Neuroscience research examining sex/gender differences aims to explain behavioral differences between men and women in terms of differences in their brains. Historically, this research has used ad hoc methods and has been conducted explicitly in order to show that prevailing gender roles were dictated by biology. I examine contemporary fMRI research on sex/gender differences in emotion processing and argue that it, too, both uses problematic methods and, in doing so, reinforces gender stereotypes.
Feminist scholars have shown that research on sex/gender differences in the brain is often used to support gender stereotypes. Scientists use a variety of methodological and interpretive strategies to make their results consistent with these stereotypes. In this paper, I analyze functional magnetic resonance imaging (fMRI) research that examines differences between women and men in brain activity associated with emotion and show that these researchers go to great lengths to make their results consistent with the view that women are more (...) emotional than men. (shrink)
It seems clear that being sick makes people vulnerable. Not only can even relatively mild, transient illnesses such as colds or flus serve as an unpleasant reminder of the vulnerability of the usual state of health that many of us are fortunate enough to enjoy, but more serious, chronic conditions can force individuals to adapt—or even abandon—life plans or projects, and can also alter their self-conception. Yet philosophical theories of health and disease do not discuss vulnerability, nor does it have (...) a central place in bioethics.1 Bioethicists need to better understand vulnerability, as it has implications for key issues in the field, such as the nature of the relationship between patients and healthcare .. (shrink)
Feminist Bioethics: At the Center, on the Margins is a collection of essays that “reflect on the positioning of feminist bioethics” (xi). The volume editors suggest that the discipline of feminist bioethics, twenty years after it began, faces tension between becoming incorporated into mainstream bioethics, which would mean that it has greater influence on bioethics as a whole, and remaining “on the margins,” where it can perhaps better continue its critical project of drawing attention to the ways in which “dominant (...) ways of doing bioethics” are gendered and “thus contribute to culturally inscribed oppressive practices” (3). The volume includes papers with diverse theoretical and methodological approaches and .. (shrink)
Feminist bioethics is committed to recognizing the way that power differentials arising from differences in social location shape health and health care, and also to ensuring that women's experiences inform bioethical analyses (Sherwin 1992, 1998; Scully et al. 2010). Yet there may be a tension between these two points of emphasis, not because they are incompatible but because they require very different perspectives. In this article, I argue that feminist analyses of the relationship between gender and mental disorder have tended (...) to emphasize the effects of women's relative lack of social power, with the result that women who experience mental disorders tend to be viewed as passive victims of oppression. I then .. (shrink)
Robert Truog describes the controversial randomized controlled trials (RCTs) of extracorporeal membrane oxygenation (ECMO) therapy in newborns. Because early results with ECMO indicated that it might be a great advance, saving many lives, Truog argues that ECMO should not have been tested using RCTs, but that a long-term, large-scale observational study of actual clinical practice should have been conducted instead. Central to Truog’s argument, however, is the idea that ECMO is an unusual case. Thus, it is an open question whether (...) Truog’s conclusions can be extended to other areas of medical research. In this paper, I look at epistemological and ethical issues arising in the care of patients with chronic diseases, using ECMO as a starting point. Both the similarities and the dissimilarities of these two cases highlight important issues in biomedical research and support a conclusion similar to Truog’s. Observational studies of clinical practice provide the best evidence to inform the treatment of patients with chronic disease. (shrink)
Evidence-based medicine (EBM) ranks different medical research methods on a hierarchy, at the top of which are randomized controlled trials (RCTs) and systematic reviews or meta-analyses of RCTs. Any study that does not randomly assign patients to a treatment or a control group is automatically placed at a lower level on the hierarchy. This article argues that what matters is whether the treatment and control groups are similar with respect to potential confounding factors, not whether they got that way through (...) randomization. Moreover, nonrandomized studies tend to have other characteristics that make them useful sources of evidence, in that they tend to last longer and to enroll more patients than do randomized trials. Replacing the sharp dichotomy between randomized and nonrandomized studies with a continuum from "clean" studies (which have high internal validity but whose results do not readily generalize to clinical practice) to pragmatic studies (which are designed to more closely reflect clinical practice) would also make a place for outcomes research and research using clinical databases, which are not included in the current hierarchy of evidence but which can provide important information about the safety and efficacy of treatments. (shrink)