Why it is unethical to charge migrant women for pregnancy care in the NHS

Shahvisi, Arianne and Finnerty, Fionnuala (2019) Why it is unethical to charge migrant women for pregnancy care in the NHS. Journal of Medical Ethics. ISSN 0306-6800

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Abstract

Pregnancy care is chargeable for migrants who do not have indefinite leave to remain in the United Kingdom. Women who are not “ordinarily resident,” including prospective asylum applicants, some refused asylum-seekers, unidentified victims of trafficking, and undocumented people are required to pay substantial charges in order to access antenatal, intra-partum, and postnatal services as well as abortion care within the NHS. In this paper we consider the ethical issues generated by the exclusion of pregnancy care from the raft of services which are free to all. We argue that charging for pregnancy care amounts to sexdiscrimination, since without pregnancy care, sex may pose a barrier to good health. We also argue that charging for pregnancy care violates bodily autonomy, entrenches the sex-asymmetry of sexual responsibility, centres the male body, and produces health risks for women and neonates. We explore some of the ideological motivations for making maternity care chargeable, and suggest that its exclusion responds to rising xenophobia. We recommend that pregnancy care always be free regardless of citizenship or residence status, and briefly explore how these arguments bear on the broader moral case against chargeable healthcare for migrants.

Item Type: Article
Keywords: women; migrants; migration; NHS; pregnancy; abortion
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Brighton and Sussex Medical School > Clinical and Experimental Medicine
Depositing User: Arianne Shahvisi
Date Deposited: 12 Mar 2019 13:18
Last Modified: 01 Jul 2019 15:46
URI: http://sro.sussex.ac.uk/id/eprint/82494

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