This essay focuses on two underlying presumptions that impinge on the effort of UNESCO to engender universal agreement on a set of bioethical norms: the conception of universality that pervades much of the document, and its disregard of structural inequalities that significantly impact health. Drawing on other UN system documents and recent feminist bioethics scholarship, we argue that the formulation of universal principles should not rely solely on shared ethical values, as the draft document affirms, but also on differences in (...) ethical values that obtain across cultures. UNESCO's earlier work on gender mainstreaming illustrates the necessity of thinking from multiple perspectives in generating universal norms. The declaration asserts the ‘fundamental equality of all human beings in dignity and rights’1 and insists that ‘the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition’2 yet it does not explicitly recognize disparities of power and wealth that deny equal dignity and rights to many. Without attention to structural inequities, UNESCO's invocation of rights is so abstract as to be incompatible with its avowed intention. (shrink)

The principled approach to theory building that has been a conspicuous mark of bioethical theory for the past generation has in recent years fallen under considerable critical scrutiny. Although some critics have confined themselves to reordering the dominant principles, others have rejected a principled approach entirely and turned to alternative paradigms. Prominent among critics are antiprin-ciplists, who want to jettison the principle-based approach altogether and adopt a casuistic model, and communitarians, who favor an eclectic model combining features of both the (...) casuistic model and a modified principled approach. Particularly conspicuous in virtually all such critiques is their challenge to the preeminence of the principle of autonomy. Critical barbs have been aimed not only at theories favoring a hierarchical ordering of moral principles that give first place to autonomy, but also at those that include autonomy among a set of ostensibly coequal principles. Though these critics have performed a valued function by displacing bioethical principles from their Olympian perch beyond actual decision-making contexts, some version of the principle of autonomy may, nonetheless, be well worth defending but for very different reasons than those put forward by its supporters. (shrink)

Medical issues affecting health care have become everyday media events. In response to mounting public concern, growing numbers of bioethicists are being appointed to medical school faculties and public policy panels. However the ideas voiced in these forums are seldom informed by feminist perspectives. In this important book, a distinguished group of feminist scholars and activists discuss crucial bioethics topics in a feminist light. Among the subjects explored are the care/justice debates, transforming bioethics, practice, and reproduction. The book also covers (...) less commonly discussed issues, such as culturally appropriate responses to reproductive health problems in developing countries. (shrink)

Principle-based formulations of bioethical theory have recently come under increasing scrutiny, particularly insofar as they give prominence to personal autonomy. This essay critiques the dominant conceptualization of autonomy and urges an alternative formulation freed from the individualistic assumptions that pervade the prevailing framework. Drawing on feminist perspectives, I discuss the need for a vision of patient autonomy that joins relational experiences to individuality and acknowledges the influence of patterns of power and authority on the exercise of patient agency. Deficiencies in (...) the current models of science and social relations guiding medical practice are analyzed, particularly (1) the tendency to disregard the patients self-knowledge and (2) failure to recognize limitations on the generalizability of medical knowledge. Models of social relations such as mothering and friendship are explored to advance a conception of autonomy better suited to the practical activities of medicine. In conclusion, I consider how acknowledgement of the specificity and complexity of social relations can contribute to reconfiguration of other principles comprising the standard framework of bioethics, particularly beneficence, justice, and equality. (shrink)

Reproductive tourism is a manifestation of a larger, more inclusive trend toward globalization of capitalist cultural and material economies. This paper discusses the development of cross-border assisted reproduction within the globalized economy, transnational and local structural processes that influence the trade, social relations intersecting it, and implications for the healthcare systems affected. I focus on prevailing gender structures embedded in the cross-border trade and their intersection with other social and economic structures that reflect and impact globalization. I apply a social (...) connection model of responsibility for unjust outcomes and consider strategies to counter structural injustices embedded in this industry. The concluding section discusses policy reforms and proposals for collaborative action to preclude further injustices and extend full human rights to all. (shrink)

Western philosophy has been powerfully influenced by a paradigm of personal agency that is linked to an individualistic conception of autonomy. This essay contrasts this conception with an alternative understanding that recognizes a social component built into the very meaning of autonomy. After reviewing feminist critiques of the dominant conception of autonomy, I develop the broad outlines of a relational view and apply this reconceptualization to a concrete situation in order to show how this altered view reconfigures understanding of the (...) participants' relationships and each of their personal perspectives. The situation chosen, physician‐assisted suicide, is intended principally to illustrate one respect in which a relational conception of autonomy reframes a controversial moral issue and reveals perspectives toward it that are likely to be obscured when autonomy is viewed through the lens of the dominant individualistic conception. My principal aim is to show that when autonomy is understood relationally, respecting others' autonomy is likely to be a far more complex issue than is apparent within the standard conception, both for those with professional responsibilities and often for personal intimates as well. (shrink)

This paper interprets the British legislative process that initiated the first comprehensive national regulation of embryo research and fertility services and examines subsequent efforts to restrain the assisted reproduction industry. After describing and evaluating British regulatory measures, I consider successive failures to control the assisted reproduction industry in the US. I discuss disparities between UK and US regulatory initiatives and their bearing on regulation in other countries. Then I turn to the political and social structures in which the assisted reproduction (...) industry is embedded. I argue that regulatory bodies are seldom neutral arbiters. They tend to respond most readily to special interests and neglect strategies that could more effectively meet the health needs of the people they represent. Neither national nor international bodies have aggressively pursued policies to harness the industry, reduce infertility rates, or meet the needs of people whose fertility is threatened by substandard healthcare and environmental neglect. In conclusion, I consider recent initiatives by activist groups to mount an alternative response to the industry's current practices and build a transnational reproductive justice movement. (shrink)

Medical issues affecting health care have become everyday media events. In response to mounting public concern, growing numbers of bioethicists are being appointed to medical school faculties and public policy panels. However the ideas voiced in these forums are seldom informed by feminist perspectives. In this important book, a distinguished group of feminist scholars and activists discuss crucial bioethics topics in a feminist light. Among the subjects explored are the care/justice debates, transforming bioethics, practice, and reproduction. The book also covers (...) less commonly discussed issues, such as culturally appropriate responses to reproductive health problems in developing countries. (shrink)

This collection brings together fourteen contributions by authors from around the globe. Each of the contributions engages with questions about how local and global bioethical issues are made to be comparable, in the hope of redressing basic needs and demands for justice. These works demonstrate the significant conceptual contributions that can be made through feminists' attention to debates in a range of interrelated fields, especially as they formulate appropriate responses to developments in medical technology, global economics, population shifts, and poverty.

Anne Donchin attended graduate school while raising four children, received her doctorate from the University of Texas in 1970, taught for 18 years in Texas and New York, then joined the philosophy department at Indiana University–Purdue University Indianapolis in 1982. Here she developed a Women’s Studies program, specialized and in numerous ways pioneered in feminist bioethics, and won two prestigious grants. She co-edited two books, published some forty articles, and co-founded and co-ordinated The International Network on Feminist Approaches (...) to Bioethics. Before and after retiring she served on the editorial boards of an encyclopedia, several international bioethics collections and nine prestigious journals. Her publications have influenced many scholars here and abroad. At the time of her death she was at work on a book: Procreation, Power and Personal Autonomy: Feminist Reflections, which is now available on IUPUIScholarWorks. Laura Purdy has generously edited, organized, and, where possible, updated the manuscript. (shrink)

The recent case of the UK woman who lost her legal struggle to be impregnated with her own frozen embryos, raises critical issues about the meaning of reproductive autonomy and the scope of regulatory practices. I revisit this case within the context of contemporary debate about the moral and legal dimensions of assisted reproduction. I argue that the gender neutral context that frames discussion of regulatory practices is unjust unless it gives appropriate consideration to the different positions women and men (...) occupy in relation to reproductive processes and their options for autonomous choice. First, I consider relevant legal rulings, media debate, and scholarly commentary. Then I discuss the concept of reproductive autonomy imbedded in this debate. I argue that this concept conflates informed consent and reproductive autonomy, thereby providing an excessively narrow reading of autonomy that fails to give due regard to relations among individuals or the social, political and economic environment that shapes their options. I contrast this notion of autonomy with feminist formulations that seek to preserve respect for the agency of individuals without severing them from the conditions of their embodiment, their surrounding social relationships, or the political contexts that shape their options. Taking these considerations into account I weigh the advantages of regulation over the commercial market arrangement that prevails in some countries and suggest general guidelines for a regulatory policy that would more equitably resolve conflicting claims to reproductive autonomy. (shrink)

ABSTRACT This essay focuses on two underlying presumptions that impinge on the effort of UNESCO to engender universal agreement on a set of bioethical norms: the conception of universality that pervades much of the document, and its disregard of structural inequalities that significantly impact health. Drawing on other UN system documents and recent feminist bioethics scholarship, we argue that the formulation of universal principles should not rely solely on shared ethical values, as the draft document affirms, but also on differences (...) in ethical values that obtain across cultures. UNESCO's earlier work on gender mainstreaming illustrates the necessity of thinking from multiple perspectives in generating universal norms. The declaration asserts the ‘fundamental equality of all human beings in dignity and rights’1 and insists that ‘the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition’2 yet it does not explicitly recognize disparities of power and wealth that deny equal dignity and rights to many. Without attention to structural (as opposed to merely accidental) inequities, UNESCO's invocation of rights is so abstract as to be incompatible with its avowed intention. (shrink)

This essay reviews and evaluates the accomplishments of The International Network on Feminist Approaches to Bioethics over its initial fifteen years. It focuses on the origins, development, and expanding influence of FAB as a multi-disciplinary organization of feminist bioethicists. Also noted are areas of bioethics that as yet have not been adequately addressed from feminist perspectives, including intersections between health and human rights, gender disparities in the treatment of chronic disease, health research priorities that shortchange women, HIV/AIDS proliferation among women (...) in the global South, the health needs of recent migrants, and the encroachment of corporate interests on bioethics. (shrink)

This essay reviews and evaluates the accomplishments of The International Network on Feminist Approaches to Bioethics over its initial fifteen years. It focuses on the origins, development, and expanding influence of FAB as a multidisciplinary organization of feminist bioethicists. Also noted are areas of bioethics that as yet have not been adequately addressed from feminist perspectives, including intersections between health and human rights, gender disparities in the treatment of chronic disease, health research priorities that shortchange women, HIV/AIDS proliferation among women (...) in the global South, the health needs of recent migrants, and the encroachment of corporate interests on bioethics. (shrink)

An exploration of alternative perspectives toward recent innovations in reproductive technology: support for new techniques for the sake of the kind of feminist future they facilitate; unqualified opposition despite therapeutic benefit to individual women; or qualified opposition depending upon specific threats to women's interests and relationships between these positions and values bound up with mothering practices.

A critical review of four recent works that reflect current conflicts and tensions among feminists regarding new reproductive technologies: In Search of Parenthood by Judith Lasker and Susan Borg; Ethics and Human Reproduction by Christine Overall; Made to Order, Patricia Spallone and Deborah Steinberg, eds. and Reproductive Technologies: Gender, Motherhood and Medicine, Michelle Stanworth, ed. Their positions are evaluated against the background of growing feminist dialogue about the future of reproduction and the bearing of reproductive innovations on such related issues (...) as racism, sexuality, motherhood and abortion. (shrink)

A critical review of four recent works that reflect current conflicts and tensions among feminists regarding new reproductive technologies: In Search of Parenthood by Judith Lasker and Susan Borg; Ethics and Human Reproduction by Christine Overall; Made to Order, Patricia Spallone and Deborah Steinberg, eds. and Reproductive Technologies: Gender, Motherhood and Medicine, Michelle Stanworth, ed. Their positions are evaluated against the background of growing feminist dialogue about the future of reproduction and the bearing of reproductive innovations on such related issues (...) as racism, sexuality, motherhood and abortion. (shrink)

This article is an expansion of comments I was honored to present at a celebration of the life and work of Anne Donchin at the June 2016 meeting of the International Network on Feminist Approaches to Bioethics in Edinburgh. It is obviously far from comprehensive, but I hope it gives readers a glimpse of an Anne of whose depths many of us were not fully aware. One of the most difficult parts of talking about someone who has (...) died is highlighting the positive without overdoing it to the extent that their friends and loved ones find themselves rolling their mental eyes a bit, since most of us—no matter how wonderful—are a little less than perfect. But my problem here is that the more I have found out... (shrink)

This paper comes out of a panel honoring the work of Anne Donchin (1940-2014), which took place at the 2016 Congress of the International Network on Feminist Approaches to Bioethics (FAB) in Edinburgh. My general aim is to highlight the contributions Anne made to feminist bioethics, and to feminist reproductive ethics in particular. My more specific aim, however, is to have a kind of conversation with Anne, through her work, about whether reproductive justice could demand insurance (...) coverage for in vitro fertilization. I quote liberally from Anne’s work for this purpose, but also to shower the reader with her words, reminding those of us who knew her well what a wonderful colleague she was. (shrink)

The Donchin and Holmes Emerging Scholar Prize was established in 2016 on the occasion of the twentieth anniversary of the founding of the International Network on Feminist Approaches to Bioethics. The name of the prize honors the two cofounders of FAB, Anne Donchin and Helen Bequaert Holmes. Anne was Professor Emerita of Philosophy at Indiana University at the time of her death in 2014, and she had recruited Becky Holmes, a biologist and independent women’s studies scholar, (...) to help set up the first international network of feminists writing and researching in areas related to bioethics.Both Anne and Becky were strongly committed to what now tends to be called “building capacity”: a rather ugly description... (shrink)

Tenure is designed to protect the academic freedom of faculty members by insulating them from arbitrary dismissal by administrative authorities external to their community of scholars. Therefore, the target article's focus on constraints that derive from peer pressures and academic politics is misplaced, rendering the results of the survey irrelevant to the issue of the value of tenure. (Published Online February 8 2007).

Stress in health care is affected by moral factors. When people are prevented from doing ‘good’ they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations (...) and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach’s alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: ‘internal demands’ and ‘external demands and restrictions’. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts. (shrink)

To understand the endogenous components of the event-related brain potential (ERP), we must use data about the components' antecedent conditions to form hypotheses about the information-processing function of the underlying brain activity. These hypotheses, in turn, generate testable predictions about the consequences of the component. We review the application of this approach to the analysis of the P300 component. The amplitude of the P300 is controlled multiplicatively by the subjective probability and the task relevance of the eliciting events, whereas its (...) latency depends on the duration of stimulus evaluation. These and other factors suggest that the P300 is a manifestation of activity occurring whenever one's model of the environment must be revised. Tests of three predictions based on this “context updating” model are reviewed. Verleger's critique is based on a misconstrual of the model as well as a partial and misleading reading of the relevant literature. (shrink)

This study explored patients' experiences of participation and non-participation in their health care. A questionnaire-based survey method was used. Content analysis showed that conditions for patient participation occurred when information was provided not by using standard procedures but based on individual needs and accompanied by explanations, when the patient was regarded as an individual, when the patient's knowledge was recognized by staff, and when the patient made decisions based on knowledge and needs, or performed self-care. Thus, to provide conditions for (...) true patient participation, professionals need to recognize each patient's unique knowledge and respect the individual's description of his or her situation rather than just inviting the person to participate in decision making. (shrink)

The carer of the person with dementia is enjoined to maintain respect, and to reinforce this a bill of rights has been established . Of course, talk of rights does not guarantee respectful behaviour. In this paper it is argued that the discovery that the sufferer continues to be a person, with a unique lifeworld, can assist the carer to conform willingly to the demand that they act respectfully.The current research project makes central the idiographic description of the individual case.

"Deleuze plonge la critique kantienne transcendantale dans le bain dissolvant d'un empirisme renouvelé. Ce livre se propose de restituer cette entreprise, et d'analyser l'étonnante création de ce concept, que Deleuze mène depuis ses premières monographies jusqu'à Différence et Répétition dans un dialogue fécond avec l'histoire de la philosophie. Par quelles opérations de distorsion et de collage, Deleuze compose-t-il l'empirisme de Hume, la théorie du signe comme force de Nietzsche, le virtuel et les multiplicités de Bergson, les modes de Spinoza, les (...) individualisations impersonnelles de Simondon pour renouveler la théorie kantienne du transcendantal? C'est tout l'objet de cette enquête, qui permet d'entrer dans le laboratoire du penseur, pour saisir la philosophie se faisant, mais qui permet également d'expliquer l'insistance du transcendantal dans toute son oeuvre"--P. [4] of cover. (shrink)

Here is the question: what constitutes a good explanation of phenomena?

This essay aims to show how feminist theoretical and practical perspectives have enriched and deepened debate about moral and social issues generated by the proliferation and commodification of new reproductive techniques. It evaluates alternative feminist appraisals beginning with the first group to organize a collective response to the medicalization of infertility and explores several weaknesses working within their assessment: objectification of infertile women, naturalizing constructions of motherhood, hostility to technology, and an overly simplistic conception of power relations. Next, it shows (...) how subsequent feminists have reframed the issues to overcome these weaknesses, drawing on themes prominent in recent theoretical debates: the need to reclaim women's agency, to revalue mothering, and to reappraise power relations. Lastly, it weighs the prospects for a collaborative politics that is sensitive to the social marginalization of vulnerable women and suggests practical strategies for responding to mounting pressures to procreate at any price. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:MATERNAL COMPASSION IN THE THOUGHT OF RENÉ GIRARD, EMIL FACKENHEIM, AND EMMANUEL LÉVINAS Ann W. Astell Purdue University l;ike empathy, compassion is a word that seldom occurs in the /writings of René Girard,' who prefers to answer to Martin Heidegger's "anxiety" [Die Sorge] before death by speaking instead of a "concern for victims" [le souci des victims].2 Maternal corn-passion does enter Girardian analysis directly, however, in his discussion ofthe (...) biblical good harlot, a compassionate mother whom Girard calls "the most perfect figura Christi that can be imagined" (1978, 241). In this paper I focus on the neglected theme of maternal compassion in the writings of Girard, letting them enter into conversation, first, with Emil Fackenheim's reflections on the plight and actions of Jewish mothers during the Holocaust and, second, with themes sounded in the philosophy of Emmanuel Lévinas. I argue that maternal compassion is actually central to Girard's understanding of the unveiling of the victimage mechanism, because it sees goodness in the very life of every potential victim, regardless ofwhat that person has done or is capable ofdoing, simply because he or she exists, has a face. The "innocence" of every victim is reducible to the innocence of the infant, because an infant within a sacrificial system can substitute for every other possible victim. The infant and, even more, the unborn bring us back to the very origins of life, to the Creator. There 1 On empathy and Girard, see my "Saintly Mimesis, Contagion, and Empathy." " See James William's comment on this topic in René Girard, ISee Satan Fall Like Lightning (177, note 4). The locus classicus for Martin Heidegger's "anxiety" is his Being and Time, sections 39-42. 16Ann W. Astell is, as Plato asserts and Lévinas reminds us, a "Good beyond being" that, on a transcendent plane, constitutes the "innocence" ofevery human being that lives, protesting against any one's murder. To illustrate the triangulation of desire, the rivalry of doubles, the mimetic crisis, and its possible outcome in victimage, René Girard turns to the famous biblical story ofthe judgment of Solomon in 3 Kings 3:16-28. In that story two women, two harlots, approach the king, each claiming to be the mother ofa single, living infant, over whom they are fighting. "The symmetry is obvious," Girard writes, "and it represents the very essence of human conflict" (1978, 238). Unable to determine the truth ofthe case on the basis of their conflicting testimonies, the wise king tests them by proposinga sacrificial solution that parodies distributivejustice. He decides to cut the baby in half, giving each woman an equal share, the symmetrical division ofthe victim mirroring the symmetry between the litigants. "The Latin word decidere," Girard notes, "mean etymologicalIy to divide by the sacrificial knife, to cut the throat of a victim" (1978, 238). The proposed sacrifice is averted because its horrific promise of an equal apportionment of parts of the baby's body—a sameness that would confirm the two as doubles—reveals a significant difference between the two women. According to the usual reading of the passage, one of the mothers, having (either deliberately or accidentally) killed her own baby by smothering him, lacks any genuine love for the other woman's infant. As Girard explains, "The only thing that counts for her ispossessing what the other onepossesses. In the last resort, she is ready to accept being deprived ofthe child as long as her opponent is deprived of it in the same way.... All that counts is her fascination with her hated model and rival" (1978, 239). The other woman, however, filled with yearning for the life ofthe child to whom she has given birth, reveals herself to be its true mother by renouncing her maternal rights in a passionate plea: "I beseech thee, my lord, give her the child alive, and do not kill it" (3 Kings 3:26). Commenting on the passage, Girard characterizes the values of the false mother as sacrificial, those ofthe good mother as anti-sacrificial. With reference to the child whose fate hangs in the balance, the distinction is clear enough. The true mother begs for the baby... (shrink)