pp. 180-182 in
Bioethics in Asia
Editors: Norio Fujiki and Darryl R. J. Macer, Ph.D.
Eubios Ethics Institute
Copyright 2000, Eubios Ethics Institute
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5.2. Fertility Regulation: A Feminist Perspective
Jiangsu Provincial Academy of Social Sciences, Nanjing, 210013, China
Population and development are interrelated. The Action Plan of World Population (1974) pointed out that since the second half of this century, more and more countries have considered population policy a part of development. Population control has been a major trend in developing countries. Likewise, family planning is a fundamental policy of China. Fertility interference or control by the state produces many problems, however, which reflect conflicts of interest in society, as well as causing problems between persons and different groups, reflecting conflicts of values. Thus, to make it conform better with humanistic developmental goals, it seems necessary that family planning have an ethical perspective reflecting the aims and means of fertility control. As a part of this process, feminist criticisms have been embodied in many dialogues between scholars of bioethics and officials of government departments, concerning family planning since 1990. This is very remarkable.
In China, examining fertility control from a feminist viewpoint may be a new experiment. Many questions may be put forward regarding its suitability and necessity. I here put forward two of the points of my feminist criticism on Chinese fertility control policy.
1. Feminism: a New Analytical Perspective
First, deconstructing the false appearance of gbenefit-to-allh feminism uncovers the existence of conflicts of interest between males and females in the whole process of sexuality and reproduction.
The doctrine of gbenefit-to-allh, which denies the differences between men and women, is popular in China. For example, it is emphasized that one policy or tactic can meet everyonefs interest, including womensf, if it meets the interests of society. In fact, the benefit and cost of enforcement of any policy or measure, are distributed unequally among social groups, even it meets the interests of society. Feminism have keenly uncovered the sexual inequality of the fertility process:
Sexuality, of the fertility process, is never a mere natural process. It is always a natural-social process. Under the system of patriarchy, female sexuality and reproduction is dominated by two kinds of power: family (which represents the interest of male householder) and the State.
On the one hand, it is very obvious that the male controls and dominates the female in the process of sex and reproduction. The same is true of sex discrimination (e.g., having a preference for boys; discrimination against a woman who gives birth to a female infant). On the other hand, through its population policy sometimes encouraging a limit, the State controls the fertility of the family according to the status of its resources at different times. These controls are upon the female. The benefits and cost of male and female in the process of fertility are imbalanced. Thus, feminists point out that it is inadequate to say simply that a decrease of reproduction rate is beneficial to females. The costs and burdens on particular groups must be considered as standards when evaluating a policy. That is, when regulation of fertility is evaluated, a women's voice must be heard.
Second, feminism insists that family planning is more a problem of sexual equality, than merely a population problem, so, it must enhance the equality of man and woman.
Feminists believe that regulation of fertility is not an isolated, neutral and technical process. It is operated in a specific cultural and social environment, affected by certain values; it thus reflects a certain order of interest of the two sexes. If the cultural environment of male-centralism that sees the female as mere tool of sexuality and reproduction of the male is not fundamentally changed, the stronger the state controls fertility, the greater the weakest group suffers.
More concretely speaking, the result of male control of sex and the fertility of women is that the latter suffer the following three burdens, (1) hazardous childbirth, (2) discrimination due to being barren or failing to giving birth to a boy, and (3) hardship and poverty from bearing many children.
In the case of the state enforcing control of fertility, women must also bear the following two additional costs: (1) the depression of giving birth to a boy in limited amount of reproduction; (2) the hazards of contraception, both physiological and social. Physiological hazards of the total number of children refers to the side-effects of contraception, and abortion hurting the health in the case of failure. Social includes the disastrous consequences of reproduction beyond family planning (dodging, having no aid during childbirth, malnutrition, etc..)
So, we may not deal with fertility regulation in isolation. The problem of fertility regulation is a complex one. Given the changing social cultural environment, establishing a balance between duty and responsibility, maybe furthering the social goal of equality of man and woman. These are the aspects of fertility regulation that the feminist view propounds to us.
2. Feminism: How to further changes in the mechanism of fertility regulation
Feminism is not only criticism; it is also constructionism. It is not merely a theory, but a movement whose premises that women have equal rights with men - including in the field of sexuality and reproduction.
In China the Ethical Principles and Recommendations for Action Concerning Family Planning, that originated in a 'Symposium on Fertility, Sex, Ethics and Woman Right' sponsored by the Program of Reproductive Health and Ethics, Institute of Philosophy, Chinese Academy of Social Sciences, and endorsed by an Expert Workshop on Family Planning, Ethics and Human Values, April 23-27,1995, is a milestone. Reviewing fertility regulation in terms of feminism, the Recommendation has produced a series of effects on policy making, promoting changes in the regulation of fertility:
1. The evaluation goal of fertility regulation should be that the individual should be treated as the final aim, the woman should be treated as the final end. The Recommendation points out: gThe primary goal of any action or decision-making concerning reproduction and sexuality as an integral part of social, economic and cultural development, should be promoting health, improving quality of life and enhancing the human dignity of all people, especially promoting women's health, their interests and well-being. It should result in a balance of the benefits it will bring to woman over the costs or risks it causes to them.h Here, feminists especially stress that humans are not a means, but an end in themselves, and a center of social development. It stresses the moral principles: woman should be at the center of the provision of family planning; woman ought have to the final right of determination on sexuality and reproductivity; the goals of fertility regulation should be directed to woman's health and development.
2. Reproductive health is defined as a condition in which reproduction and sexuality are accomplished in a state of complete physical, mental, and social well-being. It is a right of women, and the state has an obligation to promote it. Its scope is broader than family planning, as reproductive health has as its final aim the individual. Thus, family planning should be unified with reproduction health.
3. Women are not merely objects of population control, but subjects in sexuality and the reproductive process, as well as subjects in physical and reproductive behavioral control. Thus what ought to be emphasized is not merely the quantitative targets but the information on reproduction and service given to women, allowing them to make the decisions, and the enhancing of their ability for informed choice. Woman's reproductive right is embodied in informed choice. The process of promoting women's ability for informed choice is also the process of empowering women. What the state should do is not only to offer the necessary information, and to help a person to understand the information, but also and more importantly, in education and employment to promote equality between men and women, to change social and cultural ideas, to ensure women's capability of making choices and making a free choice after deliberation and her readiness to be responsible for the consequences of that choice under no pressure or coercion.
4. The principle that the services and benefits as well as the burdens and costs should be fairly distributed among men and women is emphasized. That is, through women's taking part in reproductive decision-making, as well as man's responsibility and participation, sexual equality in sexuality and reproduction will be enhanced. Chinese feminists are not proposing a new principle of reproductive health, but for first time in Chinese history, they have forced the population policy-makers to listen to the voice of women, during the process of implementation of fertility regulation. It is the criticism of feminism that allows the policy-makers reflect values in the policy of fertility regulation, and it is also the criticism from feminism that allows moral principles enter the policy of fertility regulation. That principle can be simply expressed as that the person, especially the woman, must be treated as the end itself.
The introduction of these principles of reproductive health directs the emphasis of the work of family planning. The administrative sector of government moves from mere quantitative control of population to service for women. It represents a great change in the control model, and is reproduction health. The process of transformation shifting from mere quantitative control of population to reproduction health may be long, but it is certain the direction of family planning is towards a service approach.
The emphasis on woman's right in reproduction, the introduction of the right of informed choices, also propels the relevant organ through which the government makes its promises to "gradually establish the service network for medical treatment, information and counseling". The man has only passively participated in family planning, but the idea that git is man's responsibility to prevent a woman from being pregnant beyond expectationh is widely accepted.
In one sentence, feminism takes a unique role in pushing forward changes of values, goals,
and the transformation of the control model of governmental fertility regulation.
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