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Ethics is a philosophical study of moral actions. Ethics attempts to determine what is valuable for individuals and society. It examines the rational justification of moral judgments and analyzes what is morally just, fair, and right. Bioethics is a sub-discipline of applied ethics that analyzes the philosophical, social, and legal issues in life sciences and medicine. Ethical theories serve as a foundation for decision-making and represent the viewpoints from which people seek direction. They...
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Federalism for Bioethics?

Leslie Francis1, John Francis2

  • 1Department of Political Science, University of Utah, Salt Lake City, UT, USA.

Cambridge Quarterly of Healthcare Ethics : CQ : the International Journal of Healthcare Ethics Committees
|September 22, 2023
PubMed
Summary
This summary is machine-generated.

Federalism creates significant state-level differences in reproductive rights and gender-affirming care access post-Dobbs. While federalism allows some states to protect rights, only federal-level protection ensures equal access for all citizens.

Keywords:
Dobbsabortionfederalismgender-affirming carelaboratory of the statesnatural experimentnonideal theoryrights to movement

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Area of Science:

  • Political Science
  • Public Health Law
  • Constitutional Law

Background:

  • The Dobbs decision eliminated federal protection for reproductive rights, leading to state-level conflicts over abortion and gender-affirming care.
  • Federalism, a system of shared governance, presents arguments for state autonomy, including accommodating cultural differences and fostering local responsiveness.
  • Existing legal frameworks are challenged by disparities in healthcare access and rights protection across different states.

Purpose of the Study:

  • To critically examine the traditional arguments supporting federalism in the context of recent reproductive and gender-affirming care restrictions.
  • To evaluate whether federalism justifies significant state-by-state variations in fundamental well-being and rights.
  • To explore the implications of state-level rights protection versus the necessity of federal oversight.

Main Methods:

  • Analysis of standard arguments for federalism.
  • Examination of state-level legislative actions concerning reproductive and gender-affirming care.
  • Nonideal theoretical approach to assess practical implications of federalism on rights protection.

Main Results:

  • Arguments for federalism do not justify substantial disparities in state-level recognition of well-being and rights.
  • Federalism allows for some states to offer protections unavailable elsewhere, creating a patchwork of rights.
  • Mobility as a means to access rights is limited for vulnerable populations including minors, undocumented individuals, people with disabilities, and those with economic or familial constraints.

Conclusions:

  • Significant injustices arising from subnational differences cannot be justified by federalism.
  • While some individuals may access rights by crossing state lines, this is not a viable solution for everyone.
  • Comprehensive rights protection necessitates federal-level intervention to ensure equity and access for all citizens.