Beyond autonomy: Care ethics for midwifery and the humanization of birth. (November 2019)

• Record Type: Journal Article
• Authors: Newnham, Elizabeth; Kirkham, Mavis
• Is Part Of: Nursing ethics. Volume 26:Number 7/8(2019)
• Page Start: 2147
• Page End: 2157
• Publication Date: 2019-11
• Subjects: Bioethics -- ethics of care/care ethics -- informed consent -- midwifery -- moral/ethical climate of organizations -- theory/philosophical perspectives; Nursing ethics -- Periodicals; 174.2907305
• DOI: 10.1177/0969733018819119
• Languages: English
• ISSNs: 0969-7330

Abstract

The bioethical principle of respect for a person's bodily autonomy is central to biomedical and healthcare ethics. In this article, we argue that this concept of autonomy is often annulled in the maternity field, due to the maternal two-in-one body (and the obstetric focus on the foetus over the woman) and the history of medical paternalism in Western medicine and obstetrics. The principle of respect for autonomy has therefore become largely rhetorical, yet can hide all manner of unethical practice. We propose that large institutions that prioritize a midwife–institution relationship over a midwife–woman relationship are in themselves unethical and inimical to the midwifery philosophy of care. We suggest that a focus on care ethics has the potential to remedy these problems, by making power relationships visible and by prioritizing the relationship above abstract ethical principles.