Maternal consumption of alcohol and moral responsibility in pregnancy

A/Prof. Catherine Mills1

1Monash University, Wellington Road, Australia

Internationally, the consumption of alcohol during pregnancy is recognized as a significant public health concern, since alcohol is known to have teratogenic effects on the developing fetus. Indeed, prenatal alcohol exposure is now one of the leading causes of preventable birth anomalies and can have life-long negative consequences for the child of that pregnancy. There is a growing discussion of the ethics of the maternal consumption of alcohol, and of different strategies for preventing it. This paper contributes to this through a philosophical discussion of moral responsibility and blameworthiness in pregnancy. I challenge the argument made in recent discussions of maternal consumption of alcohol and fetal alcohol spectrum disorder that attempt to justify punitive legal interventions to prevent harm to a future child. I show that these rely on an overly individualized conception of gestational responsibility that fails to take account of the ways in which structural exclusions and social vulnerabilities contribute to harm to future persons. Consequently, the preventative interventions they propose can reinforce social exclusions and vulnerabilities. Instead, I draw on recent work on marginal responsibility and moral disorientation to sketch an approach that takes account of the embodied relationship entailed in pregnancy, as well as the ways in which social and subjective vulnerabilities may shape and produce moral failure. This gives rise to a new account of blameworthiness regarding the consumption of alcohol in pregnancy that allows for greater consideration of vulnerability in responsibility than is typical in bioethics.


Associate Professor Catherine Mills is an ARC Future Fellow in the Monash Bioethics Centre at Monash University. Her disciplinary background is philosophy, and she uses feminist philosophy and bioethics to explore ethical issues that arise in human reproduction, especially relating to innovative reproductive technologies. In her current research, she is looking at the moral responsibilities of women in pregnancy, as well as examining the ethical, social and legal implications of inheritable genetic modification of humans. This includes the implications of technologies such as CRISPR-Cas9 and mitochondrial replacement therapy.