{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:39:43Z","timestamp":1788950383776,"version":"build-2803163510"},"reference-count":39,"publisher":"BMJ","issue":"2","funder":[{"name":"UiO Life Science Convergence Project: Epigenetics and bioethics of human embryonic development"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Med Ethics"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>Fetal reduction is the practice of reducing the number of fetuses in a multiple pregnancy, such as quadruplets, to a twin or singleton pregnancy. Use of assisted reproductive technologies increases the likelihood of multiple pregnancies, and many fetal reductions are done after in vitro fertilisation and embryo transfer, either because of social or health-related reasons. In this paper, I apply Joe Horton\u2019s <jats:italic>all or nothing problem<\/jats:italic> to the ethics of fetal reduction in the case of a twin pregnancy. I argue that in the case of a twin pregnancy, there are two intuitively plausible claims: (1) abortion is morally permissible, and (2) it is morally wrong to abort just one of the fetuses. But since we should choose morally permissible acts rather than impermissible ones, the two claims lead to another highly implausible claim: the woman ought to abort both fetuses rather than only one. Yet, this does not seem right. A plausible moral theory cannot advocate such a pro-death view. Or can it? I suggest ways to solve this problem and draw implications for each solution.<\/jats:p>","DOI":"10.1136\/medethics-2020-106938","type":"journal-article","created":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T18:19:03Z","timestamp":1608747543000},"page":"101-105","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Twin pregnancy, fetal reduction and the 'all or nothing problem\u2019"],"prefix":"10.1136","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7383-6138","authenticated-orcid":false,"given":"Joona","family":"R\u00e4s\u00e4nen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,12,21]]},"reference":[{"issue":"9","key":"2022012103552172000_48.2.101.1","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1002\/pd.1261","article-title":"Update on selective reduction","volume":"25","author":"Evans","year":"2005","journal-title":"Prenat Diagn"},{"issue":"6","key":"2022012103552172000_48.2.101.2","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1093\/humrep\/15.6.1217","article-title":"Avoiding multiple pregnancies in ART: consideration of new strategies","volume":"15","author":"Hazekamp","year":"2000","journal-title":"Hum Reprod"},{"issue":"11","key":"2022012103552172000_48.2.101.3","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1136\/medethics-2018-104910","article-title":"Artificial womb technology and the frontiers of human reproduction: conceptual differences and potential implications","volume":"44","author":"Romanis","year":"2018","journal-title":"J Med Ethics"},{"issue":"9","key":"2022012103552172000_48.2.101.4","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1111\/bioe.12404","article-title":"Ectogenesis, abortion and a right to the death of the fetus","volume":"31","author":"R\u00e4s\u00e4nen","year":"2017","journal-title":"Bioethics"},{"issue":"9","key":"2022012103552172000_48.2.101.5","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1111\/bioe.12512","article-title":"Ectogenesis and a right to the death of the prenatal human being: a reply to R\u00e4s\u00e4nen","volume":"32","author":"Kaczor","year":"2018","journal-title":"Bioethics"},{"key":"2022012103552172000_48.2.101.6","doi-asserted-by":"crossref","unstructured":"Stratman CM . 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