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Book Review: Regulating Autonomy

19 April 2010
By Dr Malcolm Smith
Claims Manager, Imperial College Healthcare NHS Trust Legal Services
Appeared in BioNews 554

Regulating Autonomy: Sex, Reproduction and Family

Edited by Professor Shelley Day-Sclater, Dr Fatemeh Ebtehaj, Professor Emily Jackson and Professor Martin Richards

Published by Hart Publishing

ISBN-10: 1841139467, ISBN-13: 978-1841139463

Buy this book from Amazon UK

Regulating Autonomy: Sex, Reproduction and Family' edited by Professor Shelley Day-Sclater, Dr Fatemeh Ebtehaj, Professor Emily Jackson and Professor Martin Richards

This book consists of twelve essays that consider the concept of autonomy - individual self-governance - in private life. The book is split into two main parts, the first which deals with 'Intimacies and Domestic Lives' and the second with 'Reproduction'. The essays analyse how much intimate relationships and reproductive decision-making should be affected by law, regulation and social policy. The collection will therefore appeal to legal scholars, social scientists, bioethicists, and policy makers alike.

The second part of the book is probably of most interest to BioNews readers - it focuses on reproductive autonomy. Most of the essays analyse the social and regulatory issues surrounding assisted reproductive technologies (ART), but the final chapter analyses how autonomy is applicable to UK abortion laws.

In Chapter Nine, Theresa Glennon considers ART regulation in the USA and the UK. Glennon's analysis highlights the markedly different regulatory approaches in the two countries and cleverly shows how autonomy is not always best promoted by market-based regulation. Specific issues covered by Glennon include: access to ART; multiple gestation, and; donor anonymity.

In Chapter Ten, Martin H Johnson and Kerry Petersen consider ART regulation in Australia and the UK. The authors examine how to deliver 'smart regulation' and consider several different regulatory options. Their analysis is interesting to those unfamiliar with Australian ART regulation.

The freedom to choose a child's characteristics using ART is discussed by Martin Richards in Chapter Eleven. Richards provides an insightful analysis of the more controversial issues. For example, he discusses whether prospective parents should be able to use reproductive techniques to create a deaf child or to create a child as a 'saviour sibling'. He also considers whether we should 'curtail parents' freedom to choose fertility treatments, and the freedom of clinicians to advise them in the interests of reducing the frequency of multiple births?'

The conflict between prospective parents' autonomy and the interests of others is most clearly demonstrated in Chapter Twelve where Susan Golombok considers the autonomy of donor-conceived children. Golombok's essay is multidisciplinary and based on the significant research she has undertaken in this field.

Finally, in Chapter Twelve, Laura Riley and Ann Furedi provide an excellent analysis of the UK abortion laws and how they impact on women's reproductive autonomy. The contributors show how abortion law needs reviewing and how reform could enhance the autonomy of pregnant women and those who object to giving abortions.

Unfortunately, some of the chapters in this collection lack cohesion and others fail to address the issue of autonomy in sufficient depth. For example, in Chapter six, the repeated references to the stresses and strains faced by barristers draw attention away from the authors' arguments.

A range of topics are covered in the first half of the book and provide the reader with a different perspective and understanding of the concept of autonomy. For example, Jonathan Herring considers the notion of relational autonomy in the context of rape. Additionally, Ellie Lee and Jennie Bristow consider the social pressures faced by mothers when deciding whether to breast feed newborn children and the issue of regulating stepfamilies is considered by Jan Pryor in Chapter Seven.

Overall, this collection of essays engagingly discusses the intersection of autonomy and regulation in private decision-making. For those who have an in-depth understanding of autonomy, it's unlikely to contain anything radically new. But the essays are all of high standard and, despite the lack of cohesion between some of the chapters, the book makes a good contribution to its field.

Buy Regulating Autonomy: Sex, Reproduction and Family from Amazon UK.

26 August 2014 - by Antony Starza-Allen 
The legal framework for the regulation and provision of assisted reproductive technologies is situated within enormous social change, not least in the construction of the family, personal health management and expectations around access to emerging medical technologies....
19 August 2013 - by Jennie Bristow 
For anyone with an interest in reproductive healthcare, 'Reproductive Politics: What everyone needs to know' is a treasure trove of information and insight. This accessible, short(ish) book manages to cover everything from abortion and contraception to assisted reproductive technologies, childbirth, breastfeeding and disability...
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