‘Toto, I've a feeling we're not in Kansas anymore.’
Of course it is a long time since the perusal of scientific articles and their rejoinders could be viewed through the ingredients list of a pie-chart or dissected with a rudimentary but cocky chi-square penknife but now, having to debate Chervenak and McCullough's malign (‘not benign’) condemnation of rights-based reductionism in the middle of a busy outpatients clinic, means I am definitely not in ‘Kansas’ any more.
In echoing Alon Harel's general argument for the abandonment of rights-based reductionism; in targeting obstetric care the authors casually omit to fully discuss how the necessary non-reductionist or reactionary requirement for a determination of ‘value’ for any individual society can be adequately constructed and applied. In Ireland at present we are in the midst of such a debate with no clear consensus of either the value of rights or the right to value. Obstetric professional ethical practice has not provided an unequivocal direction, and never can.
In a master's thesis for an LL.M in Human Rights Law I explored the reductionist jus cogens prohibition on torture and at the end of my studies came to an ethical and legal determination that there has to be a reductionist foundation of rights. To expand on Chervenak and McCullough's Odyssian metaphor in their original paper, a ship in dock is moored to a bollard of certainty, but once at sea, once charting the channel between the competing attentions of Scylla and Charybdis, then tide and wind and skill will influence the outcome. Both perspectives have a role, a place in the scheme of things.
Mevlana (Rumi) wrote in the thirteenth century: ‘Out beyond ideas of rightdoing and wrongdoing there is a field. I will meet you there.'