Paternal-Fetal Harm and Men’s Moral Duty to Use Contraception: Applying the Principles of Nonmaleficence and Beneficence to Men’s Reproductive Responsibility


Discussions of reproductive responsibility generally draw heavily upon the principles of nonmaleficence and beneficence. However, these principles are typically only applied to women due to the incorrect belief that only women can cause fetal harm. The cultural perception that women are likely to cause fetal and child harm is reflected in numerous social norms, policies, and laws. Conversely, there is little public discussion of men and fetal and child harm, which implies that men do not (or cannot) cause such harm. My goal in this paper is to begin to fill the void in the academic literature about men’s reproductive responsibility by highlighting the health-related, economic, and social harms men can cause to potential fetuses and children and then examining what it would mean to hold them responsible for preventing these harms. Applying the principles of nonmaleficence and beneficence to men, I conclude that men have a moral duty to use contraception if their behavior—past, current, or future—could harm the potential fetuses and children who result from their unprotected sexual behavior.

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  1. 1.

    More specifically, I limit the type of health-related harms I discuss to those caused by parental behavior (e.g., parental smoking leading to low birth weight).

  2. 2.

    Van Der Boukje and de Beaufort (2011, 452).

  3. 3.

    Arras and Blustein (1995, S27).

  4. 4.

    Ronald Dworkin (1981, 293).

  5. 5.

    Arras and Blustein (1995).

  6. 6.

    Cassidy (2006, 47).

  7. 7.

    Sparrow (2011, 32).

  8. 8.

    Daniels (1997, 597).

  9. 9.

    Daniels (1997, 579).

  10. 10.

    For both historical and current examples, see Kukla (2005).

  11. 11.

    Daniels (1997, 583).

  12. 12.

    Sheldon (1999, 130).

  13. 13.

    Kass v. Kass (1998).

  14. 14.

    Sarto (2004).

  15. 15.

    Cain et al. (2000, 862).

  16. 16.

    Ibid. 863.

  17. 17.

    For more on the lack of trust for women to use contraception, see Campo-Engelstein (2012).

  18. 18.

    Ibid. 862.

  19. 19.

    Ibid. 864.

  20. 20.

    Cain et al. (2000, 864); emphasis added.

  21. 21.

    Daniels (1997, 597).

  22. 22.

    Sheldon (1999, 144).

  23. 23.


  24. 24.

    Daniels (1997, 602).

  25. 25.

    Ibid. 601.

  26. 26.

    Daniels (1997, 587).

  27. 27.

    Daniels (1997, 579).

  28. 28.

    While I think it is problematic to refer to pregnant women as mothers and their male partners as fathers, I use such language due to the lack of better terms that are not awkward.

  29. 29.

    Onora O’Neill and William Ruddick’s (1979) edited collection is an early example.

  30. 30.

    Knight and Callahan (1989, 286–287).

  31. 31. (2008).

  32. 32.

    Hatcher et al. (2004, 245).

  33. 33.

    Campo-Engelstein (2011).

  34. 34.

    Campo-Engelstein (2011).

  35. 35.

    Although I have limited my discussion to harms experienced by potential fetuses and children, unintended pregnancy can also lead to harms for women, a topic which is outside the scope of this paper.

  36. 36.

    Kraft (2012).

  37. 37.

    See, for example, Gerald Dworkin (1987).

  38. 38.

    Sullivan and Tuana (2007). See their edited collection for some excellent articles on race and epistemologies of ignorance.

  39. 39.

    Frye (1983, 18).

  40. 40.

    The eight articles on paternal-fetal harm are by Goldberg (2008), Jha (2008), Laurance (2008), Macrae (2008), No author (2008a) (Chromosomal abnormalities), No author (2008b) (Fathers who smoke ‘hit future generations’), Smith (2008), Taylor (2008).

  41. 41.

    Following empirical evidence, my assumption here is that, in situations where the biological parents are not living together, children will generally live with their mothers.

  42. 42.

    My concern in making this argument is that it will be misconstrued and used to buttress claims that children need to be raised in heterosexual, two parent households in order to avoid harm. I do not agree with that claim. I think the reasons fathers (and mothers) can harm their children are complex and are beyond the scope of this paper. What I want to make clear is that just because absent or uninvolved fathers can harm their children, this does not mean that present and involved fathers do not cause harm or provide an overall better environment for their children. Furthermore, as I discuss later in the paper, there is strong evidence that children raised in nontraditional families are just as well adjusted (and in some instances more so) than children raised in traditional families.

  43. 43.

    Amato (1994), Boyce et al. (2006), Scharte et al. (2012).

  44. 44.

    U.S. Census Bureau (2005).

  45. 45.

    Lino (2007, ii).

  46. 46.

    Coughlin and Wade (2012).

  47. 47.

    See, for example, Wainright et al. (2004), Golombok and Badger (2010) and Brewaeys and van Hall (1997).

  48. 48.

    U.S. Department of Health and Human Services (2008).

  49. 49.

    Glazier et al. (2004).

  50. 50.

    For interesting responses to these questions, see Elizabeth Brake (2005) and Sally Sheldon (2003).

  51. 51.

    It is interesting to note the difference between the verb “to father” and “to mother.” The former, and its synonym “to sire” both have to do with impregnating a woman—they are limited to the one time event of fertilization. In contrast, the latter refers to a life-long process of caregiving and nurturing.


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I'd like to thanks Lisa Schwartzman for reading earlier drafts of this paper. I'd also like to thank my anonymous reviewers for their helpful comments.

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Correspondence to Lisa Campo-Engelstein.

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Campo-Engelstein, L. Paternal-Fetal Harm and Men’s Moral Duty to Use Contraception: Applying the Principles of Nonmaleficence and Beneficence to Men’s Reproductive Responsibility. Medicine Studies 4, 1–13 (2014).

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  • Contraception
  • Nonmaleficence
  • Paternal-fetal harm
  • Men
  • Responsibility