Ubuntu and Structural Injustice in FASD Prevention: Relational Responsibility and the Ethical Limits of Criminalisation in South Africa

Fetal Alcohol Spectrum Disorder (FASD) remains a persistent public health concern in South Africa, yet prevention debates often default to individualised "maternal responsibility" framings, and at the coercive end, to criminalisation or other punitive maternal-fetal governance. This article argues that such approaches are ethically unstable in structurally constrained settings, where prenatal alcohol use is shaped by intersecting social and institutional constraints. Because FASD is a spectrum that may involve enduring neurocognitive, behavioural, and adaptive impairments, the prevention imperative is real; the question is how to institutionalise it without entrenching maternal blame or ableist framings. Ubuntu does more than supply culturally resonant vocabulary. It provides independent relational reasons to treat trust, mutual recognition, least infringement and shared stewardship as central to legitimate prevention. Where supportive alternatives remain under-implemented, coercive legal responses are difficult to justify and may undermine disclosure, care-seeking and reproductive autonomy.