The Patient in the Family diagnoses the ways in which the worlds of home and hospital misunderstand each other. The authors explore how medicine, through its new reproductive technologies, is altering the stucture of families, how families can participate more fully in medical decision-making, and how to understand the impact on families of medical advances to extend life but not vitality.

Surrogate motherhood-at least if carefully structured to protect the interests of the women involved-seems defensible along standard liberal lines which place great stress on free agreements as moral bedrocks. But feminist theories have tended to be suspicious about the importance assigned to this notion by mainstream ethics, and in this paper, we develop implications of those suspicions for surrogacy. We argue that the practice is inconsistent with duties parents owe to children and that it compromises the freedom of surrogates to (...) perform their share of those duties. Standard liberal perspectives tend to be insensitive to such considerations; we propose a view which takes more seriously the moral importance of the causal relationship between parents and children, and which therefore illuminates rather than obscures the stake that women and children have in surrogacy. (shrink)

: The feminist ethic of care has often been criticized for its inability to address four problems--the problem of exploitation as it threatens care givers, the problem of sustaining care-giver integrity, the dangers of conceiving the mother-child dyad normatively as a paradigm for human relationships, and the problem of securing social justice on a broad scale among relative strangers. We argue that there are resources within the ethic of care for addressing each of these problems, and we sketch strategies for (...) developing the ethic more fully. (shrink)

Girls learn the lesson of cognitive deference most clearly, perhaps, growing up in patriarchal families. Taught to discount their own judgments and to depend on those of the family's dominant men, they lose self-trust and cannot take themselves seriously as moral deliberators. I argue that through the telling of counterstories, which undermine normative stories of oppression, it is sometimes possible for women to reclaim these families as places where they have cognitive authority.

The primary contribution of feminism to bioethics is to note how imbalances of power in the sex‐gender system play themselves out in medical practice and in the theory surrounding that practice. I trace the ten‐year history of feminist approaches to bioethics, arguing that while feminists have usefully critiqued medicine's biases in favor of men, they have unmasked sexism primarily in the arena of women's reproductive health, leaving other areas of health care sorely in need of feminist scrutiny. I note as (...) well that feminist bioethicists have contributed very little to bioethical theory. In the second part of the paper I suggest two future directions for feminist bioethics. The first is to expand its critique of gender bias beyond reproductive medicine, devoting attention to the same issues raised by advances in biomedical technology as are taken up by mainstream bioethicists. The second is to develop bioethical theory that is more responsive than are mainstream moral theories to the social practices that subordinate women and minority groups. (shrink)

If personhood involves the construction of a narrative identity, then what are we to say of someone who is seriously ill or disabled? How can her life have any narrative when she is unable to write one?

A chief aim of this resource is to rekindle interest in seeing health care not solely as a set of practices so problematic as to require ethical analysis by philosophers and other scholars, but as a field whose scrutiny is richly rewarding for the traditional concerns of philosophy.

A chief aim of this resource is to rekindle interest in seeing health care not solely as a set of practices so problematic as to require ethical analysis by philosophers and other scholars, but as a field whose scrutiny is richly rewarding for the traditional concerns of philosophy.

The primary contribution of feminism to bioethics is to note how imbalances of power in the sex‐gender system play themselves out in medical practice and in the theory surrounding that practice. I trace the ten‐year history of feminist approaches to bioethics, arguing that while feminists have usefully critiqued medicine's biases in favor of men, they have unmasked sexism primarily in the arena of women's reproductive health, leaving other areas of health care sorely in need of feminist scrutiny. I note as (...) well that feminist bioethicists have contributed very little to bioethical theory. In the second part of the paper I suggest two future directions for feminist bioethics. The first is to expand its critique of gender bias beyond reproductive medicine, devoting attention to the same issues raised by advances in biomedical technology as are taken up by mainstream bioethicists. The second is to develop bioethical theory that is more responsive than are mainstream moral theories to the social practices that subordinate women and minority groups. (shrink)

This collection of papers by prominent feminist thinkers advances the positive feminist project of remapping the moral by developing theory that acknowledges the diversity of women.

I introduce the notion of the counterstory: a story that contributes to the moral self-definition of its teller by undermining a dominant story, undoing it and retelling it in such a way as to invite new interpretations and conclusions. Counterstories can be told anywhere, but particularly when told within chosen communities, they permit their tellers to reenter, as full citizens, the communities of place whose goods have been only imperfectly available to its marginalized members.

ABSTRACTDo physicians have a duty to sustain the pregnancies of women who die during the first or second trimester? Physicians cannot simply assume that the woman would have wished the pregnancy to continue, nor is it clear that the state has any interest in fetal life before viability. The conditions for beneficence‐based duties of fetal rescue will often be unmet, both because sustaining the pregnancy is not always a clear gain to the born child and because it may impose a (...) substantial burden on the benefactor. And duties of special relationship cannot readily be applied in these cases, as it is difficult to see how the relationship between someone who no longer exists and someone who does not yet exist can breed special duties. Further, to draw on Marx's distinction between the architect, who builds purposefully, and the bee, who cannot help what she is doing, I argue that human pregnancy is in a number of respects purposeful, creative, and deliberate, and that postmortem pregnancy, which follows the model of the bee, is a destructive icon that undercuts women's agency. (shrink)

ABSTRACT Do physicians have a duty to sustain the pregnancies of women who die during the first or second trimester? Physicians cannot simply assume that the woman would have wished the pregnancy to continue, nor (in the U. S., at any rate) is it clear that the state has any interest in fetal life before viability. The conditions for beneficence‐based duties of fetal rescue will often be unmet, both because sustaining the pregnancy is not always a clear gain to the (...) born child and because it may impose a substantial burden on the benefactor. And duties of special relationship cannot readily be applied in these cases, as it is difficult to see how the relationship between someone who no longer exists and someone who does not yet exist can breed special duties. Further, to draw on Marx's distinction between the architect, who builds purposefully, and the bee, who cannot help what she is doing, I argue that human pregnancy is in a number of respects purposeful, creative, and deliberate, and that postmortem pregnancy, which follows the model of the bee, is a destructive icon that undercuts women's agency. (shrink)

There is something about the debate over reproductive technologies of all kinds—from coerced use of Norplant to trait-selection technologies, to issues surrounding in vitro fertilization, to fetal tissue transplantation—that seems to invite dubious analogies. A Tennessee trial court termed Mary Sue and Junior Davis's frozen embryos “in vitro children” and applied a best-interests standard in awarding “custody” to Mary Sue Davis; the Warnock Committee drew an implicit analogy between human gametes and transplantable organs in its recommendation of a voluntary, nonprofit (...) system for collecting and distributing gametes in the United Kingdom; Owen Jones compares the right to trait-selection to the right to abortion; Robert Veatch once claimed that if a woman had signed an organ donation card and then died while pregnant, she had in effect given consent to the attempt to sustain the pregnancy after her death; John Robertson has argued that contract pregnancy poses no problems we have not already encountered with adoption; and Andrea Bonnicksen has compared the wonders of preembryonic genetic screening to the riches housed in the gold museum in Bogota, Colombia. (shrink)

In this essay I examine Margaret Edson’s Pulitzer prizewinning play, Wit, to explore the numerous connections drawn there between damage to bodies and damage to identities. In the course of this exploration I aim to get clearer about the kinds of illness, injury, or medical interventions that damage patients’ identities; how the damage is inflicted; and what might be done to repair identities that have been damaged in these ways. I argue that just as bodily illness and injury can damage (...) the identity-constituting narratives by which we understand ourselves and others, so too (as the play demonstrates) injurious identity-constituting narratives can result in bodily harm. Because identities are narrative constructions, the damage inflicted on them requires narrative repair. The defective stories must be uprooted and replaced, but the success of the repair depends on both the soundness of the replacement story and the willingness of others to take up the new story. (shrink)

There is something about the debate over reproductive technologies of all kinds—from coerced use of Norplant to trait-selection technologies, to issues surrounding in vitro fertilization, to fetal tissue transplantation—that seems to invite dubious analogies. A Tennessee trial court termed Mary Sue and Junior Davis's frozen embryos “in vitro children” and applied a best-interests standard in awarding “custody” to Mary Sue Davis; the Warnock Committee drew an implicit analogy between human gametes and transplantable organs in its recommendation of a voluntary, nonprofit (...) system for collecting and distributing gametes in the United Kingdom; Owen Jones compares the right to trait-selection to the right to abortion; Robert Veatch once claimed that if a woman had signed an organ donation card and then died while pregnant, she had in effect given consent to the attempt to sustain the pregnancy after her death; John Robertson has argued that contract pregnancy poses no problems we have not already encountered with adoption; and Andrea Bonnicksen has compared the wonders of preembryonic genetic screening to the riches housed in the gold museum in Bogota, Colombia. (shrink)

A ground-breaking volume of all new essays covering the conjunction of two topics--feminism and families--that, for all their centrality in our culture, have not been adequately examined in light of one another. While the family has suffered feminist neglect, most women _are_ in fact members of families, living their lives within the social context of families, even at a time when the concept of "family" has become bewilderingly unstable. The intersection of families and feminism is thus one in need of (...) philosophical reflection, as a basis both for good public policy and for the ethical relationships of intimate life. (shrink)

I defend the view that a person's identity is injured when a powerful social group views the members of her own, less powerful group as unworthy of full moral respect, and in consequence unjustly prevents her from occupying valuable social roles or entering into desirable relationships that are themselves identity constituting. We may call this harm deprivation of opportunity. Further, a person's identity is injured when she endorses, as a portion of her self-concept, a dominant group's dismissive or exploitative understanding (...) of her group, and in consequence loses or fails to acquire a sense of herself as worthy of full moral respect. We may call this harm infiltrated consciousness. Either injury to the identity constricts the person's ability to exercise her moral agency. ;I argue that because identities are narratively constituted and narratively injured, they can be narratively repaired. The morally pernicious stories that construct the identity according to the requirements of an abusive power system can be at least partially dislodged and replaced by identity-constituting counterstories that portray group members as fully developed moral agents. I develop the concept of the counterstory: it is a purposive act of moral definition, developed on one's own behalf or on behalf of others. It sets out to resist, to one degree or another, the stories that identify certain groups of people as targets for ill treatment. Its aim is to reidentify such people as competent members of the moral community and so to free their moral agency. (shrink)

As the initial book in the Feminist Constructions series, Feminists Doing Ethics broaches the ideas of critiquing social practice and developing an ethics of universal justness. The essays collected within explore the intricacies and impact of reasoned moral action, the virtues of character, and the empowering responsibility that comes with morality. These and other essays were taken from Feminist Ethics Revisited: An International Conference on Feminist Ethics held in October of 1999. Waugh and DesAutels bring to light in these pages (...) work discussed at this conference that extends our understanding of morality and ourselves. Visit our website for sample chapters! (shrink)

The authority of surrogates—often close family members—to make treatment decisions for previously capacitated patients is said to come from their knowledge of the patient, which they are to draw on as they exercise substituted judgment on the patient’s behalf. However, proxy accuracy studies call this authority into question, hence the Patient Preference Predictor (PPP). We identify two problems with contemporary understandings of the surrogate’s role. The first is with the assumption that knowledge of the patient entails knowledge of what the (...) patient’s choice of treatment would be. The second is with the assumption that a good decision reproduces the content of that choice. If we are right, then the PPP, helpful though it might be in guiding surrogates’ decisions, nevertheless would hold them to the wrong standards and in that way could add to, rather than relieve, the stress they experience as they try to do their job. (shrink)

We should not always expect parents to put their children first.