Feminist Bioethics

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)

Uterus transplantation (UTx) is an experimental surgery likely to face the issue of organ shortage. In my article, I explore how this issue might be addressed by changing the prevailing practices around live uterus donor recruitment. Currently, women with children – often the mothers of recipients – tend to be overrepresented as donors. Yet, other potentially eligible groups who may have an interest in providing their uterus – such as transgender men, or cisgender women who do not wish to gestate (...) or to have children – tend to be excluded as potential donors. Moving forward, I recommend that donor inclusion criteria for UTx be broadened to be more inclusive of these latter groups. (shrink)

East Asian countries such as South Korea have recently made headlines for experimenting with different methods to incentivise people to have (more) children, in a bid to reverse declining birth rates. Many such incentives—child benefits, cash bonuses, dating events, and so on—appear morally innocuous at first glance. I will demonstrate in this analysis, however, that they amount to stopgap measures which reveal fundamental shortcomings with the way various nation states are approaching the so-called ‘problem’ of fertility decline.

This paper critically interrogates the anti-fat beliefs that are employed in environmental bioethics, particularly in response to climate change. Fat bodies have been associated with climate change because they are presumed to consume more resources and produce more greenhouse gas emissions. In this paper, we argue that such interpretations employ mistaken assumptions to justify placing disproportionate blame on already oppressed individuals, reinforcing weight stigma, which increases the vulnerability of fat people to a range of harms and disproportionately affects communities of (...) color. For these reasons, conceiving fat bodies as harmful to the environment is both misguided and unjust. (shrink)

A feminist reading of how Heidegger may have responded to an unanswered questioned he posed in 1923, "Problem: What is woman?" while using his thought to better understand how contemporary society replies to questions in the realms of law, bioethics, pedagogy, and politics.

This article is concerned with "all-or-nothing" approaches to female genital cosmetic surgeries, those that overemphasize either women's autonomy to defend total accessibility or the oppressive social context affecting women to defend the total banning of the procedures. By contrast, the author takes both phenomena into consideration. The author argues identifying patterns of false consciousness and weighing those against harm done to a patient provides a moral basis for a doctor to possibly deny their consent at face value. This also requires (...) a shift in understanding the doctor–patient relationship as a first step toward a feminist model for women's healthcare. (shrink)

Research in epigenetics is demonstrating the importance of maternal care towards offspring early in life for long-term health and behavioral outcomes. Although most of this research has been conducted in rodents, these findings are increasingly framing broader debates about mothers’ moral responsibilities for the health of their offspring. In this paper, I investigate the implications of scientific narratives and research agendas of maternal care for current discourses surrounding maternal epigenetic responsibility. I show how despite clear differences between rodent and human (...) contexts of care, researchers tend to construct rodent maternal care as a form of love or emotional commitment. This construction, which ignores fathers’ care for their offspring, reflects widespread social assumptions about mothers’ particular or “natural” capacities to love their children. This has important implications for how we assign moral blame. Because love is important to our widespread understandings of parental virtues, mothers who act “unlovingly” are prone to being judged in an especially harsh manner. By embedding simplistic and gendered assumptions about mothers’ love for their children, then, epigenetics research perpetuates the tendency to consider mothers especially blameworthy where they are perceived as failing to sufficiently care for or love their children. (shrink)

The Routledge Handbook of Feminist Bioethics, edited by Wendy A. Rogers et al., presents a thorough, contemporary understanding of feminist bioethics, linking feminist efforts to other critical approaches in the field of bioethics. A more demanding standard for feminist scholarship is set by engaging gender at its intersections with race, class, sexuality, and ability––intersections that require bioethicists to attend to issues like incarceration and transmisogynistic violence that are less frequently tackled in the field. Editors and contributors alike in this volume (...) show that long‐standing feminist conceptual interventions, especially those regarding the significance of relationality and epistemic marginalization, provide key tools for a coalition of critical approaches to bioethics. (shrink)

In this paper, I claim that live uterus donors ought to be considered for the possibility of compensation. I support my claim on the basis of comparable arguments which have already been applied to gamete donation, surrogacy, and other kinds of organ donation. However, I acknowledge that there are specificities associated with uterus donation, which make the issue of incentive and reward a harder ethical case relative to gamete donation, surrogacy, and other kinds of organ donation. Ultimately, I contend that (...) while reimbursement for the costs incurred by live uterus donors should be treated as a necessary ethical minimum, how much further we ought to remunerate uterus donations remains an open question. (shrink)

It is well-known that racism is encoded into the social practices and institutions of medicine. Less well-known is that racism is encoded into the material artifacts of medicine. We argue that many medical devices are not merely biased, but materialize oppression. An oppressive device exhibits a harmful bias that reflects and perpetuates unjust power relations. Using pulse oximeters and spirometers as case studies, we show how medical devices can materialize oppression along various axes of social difference, including race, gender, class, (...) and ability. Our account uses political philosophy and cognitive science to give a theoretical basis for understanding materialized oppression, explaining how artifacts encode and carry oppressive ideas from the past to the present and future. Oppressive medical devices present a moral aggregation problem. To remedy this problem, we suggest redundantly layered solutions that are coordinated to disrupt reciprocal causal connections between the attitudes, practices, and artifacts of oppressive systems. (shrink)

In this article, I argue that in portending potentially fatal harm to immunocompromised others, certain vaccine-hesitant views create a paradox for democratic deliberation on public health matters. In this paradox, either vaccine-hesitant views entailing potential harm to others are entertained as legitimate public health policy, or these views are disallowed, excluding discussion of competing harms from the deliberative process. In either case, the result is a deliberative process in which some group is not treated with the consideration owed to free (...) and equal persons as required by the terms of democratic membership. I argue for capitalizing on and refining certain epistemic traits exhibited by anti-vaxxers to address vaccine-hesitant views and minimize this paradox. However, I make the case that this paradox cannot be completely resolved, so we should focus on certain demands of justice to protect the most vulnerable. (shrink)

In this essay, I delineate the relationship between movement, thought, and the ability to speak. In neurology, the biomedical view constructs the image of the subaltern, a muted lifeform devoid of personality and whose life is not congruent with the concepts of autonomy and capacity. I propose to name these human beings “biomedical others.” An anomaly, this subaltern, is an underside of the philosophical totalization of subjectivity. In the biomedical framework, others are devoid of speech. Medicine, its institutes, and agents (...) in the healthcare system speak to them. However, the lives of biomedical others are based on gestures, facial expressions, and body commands that are enacted as micro-gestures. The urgency to give voice to the biomedical others is the ethical task of this essay. They are namely voiceless and powerless, evoking a different kind of ethics: fragility, minority, and silence. (shrink)

Synthetic biology (synbio) involves designing and creating new living systems to serve human ends, using techniques including molecular biology, genomics, and engineering. Existing bioethical analyses of synbio focus largely on balancing benefits against harms, the dual-use dilemma, and metaphysical questions about creating and commercializing synthetic organisms. We argue that these approaches fail to consider key feminist concerns. We ground our normative claims in two case studies, focusing on the public good, who holds and wields power, and synbio research projects’ particularity (...) and context. Attention to feminist concerns is essential for synbio to realize its potential in ethically justifiable ways. (shrink)

We expand on Della Croce’s ambition to interpret “epistemic injustice” as a specification of non-maleficence in the use of the influential four-principle framework. This is an alluring line of thought for conceptual, moral, and heuristic reasons. Although it is commendable, Della Croce’s attempt remains tentative. So does our critique of it. Yet, we take on the challenge to critically address two interrelated points. First, we broaden the analysis to include deliberations about hermeneutical injustice. We argue that, if due consideration of (...) epistemic injustice is to require more than negative ethical obligations in medicine, dimensions of hermeneutical injustice should be explored as an avenue to arrive at such positive duties. Second, and relatedly, we argue that this may encompass moral responsibilities beyond the individual level, that is: positive obligations to take action on a structural level. Building on Dotson’s concept of “contributory injustice” and Scheman’s concept of “perceptual autonomy,” we suggest that the virtues of testimonial and hermeneutical justice may provide additional content not only to negative prohibitions of action (i.e. non-maleficence) but also to positive requirements of action, like respecting patient autonomy. (shrink)

In this article, we explicate evidence-based nursing (EBN), critically appraise its framework and respond to nurses’ concern that EBN sidelines the caring elements of nursing practice. We use resources from care ethics, especially Vrinda Dalmiya’s work that considers care as crucial for both epistemology and ethics, to show how EBN is compatible with, and indeed can be enhanced by, the caring aspects of nursing practice. We demonstrate that caring can act as a bridge between ‘external’ evidence and the other pillars (...) of the EBN framework: clinical expertise; patient preferences and values. Drawing on an influential EBN handbook, section 1 presents the aims and features of EBN, including the normative principle that EBN should take place within a ‘context of caring’. We aim to understand this context and whether it can be neatly detached from the EBN framework, as the handbook seems to suggest. In section 2, we highlight the grounds for resistance to EBN from the nursing community, before mounting the argument that nursing practices can be understood fruitfully through feminist care ethics and/or virtue ethics lenses. In section 3, we deepen that analysis using Dalmiya’s concepts of care-knowing and care as a hybrid ethico-epistemic virtue, which are ideally suited to the complex practices of nursing. In section 4, we bring this rich understanding of care into conversation with EBN, showing that its framework cannot be adequately theorised without paying proper attention to care. Caring can be neither an innocuous background assumption of nor an afterthought to the EBN framework. (shrink)

I am a feminist bioethicist whose work focuses on the ethics of eating. Though COVID-19 is not a foodborne illness, it has had significant impacts on eating around the world, including increases in food insecurity, dining restrictions and closures of restaurants, interruptions in supply chains, and rising food prices. Many people have been eating at home more often—some alone, others with members of their households—and emotional or stress eating is on the rise.A feminist perspective is indispensable for understanding and responding (...) appropriately to these changes. The costs of these changes have not been distributed equally, and drawing attention to how disproportionate harm tracks gendered and intersectional... (shrink)

This paper uses the figure of the nomad from the work of Rosi Braidoti to critically examine rhetoric about vaccine and masking mandates, and the science of covid more broadly. I draw out the tensions and ambivalence felt as we navigate this on-going crisis in ways epitomized by the phrase “I have a healthy mistrust of authority, and I am still vaccinated.” Though ambivalent, the nomadic subject finds an affirmative ethics, navigating the “right” response to incite positive change and expose (...) our current states of subjectivity. Recognizing the ambivalence of this state may be useful for feminists who critique medicine for its historical sexist and racist “objectivism,” while also supporting medical science and trust in the case of vaccine mandates. (shrink)

ABSTRACT This article takes Judith Butler’s epistemological problem of “framing” alongside Dana S. Belu’s notion of “reproductive enframing” to analyze whose bodies lie outside the borders of who is considered the appropriate reproductive citizen. Are all bodies subject to reproductive enframing under a totalizing technological ideology that Martin Heidegger refers to as Gestell? Or, does Belu’s notion of “partial enframing” allow a space to queer, or upset, our current understanding of such ideology? By queering the way that we currently view (...) assisted reproductive technology, can we widen the frame or cross its borders? In this article, I am primarily concerned with the necessity to queer French reproductive policy, though the questions I raise can be extended to any critiques of ART. (shrink)

In May of 2020, reports of so-called "long-COVID" began to surface. Long COVID is a collection of post-COVID-19 physical, cognitive and psychological symptoms, such as depression, brain fog, fatigue, and dizziness. As long-COVID is considered a "new" disease, it is not always covered by health insurance or government programs, moreover it is a set of constantly evolving symptoms.While severe cases of COVID-19 itself tend to be mostly in males over fifty-years-old, those individuals affected by long-COVID tend to be mainly female (...) and younger in age. Data supporting the existence of the long-COVID syndrome... (shrink)

The ongoing COVID-19 pandemic has made explicit what many of us already knew and some of us are constantly made to feel: good health and the abilities of our bodies & minds1 are fluid and uncertain. We can only ever hold them precariously (Butler, 2004; Scully, 2014). In the end, we are all vulnerable beings. And, yet, vulnerability, perhaps especially in times of crisis, can never be fully universalised, nor is it distributed equally: the value and definition of what our (...) bodies & minds can do, what they mean, and how they are expected – and often pushed – to function, are intrinsically unstable, as they depend on the socio-cultural, political, and economic context. This is perfectly echoed by the title Rosi Braidotti (2020) gave to one of her recent articles on the ongoing COVID-19 crisis and the current posthuman predicament: ‘“We” Are in This Together, But We Are Not One and the Same’. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S21-S23, March‐April 2022.

My mother died within the first few months of the pandemic. Her sudden and rapid decline from Alzheimer's disease is difficult to separate from the COVID-19 restrictions put in place by her nursing home just two months prior. We went from visiting her daily to not at all, then to a strictly enforced twenty-minute hospice visit to say goodbye. After her passing, and still amidst the pandemic, I could not write. The conventional methods and outputs of bioethics inquiry felt impossible.Making (...) art is the only thing that felt possible then. Perhaps that's the function of art, to make things feel more possible. I began by collecting materials from work—package inserts, empty prescription bottles and gelatin capsules—to... (shrink)

The COVID-19 pandemic has changed the world. The depth and breadth of changes are still unfolding. What is the place of feminist bioethics in this new world? It's important to point out that COVID-19 is only one of a few major catastrophes we are facing as humans. The ongoing and worsening effects of climate change, along with the paltry efforts of politicians to address it, are an urgent concern. Humanitarian crises caused by climate change, by COVID-19, or crises unrelated to (...) either but surely worsened by both, are also... (shrink)

The COVID-19 pandemic is not the first pandemic that many of us have faced in our lives. The HIV/AIDS pandemic continues to affect women, racialized people, and LGBTQ2S+ people around the world today, and there are significantly fewer resources to address, and less political will and news coverage of, this other pandemic.1 Although many see COVID-19 as an unprecedented public health crisis that is challenging our societies and our relationships with each other in unique ways, I argue that we actually (...) have a lot to learn from our responses to HIV/AIDS and that feminist bioethicists can help us understand how the present situation is actually an extension of several underlying medical and social issues and... (shrink)

This paper tackles the concept of alterity through an embodied perspective. By questioning my lived experience of cancer and how illness—as a disruptive event (Carel, 2008, 2016, 2021)—enables philosophical reflection and the exploration of ‘other’ ways of being-in-the-world (Merleau-Ponty 2012 [1945]), I ask if an embodied ‘chimeric-thinking’ can be used to question established notions of alterity and reshape our relationship with ‘otherness’ (Leistle 2015, 2016b). Building on a phenomenological approach to illness (Carel 2012, 2014, 2016, 2021), and a feminist post-humanist (...) approach (Haraway 1990, 1991, 2016), I present a case in which an autoethnographic and phenomenological approach focused on embodied experience may help revise dominant perspectives, providing access to understanding and engaging with profound biopsychosocial and somatic transformations. (shrink)

Introductory and advanced textbooks in bioethics focus almost entirely on issues that disproportionately affect disabled people and that centrally deal with becoming or being disabled. However, such textbooks typically omit critical philosophical reflection on disability, lack engagement with decades of empirical and theoretical scholarship spanning the social sciences and humanities in the multidisciplinary field of disability studies, and avoid serious consideration of the history of disability activism in shaping social, legal, political, and medical understandings of disability over the last fifty (...) years. For example, longstanding discussions on topics such as euthanasia, physician aid-in-dying, pre-implantation genetic diagnosis, prenatal testing, selective abortion, enhancement, patient autonomy, beneficence, non-maleficence, and health care rationing all tend to be premised on shared and implicit assumptions regarding disability, especially in relation to quality of life, yet with too little recognition of the way that “disability” is itself a topic of substantial research and scholarly disagreement across multiple fields. This is not merely a concern for academic and medical education; as an applied field tied to one of the largest economic sectors of most industrialized nations, bioethics has a direct impact on healthcare education, practice, policy, and, thereby, the health outcomes of existing and future populations. It is in light of these pressing issues that the Disability Bioethics Reader is the first reader to introduce students to core bioethical issues and concepts through the lens of critical disability studies and philosophy of disability. The Disability Bioethics Reader will include over thirty-five chapters covering key areas such as: critical histories and state-of-the-field analyses of modern medicine, bioethics, disability studies, and philosophy of medicine; methods in bioethics; concerns at the edge- and end-of-life; enhancement; disability, quality of life, and well-being; prenatal testing and abortion; invisible disabilities; chronic illness; healthcare justice; genetics and genomics; intellectual disability and neurodiversity; ethics and diagnosis; and epistemic injustice in healthcare. (shrink)

The Routledge Handbook of Feminist Bioethics is an outstanding resource for anyone with an interest in feminist bioethics, with chapters covering topics from justice and power to the climate crisis. Comprising 42 chapters by emerging and established scholars, the volume is divided into six parts: Foundations of Feminist Bioethics Identity and Identifications Science, Technology and Research Health and Social Care Reproduction and Making Families Widening the Scope of Feminist Bioethics The volume is essential reading for anyone with an interest in (...) bioethics or feminist philosophy, and will prove an invaluable resource for scholars, teachers, and advanced students. (shrink)

This chapter shows that feminist bioethics begins with critical engagement. Feminist bioethics as perspective centers the experiences of women – women's health, challenges that women primarily face within health care contexts, gaps in research that are only understood as gaps when one takes women seriously as women. The chapter highlights a few significant breakthroughs in feminist theory broadly that have informed feminist bioethics as perspective and as methodology – standpoint theory, relational autonomy, and intersectionality – in order to show how (...) an intentionally feminist lens can improve bioethics for everyone. Feminists understood that healthcare generally, and bioethics, in particular, were important sites for feminist thought. The traditional view of autonomy in bioethics is centered on the individual. The chapter also highlights an example of public practice, The Black Mamas Matter Alliance, that shows the important work of Black women's community advocacy as a blueprint for a public feminist bioethics. (shrink)

Sometimes, people who are otherwise eligible to donate blood are unduly deferred from donating. “Unduly” indicates a gap where a deferral policy misstates what exposes potential donors to risk and so defers more donors than is justified. Since the error is at the policy-level, it’s natural and understandable to focus criticism on reformulating or eliminating the offending policies. Policy change is undoubtedly the right goal because the policy is what prevents otherwise safe eligible donors from donating needed blood. But focusing (...) exclusively at the policy-level passes over a largely undiscussed question: if policy change takes time and there is an urgent need for blood now, then what should unduly deferred donors do in the meanwhile? Blood banks and federal agencies recommend that deferred donors donate their time or money until they become eligible, but blood is a non-fungible good: donated cash or volunteered time cannot replace a transfusion. Further, this request ignores that otherwise eligible donors could safely donate their blood in addition to their time and money. Here is the central question I will focus on in this paper: is a donor morally justified in lying on a questionnaire to donate blood if they justifiably believe that their blood poses no risk to a recipient and knows that honestly answering a donor questionnaire would unduly defer them from donating? (shrink)

The purpose of cultural competence education for medical professionals is to ensure respectful care and reduce health disparities. Yet as Berger and Miller (2021) show, the cultural competence framework is dated, confused, and self-defeating. They argue that the framework ignores the primary driver of health disparities—systemic racism—and is apt to exacerbate rather than mitigate bias and ethnocentrism. They propose replacing cultural competence with a framework that attends to two social aspects of structural inequality: health and social policy, and institutional-system activity; (...) and two psychological aspects of structural inequality: the clinical encounter, and the epistemic. -/- We agree with the structural approach. To that end, we think it would be fruitful to include attention to physical contributors to structural inequality, namely the material artifacts used in medicine. Devices, tools, and technologies can materialize biases, perpetuate oppression, and contribute to health disparities. Granted, not everything that interests philosophers can be squeezed into medical education. Nevertheless, there are compelling reasons for including the study of material artifacts in education designed to reduce health disparities. First, devices and tools often carry forward biases from the past, and keep biases hidden from plain sight. Second, by studying these artifacts, future clinicians can begin to see themselves as part of a larger sociotechnical system. Finally, as medicine becomes increasingly tech-laden, it’s important for clinicians to see how material artifacts (including algorithms) connect individuals to structures. This will help to undermine oversimplified narratives according to which objective tools and technologies can correct for the bias and subjectivity of flawed human beings. (shrink)

Should the remains of aborted fetuses be treated as human corpses or medical waste? How can feminists defend abortion rights without erasing the experiences of women who mourn fetal death or lending support to pro-life constructions of fetal personhood? To answer these questions, I trace the role of abjection and mourning in debates over fetal remains disposal regulations. Critiquing pro-life views of fetal personhood while challenging feminists to develop richer and more compelling accounts of fetal remains, I argue that embracing (...) the ambiguity and diversity of pregnant bodies can strengthen rather than undermine reproductive autonomy. I conceptualize reproductive autonomy relationally, contending that it entails the pregnant subject’s authority to construct as well as to interpret her lived body, including the fetus. Additionally, because the embodied self is inextricable from social context, reproductive autonomy also requires community support. To support these claims, I develop an account of pregnant bodies as ontologically multiple and advocate embracing abjection rather than suppressing it. Finally, I object to fetal remains regulations because they inscribe fetal grievability into the law. (shrink)

Empresas de todo el mundo están desarrollando y vendiendo robots sexuales. Preguntas sobre "¿Cómo afectarán las relaciones con los robots a las relaciones humanas en el futuro?" surgen cuando las tecnologías se utilizan para satisfacer las necesidades sociales y emocionales de las personas. Este artículo analiza el uso de robots sexuales desde una perspectiva bioética, considerando que las tecnologías y los diseños tienen valores intrínsecos que hay que tener en cuenta. Las relaciones con robots y sistemas informáticos, como la inteligencia (...) artificial, son una posibilidad para muchas personas en todo el mundo. Presentamos preguntas planteadas por voces a favor y en contra del sexo con robots. Además de la polarización binaria, la perspectiva bioética recuerda los conceptos de biopolítica y biopoder de Foucault para situar problemas como la mecanización de las relaciones íntimas. Sostenemos que el debate sobre los robots sexuales ofrece la oportunidad de revisar viejos patrones en relación con el género, desigualdad y la salud. (shrink)

This exciting new Handbook offers a comprehensive overview of the contemporary state of the field in feminist philosophy. The editors' introduction and forty-five essays cover feminist critical engagements with philosophy and adjacent scholarly fields, as well as feminist approaches to current debates and crises across the world. Authors cover topics ranging from the ways in which feminist philosophy attends to other systems of oppression, and the gendered, racialized, and classed assumptions embedded in philosophical concepts, to feminist perspectives on prominent subfields (...) of philosophy. The first section contains chapters that explore feminist philosophical engagement with mainstream and marginalized histories and traditions, while the second section parses feminist philosophy's contributions to numerous philosophical subfields, for example metaphysics and bioethics. A third section explores what feminist philosophy can illuminate about crucial moral and political issues of identity, gender, the body, autonomy, prisons, among numerous others. The Handbook concludes with the field's engagement with other theories and movements, including trans studies, queer theory, critical race, theory, postcolonial theory, and decolonial theory. The volume provides a rigorous but accessible resource for students and scholars who are interested in feminist philosophy, and how feminist philosophers situate their work in relation to the philosophical mainstream and other disciplines. Above all it aims to showcase the rich diversity of subject matter, approach, and method among feminist philosophers. (shrink)

Bioethics scholarship considering the possibility of gestating an embryo to full term in an artificial womb (ectogenesis) often overstates the capacities of current technologies and underestimates the barriers to the development of full ectogenesis. Moreover, this debate causes harm by (1) neglecting more immediate problems in the development of artificial wombs, (2) treating abortion as a “problem with a technological solution,” bolstering anti-abortion rhetoric, and (3) presuming the stability of women’s reproductive rights. The ectogenesis conversation must consider anticipated uses of (...) the technology (neonatal intensive care) and acknowledge the immediate context (recognizing abortion as essential healthcare and existing reproductive inequities). (shrink)

One branch of bioethics assumes that mainly agents of the state are responsible for public health. Following Susan Sherwin’s relational ethics, we suggest moving away from a “state-centered” approach toward a more thoroughly relational approach. Indeed, certain agents must be reconstituted in and through shifting relations with others, complicating discussions of responsibility for public health. Drawing on two case studies—the health politics and activism of the Black Panther Party and the work of the Common Ground Collective in post-Katrina New Orleans—we (...) argue for the need to attend more carefully to the limitations of states and state-driven public health programs. (shrink)

Adoption may be defined as ‘the legal process through which the state establishes a parental relationship, with all its attendant rights and duties, between a child and a (set of) parent(s) where there exists no previous procreative relationship’ . In adoptions from care, state intervention effectively converts an established, or nascent, adult– child relationship into ‘family’ in the legal sense. From the state’s perspective, adoption thus entails the transfer of parental responsibilities for a child in public care to a private (...) family unit, enabling the state to permanently delegate its duties towards a child to this new unit. This seemingly straightforward legal act raises deeper philosophical questions relating to such state ‘family creation’, particularly when the child’s perspective is taken. Such a child- centric approach normatively regards children as equal moral beings, who ought to be included in actions concerning them, regardless of their capacity to form and express an opinion. Accordingly, adoption from care can be described as a moral decision, aimed at doing what is in the child’s best interests. The purpose of this chapter is to explore a suspicion of a lack of child- centrism in adoption from care practice, and to illustrate how adopted children’s rights are inferior to those of their non- adopted peers. This will shed light on a practice currently lacking transparency and accountability and will increase our understanding of how we fail to treat children as equal moral individuals in decision- making that severely impacts children’s lives. (shrink)

Shared Decision Making (‘SDM’) is one of the most significant developments in Western health care practices in recent years. Whereas traditional models of care operate on the basis of the physician as the primary medical decision maker, SDM requires patients to be supported to consider options in order to achieve informed preferences by mutually sharing the best available evidence. According to its proponents, SDM is the right way to interpret the clinician-patient relationship because it fulfils the ethical imperative of respecting (...) patient autonomy. However, there is no consensus about how decisions in SDM contexts relate to the principle of respect for autonomy. In response, I demonstrate that in order to make decisions about what treatment they will or will not receive, patients will be required to meet different conditions depending on the approach proponents of SDM take to understanding personal autonomy. Due to the fact that different conceptions of autonomy yield different obligations, I argue that if physicians and patients satisfied all the conditions described in standard accounts of SDM, then SDM would undermine patient autonomy. (shrink)

Love enhancement can give us as a say on whom we love and thus ‘free’ us from our brain chemistry, which is mostly out of our control. In that way, we become more autonomous in love and in our life in general, as long as love enhancement is a free, voluntary choice. So goes the argument in favour of this addition to medical interventions of relationships. In this paper, I show that proponents of love enhancement have overlooked, or at least (...) underestimated, the fact that love itself impacts people’s choices. Since this could include the choice for love or anti-love drugs, I call for a re-formulation of the underlying view on autonomy before this medical intervention is made available to the public. (shrink)

Conscience in Reproductive Health Care responds to the growing worldwide trend of health care professionals conscientiously refusing to provide abortions and similar reproductive health services in countries where these services are legal and professionally accepted. Carolyn McLeod argues that conscientious objectors in health care should prioritize the interests of patients in receiving care over their own interest in acting on their conscience. She defends this "prioritizing approach" to conscientious objection over the more popular "compromise approach" without downplaying the importance of (...) health care professionals having a conscience or the moral complexity of their conscientious refusals. McLeod's central argument is that health care professionals who are gatekeepers of services such as abortions are fiduciaries for their patients and for the public they are licensed to serve. As such, they owe a duty of loyalty to these beneficiaries and should give primacy to their beneficiaries' interests in accessing care. This conclusion is informed by what McLeod believes is morally at stake for the main parties to the conflicts generated by conscientious refusals: the objector and the patient. What is at stake, according to McLeod, depends on the relevant socio-political context, but typically includes the objector's integrity and the patient's interest in avoiding harm. (shrink)

We are preparing this special issue celebrating the work of Susan Sherwin under extraordinary circumstances. We are sitting in our homes, isolating ourselves from each other, in order to support and protect each other. Each of us is curtailing our preferences in order not only to protect ourselves but to protect everyone else in our community—local and global—from COVID-19. In this historic moment it is abundantly clear that our lives are inescapably relational—that, through our own decisions and actions, each individual (...) makes possible, or impossible, other actions for other people. To take a relatively simple example, consider one type of physical distancing that our government is asking us to practice... (shrink)

Influenced by critical disability studies, feminist thought and participatory and emancipatory approaches to research, this paper explores new ways of thinking about the ethics of developing a literature review during doctoral study. It questions what kind of knowledge the literature review values, whose lens is upheld and more importantly whose is ignored. It is argued that reimagining the literature review as a ‘community of knowledge’ and drawing on a variety of sources and voices, not only contributes to the overall transparency (...) and integrity of the thesis, but enables the literature review to become a space in which dominant discourses can be challenged and unequal relations of power disrupted. (shrink)

The debate regarding the role of conscientious objection in healthcare has been protracted, with increasing demands for curbs on conscientious objection. There is a growing body of evidence that indicates that in some cases, high rates of conscientious objection can affect access to legal medical services such as abortion—a major concern of critics of conscientious objection. Moreover, few solutions have been put forward that aim to satisfy both this concern and that of defenders of conscientious objection—being expected to participate in (...) the provision of services that compromise their moral integrity. Here we attempt to bring some resolution to the debate by proposing a pragmatic, long-term solution offering what we believe to be an acceptable compromise—a quota system for medical trainees in specialties where a conscientious objection can be exercised, and is known to cause conflict. We envisage two main objectives of the quota system we propose. First, as a means to introduce conscientious objection into countries where this is not presently permitted. Second, to minimise or eliminate the effects of high rates of conscientious objection in countries such as Italy, where access to legal abortion provision can be negatively affected. (shrink)

Penelope Deutscher’s book, "Foucault’s Futures: A Critique of Reproductive Reason" engages with the recent interest in reproduction, futurity, failure, and negativity in queer theory, but also the historical and ongoing investments in the concept of reproduction in feminist theory as well as (US) social movements. "Foucault’s Futures" troubles the forms of subjectivation presupposed by “reproductive rights” from a feminist perspective, exploring the “contiguity” between reproductive reason and biopolitics—specifically the proximity of reproduction to death, risk, fatality, and threat: its thanatopolitical underbelly.

Liminal Bodies, Reproductive Health, and Feminist Rhetoric presents composition professor Lydia McDermott's "sonogram" methodology of rhetorical listening, an exercise that discloses feminine voices muted or unjustly disciplined within texts ostensibly written on women's behalf. The texts examined by McDermott range from eighteenth-century pregnancy manuals to speeches by Favorinus, the ancient sophist, who is described from antiquity as a hermaphrodite. Part of McDermott's purpose in sonogramming is to critique modern and contemporary feminists. She objects to the feminist trend of perpetuating and (...) answering a "disability" rhetoric about women, or of demonstrating that women can overcome a... (shrink)

In this peer commentary on Maura Priest's "Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm", I argue against the "mismatch" model of trans identity. On this model, which is prevalent in institutional and medical contexts, to be trans is to have one's gender identity "mismatch" with one's sexed body.

This paper argues that it is not incoherent to think that abortion should be “legal but rare.” The argument draws upon virtue ethics, feminism, critical theory, and the theory of biopolitics to argue that the idea that abortion should be legal but rare is best understood as aiming at the elimination of unwanted pregnancies. Some pro-choice defenders of abortion rights worry that the “legal but rare” idea stigmatizes women who choose abortion. But when this idea is unpacked using the tools (...) of intersectional analysis, biopolitical theory, and virtue ethics it can be understood as pointing toward a transformation of social reality that empowers women. (shrink)