebiri. Sholeh, Asrorun Niam. “KPAI: Suntik Kebiri Hukuman Tepat Bagi Paedofil.” Regional Kompas, 2014. https://regional.kompas.com/read/2014/05/10/1918569/KPAI.Suntik.Kebiri.Hukuman.Tepat.bagi.Paedofil. Sholehuddin. Sistem Sanksi Dalam Hukum Pidana, Ide Dasar Double Track System Dan Implementasinya. Jakarta: Rajagrafindo Persada, 2003. Simons. Kitab Pelajaran Hukum Pidana. Bandung: Pionir Jaya, 1992. Soekanto, Soerjono, and Sri Mamudji. Penelitian Hukum Normatif. Jakarta: PT Raja Grafindo Persada, 2004. Sudarto. Hukum Pidana Dan Perkembangan Masyarakat, Kajian Terhadap Pembaharuan Hukum Pidana. Bandung: Sinar Baru, 1993. Warsono, Agustinus Tri Edy. “Krisis Sexual Abuse Di Usa Dan Pembelajaran Bagi Gereja Indonesia.” Lumen Veritatis: Jurnal Filsafat Dan Teologi 10, no. 2 (2020): 165–80. Peraturan Pemerintah Nomor 70 Tahun 2020 tentang Tata Cara Pelaksanaan Tindakan Kebiri Kimia, Pemasangan Alat Deteksi Elektronik, Rehabilitasi, dan Pengumuman Identitas Pelaku Kekerasan Seksual terhadap Anak. Undang-Undang Dasar Negara Republik Indonesia 1945 (UUD 1945). Undang-Undang Nomor 1 Tahun 1946 tentang Peraturan Hukum Pidana (KUHP). Undang-Undang Nomor 8 Tahun 1981 tentang Peraturan Hukum Acara Pidana (KUHAP). Undang-Undang Nomor 39 Tahun 1999 tentang Hak Asasi Manusia (UU HAM). Undang-Undang Nomor 17 Tahun 2016 Tentang Penetapan Perppu Nomor 1 Tahun 2016 Tentang Perubahan Kedua Atas Undang-Undang Nomor 23 Tahun 2002 Tentang Perlindungan Anak Menjadi Undang-Undang. Undang-Undang Nomor 13 Tahun 2006 tentang Perlindungan Saksi dan Korban Hiariej, Edward Omar Sharif. “Wamenkumham Sebut Ada 7 Bentuk Tindak Pidana Kekerasan Seksual Di RUU TPKS.” Kompas.Com, 2022. https://nasional.kompas.com/read/2022/02/11/15503401/wamenkumham-sebut-ada-7-bentuk-tindak-pidana-kekerasan-seksual-di-ruu-tpks. Kementerian Koordinator Bidang Pembangunan Manusia dan Kebudayaan. “N.” https://www.kemenkopmk.go.id, 2020. https://www.kemenkopmk.go.id/anak-sebagai-penentu-masa-depan-indonesia. Napitupulu, Erasmus. “PP Kebiri Kimia, Diyakini Bisa Jadi Efek Jera Dan Kritik Soal Perlindungan Korban.” Kompas.Com, 2020. https://nasional.kompas.com/read/2021/01/05/08513071/pp-kebiri-kimia-diyakini-bisa-jadi-efek-jera-dan-kritik-soal-perlindungan?page=all. Purnama, Dharmawan A. “Apa Arti Pedofilia Dan Dampaknya Pada Korban? Begini Penjelasan Dokter.” Kompas.Com, 2021. https://health.kompas.com/read/2021/09/12/190100568/apa-arti-pedofilia-dan-dampaknya-pada-korban-begini-penjelasan-dokter?page=all. Satrio, Ariedwi. “Jokowi Teken PP Nomor 70 Tahun 2020, Predator Seksual Dihukum Kebiri.” INews, 2021. https://www.inews.id/news/nasional/jokowi-teken-pp-nomor-70-tahun-2020-predator-seksual-dihukum-kebiri. Sholeh, Asrorun Niam. “KPAI: Suntik Kebiri Hukuman Tepat Bagi Paedofil.” Regional Kompas, 2014. https://regional.kompas.com/read/2014/05/10/1918569/KPAI.Suntik.Kebiri.Hukuman.Tepat.bagi.Paedofil.

Abstract The procedures of prenatal and preimplantation diagnostics are discussed critically again and again in our community. In addition to the permanently controversial issues of embryo protection and abortion, considerations that discrimination on the basis of disability could occur with problematic consequences also for already born people with disabilities and their relatives now play a central role.

Abstract Definition The routinization of prenatal diagnosis is the source of bioethical and policy debates regarding choice, autonomy, access, and protection. To understand these debates in the context of cultural diversity and moral pluralism, we compare Israel and Germany, focusing on two recent repro-genetic “hot spots” of such policy-making at the beginning of life: pre-implantation genetic diagnosis (PGD) and non-invasive prenatal genetic testing (NIPT), two cutting-edge repro-genetic technologies that are regulated and viewed very differently in Germany and Israel, reflecting different medicolegal policies as well as public and bioethical considerations. Arguments First, we compare policy-making in the context of PGD for HLA (human leukocyte antigen) typing, used to create sibling donors, approved in Israel under specific conditions while prohibited in Germany. Second, we compare policy-making in the context of NIPT, which came under fire in Germany, while in Israel there has been little public debate about it. Conclusion Both countries justify their contrasting policies as reflecting a concern for the well-being and care of the embryo/child, thus highlighting different concepts of embryo/child protection, (relational) autonomy, family relations, and the impact of religion and history on the promotion/protection of life. We use the juxtaposition of PGD and NIPT to highlight some inconsistencies in policies concerning the protection of extra- and intra-corporeal embryos. We conclude by drawing on the comparison to show how national variations exist alongside co-evolution.

The paper discusses the judgement of the Constitutional Tribunal of the Republic of Poland, given on 22 October 2020 (K 1/20) concerning eugenic abortion. The Constitutional Tribunal adjudicated that legal provisions permitting termination of pregnancy on the basis of “a high probability of the foetus’s severe and irreversible impairment” or of “the foetus’s lifethreatening incurable illness” are inconsistent with the Constitution of the Republic of Poland. The result of the ruling is a ban on eugenic abortion and, consequently, a wider scope of protection of human life in the prenatal period.

Advances in biological sciences have led to the emergence of a specialized field called biolaw, which deals with the legal aspects of technology in this domain. A significant issue in biolaw revolves around determining the legal status of embryos and their relationship to pregnant women. This question is intertwined with the beginning of human life and the protection of the unborn. Furthermore, advancements in genetics, such as DNA decoding and mapping of the human genome, alongside developments in Medically Assisted Reproduction, have shifted legal focus to the legal status and protection of reproductive material and fertilized eggs. The European Court of Human Rights also considers these matters in relation to the European Convention. These deliberations involve balancing the rights of fathers, the value and protection of embryos, women's freedom and autonomy in motherhood choices, access to contraception and abortion, as well as public interests in preserving the health of pregnant women during situations where conflicts arise between the lives of the woman and the embryo. Based on the above, this work seeks to present some of the fundamental common aspects of biolaw from a legal standpoint, always relating to the embryo or fetus: a) The right to life and how it relates to human dignity, b) the question of conception and how it relates to pregnancy, the observed conflicts of rights, the right to reproduction and prenatal diagnosis, but also death, and c) the right to health. All the above will be described as simply as possible using jurisprudential examples from cases heard by the European Court of Human Rights (E.C.H.R). Finally, certain ethical problems about current technologies (synthetic life? mouse embryogenesis? Vaccine trials with pregnant women?) and red lines in the context of bioethics will be raised.

Abstract The United States has one of the worst maternal mortality rates among developed nations. American mothers are three times more likely than Canadian mothers and six times more likely than Scandinavian mothers to die from pregnancy-related deaths. Currently, for every 100,000 live births, 26.4 mothers are dying in the U.S, with significant disparities between White mothers and mothers of color. Projections indicate that by 2030, the maternal mortality rate will rise to 45 maternal deaths out of 100,000 live births. In direct contrast, most other similarly situated high-income nations have decreased their maternal mortality rates in recent years, evidencing only single-digit mortality per 100,000 mothers. This research examines how social protection measures afforded by the law can facilitate differences in these rates. Specifically, this presentation compares legal interventions enshrined in social law that impact maternal health in the United States, Germany, and the Netherlands, including mandated access to prenatal care, midwifery reimbursement, and obligatory duration of postnatal care. Compared to the United States, both Germany and the Netherlands enshrine more comprehensively midwifery compensation and access to postnatal care in their social legal codes and insurance benefit schemes. Evidence accumulated by comparing these interventions with maternal mortality statistics suggests that legal interventions that spur extra attention to mothers during and after birth may help prevent pregnancy-related deaths. It also opens a discussion about how policymakers can use legal interventions to help eliminate racial disparities in maternity practice. Key messages Codified legal interventions that mandate extra attention to mothers during and after birth may help prevent pregnancy-related deaths. Compared to the U.S., both Germany and the Netherlands better enshrine midwifery compensation and access to postnatal care in their social legal codes and insurance benefit schemes.

Background: Cesarean section imposes a huge social and economic cost on the individual and health care system. Iran is one of the countries that have experienced a significant increase in cesarean section in recent decades. There are few studies on the causes of women's reluctance to give natural birth. This study was conducted to determine the women’s unwillingness to have vaginal delivery through qualitative methods. Methods: The present qualitative study was conducted between March to July 2023 at private and three public centers in Qom City. Purposeful sampling was used and based on inclusion criteria; 17 women were recruited in the study. MAXQDA software was used to analyze and manage the qualitative data. Results: Three main categories appeared from the data analysis, which included individual factors, professional factors, and social factors. The findings of this study showed that beliefs, fear, lack of knowledge, previous experiences, and psychological factors are the most important individual factors that cause unwillingness to give birth vaginally. Factors related to midwives and physicians, birth environment, social modeling, and legal protection affected women’s decision to choose cesarean delivery. Conclusion: The findings of this study showed that unwillingness to have vaginal delivery by women is an issue that has various reasons. These reasons remind us that education, awareness, and support in prenatal care should be considered more than ever. In addition, treatment systems play a role in increasing cesarean section, so it is the responsibility of midwifery and obstetric experts to make improvements in the treatment systems.

La Legge 40 del 19 febbraio 2004 che regola la PMA nel suo art. 1 indica gli scopi perseguiti: il superamento della sterilità delle coppie e la garanzia dei diritti di tutti i soggetti coinvolti compreso il concepito. Le relazioni ministeriali sull’attuazione della legge riferiscono a ogni anno sulla attuazione delle nuove tecniche, ma esclusivamente con riferimento al primo dei due obiettivi ora indicati. È doveroso, verificare se anche il secondo scopo è stato perseguito e in quale misura. Ciò è divenuto particolarmente urgente dopo le sentenze costituzionali che hanno reso lecita la generazione soprannumeraria di embrioni, la PMA eterologa, il ricorso alla PMA anche da parte di coppie non sterili ma portatrici di malattie potenzialmente ereditarie. Nell’impossibilità di modificare le sentenze costituzionali il cui effetto più negativo consiste nell’accumulo di embrioni congelati e rimasti privi di un progetto parentale, lo studio propone una serie di strumenti per limitare la lesione dei diritti del concepito. In particolare si propone che la forma eterologa della PMA possa attuarsi soltanto utilizzando gli embrioni già formati congelati e abbandonati. Viene ipotizzata anche una possibile obbligatoria rappresentanza processuale dei concepiti nelle vicende giudiziarie in cui i loro diritti sono in discussione; si argomenta contro l’anonimato dei c.d. donatori di gameti differenziando il regime del diritto a conoscere le proprie origini nelle diverse situazioni dell’adozione e del parto di donne che non vogliono essere nominate; viene auspicato l’intervento ministeriale per garantire che la generazione soprannumeraria avvenga soltanto nei casi in cui essa sia “strettamente necessaria” così come la legge continua a richiedere (art. 13); si dimostrava la netta differenza tra la diagnosi genetica pre-impianto e la diagnosi prenatale con riferimento alla tutela del concepito. ---------- The Italian Law n. 40 of February, 19, 2004 (Rules governing medically assisted fertilization), in its Article 1 focuses on two goals: to remedy reproductive problems arising as a result of human sterility or infertility and guarantee the rights of all the subjects concerned, the human embryo included. Every year on the ground of Art. 15, the Minister of Health draws up a report regarding the implementation of the Italian Law n. 40/2004, but only the first of the two goal is taken into account. Therefore, it is necessary understand if the second goal has been pursued and to what extent. Reflecting on this has become particularly urgent after the constitutional decisions that made lawful the generation of supernumerary embryos, the heterologous fertilization, the resort to “medically assisted procreation” by non-sterile couples but potentially carriers of hereditary diseases. Unfortunately, it isn’t possible to change the constitutional rulings whose most negative effect is the storage of cryopreserved embryos and their abandon without a parental project. In the light of this situation, the paper here summarized proposes a set of instruments in order to limit injuries to the rights of the human embryos. Notably, it is suggested that the heterologous fertilization may be implemented only by using the frozen and abandoned embryos already generated. It is also hypothesized a possible mandatory procedural representation of the human embryos in the legal proceedings in which their rights are debated; it is argued against the anonymity of the so-called “gamete donors” (as to this regard the rules on the right to know their origins are different depending on the different situations like adoption and childbirth of women who do not want to be named). Moreover the Ministerial intervention is called for ensuring that the supernumerary generation of human embryos is realized only when it is “strictly necessary” as the law continues to require (art. 13). Finally it is showed the clear difference between the genetic pre-implantation diagnosis and prenatal diagnosis with reference to the protection of the human beings at the beginning of their life.

AbstractPeople with serious mental illness (SMI) diagnoses who become pregnant are particularly vulnerable to symptom recurrence and resulting potential lack of decision-making capacity (Taylor et al. J Psychiatr Res 104:100-107, 2018; Bagadia et al. Int J Soc Psychiatry 66:792-798, 2020). In these situations, prenatal and behavioral health providers have little legally viable guidance on what medical and/or psychiatric care the patient desires (Aneja and Arora Indian J Med Ethics V:133-139, 2020). We created a “Reproductive Psychiatric Advance Directive (PAD),” grounded in Reproductive Justice principles, that promotes patient autonomy by proactively articulating perinatal medical and psychiatric care preferences. We conducted a medical and legal literature review using two sets of terms related to (1) PADs and (2) reproductive health. We convened an expert working group of legal, medical, psychiatric, peer, and advocacy leaders and community-based organizations to develop a Reproductive PAD. Our literature review yielded no results about Reproductive PADs. We created de novo a Reproductive PAD template with sections on medical and psychiatric history, informed consent for critical medical and psychiatric care, family planning and custody preferences, and optional sections on abortion and on electroconvulsive therapy. The Reproductive PAD provides a possible legal mechanism for people of childbearing age with SMI diagnoses to articulate their medical and psychiatric care choices around reproduction and pregnancy. Future research should evaluate the Reproductive PAD as an effective tool for protecting patient autonomy during pregnancy and postpartum and guiding medical and psychiatric providers.

This study offers an in-depth analysis of Down syndrome (DS) in Saudi Arabia, encompassing healthcare, societal integration, and policy frameworks. It assesses DS prevalence within the Saudi population against global rates and underscores the progress in prenatal diagnostics and screening for early detection. The significance of neonatal care and early intervention programs in the comprehensive development of children with DS is highlighted. The paper explores societal perceptions and efforts to increase public awareness and reduce stigma, with a particular focus on media and educational initiatives. It reviews the educational landscape for individuals with DS, touching on inclusive policies and specialized programs, and evaluates the effectiveness and obstacles of these approaches. The study also compares Saudi policies and legal protections for individuals with DS to international standards, illustrating the country’s advancements toward global norms. It examines support systems, including contributions from nonprofits, community programs, and family services, and concludes with an identification of ongoing challenges and recommendations for future enhancements. This comprehensive overview underlines the importance of a multifaceted approach to supporting individuals with DS in Saudi Arabia, aiming to enhance their quality of life and ensure their full integration into society.

Discrete events and processes influence development of individual humans. Attribution of personhood to any individual human being cannot be disconnected from the underlying biological events and processes of early human development. Nonetheless, the philosophical, sociological and legal components that are integral to the meaning of the term as commonly used cannot be deduced from biology alone. The challenge for biomedical scientists to inform discussion in this arena then rests on profiling the key biological events and processes that must be assessed when considering how one might objectively reason about the task of superimposing the concept of personhood onto the developing biological entity of a potential human being. Endogenous genetic and epigenetic events and exogenous developmental milieu processes diversify developmental trajectories of potential individual humans prior to livebirth. First, fertilization and epigenetic resetting of each individual's organismic clock to time zero (t = 0) at the gastrulation/primitive streak stage (day 15 of embryogenesis), are two discrete unseen biological events that impact a potential individual human's attributes. Second, those two discrete unseen biological events are immersed in the continuous developmental process spanning pre-fertilization and gestation, further driving individualization of diverse attributes of each future human before the third discrete and blatant biological event of parturition and livebirth. Exposures of the gravida to multiple diverse exogenous exposures means that morphogenesis and physiogenesis of every embryo/fetus has individualized attributes for its future human lifespan. Our proposed framework based on the biological discrete events and processes spanning pre-fertilization and prenatal development, implies that personhood should be incrementally attributed, and societal protections should be graduated and applied progressively across the pre-birth timespan.

Photo by niu niu on Unsplash ABSTRACT Shackling prisoners has been implemented as standard procedure when transporting prisoners in labor and during childbirth. This procedure ensures the protection of both the public and healthcare workers. However, the act of shackling pregnant prisoners violates the principles of ethics that physicians are supposed to uphold. This paper will explore how shackling pregnant prisoners violates the principle of justice and beneficence, making the practice unethical. INTRODUCTION Some states allow shackling of incarcerated pregnant women during transport and while in the hospital for labor and delivery. Currently, only 22 states have legislation prohibiting the shackling of pregnant women.[1] Although many states have anti-shackling laws prohibiting restraints, these laws also contain an “extraordinary circumstances” loophole.[2] Under this exception, officers shackle prisoners if they pose a flight risk, have any history of violence, and are a threat to themselves or others.[3] Determining as to whether a prisoner is shackled is left solely to the correctional officer.[4] Yet even state restrictions on shackling are often disregarded. In shackling pregnant prisoners during childbirth, officers and institutions are interfering with the ability of incarcerated women to have safe childbirth experiences and fair treatment. Moreover, physicians cannot exercise various ethical duties as the law constrains them. In this article, I will discuss the physical and mental harms that result from the use of restraints under the backdrop of slavery and discrimination against women of color particularly. I argue that stereotypes feed into the phenomenon of shackling pregnant women, especially pregnant women of color. I further assert that shackling makes it difficult for medical professionals to be beneficent and promote justice. BACKGROUND Female incarceration rates in the United States have been fast growing since the 1980s.[5] With a 498 percent increase in the female incarceration population between 1981 and 2021, the rates of pregnancy and childbirth by incarcerated people have also climbed.[6],[7] In 2021, over 1.2 million women were incarcerated in the United States.[8] An estimated 55,000 pregnant women are admitted to jails each year.[9],[10] Many remain incarcerated throughout pregnancy and are transported to a hospital for labor and delivery. Although the exact number of restrained pregnant inmates is unclear, a study found that 83 percent of hospital prenatal nurses reported that their incarcerated patients were shackled.[11] I. Harms Caused by Shackling Shackling has caused many instances of physical and psychological harm. In the period before childbirth, shackled pregnant women are at high risk for falling.[12] The restraints shift pregnant women’s center of gravity, and wrist restraints prevent them from breaking a fall, increasing the risk of falling on their stomach and harming the fetus.[13] Another aspect inhibited by using restraints is testing and treating pregnancy complications. Delays in identifying and treating conditions such as hypertension, pre-eclampsia, appendicitis, kidney infection, preterm labor, and especially vaginal bleeding can threaten the lives of the mother and the fetus.[14] During labor and delivery, shackling prevents methods of alleviating severe labor pains and giving birth.[15] Usually, physicians recommend that women in labor walk or assume various positions to relieve labor pains and accelerate labor.[16] However, shackling prevents both solutions.[17] Shackling these women limits their mobility during labor, which may compromise the health of both the mother and the fetus.[18] Tracy Edwards, a former prisoner who filed a lawsuit for unlawful use of restraints during her pregnancy, was in labor for twelve hours. She was unable to move or adjust her position to lessen the pain and discomfort of labor.[19] The shackles also left the skin on her ankles red and bruised. Continued use of restraints also increases the risk of potentially life-threatening health issues associated with childbirth, such as blood clots.[20] It is imperative that pregnant women get treated rapidly, especially with the unpredictability of labor. Epidural administration can also become difficult, and in some cases, be denied due to the shackled woman’s inability to assume the proper position.[21] Time-sensitive medical care, including C-sections, could be delayed if permission from an officer is required, risking major health complications for both the fetus and the mother.[22] After childbirth, shackling impedes the recovery process. Shackling can result in post-delivery complications such as deep vein thrombosis.[23] Walking prevents such complications but is not an option for mothers shackled to their hospital beds.[24] Restraints also prevent bonding with the baby post-delivery and the safe handling of the baby while breast feeding.[25] The use of restraints can also result in psychological harm. Many prisoners feel as though care workers treat them like “animals,” with some women having multiple restraints at once— including ankles, wrists, and even waist restraints.[26] Benidalys Rivera describes the feeling of embarrassment as she was walking while handcuffed, with nurses and patients looking on, “Being in shackles, that make you be in stress…I about to have this baby, and I’m going to go back to jail. So it’s too much.”[27] Depression among pregnant prisoners is highly prevalent. The stress of imprisonment and the anticipation of being separated from their child is often overwhelming for these mothers.[28] The inhumane action has the potential to add more stress, anxiety, and sadness to the already emotionally demanding process of giving birth. Shackling pregnant prisoners displays indifference to the medical needs of the prisoner.[29] II. Safety as a Pretense While public safety is an argument for using shackles, several factors make escape or violence extremely unlikely and even impossible.[30] For example, administering epidural anesthesia causes numbness and eliminates flight risk.[31] Although cited as the main reason for using shackles, public safety is likely just an excuse and not the main motivator for shackling prisoners. I argue that underlying the shackling exemplifies the idea that these women should not have become pregnant. The shackling reflects a distinct discrimination: the lawmakers allowing it perhaps thought that people guilty of crimes would make bad mothers. Public safety is just a pretense. The language used to justify the use of restraint of Shawanna Nelson, the plaintiff in Nelson v. Correctional Medical Services, discussed below, included the word “aggressive.”[32] In her case, there was no evidence that she posed any danger or was objectively aggressive. Officer Turnesky, who supervised Nelson, testified that she never felt threatened by Nelson.[33] The lack of documented attempts of escape and violence from pregnant prisoners suggests that shackling for flight risk is a false pretense and perhaps merely based on stereotypes.[34] In 2011, an Amnesty International report noted that “Around the USA, it is common for restraints to be used on sick and pregnant incarcerated women when they are transported to and kept in hospital, regardless of whether they have a history of violence (which only a minority have) and regardless of whether they have ever absconded or attempted to escape (which few women have).”[35] In a 2020 survey of correctional officers in select midwestern prisons, 76 percent disagreed or strongly disagreed with restraining pregnant women during labor and delivery.[36] If a correctional officer shackles a pregnant prisoner, it is not because they pose a risk but because of a perception that they do. This mindset is attributed to select law enforcement, who have authority to use restraints.[37] In 2022, the Tennessee legislature passed a bill prohibiting the use of restraints on pregnant inmates. However, legislators amended the bill due to the Tennessee Sherriff Association’s belief that even pregnant inmates could pose a “threat.”[38] Subjecting all prisoners to the same “precautions” because a small percentage of individuals may pose such risks could reflect stereotyping or the assumption that all incarcerated people pose danger and flight risk. To quell the (unjustified) public safety concern, there are other options that do not cause physical or mental harm to pregnant women. For example, San Francisco General Hospital does not use shackles but has deputy sheriffs outside the pregnant women’s doors.[39] III. Historical Context and Race A. Slavery and Post-Civil War The treatment of female prisoners has striking similarities to that of enslaved women. Originally, shackling of female slaves was a mechanism of control and dehumanization.[40] This enabled physical and sexual abuses. During the process of intentionally dehumanizing slaves to facilitate subordination, slave owners stripped slave women of their feminine identity.[41] Slave women were unable to exhibit the Victorian model of “good mothering” and people thought they lacked maternal feelings for their children.[42] In turn, societal perception defeminized slave women, and barred them from utilizing the protections of womanhood and motherhood. During the post-Civil War era, black women were reversely depicted as sexually promiscuous and were arrested for prostitution more often than white women.[43] In turn, society excluded black women; they were seen as lacking what the “acceptable and good” women had.[44] Some argue that the historical act of labeling black women sexually deviant influences today’s perception of black women and may lead to labeling them bad mothers.[45] Over two-thirds of incarcerated women are women of color.[46] Many reports document sexual violence and misconduct against prisoners over the years.[47] Male guards have raped, sexually assaulted, and inappropriately touched female prisoners. Some attribute the physical abuse of black female prisoners to their being depicted or stereotyped as “aggressive, deviant, and domineering.”[48] Some expect black women to express stoicism and if they do not, people label them as dangerous, irresponsible, and aggressive.[49] The treatment of these prisoners mirrors the historical oppression endured by black women during and following the era of slavery. The act of shackling incarcerated pregnant women extends the inhumane treatment of these women from the prison setting into the hospital. One prisoner stated that during her thirty-hour labor, while being shackled, she “felt like a farm animal.”[50] Another pregnant prisoner describes her treatment by a guard stating: “a female guard grabbed me by the hair and was making me get up. She was screaming: ‘B***h, get up.’ Then she said, ‘That is what happens when you are a f***ing junkie. You shouldn’t be using drugs, or you wouldn’t be in here.”[51] Shackling goes beyond punishing by isolation from society – it is an additional punishment that is not justified. B. Reproductive Rights and “Bad Mothers” As with slaves not being seen as maternal, prisoners are not viewed as “real mothers.” A female prison guard said the following: “I’m a mother of two and I know what that impulse, that instinct, that mothering instinct feels like. It just takes over, you would never put your kids in harm’s way. . . . Women in here lack that. Something in their nature is not right, you know?”[52] This comment implies that incarcerated women lack maternal instinct. They are not in line with the standards of what society accepts as a “woman” and “mother” and are thought to have abandoned their roles as caretakers in pursuit of deviant behaviors. Without consideration of racial discrimination, poverty issues, trauma, and restricted access to the child right after delivery, these women are stereotyped as bad mothers simply because they are in prison. Reminiscent of the treatment of female black bodies post-civil war and the use of reproductive interventions (for example, Norplant and forced sterilization) in exchange for shorter sentences, I argue that shackles are a form of reproductive control. Justification for the use of shackles even includes their use as a “punitive instrument to remind the prisoner of their punishment.”[53] However, a prisoner’s pregnancy should have no relevance to their sentence.[54] Using shackles demonstrates to prisoners that society tolerates childbirth but does not support it.[55] The shackling is evidence that women are being punished “for bearing children, not for breaking the law.”[56] Physicians and healthcare workers, as a result, are responsible for providing care for the delivery and rectifying any physical problems associated with the restraints. The issues that arise from the use of restraints place physicians in a position more complex than they experience with regular healthy pregnancies. C. Discrimination In the case of Ferguson v. City of Charleston, a medical university subjected black woman to involuntary drug testing during pregnancy. In doing so, medical professionals collaborated with law enforcement to penalize black women for their use of drugs during pregnancy.[57] The Court held the drug tests were an unreasonable search and violated the Fourth Amendment. Ferguson v. City of Charleston further reveals an unjustified assumption: the medical and legal community seemed suspicious of black women and had perhaps predetermined them more likely to use drugs while pregnant. Their fitness to become mothers needed to be proven, while wealthy, white women were presumed fit.[58] The correctional community similarly denies pregnant prisoners’ medical attention. In the case of Staten v. Lackawanna County, an African American woman whose serious medical needs were treated indifferently by jail staff was forced to give birth in her cell.[59] This woman was punished for being pregnant in prison through the withholding of medical attention and empathy. IV. Failure to Follow Anti-Shackling Laws Despite 22 states having laws against shackling pregnant prisoners, officers do not always follow these laws. In 2015, the Correctional Association of New York reported that of the 27 women who gave birth under state custody, officers shackled 23 women in violation of the anti-shackling laws.[60] The lawyer of Tracy Edwards, an inmate who officers shackled unlawfully during her twelve-hour labor stated, “I don’t think we can assume that just because there’s a law passed, that’s automatically going to trickle down to the prison.”[61] Even with more restrictions on shackling, it may still occur, partly due to the stereotype that incarcerated women are aggressive and dangerous. V. Constitutionality The Eighth Amendment protects people from cruel and unusual punishment. In Brown vs. Plata, the court stated, “Prisoners retain the essence of human dignity inherent in all persons.”[62] In several cases, the legal community has held shackling to be unconstitutional as it violates the Eighth Amendment unless specifically justified. In the case of Nelson v. Correctional Medical Services, a pregnant woman was shackled for 12 hours of labor with a brief respite while she pushed, then re-shackled. The shackling caused her physical and emotional pain, including intense cramping that could not be relieved due to positioning and her inability to get up to use a toilet.[63] The court held that a clear security concern must justify shackling. The court cited a similar DC case and various precedents for using the Eighth Amendment to hold correctional facilities and hospitals accountable.[64] An Arkansas law similarly states that shackling must be justified by safety or risk of escape.[65] If the Thirteenth Amendment applied to those convicted of crimes, shackling pregnant incarcerated people would be unconstitutional under that amendment as well as the Eighth. In the Civil Rights Cases, Congress upheld the right “to enact all necessary and proper laws for the obliteration and prevention of slavery with all its badges and incidents.”[66] Section two of the Thirteenth Amendment condemns any trace or acts comparable to that of slavery. Shackling pregnant prisoners, stripping them of their dignity, and justification based on stereotypes all have origins in the treatment of black female slaves. Viewed through the lens of the Thirteenth Amendment, the act of shackling would be unconstitutional. Nonetheless, the Thirteenth Amendment explicitly excludes people convicted of a crime. VI. Justice As a result of the unconstitutional nature of shackling, physicians should have a legal obligation, in addition to their ethical duty, to protect their patients. The principle of justice requires physicians to take a stand against the discriminatory treatment of their patients, even under the eye of law enforcement.[67],[68] However, “badge and gun intimidation,” threats of noncompliance, and the fear of losing one’s license can impede a physician’s willingness to advocate for their patients. The American College of Obstetricians and Gynecologists (ACOG) finds the use of physical restraints interferes with the ability of clinicians to practice medicine safely.[69] ACOG, The American Medical Association, the National Commission on Correctional Health Care, and other organizations oppose using restraints on pregnant incarcerated people.[70] Yet, legislators can adopt shackling laws without consultation with physicians. The ACOG argues that “State legislators are taking it upon themselves to define complex medical concepts without reference to medical evidence. Some of the penalties [faced by OBGYNs] for violating these vague, unscientific laws include criminal sentences.”[71] Legislation that does not consider medical implications or discourages physicians’ input altogether is unjust. In nullifying the voice of a physician in matters pertaining to the patient’s treatment, physicians are prevented from fulfilling the principle of justice, making the act of shackling patients unethical. VII. Principle of Beneficence The principle of beneficence requires the prevention of harm, the removal of harm, and the promotion of good.[72] Beneficence demands the physician not only avoid harm but benefit patients and promote their welfare.[73] The American Board of Internal Medicine Foundation states that physicians must work with other professionals to increase patient safety and improve the quality of care.[74] In doing so, physicians can adequately treat patients with the goal of prevention and healing. It is difficult to do good when law enforcement imposes on doctors to work around shackles during labor and delivery. Law enforcement leaves physicians and healthcare workers responsible not only to provide care for the delivery, but also rectify any ailments associated with the restraints. The issues arising from using restraints place physicians in a position more complex than they experience with other pregnancies. Doctors cannot prevent the application of the shackles and can only request officers to take them off the patient.[75] Physicians who simply go along with shackling are arguably violating the principle of beneficence. However, for most, rather than violating the principle of beneficence overtly, physicians may simply have to compromise. Given the intricate nature of the situation, physicians are tasked with minimizing potential harm to the best of their abilities while adhering to legal obligations.[76] It is difficult to pin an ethics violation on the ones who do not like the shackles but are powerless to remove them. Some do argue that this inability causes physicians to violate the principle of beneficence.[77] However, promoting the well-being of their patients within the boundaries of the law limits their ability to exercise beneficence. For physicians to fulfill the principle of beneficence to the fullest capacity, they must have an influence on law. Protocols and assessments on flight risks made solely by the officers and law enforcement currently undermine the physician’s expertise. These decisions do not consider the health and well-being of the pregnant woman. As a result, law supersedes the influence of medicine and health care. CONCLUSION People expect physicians to uphold the four major principles of bioethics. However, their inability to override restraints compromises their ability to exercise beneficence. Although pledging to enforce these ethical principles, physicians have little opportunity to influence anti-shackling legislation. Instead of being included in conversations regarding medical complexities, legislation silences their voices. Policies must include the physician's voice as they affect their ability to treat patients. Officers should not dismiss a physician's request to remove shackles from a woman if they are causing health complications. A woman's labor should not harm her or her fetus because the officer will not remove her shackles.[78] A federal law could end shackling pregnant incarcerated people. Because other options are available to ensure the safety of the public and the prisoner, there is no ethical justification for shackling pregnant prisoners. An incarcerated person is a human being and must be treated with dignity and respect. To safeguard the well-being of incarcerated women and the public, it is essential for advocates of individual rights to join forces with medical professionals to establish an all-encompassing solution. - [1] Ferszt, G. G., Palmer, M., & McGrane, C. (2018). Where does your state stand on shackling of Pregnant Incarcerated Women? Nursing for Women’s Health, 22(1), 17–23. https://doi.org/10.1016/j.nwh.2017.12.005 [2] S983A, 2015-2016 Regular Sessions (N.Y. 2015). https://legislation.nysenate.gov/pdf/bills/2015/S983A [3] Chris DiNardo, Pregnancy in Confinement, Anti-Shackling Laws and the “Extraordinary Circumstances” Loophole, 25 Duke Journal of Gender Law & Policy 271-295 (2018) https://scholarship.law.duke.edu/djglp/vol25/iss2/5 [4] Chris DiNardo (2018) [5] U.S. Bureau of Justice Statistics. 1980. " Prisoners in 1980 – Statistical Tables”. Retrieved April 20, 2023 (https://bjs.ojp.gov/content/pub/pdf/p80.pdf). [6] U.S. Bureau of Justice Statistics. 2022. " Prisoners in 2021 – Statistical Tables”. Retrieved April 20, 2023 (https://bjs.ojp.gov/sites/g/files/xyckuh236/files/media/document/p21st.pdf). [7] U.S. Bureau of Justice Statistics (1980) [8] Sufrin C, Jones RK, Mosher WD, Beal L. Pregnancy Prevalence and Outcomes in U.S. Jails. Obstet Gynecol. 2020;135(5):1177-1183. doi:10.1097/AOG.0000000000003834 [9] Kramer, C., Thomas, K., Patil, A., Hayes, C. M., & Sufrin, C. B. (2022). Shackling and pregnancy care policies in US prisons and jails. Maternal and Child Health Journal, 27(1), 186–196. https://doi.org/10.1007/s10995-022-03526-y [10] House, K. T., Kelley, S., Sontag, D. N., & King, L. P. (2021). Ending restraint of incarcerated individuals giving birth. AMA Journal of Ethics, 23(4). https://doi.org/10.1001/amajethics.2021.364 [11] Goshin, L. S., Sissoko, D. R., Neumann, G., Sufrin, C., & Byrnes, L. (2019). Perinatal nurses’ experiences with and knowledge of the care of incarcerated women during pregnancy and the postpartum period. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(1), 27–36. https://doi.org/10.1016/j.jogn.2018.11.002 [12] Shackling and separation: Motherhood in prison. (2013). AMA Journal of Ethics, 15(9), 779–785. https://doi.org/10.1001/virtualmentor.2013.15.9.pfor2-1309 [13] King, L. (2018). Labor in chains: The shackling of pregnant inmates. Policy Perspectives, 25, 55–68. https://doi.org/10.4079/pp.v25i0.18348 [14] King, L. (2018). [15] AMA Journal of Ethics (2013) [16] Lawrence, A., Lewis, L., Hofmeyr, G. J., & Styles, C. (2013). Maternal positions and mobility during first stage labour. Cochrane database of systematic reviews, (8). [17] Association of Women’s Health, Obstetric and Neonatal Nurses. (2011). AWHONN position statement: Shackling incarcerated pregnant women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 40(6), 817–818. doi:10.1111/j.1552-6909.2011.01300.x [18] Ferszt, G. G., Palmer, M., & McGrane, C. (2018). Where does your state stand on shackling of Pregnant Incarcerated Women? Nursing for Women’s Health, 22(1), 17–23. https://doi.org/10.1016/j.nwh.2017.12.005 [19] Thompson, E. (2022, August 30). Woman sues NC state prison system for mistreatment while pregnant. North Carolina Health News. Retrieved March 12, 2023, from https://www.northcarolinahealthnews.org/2022/05/25/woman-sues-nc-state-prison-system-for-mistreatment-while-pregnant/ [20] CBS Interactive. (2019, March 13). Shackling pregnant inmates is still a practice in many states. CBS News. Retrieved March 12, 2023, from https://www.cbsnews.com/news/shackling-pregnant-inmates-is-still-a-practice-in-many-states/ [21] Griggs, Claire Louise. "Birthing Barbarism: The Unconstitutionality of Shackling Pregnant Prisoners." American University Journal of Gender Social Policy and Law 20, no. 1 (2011): 247-271. [22] American Civil Liberties Union. (2012, October 12). ACLU briefing paper: The shackling of pregnant women & girls in U.S ... American Civil Liberties Union (ACLU). https://www.aclu.org/wp-content/uploads/legal-documents/anti-shackling_briefing_paper_stand_alone.pdf [23] King.L (2018) [24] Griggs, Claire Louise (2011) [25] American Civil Liberties Union. (2012) [26] Clarke, J. G., & Simon, R. E. (2013). Shackling and separation: Motherhood in prison. AMA Journal of Ethics, 15(9), 779–785. https://doi.org/10.1001/virtualmentor.2013.15.9.pfor2-1309 [27] Berg, M. D. (2014, April 18). Pregnant prisoners are losing their shackles - The Boston Globe. BostonGlobe.com. Retrieved March 12, 2023, from https://www.bostonglobe.com/magazine/2014/04/18/taking-shackles-off-pregnant-prisoners/7t7r8yNBcegB8eEy1GqJwN/story.html [28] Levi, R., Kinakemakorn, N., Zohrabi, A., Afanasieff, E., & Edwards-Masuda, N. (2010). Creating the bad mother: How the U.S. approach to pregnancy in prisons violates the right to be a mother. UCLA Women's Law Journal, 18(1). https://doi.org/10.5070/l3181017816 [29] Chris DiNardo (2018) [30] Griggs, Claire Louise (2011). [31] Allen, J. E. (2010, October 21). Shackled: Women Behind Bars Deliver in Chains. ABC News. https://abcnews.go.com/Health/WomensHealth/pregnant-shackled-women-bars-deliver-chains/story?id=11933376&page=1 [32] Nelson v. Correctional, 533 F.3d 958 (8th Cir. 2009) [33] Nelson v. Correctional(2009) [34] House, K. T., Kelley, S., Sontag, D. N., & King, L. P. (2021). Ending restraint of incarcerated individuals giving birth. AMA Journal of Ethics, 23(4). https://doi.org/10.1001/amajethics.2021.364 [35] Amnesty International USA. (1999, March). “Not part of my sentence” Violations of the Human Rights of Women in Custody. Amnesty International USA. Retrieved March 12, 2023, from https://www.amnestyusa.org/reports/usa-not-part-of-my-sentence-violations-of-the-human-rights-of-women-in-custody/ [36] Pendleton, V., Saunders, J. B., & Shlafer, R. (2020). Corrections officers' knowledge and perspectives of maternal and child health policies and programs for pregnant women in prison. Health & justice, 8(1), 1. https://doi.org/10.1186/s40352-019-0102-0 [37] Elizabeth Alexander, Unshackling Shawanna: The Battle Over Chaining Women Prisoners during Labor and Delivery, 32 U. ARK. LITTLE ROCK L. REV. 435 (2010). Available at: https://lawrepository.ualr.edu/lawreview/vol32/iss4/1 [38] Hernandez, J. (2022, April 22). More states are restricting the shackling of pregnant inmates, but it still occurs. NPR. Retrieved March 12, 2023, from https://www.npr.org/2022/04/22/1093836514/shackle-pregnant-inmates-tennessee [39] Sufrin, C. (2012, June 24). End practice of shackling pregnant inmates. SFGATE. Retrieved March 12, 2023, from https://www.sfgate.com/opinion/openforum/article/End-practice-of-shackling-pregnant-inmates-3176987.php [40] Mullings, L. (1997). On our own terms: Race, class, and gender in the lives of African American women. Routledge [41] Ocen, Priscilla A., (2011). [42] Ladd-Taylor, M. (1998). "Bad" mothers: The politics of blame in Twentieth-century America. New York Univ. Press. [43] Hine, D. C. (1998). Hine Sight: Black women and the re-construction of American history. Indiana University Press. [44] Baldwin, L. (2019). Excluded from good motherhood and the impact of prison: Motherhood and Social Exclusion, 129–144. https://doi.org/10.2307/j.ctvk12qxr.13 [45] Ocen, Priscilla A., Punishing Pregnancy: Race, Incarceration, and the Shackling of Pregnant Prisoners (October 3, 2011). California Law Review, Vol. 100, 2012, Available at SSRN: https://ssrn.com/abstract=1937872 [46] Johnson, P. C. (2004). Inner lives: Voices of african american women in prison. New York University Press. [47] Thomas, D. Q. (1996). All too familiar: Sexual abuse of women in U.S. state prisons. Human Rights Watch. [48] Ocen, Priscilla A., (2011). [49] Ashley W. The angry black woman: the impact of pejorative stereotypes on psychotherapy with black women. Soc Work Public Health. 2014;29(1):27-34. doi: 10.1080/19371918.2011.619449. PMID: 24188294. [50] CBS Interactive. (2019, March 13). Shackling pregnant inmates is still a practice in many states. CBS News. Retrieved March 12, 2023, from https://www.cbsnews.com/news/shackling-pregnant-inmates-is-still-a-practice-in-many-states/ [51] Guardian News and Media. (2020, January 24). Pregnant and shackled: Why inmates are still giving birth cuffed and bound. The Guardian. Retrieved March 25, 2023, from https://www.theguardian.com/us-news/2020/jan/24/shackled-pregnant-women-prisoners-birth [52] Oparah, J. C. (2015). Birthing justice: Black women, pregnancy, and childbirth. Routledge. [53] Chris DiNardo (2018) [54] Griggs, Claire Louise (2011). [55] Chris DiNardo (2018) [56] Griggs, Claire Louise (2011). [57] Song, Ji Seon, Policing the Emergency Room (June 10, 2021). 134 Harvard Law Review 2646 (2021), Available at SSRN: https://ssrn.com/abstract=3864225 [58] Ocen, Priscilla A., (2011). [59] Staten v. Lackawanna Cnty., No. 4:07-CV-1329, 2008 WL 249988, at *2 (M.D. Pa. Jan. 29, 2008) [60] Lovett, K. (2018, April 9). Pregnant inmates at New York prisons will no longer be shackled under new law. New York Daily News. Retrieved March 12, 2023, from https://www.nydailynews.com/new-york/new-york-pregnant-inmates-no-longer-shackled-article-1.2474021 [61] Thompson, E. (2022, August 30). Woman sues NC state prison system for mistreatment while pregnant. North Carolina Health News. Retrieved March 12, 2023, from https://www.northcarolinahealthnews.org/2022/05/25/woman-sues-nc-state-prison-system-for-mistreatment-while-pregnant/ [62] Brown v. Plata, 563 U.S. 493 (2011) [63] Nelson v. Correctional Medical Serices, et al., Nelson v. Correctional Med. Servs, 583 F.3d 522 (8th Cir. 2009) [64] Nelson citing Women Prisoners of D.C. Dep't of Corr. v. District of Columbia, 877 F.Supp. 634, 668-69 (D.D.C. 1994), modified in part on other grounds, 899 F.Supp. 659 (D.D.C. 1995). [65] Ark. Dep't of Corr. Admin. Reg. 403 § V (1992) [66] Civil Rights Cases, 109 U.S. 3 (1883) [67] Physician charter. ABIM Foundation. (2022, October 18). Retrieved March 10, 2023, from https://abimfoundation.org/what-we-do/physician-charter#:~:text=Principle%20of%20social%20justice.&text=Physicians%20should%20work%20actively%20to,or%20any%20other%20social%20category. [68] Riddick FA Jr. The code of medical ethics of the american medical association. Ochsner J. 2003 Spring;5(2):6-10. PMID: 22826677; PMCID: PMC3399321. [69] American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women (2021). Reproductive Health Care for Incarcerated Pregnant, Postpartum, and Nonpregnant Individuals: ACOG Committee Opinion, Number 830. Obstetrics and gynecology, 138(1), e24–e34. https://doi.org/10.1097/AOG.0000000000004429 [70] American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women (2021). [71] American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women (2021). [72] Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics. Oxford University Press. [73] Varkey, B. (2020). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119 [74] Medical professionalism in the new millennium: A physician charter. (2002). Annals of Internal Medicine, 136(3), 243. https://doi.org/10.7326/0003-4819-136-3-200202050-00012 [75] Allen, J. E. (2010, October 21). Shackled: Women Behind Bars Deliver in Chains. ABC News. https://abcnews.go.com/Health/WomensHealth/pregnant-shackled-women-bars-deliver-chains/story?id=11933376&page=1 [76] Jonsen, A. R. (2010). The Birth of Bioethics. Oxford University Press. [77] Beauchamp, T. L., & Childress, J. F. (2019). [78] Amnesty International USA. (1999, March). “Not part of my sentence” Violations of the Human Rights of Women in Custody. Amnesty International USA. Retrieved March 12, 2023, from https://www.amnestyusa.org/reports/usa-not-part-of-my-sentence-violations-of-the-human-rights-of-women-in-custody/