THE ETHICAL IMPERATIVE OF PUBLIC HEALTH INSTITUTIONS TO PROTECT THE REPRODUCTIVE AUTONOMY OF VULNERABLE POPULATIONS

Author

• Kennethea WilsonFollow

Defense Date

4-7-2026

Graduation Date

Spring 5-7-2026

Availability

Immediate Access

Submission Type

thesis

Degree Name

PhD

Department

Health Care Ethics

School

McAnulty College and Graduate School of Liberal Arts

Committee Chair

Gerard Magill

Committee Member

Joris Gielen

Committee Member

Peter Ikechukwu Osuji

Keywords

Reproductive Autonomy, Public Health Ethics, Vulnerable Populations, Health Care Access, Health Disparities, Socioecological Factors

Abstract

This dissertation establishes the ethical responsibility of public health institutions to safeguard reproductive autonomy, especially among vulnerable populations. While reproductive decision-making is traditionally framed within individual clinical encounters, this work contends that reproductive autonomy is fundamentally a matter of public health ethics. Socioecological determinants, including social, legal, environmental, and structural factors, often constrain individuals’ ability to make meaningful reproductive choices, leading to preventable harm.

Reproductive autonomy is defined as the capacity to make informed decisions about whether and when to conceive, as well as how to parent. The dissertation critiques the sufficiency of clinical ethics frameworks, such as informed consent and patient-centered care, when broader population-level factors distort genuine personal choice. It highlights the unique structural leverage public health institutions possess through surveillance, policy authority, funding, and regulatory oversight.

Reproductive health disparities are explored across domains such as access to contraception and maternal care, the impact of medical error in obstetrics and gynecology, and the ethical inclusion of vulnerable populations, such as Black women, in research. It further addresses the intersection of climate change on the reproductive system, drawing on epigenetic evidence that environmental exposures and structural inequities shape reproductive outcomes across generations.

This dissertation concludes that public health institutions have a professional ethical duty to intervene when socioecological risks are likely to undermine access to reproductive healthcare. Protecting reproductive autonomy at the population level is presented as essential for achieving health equity and preventing avoidable harm among vulnerable groups. This work thus reframes reproductive autonomy not only as an individual right, but as a public health mandate demanding institutional action.

Language

English

Recommended Citation

Wilson, K. (2026). THE ETHICAL IMPERATIVE OF PUBLIC HEALTH INSTITUTIONS TO PROTECT THE REPRODUCTIVE AUTONOMY OF VULNERABLE POPULATIONS (Master's thesis, Duquesne University). Retrieved from https://dsc.duq.edu/etd/2436

Additional Citations

Wilson, K. “Safeguarding Reproductive Autonomy to Foster Well-being Among Vulnerable Black Women and Girls in the US.” In Fostering Well-being as a UN Sustainable Development Goal. Magill, G., J. Benedict, eds., Cambridge Scholars Publishing, 2024. 224-251 https://www.cambridgescholars.com/product/978-1-0364-1670-6