The Metaphysics of Pregnancy: A Bifurcating Process

John Dupré
Egenis, University of Exeter

The standard view of pregnancy is well captured by the English expression “a bun in the oven”. There is one thing, the foetus, contained within another, the mother. This is the natural way of thinking about pregnancy within the widely assumed general metaphysics of substances, or things, and their properties. Notoriously, however, this picture presents a difficulty about when the second, smaller thing, first appears. What kind of thing is this—zygote, embryo, foetus, neonate, etc.—and when do these things transform from one to another? Questions of this kind have been endlessly debated in discussions of the ethics of abortions, and the strange contortions into which these discussions have been led might well suggest that the issue has been badly framed at the outset.

Elselijn Kingma has recently argued that a pregnant animal is not two things, but only one. The foetus is not a distinct thing, but a part of the mother. For several reasons, I think this view is a great improvement over the bun in the oven idea, but it does leave a serious worry about how something as complex as a new-born infant can emerge into existence as a distinct and autonomous individual.

The solution, I shall suggest, is to abandon the metaphysics of things that gives rise to all these difficulties. If instead we see the organism as a kind of process, a move fully justified on quite independent grounds, then we should see the pregnant mammal as a very gradually bifurcating process. The search for distinct, fully autonomous individuals and their objective points of origin is misguided. Although it is possible to distinguish some kinds of processes into countable, persistent individuals, this is something we do for particular purposes, not something that is provided unambiguously for us by Nature.

Female embodiments: hormonal, subjective and intersubjective interactions across menstrual cycle.

Alejandra Martínez Quintero
IAS-Research, University of the Basque Country

Is there a link between menstruation and cognition? There is a hot debate whether hormonal levels affect high-level cognitive performance and women’s mental health across the menstrual cycle. At the personal level, men and women report that women’s cognitive/affective skills are affected by their menstrual cycle, positively as well as negatively. But this research line in cognitive science has contributed to establishing theories of sexual dimorphic task to justify cognitive inferiority (Sainy, 2017). In reaction to this, recent observational studies (Leeners et al, 2017) and methodological reviews (Sundström Poromaa and Gingnell 2014) have found no associations between female hormone levels and the prefrontal cortex functions across the menstrual cycle. Even though cognitive differences across menstrual cycle seems to depend only to hormonal variations, female phenomena are highly problematic in neuroscience, psychology and medicine because of the lack of an adequate theoretical framework that puts together biological explanations with the subjective and the social influences that impact on women’s health. This paper suggests that the menstrual cycle has to be taken seriously as an embodied process to understand female differences in the full scope of a sense-maker.
Our attempt is to open a dialogue between neuroendocrine studies and embodied explanations to complete the characterization of menstrual bodies for further and richer explanations of relevant cognitive differences.

Medical humanities: attempts at solving gender bias in medicine and medical education.

Laura Menatti
Associated researcher, Laboratoire Passages (CNRS UMR5319) University of Bordeaux, France

Carla Benaglio
Professor and Vice Dean for Development, Faculty of Medicine, Universidad del Desarrollo (UDD-CAS) Santiago, Chile

Gender biases in medicine and in medical education are recognized with respect to the presence of women in medical academia and professions, in medical diagnosis and treatment, as well as how medicine is taught and medical research and clinical trials are conducted.

In this talk we discuss how the Medical Humanities (MH) face this complex problem through seminars and practical experiences conducted inside hospitals and medical schools.

The MH are variously theoretically inspired, but share a common focus on the introduction of visual art, literature, fiction, theatre, history of medicine and philosophy into medical education programs, medical curricula and practices. The MH are aimed at shifting the attention of medicine from a biological essentialism oriented practice towards the improvement of empathy and communication. Medical educators have long recognized that physicians-in-training require more than just an understanding of scientific principles to become successful doctors. The humanities provide invaluable insights into the human condition and enhance medical students’ ability to communicate with patients or improve their comfort level in the clinical setting.

MH developed in North America by taking inspiration from feminist thought and female-based practices of caring. During the very beginning, feminism contributed to the medical humanities by making clear the necessity of considering the female body as carrying a specific difference, both in taking and receiving care.

Later on, the medical humanities incorporated the third wave of feminism thinkers, scholars and movements by considering that both medical education and medical practices are confronted daily with gender, gender fluidity, transgender and queer topics.

Here we present some consequences of this debate, including the necessity of a gender-based medicine and health, as well as a gender-based approach to care and caring.

In conclusion, we discuss some examples of interventions of medical humanities, namely, some pedagogical and educational approaches conducted at the Faculty of Medicine and at the Centre for Humanities of the University of Desarrollo (Santiago de Chile), which can be considered as an attempt to discuss gender bias in medicine and medical education.

How to study human diversity?

Philipp Mitteroecker
Department of Theoretical Biology, University of Vienna

What, if anything, makes males and females different? Are these differences primarily biological, i.e., based on genetic and epigenetic factors, or is the sociocultural environment shaping sex-and gender differences in the body, behavior, and cognition? Did these differences evolve by natural selection?
In the humanities, behavioral and cognitive diversity is largely attributed to differences in individual experience within a sociocultural context; framed by this individual history, humans act freely, unaffected by genetic and other biological factors. While this paradigm is central – perhaps indispensible – to our legal and societal system, it is a pragmatic stance, an a priori assumption. As an empirical claim, it is in stark conflict with biological, medical, and psychological research. Despite recent attempts in individualized medicine, some scholars feel that studying human biological diversity is inherently discriminatory and should not be exercised at all.
In my talk I will analyze the epistemology underlying the empirical study of human diversity in biology and anthropology. I will try to unveil common misconceptions about the power and limitations of biological research in this domain. Finally, I will discuss if an evolutionary perspective can enrich our understanding of individual and sex-specific differences.

Biological individuality and reproduction: Intermittent interidentity in the evolution of pregnancy

Laura Nuño de la Rosa
Department of Logic and Theoretical Philosophy, Complutense University of Madrid

Arantza Etxeberria
IAS-Research, University of the Basque Country

The relation of gestating pregnant female and foster (foetus) in mammals offers an interesting scenario to explore interidentity in biological reproduction. In our view reproduction challenges usual assumptions of numerical biological individuality: although usually fosters (foetuses) count as fully fledged individuals in many biological fields (such as evolutionary approaches), if we take into account the relative autonomy of each during development and the different strategies or kinds of relations between the relata explored in evolution, the complex biological association formed by mother and foetus-es affords a manifold of variant cases worth examining. From an organizational perspective different situations can be found, some of which preclude the intuitive judgment of counting 2 (or more) individuals during pregnancy processes, and which offer evidences to consider that the relation among mother and fosters resembles, at some stages, a host/resident or whole/part one, rather than a relation among two (or more) autonomous beings. The requirement to consider the metaphysical interdependencies occurring in this case has been analysed metaphysically by the work of Kingma (to appear). We intend to retake this issue as a case study of biological individuality in reproduction from an evo-devo perspective, and will review literature on the evolution of mother/foetus attachment or implantation and inflammation (such as Griffith et al. 2017), the role of the placenta in different taxa, and different stages in development (Nuño de la Rosa 2010). The following are the main goals of this talk: 1) to question some intuitive ideas about biological individuality in reproductive processes; 2) to propose criteria for individuality that take into account phenomena appearing in reproduction; 3) to distinguish stages of autonomy and dependence during pregnancy and their evolutionary significance.

Female biology reinterpreted in the light of developmental evolution

Mihaela Pavlicev
Cincinnati Children’s Hospital

General societal perception, and even the narrative of textbook biology and medicine, readily reduces female biology to its reproductive function, and there to a largely passive role. This has negative consequences for the attitude towards female traits, including the attitude of women themselves, and particularly towards the female traits that have no obvious reproductive function.

Intriguingly, much of this perception is not based on scientific facts, but likely inherits from conceptualizations built on surpassed knowledge (Freud`s differentiation of immature and mature orgasms, for example), or a very narrow biological understanding (such as adaptationism). In my talk, I will discuss two important biological traits, the female orgasm and the menstruation, in which the overwhelming focus on reproductive purpose has generated apparent tensions and wide spread misinterpretations.

I intend to elicit a discussion on how we can use research insights to re-interpret and better understand the female traits in a more accurate, and less damaging, way, and contrast the attitude and biology in society and medicine. Whereas biology alone cannot be the sole source of interpretation, the biology that is used in forging interpretations must be factually correct.

Making pregnant bodies invisible: Foetus images and the karyotype

María Jesús Santesmases
Instituto de Filosofía, CSIC, Madrid

The contemporary visual culture of biomedicine that focuses on the foetus relates to a long history of foetal imaging. As ultrasound developed, the image of the unborn began to move. Though not as clear as the karyotype of the foetus’s cells, the moving images on the ultrasound screen belonged to a culture of cytogenetics. Cytogenetics brought bodies back: the foetus was placed on stage, exhibited. The superior ontology obtained by the ultrasound images and foetus karyotype in representing the unborn child made the mother’s body invisible. I will share a reflection on the historical trajectory of images from the 1960s to the mid-1970s viewed as a combination of the karyotype and the public foetus, brought about by human cytogenetics, the ultrasound and the famous Lennart Nilsson photographs of foetuses. The purpose of this reflection is to analyse the gendered pathway taken by early medical genetics that focused on the healthy offspring.

Female bodies in feminist phenomenology

Beata Stawarska
Department of Philosophy, University of Oregon

I propose to re-examine the alliance between feminist interests and phenomenological methods in light of the need to address female embodiment. Phenomenology seeks to study human reality in a concrete sense, emphasizing the bodily and socially modulated quality of lived experience and its expression. Phenomenology is therefore well suited to the feminist project of making women’s historically devalued experiences visible. Phenomenological emphasis on the embodied quality of experience is especially valuable to feminism. Natural sciences, including medical sciences, assume a natural or biological category of the body and lack the epistemic perspective of the concerned subjects themselves; they may contain unexamined biases; for example, medical sciences tends to pathologize women’s biological functions in pregnancy. Here the classical phenomenological distinction between the lived body (Leib) and the body-object (Koerper) offers a corrective, since it turns the woman’s gestating body into a site of valuable knowledge about its own functioning (Young, 2004). Despite the potential for a fruitful interchange between phenomenological and feminist goals, their relation is fraught insofar as phenomenology as an academic discipline historically assumed the category of purportedly neutral and ahistorical existence as its field of study. A skeptic could even argue that classical phenomenology is not only irrelevant to feminist interests due to its pretend subject neutrality, but is de facto hostile to feminist interests due to its barely disguised masculinism. I propose to respond to this challenge by recovering Simone de Beauvoir’s feminist phenomenology. I argue that Beauvoir’s notion of a situated subject helps to grasp the complexities of ‘woman’ or gender that include but are not reducible to embodiment.