The State and the Body ; Legal Regulation of Bodily Autonomy

191 Pages·2017·1.475 MB·English

by  Elizabeth Wicks

THE STATE AND THE BODY
This book investigates the limits of the legitimate role of the state in regulating
the human body. It questions whether there is a public interest in issues of bod-
ily autonomy, with particular focus on reproductive choices, end of life choices,
sexual autonomy, body modifications and selling the body. The main question
addressed in this book is whether such autonomous choices about the human
body are, and should be, subject to state regulation. Potential justifications for the
state’s intervention into these issues through mechanisms such as the criminal
law and regulatory schemes are evaluated. These include preventing harm to oth-
ers and/or to the individual involved, as well as more abstract concepts such as
public morality, the sanctity of human life, and the protection of human dignity.
The State and the Body argues that the state should be particularly wary about
encroaching upon exercises of autonomy by embodied selves and concludes that
only interventions based upon Mill’s harm principle or, in tightly confined cir-
cumstances, the dignity of the human species as a whole should suffice to justify
public intervention into private choices about the body.
ii
The State and the Body
Legal Regulation of Bodily Autonomy
Elizabeth Wicks
OXFORD AND PORTLAND, OREGON
2016
Hart Publishing
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First published 2016
© Elizabeth Wicks
Elizabeth Wicks has asserted her right under the Copyright, Designs and Patents Act 1988 to be identified
as Author of this work.
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accepted by the authors, editors or publishers.
All UK Government legislation and other public sector information used in the work is Crown Copyright ©. All
House of Lords and House of Commons information used in the work is Parliamentary Copyright ©.
This information is reused under the terms of the Open Government Licence v3.0 (http://www.nationalarchives.
gov.uk/doc/open-government-licence/version/3) excepted where otherwise stated.
All Eur-lex material used in the work is © European Union,
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British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library.
ISBN: HBK: 978-1-84946-779-7
ePDF: 978-1-50990-997-1
ePub: 978-1-50990-996-4
Library of Congress Cataloging-in-Publication Data
Names: Wicks, Elizabeth, 1973– author.
Title: The state and the body : legal regulation of bodily autonomy / Elizabeth Wicks.
Description: Oxford ; Portland, Oregon : Hart Publishing, an imprint of Bloomsbury Publishing Plc,
2016. | Includes bibliographical references and index.
Identifiers: LCCN 2016034318 (print) | LCCN 2016034945 (ebook) | ISBN 9781849467797
(hardback : alk. paper) | ISBN 9781509909964 (Epub)
Subjects: LCSH: Human body—Law and legislation. | Human body—Law and legislation—England.
Classification: LCC K564.H8 W53 2016 (print) | LCC K564.H8 (ebook) | DDC 344.04/194—dc23
LC record available at https://lccn.loc.gov/2016034318
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ACKNOWLEDGEMENTS
In writing this book I have benefitted from discussions with many people but I am
particularly grateful to my colleagues José Miola and Anna Carline for agreeing
to read and comment upon specific chapters, as well as Jill Marshall and Tracey
Elliott for many pertinent chats. I had the opportunity to present some of my
ideas at conferences/workshops at Queen’s University Belfast, the University of
Cape Town and the University of Leicester, and I am grateful to the participants
whose constructive questions challenged me to strengthen my arguments in cer-
tain respects. My Mum and Dad are a constant source of support and encour-
agement and show relentless enthusiasm for all of my projects. As always, I am
especially grateful to my partner Frank who offers unending support and advice
(not to mention grammatical assistance) when I am writing. Our discussions
on the topics of this book have helped refine and develop my views upon them.
I rarely win an argument against him on any issue but this book is undoubtedly
better for my continuing efforts to do so.
Liz Wicks
June 2016
vi
CONTENTS
Acknowledgements ......................................................................................................v
1. Bodily Autonomy ................................................................................................1
I. Introduction: Why the Body Matters ......................................................1
II. Autonomy: Rights and Relations .............................................................2
A. Autonomy and the Law ....................................................................4
B. A Right to Autonomy? ......................................................................6
C. Relational Autonomy ........................................................................7
III. The Body ...................................................................................................9
A. Dividing the Mind and the Body .....................................................9
B. Problems of Personhood Theory ...................................................11
C. Embodied Self .................................................................................13
IV. Conclusion ..............................................................................................16
2. The Public-Private Distinction ........................................................................17
I. Introduction ...........................................................................................17
II. Different Meanings of Public and Private:
Contexts, History and Rights .................................................................18
III. Feminist Critique of the Public-Private
Distinction ..............................................................................................21
IV. A Descriptive/Normative Spectrum ......................................................24
V. Defining the ‘Private’ ..............................................................................25
A. Private Spaces ..................................................................................26
B. Private Actions ................................................................................27
C. Private Choices ...............................................................................29
D. Private Consequences .....................................................................30
VI. Defining the ‘Public’ ...............................................................................32
VII. Conclusion ..............................................................................................33
3. Reproductive Choices .......................................................................................35
I. Introduction ...........................................................................................35
II. Reproduction, the Public-Private Distinction and the
Right to Respect for Private Life ............................................................35
viii Contents
III. State Regulation of Reproduction in England and Wales ......................39
A. Regulation of Abortion ...................................................................39
B. Regulation of Pregnancy .................................................................41
C. Regulation of Assisted Reproduction .............................................43
IV. Justification for State Regulation of Reproduction ................................45
A. Harm Principle ................................................................................46
(i) Harm to Other Parties in the Reproductive Process ...........48
(ii) Harm to the Unborn Child ...................................................51
(iii) Conclusion on the Harm Principle in the
Reproductive Process ............................................................54
B. Human Dignity ................................................................................54
(i) Human Dignity in the Reproductive Process ......................57
(ii) Human Dignity and the Unborn Child ...............................58
V. Conclusion ...............................................................................................60
4. Choices about Dying.........................................................................................62
I. Introduction .............................................................................................62
II. State Regulation of Dying in England and Wales...................................63
A. Suicide: The Freedom to Choose Death .........................................63
B. Life-Sustaining Treatment and its Withdrawal ..............................67
C. Criminal Prohibition of Assisted Dying .........................................71
III. Justifications for the Regulation of Dying ..............................................73
A. Public Interest in the Value of Human Life ....................................74
B. Prevention of Harm .........................................................................79
(i) Protecting the Dying .............................................................79
(ii) Preventing Harm to Others in Society .................................81
IV. Conclusion ...............................................................................................84
5. Sexual Autonomy ..............................................................................................86
I. Introduction .............................................................................................86
II. Regulation of Sexual Autonomy .............................................................87
A. Sexuality and Equality .....................................................................87
B. Sexual Offences and the Criminalisation
of Consensual Sexual Activity .........................................................90
C. Age of Consent .................................................................................97
D. Conclusion on Current Regulation of Sexual Autonomy ............100
III. Public Morality and (Private) Sexual Autonomy .................................101
IV. Conclusion .............................................................................................107
6. Bodily Modification ........................................................................................109
I. Introduction ...........................................................................................109
II. Cosmetic Surgery ...................................................................................110
III. Female Genital Mutilation ....................................................................113
IV. Body Integrity Identity Disorder and the Amputation
of Healthy Limbs ...................................................................................119
Contents ix
V. Gender Reassignment Surgery ..............................................................122
VI. Paternalistic Restrictions on Body Modification .................................126
VII. Conclusion .............................................................................................130
7. Selling the Body ..............................................................................................131
I. Introduction ...........................................................................................131
II. Prostitution ............................................................................................132
A. Problematic Choice .......................................................................132
B. Regulation of Prostitution.............................................................134
C. Options for Reform .......................................................................137
III. Surrogacy ................................................................................................140
IV. Sale of Eggs or Organs ...........................................................................144
A. Egg Sale...........................................................................................144
B. Organ Sales ....................................................................................147
V. Preserving the Choice Paradigm ...........................................................150
VI. Conclusion .............................................................................................152
8. Conclusion: Legitimate Justifications for Legal Regulation
of Bodily Autonomy........................................................................................154
I. Defining Bodily Autonomy ...................................................................154
II. Embracing the Harm Principle .............................................................155
III. Rejecting Paternalism and Moralism ....................................................158
IV. Preserving the Dignity of the Human Species .....................................160
V. Defending the Choice Paradigm ...........................................................162
VI. Practical Recommendations to Enhance
and Support Bodily Autonomy .............................................................163
Bibliography ............................................................................................................165
Index .......................................................................................................................173