Feminist bioethics

Last updated

Feminist bioethics is a subfield of bioethics which advocates gender and social equality through the critique of existing bioethical discourse, offering unique feminist arguments and viewpoints, and pointing out gender concerns in bioethical issues. [1] [2]

Contents

Emerging around the end of the twentieth century, feminist bioethics is a diverse academic field involving the use of social, philosophical, and feminist theories to examine and criticize gender biases and inequalities implied in bioethical problems, theories, and methodologies. [3] [4] [5] Feminist critiques of bioethics include androcentrism, gendered concepts, and overemphasis on individual rights. Feminist bioethics offers unique perspectives on several bioethical issues, such as the concept of health, healthcare, the patient-physician relationship, and reproductive issues. There are several criticisms of feminist bioethics, such as a lack of agreement among feminist bioethical arguments due to the plurality and diversity of feminist bioethical discourse, the conceptualization of feminine vulnerability as reinforcing gender oppression, and the field's loss of uniqueness as feminist perspectives in academia become increasingly common.

History

As bioethics became an established discipline in philosophy in 1970s, [6] feminist critiques of bioethics started in the late 1980s and gained recognition and attention as a separate philosophical focus in the 1990s. At the time, it was largely dismissed by the mainstream bioethics community. [7] The origin of feminist bioethics as an area of study can be traced to several articles published in Hypatia: A Journal of Feminist Philosophy . [8] These early articles focused largely on bioethical issues related to technologies connected to female reproductive concerns, such as abortion, IVF, and surrogacy.

In the 1990s, feminist bioethics marked its official disciplinary existence with the book Feminist Perspectives in Medical Ethics [9] by Helen Holmes and Laura Purdy, which was published in 1992 as a collection of journal articles that had previously been published in Hypatia in the 1980s. Several other books with feminist standpoints about bioethics were also published, including No Longer Patient: Feminist Ethics and Health Care [10] by Susan Sherwin in 1992, Feminism and Bioethics: Beyond Reproduction [3] by Susan Wolf in 1996, and Feminist Approaches to Bioethics: Theoretical Reflections and Practical Applications [11] by Rosemarie Tong in 1997.

Feminist Approaches to Bioethics (FAB), a network of feminist bioethics, was founded in 1992, along with its own publications of academic journals in the International Journal of Feminist Approaches to Bioethics (IJFAB).

Theories and methodologies

As in feminist theory as a whole, there exists no unifying "feminist bioethics", due to heterogeneity in the positions of different feminist critiques of mainstream bioethical positions. [1] [5] [12] Nonetheless, commonalities between different fields of feminist bioethics exist.

Feminist bioethics can disagree with each other about what should be viewed as being in women's best interest, due to the diversity of opinion in the field. [12]

Feminist critiques on bioethics

Androcentrism

Western philosophy has been historically dominated by men as a male-centered discipline, and women's perspectives and representations in the discipline were often excluded. Traditionally, accounts from exclusively men are regarded as complete accounts and women's only as supplements. Men's experiences and values are sufficient to be viewed as and eventually define norms for all humanity. Men are the "neutral" group and women are the group that departs from men. [2] [4]

Androcentrism has been reflected in medical research. In 1988, a research on the effects of aspirin in decreasing the risk of heart disease was conducted by Physician Health Study, It investigated 22,000 men and zero women. [16] In 1990, the United States Government Accountability Office reported that women were not sufficiently represented in clinical trials. [17] Such underrepresentation of women in medical research poses questions about drug safety for women, especially regarding dosage-sensitive drugs, given that women's average body weight is less than men's. [2] It has been argued[ by whom? ] that women's exclusion from medical research is due to the elimination of variables like the fluctuation of female hormonal levels and the difficulty of women's participation and ability to remain in research, as they often have difficult managing conflicts between drug trials, childcare, and work. Feminist bioethics argues that hormonal fluctuation should be considered an important factor in medical research rather than be ignored, and that clinical trials should be designed to accommodate women's lives and working schedules. [2]

Gendered concepts

Concepts that frequently appear in philosophical discussions are often gendered. Reason is often associated with men, while emotion is associated with women. Since the ancient era of human history, women have been viewed as inferior to men physically, emotionally, and intellectually. Gendered associations distort the meanings of these concepts and reflect patriarchal attitudes towards women. Reason is thought to be the best guide for moral judgments, while relying on emotion is thought to be unreliable and even primitive. Emotion being viewed as something lower and less desirable than reason implies a general lack of concern and compassion for patients' individual situations. [2] The result is a pattern of abstraction: patients and medical professionals are viewed not as distinct persons but as interchangeable subjects with generic characteristics operating under universal principles. Under such abstraction, the gender of patients is excluded from considerations and reduced to something more general, more "neutral". Women are subsumed into men. [5]

Overemphasis on individual rights

The tendency of bioethicists to use theories that appeal to human rights over-simplifies moral arguments by excluding other non-rights moral considerations. Some even equate the over-appeal to rights as resembling the idea of domination in masculinism. Moreover, broad appeals to human rights tend to prioritize the civil and political rights of men and dominant groups, while overlooking those of women and minority groups. [18]

Feminist perspectives on bioethical issues

Concept of health

One view is that the level of achievable health is tied to power differences caused by gender, race, and class. It is argued[ by whom? ] that a positive state of well-being is more easily achieved by well-off, able-bodied, heterosexual white men than others. Women, on the other hand, are more likely to suffer from poverty, often as an intersectionality of racism and sexism, [19] [20] and their pain is often taken less seriously than men. [19] [21] [22] Simultaneously, women's physical well-being is burdened with the duty of a youthful and sexy appearance, which can push women into "extreme" behaviours in pursuit of unapproachable beauty standards. [19]

Healthcare

The healthcare system, especially in the US, is often hierarchical and masculinist, as patients who are white and male have easier access to healthcare than those who are nonwhite and female. Within the healthcare system, nonwhite and female physicians are more often primary care physicians, while white and male physicians are more often surgeons. Even in medical trials, disadvantaged groups like women and people of color are often excluded. [23]

Medical practices are heavily influenced by sexist, classist, and racist norms. [23] Certain common practices in the healthcare system often assume and reinforce gender roles that disproportionately harm women. For example, a woman does not have autonomy over her own fertility, because she needs to obtain consent from her husband to get herself sterilized; on the other hand, vasectomy for a man can be done in a week. [24]

Patient-physician relationship

Power dynamics in the patient-physician relationship are linked to equality and inequality in communication. Patients' gender and race affects the standard of medical care received from physicians. Female patients who challenge physicians are more likely to be perceived as uncooperative, while male patients who challenge physicians are seen as rational participants in their own treatment. Similarly, female patients tend to receive information with less clarity from physicians. Patients with less power, typically women and individuals of color, frequently receive lower-standard care; this can include longer wait times for service, worse treatment, disregard of personal wishes, and less information or lower accuracy of information given. Medical care is often regarded as a private issue for patients, which makes it more difficult to observe the inequality that results from patients' gender and race.

There is also the concern about whether a patient should be viewed as a "generalized other" or a "concrete other". The "generalized other" view tends to see all patients as equally entitled to the same level of care and without regard for personal differences, while the "concrete other" view tends to see each patient as a unique individual with particular interests and needs. The "generalized other" is more distant and less intimate to physicians. Seeing patients as the "generalized other" has been the norm in health care, but feminist bioethics argues for seeing patients as the "concrete other", with a more empathetic attitude to individual concerns. [3]

Reproductive issues

Feminist bioethicists' contributions to discussions on reproductive issues are not only limited to opinions from female perspectives, but also to the revelation of the structural power difference in the areas that affect women's reproductive experience and concerns. For example, it is argued that new reproductive technologies should not be considered "gender neutral", since they disproportionately affect women's welfare. [25] Concerns over the "use" of reproductive tissues as exploitations of female bodies in research and therapy is also brought up. [26]

Criticisms

Related Research Articles

In developmental psychology and moral, political, and bioethical philosophy, autonomy is the capacity to make an informed, uncoerced decision. Autonomous organizations or institutions are independent or self-governing. Autonomy can also be defined from a human resources perspective, where it denotes a level of discretion granted to an employee in his or her work. In such cases, autonomy is known to generally increase job satisfaction. Self-actualized individuals are thought to operate autonomously of external expectations. In a medical context, respect for a patient's personal autonomy is considered one of many fundamental ethical principles in medicine.

Bioethics is both a field of study and professional practice, interested in ethical issues related to health, including those emerging from advances in biology, medicine, and technologies. It proposes the discussion about moral discernment in society and it is often related to medical policy and practice, but also to broader questions as environment, well-being and public health. Bioethics is concerned with the ethical questions that arise in the relationships among life sciences, biotechnology, medicine, politics, law, theology and philosophy. It includes the study of values relating to primary care, other branches of medicine, ethical education in science, animal, and environmental ethics, and public health.

Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy, non-maleficence, beneficence, and justice. Such tenets may allow doctors, care providers, and families to create a treatment plan and work towards the same common goal. It is important to note that these four values are not ranked in order of importance or relevance and that they all encompass values pertaining to medical ethics. However, a conflict may arise leading to the need for hierarchy in an ethical system, such that some moral elements overrule others with the purpose of applying the best moral judgement to a difficult medical situation. Medical ethics is particularly relevant in decisions regarding involuntary treatment and involuntary commitment.

<span class="mw-page-title-main">Female hysteria</span> Outdated diagnosis for patients with multiple symptoms of a neurological condition

Female hysteria was once a common medical diagnosis for women, which was described as exhibiting a wide array of symptoms, including anxiety, shortness of breath, fainting, nervousness, sexual desire, insomnia, fluid retention, heaviness in the abdomen, irritability, loss of appetite for food or sex, (paradoxically) sexually forward behavior, and a "tendency to cause trouble for others". It is no longer recognized by medical authorities as a medical disorder. Its diagnosis and treatment were routine for hundreds of years in Western Europe.

Feminist philosophy is an approach to philosophy from a feminist perspective and also the employment of philosophical methods to feminist topics and questions. Feminist philosophy involves both reinterpreting philosophical texts and methods in order to supplement the feminist movement and attempts to criticise or re-evaluate the ideas of traditional philosophy from within a feminist framework.

<span class="mw-page-title-main">Dorothy Roberts</span> American sociologist, law professor, and social justice advocate

Dorothy E. Roberts is an American sociologist, law professor, and social justice advocate. She is the Penn Integrates Knowledge Professor, George A. Weiss University Professor, and inaugural Raymond Pace and Sadie Tanner Mossell Alexander Professor of Civil Rights at the University of Pennsylvania. She writes and lectures on gender, race, and class in legal issues. Her focuses include reproductive health, child welfare, and bioethics. In 2023, she was elected to the American Philosophical Society. She also has published over 80 articles and essays in books and scholarly journals, including Harvard Law Review, Yale Law Journal, and Stanford Law Review.

Reproductive justice is a critical feminist framework that was invented as a response to United States reproductive politics. The three core values of reproductive justice are the right to have a child, the right to not have a child, and the right to parent a child or children in safe and healthy environments. The framework moves women's reproductive rights past a legal and political debate to incorporate the economic, social, and health factors that impact women's reproductive choices and decision-making ability.

<span class="mw-page-title-main">Philosophy of healthcare</span>

The philosophy of healthcare is the study of the ethics, processes, and people which constitute the maintenance of health for human beings. For the most part, however, the philosophy of healthcare is best approached as an indelible component of human social structures. That is, the societal institution of healthcare can be seen as a necessary phenomenon of human civilization whereby an individual continually seeks to improve, mend, and alter the overall nature and quality of their life. This perennial concern is especially prominent in modern political liberalism, wherein health has been understood as the foundational good necessary for public life.

<span class="mw-page-title-main">Prison healthcare</span> Medical treatment in prisons, jails, and other penal institutions

Prison healthcare is the medical specialty in which healthcare providers care for people in prisons and jails. Prison healthcare is a relatively new specialty that developed alongside the adaption of prisons into modern disciplinary institutions. Enclosed prison populations are particularly vulnerable to infectious diseases, including arthritis, asthma, hypertension, cervical cancer, hepatitis, tuberculosis, AIDS, and HIV, and mental health issues, such as Depression, mania, anxiety, and post-traumatic stress disorder. These conditions link prison healthcare to issues of public health, preventive healthcare, and hygiene. Prisoner dependency on provided healthcare raises unique problems in medical ethics.

Feminist ethics is an approach to ethics that builds on the belief that traditionally ethical theorizing has undervalued and/or underappreciated women's moral experience, which is largely male-dominated, and it therefore chooses to reimagine ethics through a holistic feminist approach to transform it.

<span class="mw-page-title-main">Gender bias in medical diagnosis</span>

Gender-biased diagnosing is the idea that medical and psychological diagnosis are influenced by the gender of the patient. Several studies have found evidence of differential diagnosis for patients with similar ailments but of different sexes. Female patients face discrimination through the denial of treatment or miss-classification of diagnosis as a result of not being taken seriously due to stereotypes and gender bias. According to traditional medical studies, most of these medical studies were done on men thus overlooking many issues that were related to women's health. This topic alone sparked controversy and brought about question to the medical standard of our time. Popular media has illuminated the issue of gender bias in recent years. Research that was done on diseases that affected women more were less funded than those diseases that affected men and women equally.

<span class="mw-page-title-main">Medical law</span> Area of law dealing with the practice of medicine

Medical law is the branch of law which concerns the prerogatives and responsibilities of medical professionals and the rights of the patient. It should not be confused with medical jurisprudence, which is a branch of medicine, rather than a branch of law.

Feminist justice ethics is a feminist view on morality which seeks to engage with, and ultimately transform, traditional universal approaches to ethics. Like most types of feminist ethics, feminist justice ethics looks at how gender is left out of mainstream ethical considerations. Mainstream ethics are argued to be male-oriented. However, feminist justice ethics does differ considerably from other feminist ethics. A universal set of ethics is a significant part of feminist justice ethics. Feminist justice ethics is clear in dividing "thick" morality from "thin" morality. Other ethical approaches that define themselves by differentiating groups from one another through culture or other phenomena are regarded as "thick" accounts of morality. Feminist justice ethics claims that "thick" accounts of morality, as opposed to "thin" accounts of morality, are intrinsically prone to eroding valid feminist critique.

Joan Callahan was a Professor Emerita of Philosophy at the University of Kentucky, an institution where she taught for more than twenty years and served in a variety of roles, including as director of the Gender and Women's Studies Program. Callahan's research has focused on feminist theory, critical race theory, ethics, social and political philosophy, the philosophy of law, and on the junctions of these topics.

<span class="mw-page-title-main">Francoise Baylis</span> Canadian bioethicist

Françoise Elvina BaylisFISC is a Canadian bioethicist whose work is at the intersection of applied ethics, health policy, and practice. The focus of her research is on issues of women's health and assisted reproductive technologies, but her research and publication record also extend to such topics as research involving humans, gene editing, novel genetic technologies, public health, the role of bioethics consultants, and neuroethics. Baylis' interest in the impact of bioethics on health and public policy as well as her commitment to citizen engagement]and participatory democracy sees her engage with print, radio, television, and other online publications.

Rosemarie "Rosie" Tong is an American feminist philosopher. The author of 1998's Feminist Thought: A More Comprehensive Introduction, an overview of the major traditions of feminist theory, she is the emeritus distinguished professor of health care ethics in the Department of Philosophy at the University of North Carolina, Charlotte.

<span class="mw-page-title-main">Hasna Begum</span> Bangladeshi philosopher and feminist (1935–2020)

Hasna Begum was a Bangladeshi philosopher and feminist, and a professor of philosophy at the University of Dhaka until her retirement in December 2000.

Susan Sherwin is a Canadian philosopher. Her pioneering work has shaped feminist theory, ethics and bioethics, and she is considered one of the world's foremost feminist ethicists.

Maternal-fetal conflict, also known as obstetric conflict, occurs when a pregnant individual's (maternal) interests conflict with the interests of the fetus. Legal and ethical considerations involving women's rights and the rights of the fetus as a patient and future child, have become more complicated with advances in medicine and technology. Maternal-fetal conflict can occur in situations where the mother denies health recommendations that can benefit the fetus or make life choices that can harm the fetus. There are maternal-fetal conflict situations where the law becomes involved, but most physicians avoid involving the law for various reasons.

<span class="mw-page-title-main">Lisa Campo-Engelstein</span> American bioethicist

Lisa Campo-Engelstein is an American bioethicist and fertility/contraceptive researcher. She currently works at the University of Texas Medical Branch as the Harris L. Kempner Chair in the Humanities in Medicine Professor, the Director of the Institute for Bioethics & Health Humanities, and an Associate Professor in Preventive Medicine and Population Health. She is also a feminist bioethicist specializing in reproductive ethics and sexual ethics. She has been recognized in the BBC's list of 100 inspiring and influential women from around the world for 2019.

References

  1. 1 2 Pinch, Winifred J. Ellenchild (1996-02-01). "Feminism and bioethics". MedSurg Nursing. 5 (1): 53–57. PMID   8696410.
  2. 1 2 3 4 5 Little, Margaret Olivia (1996-03-01). "Why a Feminist Approach to Bioethics?". Kennedy Institute of Ethics Journal. 6 (1): 1–18. doi:10.1353/ken.1996.0005. hdl: 10822/709358 . ISSN   1086-3249. PMID   10157548. S2CID   26844526.
  3. 1 2 3 Wolf, Susan M. (1996). Feminism and Bioethics : Beyond Reproduction. Cary: Oxford University Press, Incorporated. ISBN   978-0-19-975967-5. OCLC   922952651.
  4. 1 2 Rawlinson, Mary C. (2001-01-01). "The Concept of a Feminist Bioethics". The Journal of Medicine and Philosophy. 26 (4): 405–416. doi:10.1076/jmep.26.4.405.3010. ISSN   0360-5310. PMID   11484132.
  5. 1 2 3 Marway, Herjeet; Widdows, Heather (2015). "Philosophical Feminist Bioethics: Past, Present, and Future". Cambridge Quarterly of Healthcare Ethics. 24 (2): 165–174. doi:10.1017/S0963180114000474. ISSN   0963-1801. PMID   25719352.
  6. ↑ Harvey, John Collins (2013), Garrett, Jeremy R.; Jotterand, Fabrice; Ralston, D. Christopher (eds.), "André Hellegers, the Kennedy Institute, and the Development of Bioethics: The American–European Connection", The Development of Bioethics in the United States, Philosophy and Medicine, Dordrecht: Springer Netherlands, vol. 115, pp. 37–54, doi:10.1007/978-94-007-4011-2_4, ISBN   978-94-007-4011-2 , retrieved 2021-03-02
  7. ↑ Purdy, Laura M. (2001-06-01). "What Feminism Can Do for Bioethics". Health Care Analysis. 9 (2): 117–132. doi:10.1023/A:1011313800137. ISSN   1573-3394. PMID   11561992. S2CID   6533013.
  8. ↑ "Hypatia". Cambridge Core. Retrieved 2021-03-03.
  9. ↑ Holmes, Helen B.; Purdy, Laura (1992). Feminist Perspectives in Medical Ethics. Indiana University Press.
  10. ↑ "No Longer Patient | Temple University Press". tupress.temple.edu. Retrieved 2021-03-03.
  11. ↑ "Feminist Approaches To Bioethics: Theoretical Reflections And Practical Applications". Routledge & CRC Press. Retrieved 2021-03-03.
  12. 1 2 3 4 Tong, Rosemarie (1996-03-01). "Feminist Bioethics: Toward Developing a "Feminist" Answer to the Surrogate Motherhood Question". Kennedy Institute of Ethics Journal. 6 (1): 37–52. doi:10.1353/ken.1996.0004. ISSN   1086-3249. PMID   11645320. S2CID   12613313.
  13. ↑ Sherwin, Susan; Network, Feminist Health Care Ethics Research (1998). The Politics of Women's Health: Exploring Agency and Autonomy. Temple University Press. ISBN   978-1-56639-633-2.
  14. ↑ Mikkola, Mari (2016). "Feminist Metaphysics and Philosophical Methodology". Philosophy Compass. 11 (11): 661–670. doi:10.1111/phc3.12349. ISSN   1747-9991. S2CID   151917328.
  15. ↑ Ryan, Maura A. (2009). "The Introduction of Assisted Reproductive Technologies in the "Developing World": A Test Case for Evolving Methodologies in Feminist Bioethics". Signs. 34 (4): 805–825. doi:10.1086/597133. ISSN   0097-9740. JSTOR   10.1086/597133. S2CID   143831858.
  16. ↑ "Physicians' Health Study - Full Text View - ClinicalTrials.gov". clinicaltrials.gov. Retrieved 2021-03-01.
  17. ↑ Nadel, Mark V. (1990-07-24). "National Institutes of Health: Problems in Implementing Policy on Women in Study Populations. Statement of Mark v. Nadel, Associate Director, National and Public Health Issues, Human Resources Division Before the Subcommittee on Housing And Consumer Interest, Select Committee on Aging, House of Representatives". eweb:98935. Retrieved 2021-03-01.
  18. ↑ Donchin, Anne (2004). "Converging Concerns: Feminist Bioethics, Development Theory, and Human Rights". Signs. 29 (2): 299–324. doi:10.1086/378104. hdl: 1805/7493 . ISSN   0097-9740. JSTOR   10.1086/378104. S2CID   55441500.
  19. 1 2 3 Purdy, Laura (1996), Wolf, Susan (ed.), "A Feminist View of Health", Feminism and Bioethics: Beyond Reproduction, Oxford University Press, retrieved 2021-03-03
  20. ↑ Rix, Sara E. (1990). American Woman 1990-91: A Status Report. Third Edition. W. ISBN   978-0-393-30686-6.
  21. ↑ Fugh-Berman, Adriane (1992-01-20). "Tales Out of Medical School". eweb:115099. Retrieved 2021-03-03.
  22. ↑ Billock, Jennifer. "Pain bias: The health inequality rarely discussed". www.bbc.com. Retrieved 2021-03-03.
  23. 1 2 Gupta, Kristina (2020). Medical entanglements : rethinking feminist debates about healthcare. New Brunswick, New Jersey. ISBN   978-1-9788-0663-4. OCLC   1124761657.{{cite book}}: CS1 maint: location missing publisher (link)
  24. ↑ Feder, Shira. "A woman was told she needed her husband's permission to get her tubes tied. Her story went viral, but it's not uncommon". Insider. Retrieved 2021-04-07.
  25. ↑ Dickenson, Donna (2016), "Feminist Perspectives on Human Genetics and Reproductive Technologies", eLS, American Cancer Society, pp. 1–5, doi:10.1002/9780470015902.a0005592.pub3, ISBN   978-0-470-01590-2 , retrieved 2021-04-05
  26. ↑ The 'healthy' embryo : social, biomedical, legal, and philosophical perspectives. Jeffrey A. Nisker. Cambridge: Cambridge University Press. 2010. ISBN   978-0-521-74813-1. OCLC   428024428.{{cite book}}: CS1 maint: others (link)
  27. ↑ Scully, Jackie Leach (2010), Scully, Jackie Leach; Baldwin-Ragaven, Laurel; Fitzpatrick, Petya (eds.), "Conclusion : Reassessment and Renewal", Feminist Bioethics: At the Center, on the Margins, Johns Hopkins University Press, retrieved 2021-04-06
  28. ↑ Cunniff Gilson, Erinn (2016-09-01). "Vulnerability and Victimization: Rethinking Key Concepts in Feminist Discourses on Sexual Violence". Signs: Journal of Women in Culture and Society. 42 (1): 71–98. doi:10.1086/686753. ISSN   0097-9740. S2CID   225087268.
  29. ↑ Feminist bioethics : at the center, on the margins. Jackie Leach Scully, Laurel Baldwin-Ragaven, Petya Fitzpatrick. Baltimore: Johns Hopkins University Press. 2010. ISBN   978-0-8018-9424-4. OCLC   403362019.{{cite book}}: CS1 maint: others (link)
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.