Book reviewed in this article: No Longer Patient: Feminist Ethics & Health Care. By Susan Sherwin Feminist Perspectives in Medical Ethics. Edited by Helen Bequaert Holmes and Laura M. Purdy.

Problems with clinical research that create conflicts between doctors' therapeutic and research obligations may be fueled by a rigid view of science as determiner of truth, a heavy reliance on statistics, and certain features of randomized clinical trials. I suggest some creative, feminist approaches to such research and explore ways to provide choice for patients and to use values in directing both therapy and science - to enhance the effectiveness of each.

Authors in this special Hypatia issue seem called to heal ethics, medicine, and the new field - medical ethics. After explaining why feminists should feel this calling, I group authors' contributions as responses to questions: 1. Why hasn't medical ethics already healed medicine? 2. What role should 'caring' play? 3. Must we first heal science? 4. Are we calling health a virtue? 5. Why haven't the many medical ethics books helped? 6. How do our sisters in sociology support us?

This is a reply to Esther Frances's comment, "Some Thoughts on the Content of Hypatia," in which she makes specific reference to the special issue on "Feminist Ethics and Medicine" which I edited.

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. (shrink)

Life situations often seem to require dualistic, either or decision making, but this common method does not always clarify moral decisions. To show this, standard arguments on why to choose or not to choose the sex or ones child are presented. Then, our feminist thinking, which regards clusters of values, and which reframes questions rather than choosing between desirable alternatives, suggests another possibility, in a gynandrous world vision.