Abstract
Around the world the wealthy can get their lives extended while the poorget little basic medical help. Over the same years that the field ofbioethics has prospered and expanded, this disparity has increased.Reasons for the failure of bioethics to successfully address thishealth/wealth issue include its identification with the cognitiveand social authority of medicine; its gatekeeping behavior;its funding sources; its questionable use of ``principlism'' andits emphasis on crises and dilemmas to the neglect of ``housekeeping''issues. The work of most women in bioethics rarely addresses thehealth/wealth issue; if it does, their work may be ignored, aswere the recommendations of Canadian feminists working under governmentgrants. To achieve equity in health care, the structure of both medicineand bioethics needs to be changed. Yet, since bioethicists generallyhave accepted the status quo, this seems unlikely to happen.
Similar content being viewed by others
References
Annas, G.J. (1995) Asking the Courts to Set the Standard of Emergency Care — The Case of Baby K. New England Journal of Medicine 330(21), 1542-1545.
Baylis, F., Downie, J. and Sherwin, S. (1998) Reframing Research Involving Humans. In S. Sherwin et al. (Eds.), The Politics of Women's Health: Exploring Agency and Autonomy (pp. 234-259). Philadelphia: Temple University Press.
Baylis, F., Downie, J. and Sherwin, S. (1999) Women and Health Research: From Theory, to Practice, to Policy. In A. Donchin and L.M. Purdy (Eds.), Embodying Bioethics: Recent Feminist Advances (pp. 253-268). Lanham, Maryland: Rowman & Littlefield.
Beauchamp, T.L. and Childress, J.F. (1979) Principles of Biomedical Ethics. New York: Oxford University Press.
Beauchamp, T.L. and Childress, J.F. (2001) Principles of Biomedical Ethics, 5th edn New York: Oxford University Press.
Boston Women's Health Book Collective (1992) The New Our Bodies, Ourselves: A Book By and For Women. New York: Simon & Schuster.
Caplan, A. (1995) Moral Matters: Ethical Issues in Medicine and the Life Sciences. New York: Wiley & Sons.
Cohen, C. (1988) Birth of a Network. Hastings Center Report 18(1), 11.
Cook, R.J. (1994) Feminism and the Four Principles. In R. Gillon (Ed.), Principles of Health Care Ethics (pp. 193-206). Chichester, UK: John Wiley & Sons.
DeRenzo, E.G. (1995) Report on the Course, Advanced Bioethics Course VI: Feminist Perspectives on Bioethics. Newsletter of the Network on Feminist Approaches to Bioethics 3(1), 4.
Donchin, A. (2000) Autonomy and Interdependence: Quandaries in Genetic Decision Making. In C. MacKenzie and N. Stoljar (Eds.), Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self (pp. 236-258). Melbourne: Oxford University Press.
Donchin, A. and Purdy, L.M. (Eds.) (1999) Embodying Bioethics: Recent Feminist Advances. Lanham, Maryland: Rowman & Littlefield.
Dresser, R. (1996) What Bioethics Can Learn from the Women's Health Movement. In S.M. Wolf (Ed.), Feminism and Bioethics: Beyond Reproduction (pp. 144-159). New York: Oxford University Press.
Eichler, M. (1993) Frankenstein Meets Kafka: The Royal Commission on New Reproductive Technologies. In G. Basen, M. Eichler, and A. Lippman (Eds.), Misconceptions: The Social Construction of Choice and the New Reproductive Technologies, Vol. 1 (pp. 196-222). Hull, Quebec: Voyageur Publishing.
Elliott, C. (1997) Bioethics as Commodity: Does the Exchange of Money Alter the Nature of an Ethics Consultation? Bioethics Examiner 1(3), 1-2.
Elliott, C. (1999) A Philosophical Disease: Bioethics, Culture and Identity. New York: Routledge.
Evans, R.G. (1997) Going for the Gold: The Redistributive Agenda Behind Market-Based Health Care Reform. Journal of Health Politics, Policy and Law 22(2), 427-465.
Fox, R.C. and Swazey, J.P. (1984) Medical Morality is not Bioethics — Medical Ethics in China and the United States. Perspectives in Biology and Medicine 27(3), 336-360; also in R. Fox (Ed.), Essays in Medical Sociology. New Brunswick: Transaction Books (1998).
Freedman, B. (1994) From Avocation to Vocation: Working Conditions for Clinical Health Care Ethics Consultants. In F. Baylis (Ed.), The Health Care Ethics Consultant (pp. 109-132). Totowa, New Jersey: Humana Press.
Freedman, B. (1996) Where Are the Heroes of Bioethics? Journal of Clinical Ethics 7(4), 297-299.
Freudenheim, M. (1995) Penny-Pinching H.M.O.'s Showed Their Generosity in Executive Paychecks. The New York Time 15 June, pp. D1, D4.
Gilligan, C. (1982) In a Different Voice: Psychological Theory and Women's Development. Cambridge: Harvard University Press.
Guralnik, J.M. and Leveille, S.G. (1997) Annotation: Race, Ethnicity, and Health Outcomes — Unraveling the Mediating Role of Socioeconomic Status. American Journal of Public Health 87, 728-730.
Holmes, H.B. and Purdy, L.M. (Eds.) (1992) Feminist Perspectives in Medical Ethics. Bloomington: Indiana University Press.
Lebacqz, K. (1991) Feminism and Bioethics: An Overview. Second Opinion 17(2), 11-25.
MacKenzie, C., and Stoljar, N. (Eds.) (2000) Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self. Melbourne: Oxford University Press.
Mahowald, M.B. (2000) Genes, Women, Equality. New York: Oxford University Press.
Mathews, J. (1995) $6.1 Million a Year to Run an HMO. The New York Times 27 Dec, pp. B1-B2.
McLanahan, S.S., Sorensen, A. and Watson, D. (1989) Sex Differences in Poverty, 1950-1980. Signs: Journal of Women in Culture and Society 15(1), 102-122.
Miles, S. (1997) The Role of Bioethics and Access to US Health Care: Is Bioethics One of Kitty Genovese's Neighbors? Bioethics Examiner 1(2), 1-2.
Nedelsky, J. (1989) Reconceiving Autonomy: Sources, Thoughts, and Possibilities. Yale Journal of Law and Feminism 1, 7-36.
Nelson, H.L. and Nelson, J.L. (1996) Justice in the Allocation of Health Care Resources: A Feminist Account. In S.M. Wolf (Ed.), Feminism & Bioethics: Beyond Reproduction (pp. 351-370). New York: Oxford University Press.
Nicholas, B. (1995) Report on the Conference, Healthcare Ethics: Opening up the Debate. Newsletter of the Network on Feminist Approaches to Bioethics 3(1), 4.
Paris, J.J., Miles, S.H., Kohnman, A. and Reardon, F. (1995) Guidelines on the Care of Anencephalic Infants: A Response to Baby K. Journal of Perinatology 15(4), 318-324.
Pellegrino, E.D. (1993) The Metamorphosis of Medical Ethics: A Thirty-Year Retrospective. Journal of the American Medical Association 269, 1158-1162.
Purdy, L.M. (1992) A Call to Heal Ethics. In H.B. Holmes and L.M. Purdy, (Eds.), Feminist Perspectives in Medical Ethics (pp. 9-13). Bloomington: Indiana University Press.
Purdy, L.M. (1996) Reproducing Persons: Issues in Feminist Bioethics. Ithaca, New York: Cornell University Press.
Purdy, L.M. (2001) What Feminism Can Do for Bioethics. Health Care Analysis (this issue)
Royal Commission on New Reproductive Technologies, Canada (1993) Proceed with Care: Final Report of the Royal Commission on New Reproductive Technologies. Ottawa: Canada Communications Group.
Sanders, C.J. (1992) Problems and Limitations of an African-American Perspective in Biomedical Ethics: A Theological View. In H.E. Flack and E.D. Pellegrino (Eds.), African-American Perspectives on Biomedical Ethics (pp. 165-172). Washington: Georgetown University Press.
Shelp, E.E. (Ed.) (1981) Justice and Health Care. Dordrecht NL: Reidel.
Sherwin, S. (1992) No Longer Patient: Feminist Ethics and Health Care. Philadelphia: Temple University Press.
Sherwin, S. (1996) Feminism and Bioethics. In S.M. Wolf (Ed.), Feminism & Bioethics: Beyond Reproduction (pp. 47-66). New York: Oxford University Press.
Sherwin, S. (1998a) Introduction. In S. Sherwin et al. (Eds.), The Politics of Women's Health: Exploring Agency and Autonomy (pp. 1-18). Philadelphia: Temple University Press.
Sherwin, S. (1998b) A Relational Approach to Autonomy. In S. Sherwin et al. (Eds.), The Politics of Women's Health: Exploring Agency and Autonomy (pp. 19-47). Philadelphia: Temple University Press.
Tong, R. (1996) Feminist Approaches to Bioethics. In S.M. Wolf (Ed.), Feminism & Bioethics: Beyond Reproduction (pp. 67-94). New York: Oxford University Press.
Tong, R. (1997) Feminist Approaches to Bioethics: Theoretical Reflections and Practical Applications. Boulder, Colorado: Westview Press.
Tonti-Filippini, N. (1996). Review of F. Baylis (Ed.) The Health Care Ethics Consultant. Totowa, New Jersey: Humana Press (1994). Bioethics 10, 334-340.
Warren, V.L. (1992) Feminist Directions in Medical Ethics. In H.B. Holmes and L.M. Purdy (Eds), Feminist Perspectives in Medical Ethics (pp. 32-45). Bloomington: Indiana University Press. Also in Hypatia 4(2), 73-87 (1989).
Wendell, S. (1996) The Rejected Body: Feminist Philosophical Reflections on Disability. New York: Routledge.
Whitbeck, C. (1993) The Trouble with Dilemmas: Rethinking Applied Ethics. Newsletter of the Network on Feminist Approaches to Bioethics 1(1), 3.
Wilkerson, A.L. (1998) Diagnosis: Difference: The Moral Authority of Medicine. Ithaca, New York: Cornell University Press.
Williams, E. (1997) Managed Care and Disempowered Persons. Newsletter of the Network on Feminist Approaches to Bioethics 5(2), 3.
Wolf, S.M. (1991) Ethics Committees and Due Process: Nesting Rights in a Community of Caring. Maryland Law Review 50, 798-858.
Wolf, S.M. (Ed.) (1996a) Feminism & Bioethics: Beyond Reproduction. New York: Oxford University Press.
Wolf, S.M. (1996b) Introduction: Gender and Feminism in Bioethics. In S.M. Wolf (Ed.), Feminism & Bioethics: Beyond Reproduction (pp. 3-43). New York: Oxford University Press.
Wolf, S.M. (1999) Erasing Difference: Race, Ethnicity, and Gender in Bioethics. In A. Donchin and L.M. Purdy (Eds), Embodying Bioethics: Recent Feminist Advances (pp. 65-81). Lanham, Maryland: Rowman & Littlefield.
Woolhandler, S., and D.U. Himmelstein (1997) Costs of Care and Administration at For-Profit and Other Hospitals in the United States. New England Journal of Medicine 336, 769-774.
Youngner, S.J., Jackson, D.L., Coulton, C., Juknialis, B.W. and Smith, E.M. (1983) A National Survey of Hospital Ethics Committees. Critical Care Medicine 11(11), 902-905.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Holmes, H.B. When Health Means Wealth, Can bioethicists Respond?. Health Care Analysis 9, 213–228 (2001). https://doi.org/10.1023/A:1011338404680
Issue Date:
DOI: https://doi.org/10.1023/A:1011338404680