| Acknowledgements |
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vii | |
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xv | |
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xvii | |
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xxi | |
| Introduction --- Purpose and Plan of the Book |
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1 | (10) |
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Ethical Issues in Selection Practices --- Whose Interests are at Stake? |
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11 | (60) |
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11 | (1) |
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Reproductive Autonomy and the Embryo or Fetus |
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12 | (14) |
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Choosing Whether to Have a Child |
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12 | (2) |
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The Possibility of a Disabled Child |
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14 | (1) |
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Reproductive Autonomy and the Positive Duties Inherent in Child-raising |
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15 | (5) |
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The Moral Status of the Embryo and Fetus |
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20 | (3) |
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The Scope of Reproductive Autonomy: Interests, Reasons and Rights |
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23 | (3) |
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Understandings of Disability |
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26 | (8) |
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27 | (1) |
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28 | (1) |
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The Severity of a Condition |
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29 | (1) |
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A life that someone may think is not worth living |
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29 | (1) |
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A life that someone will think is worth living |
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30 | (2) |
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Severity: whose interests? |
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32 | (2) |
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34 | (14) |
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A Life that Someone May Think is Not Worth Living |
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34 | (3) |
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A Life that Someone Will Think is Worth Living |
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37 | (1) |
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Person- and Non-person-affecting Principles |
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38 | (4) |
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42 | (2) |
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The stage of development of the fetus |
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44 | (1) |
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The difficulty of judging a disability to be serious |
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45 | (1) |
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Costs or difficulties or loss of benefits for parents |
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46 | (1) |
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47 | (1) |
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The Interests of People with Impairments |
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48 | (17) |
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Models of Disability and Discrimination Issues |
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48 | (2) |
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Information and Assumptions about Suffering or Difficulty |
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50 | (4) |
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The `Expressivist Objection' |
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54 | (1) |
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54 | (3) |
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Devaluing impairments but equally valuing those with impairments |
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57 | (2) |
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The `any/particular' distinction |
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59 | (3) |
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Interweaving parents' and children's interests |
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62 | (2) |
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Opportunity --- non-person-affecting principles again |
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64 | (1) |
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65 | (3) |
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68 | (3) |
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Selective Abortion --- The Interpretation and Operation of the Law |
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71 | (72) |
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71 | (2) |
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Exploring the Terms of the Disability Ground of the Abortion Act |
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73 | (13) |
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73 | (1) |
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73 | (1) |
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73 | (3) |
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76 | (1) |
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76 | (1) |
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77 | (1) |
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The probability of effective treatment in utero or after birth |
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78 | (3) |
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The probable degree of self-awareness and of ability to communicate with others |
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81 | (1) |
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The suffering that would be experienced |
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82 | (1) |
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The extent to which the actions essential for health that normal individuals perform unaided would have to be provided by others |
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83 | (2) |
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The probability of being able to live alone and to be self-supporting as an adult |
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85 | (1) |
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A Woman's or Couple's Moral and Legal Interests in Decisions Relating to Selective Abortion |
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86 | (16) |
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Parents' Moral Interests in Being Able to Choose Whether to Have a Disabled Child |
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86 | (3) |
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89 | (1) |
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Parents' possible legal interests in the interpretation of the disability ground of the Abortion Act |
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89 | (5) |
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Implications of the wrongful birth cases |
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94 | (8) |
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Cases Under the European Convention on Human Rights |
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102 | (17) |
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102 | (1) |
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103 | (5) |
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Legal Protection: Fetal Rights or Fetal Value? |
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108 | (4) |
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112 | (4) |
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116 | (3) |
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Abortion for Fetal Anomaly After 24 Weeks |
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119 | (18) |
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The Pregnant Woman's Interests |
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122 | (2) |
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124 | (10) |
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134 | (3) |
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137 | (6) |
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Informational Duties --- the Impact on Prenatal Screening, Diagnosis and Selective Abortion |
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143 | (54) |
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143 | (1) |
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Consent to Screening and Diagnosis: Information and Counselling |
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144 | (9) |
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145 | (1) |
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Voluntariness: Offers of Screening and Testing |
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145 | (4) |
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Information: Nature and Purpose, Not Results of Screening or Testing |
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149 | (4) |
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The Effect of a Rights-Based Approach to Abortion on Prenatal Screening and Testing |
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153 | (7) |
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The Right to Abort For Any Reason |
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153 | (2) |
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The Role of the Medical Profession |
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155 | (2) |
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Autonomy --- Information That Aids, Not Burdens |
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157 | (3) |
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The Role of Wrongful Birth Liability |
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160 | (18) |
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Tort's Concern to Protect Reproductive Autonomy, But Only So Far |
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160 | (2) |
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Issues of Conscience for the Medical Profession |
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162 | (4) |
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The Basis of the Wrongful Birth Action |
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166 | (3) |
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The Standard of Care: Traditional Negligence or Negligent Non-disclosure |
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169 | (3) |
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The risk of a given fetal condition |
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172 | (6) |
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The Relationship Between the Seriousness of a Fetal Condition and the Reasons for Exercising Reproductive Autonomy |
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178 | (14) |
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Reasons: A Moral Framework |
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178 | (3) |
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181 | (1) |
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181 | (1) |
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Reasons in wrongful birth case law |
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182 | (3) |
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Defining seriousness in wrongful birth case law |
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185 | (2) |
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Implications for the current and future scope of the wrongful birth action |
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187 | (5) |
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192 | (5) |
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Preimplantation Genetic Diagnosis --- The Interpretation and Operation of the Law |
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197 | (50) |
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197 | (2) |
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Background and Legal Context |
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199 | (6) |
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The Recommendations on Risk and Seriousness |
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205 | (6) |
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207 | (1) |
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`Serious Genetic Condition' |
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208 | (1) |
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209 | (2) |
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Health Professionals' and Scientists' Views and Experience |
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211 | (32) |
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212 | (1) |
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`Serious Genetic Condition' |
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213 | (1) |
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The view of those seeking treatment of the condition |
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214 | (6) |
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The likely degree of suffering associated with the condition |
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220 | (1) |
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220 | (5) |
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225 | (1) |
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225 | (3) |
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228 | (9) |
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The extent of any intellectual impairment |
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237 | (1) |
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The extent of social support available |
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237 | (1) |
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The family circumstances of the people seeking treatment |
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238 | (1) |
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The availability of effective therapy or management now and in the future |
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239 | (1) |
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The speed of degeneration in progressive disorders |
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240 | (2) |
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Their previous reproductive experience |
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242 | (1) |
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243 | (4) |
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The Future Scope of Preimplantation Genetic Diagnosis |
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247 | (50) |
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247 | (2) |
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Fears of Trivial or Eugenic Use of Embryos |
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249 | (3) |
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The Interests at Stake: The Reasons for Choosing Between Possible Lives |
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252 | (36) |
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The Moral and Legal Status of the Embryo and Fetus |
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253 | (3) |
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The Subject of Moral Concern |
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256 | (1) |
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Selecting Against `Serious' Genetic Anomalies |
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257 | (3) |
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Selecting Against Or For Purely Aesthetic or Generally Trivial Features |
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260 | (1) |
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Parents' interests and attitudes: central versus marginal features |
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261 | (3) |
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The child's interests: autonomy and flourishing |
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264 | (6) |
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The claims of the embryo and the processes in PGD |
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270 | (4) |
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The professionals involved in IVF and PGD |
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274 | (1) |
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The interests of those with impairments |
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275 | (2) |
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The issue of legalisation |
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277 | (2) |
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Selecting in Favour of `Serious' Features |
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279 | (1) |
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Selecting for intelligence |
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280 | (3) |
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Selecting for better health |
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283 | (2) |
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Selecting for specific aptitudes or abilities |
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285 | (3) |
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288 | (9) |
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Uses of Preimplantation Genetic Diagnosis --- Two Particular Cases |
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297 | (54) |
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297 | (1) |
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297 | (22) |
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Person-affecting and Non-Person-Affecting Principles and Harm Revisited |
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298 | (2) |
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Choosing a Deaf Embryo Versus Failing to Cure a Deaf Child |
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300 | (4) |
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`Sarah Can Hear, But I Can't' |
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304 | (3) |
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Parents' Possible Interests in Selecting for Disability and Implications for Third-Party Assistance |
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307 | (2) |
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309 | (5) |
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Selecting for Achondroplasia |
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314 | (1) |
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Selecting for Down's Syndrome or Cystic Fibrosis |
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315 | (3) |
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318 | (1) |
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319 | (26) |
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Parents' and Children's Interests |
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321 | (2) |
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The Claims of the Embryo and the Processes in IVF and PGD |
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323 | (3) |
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The Views of Clinicians, Scientists and Those With Impairments |
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326 | (1) |
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The Views of the HFEA and Government: Is Legal Prohibition Justified? |
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327 | (3) |
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Analysis under Article 8(1) of the ECHR |
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330 | (2) |
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Analysis under Article 8(2) of the ECHR |
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332 | (1) |
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332 | (1) |
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333 | (1) |
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Necessary in a democratic society |
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333 | (2) |
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335 | (1) |
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Proportionate to the legitimate aim pursued |
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335 | (1) |
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Relevant and sufficient reasons |
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336 | (1) |
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Implications: justifiable interference? |
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336 | (9) |
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345 | (6) |
| Bibliography |
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351 | (8) |
| Index |
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359 | |