Larsen Ann-Claire
Senior Lecturer, School of Arts and Humanities, Edith Cowan University, Joondalup, Western Australia.
J Law Med. 2018 Feb;25(2):448-464.
This article explores a systems-theoretical question on the resonance capacity of medicine and law that has enabled a recent obstetric change. Insights from autopoietic theory guide my analysis of these subsystems' preconditions or self-referencing processes supporting obstetrics to take up pregnant women's requests for caesarean sections for social reasons. Previously, obstetricians performed caesarean sections on medical grounds only. That change became possible: it resonated with obstetrics, despite limitations imposed on obstetrics and law by these subsystems' unique codes and programs, and in light of law's self-determining individual. This article argues that although the change represents a victory for women's human rights in challenging paternalistic medical decision-making, paradoxically it extended medical control over childbirth by further displacing midwifery. However, obstetricians, midwives and pregnant women have been less empowered by the change. The article interprets how structural limitations or preconditions affect the capacity of communications to resonate and contribute to society's evolution.
本文探讨了一个关于医学与法律共振能力的系统理论问题，正是这种共振能力促成了近期产科领域的一项变革。自创生理论的见解指导我分析这些子系统的先决条件或自我参照过程，这些过程支持产科满足孕妇出于社会原因提出的剖宫产请求。以前，产科医生仅基于医学理由进行剖宫产。这一变革成为可能：尽管这些子系统独特的代码和程序给产科和法律带来了限制，且鉴于法律强调自我决定的个体，但它与产科产生了共鸣。本文认为，尽管这一变革在挑战家长式医疗决策方面代表了女性人权的胜利，但自相矛盾的是，它通过进一步取代助产服务，扩大了医学对分娩的控制。然而，产科医生、助产士和孕妇并未因这一变革而获得更多权力。本文阐释了结构限制或先决条件如何影响沟通的共振能力以及对社会演变的贡献。
