Abortion considerations require deep reflection on law, convention, social mores, religious norms, family contexts, emotions, and relationships. I have three arguments. First, a liberal “right to choose” framework is inadequate because it is based on individualist notions of rights. Second, reproductive freedoms should be extended to all women. Third, abortion ethics involves a dialectical interplay between rights and responsibilities, and between social, cultural, and particular contexts, and is best understood in terms of moral praxis.
We criticize a view of maternity that equates the natural with the genetic and biological and show how such a practice overdetermines the maternal body and the maternal experience for women who are mothers through adoption and ART (Assisted Reproductive Technologies). As an alternative, we propose a new framework designed to rethink maternal bodies through the lens of feminist embodiment. Feminist embodied maternity, as we call it, stresses the particularity of experience through subjective embodiment. A feminist embodied maternity emphasizes the physical relations of the subjective lived-body rather than the genetic or biological connections. Instead of universalizing claims about the maternal body, embodied maternity looks to communicable experiences and empathetic understanding.
Canada's Royal Commission on New Reproductive Technologies rejects all forms of surrogacy arrangement under the rubric of objecting to commercial surrogacy. Noncommercial surrogacy arrangements, however, can be defended against the commission's objections. They can be viewed as cases of giving a benefit or service to another in a way that expresses benevolence, and establishes a relationship between surrogates and prospective 'social' parents that allows mutual understanding and reciprocal personal interaction between them.
I bring several ecofeminist critiques of deep ecology to bear on mainstream animal rights theories, especially on the rights and utilitarian treatments of the animal research issue. Throughout, I show how animal rights issues are feminist issues and clarify the relationship between ecofeminism and animal rights.
This essay critiques feminist treatments of maternal-fetal “relationality” that unwittingly replicate features of Western individualism (for example, the Cartesian division between the asocial body and the social-cognitive person, or the conflation of social and biological birth). I argue for a more reflexive perspective on relationality that would acknowledge how we produce persons through our actions and rhetoric. Personhood and relationality can be better analyzed as dynamic, negotiated qualities realized through social practice.
Feminist ethics and medical ethics are critical of contemporary moral theory in several similar respects. There is a shared sense of frustration with, the level of abstraction and generality that characterizes traditional philosophic work in ethics and a common commitment to including contextual details and allowing room for the personal aspects of relationships in ethical analysis. This paper explores the ways in which context is appealed to in feminist and medical ethics, the sort of details that should be included in the recommended narrative approaches to ethical problems, and the difference it makes to our ethical deliberations if we add an explicitly feminist political analysis to our discussion of context. It is claimed that an analysis of gender is needed for feminist medical ethics and that this requires a certain degree of gener-ality, i. e. a political understanding of context.
Modern technology and gender relations are deeply intertwined. There has yet to emerge, however, a feminist analysis of modem technology as a phenomenon and this has inhibited the development of a consistent feminist response and theory regarding infertility/reproductive technologies. After taking a look at the character of the ongoing debate surrounding reproductive/infertility technologies, this paper considers how the contributions of Hannah Arendt and Martin Heidegger might add some further insight to the debate and aid in the effort to develop such a feminist framework.
In this essay, I examine the arguments against physician-assisted suicide (PAS) Susan Wolf offers in her essay, “Gender, Feminism, and Death: Physician-Assisted Suicide and Euthanasia.” I argue that Wolf's analysis of PAS, while timely and instructive in many ways, does not require that feminists reject policy approaches that might permit PAS. The essay concludes with reflections on the relationship between feminism and questions of agency, especially women's agency.
This review essay examines H. Tristram Engelhardt, Jr.'s The Foundations of Bioethics, a contemporary nonfeminist text in mainstream biomedical ethics. it fo-cuses upon a central concept, Engelhardt's idea of the moral community and argues that the most serious problem in the book is its failure to take account of the political and social structures of moral communities, structures which deeply affect issues in biomedical ethics.
The surgical treatment of breast cancer has changed in recent years. Analysis of the research that led to these changes yields apparently good arguments for all of the following: (1) The research yielded very great benefits for women. (2) There was no other way of obtaining these benefits. (3) This research violated the fundamental rights of the women who were research subjects. This sets a problem for ethics at many levels.
Since her insurance premiums are paid, the resources of modem medicine can be hers: an arsenal of antibiotics, an assemblage of devices and equipment, an inventory of tests - all in the local hospital. Why then does she hesitate? Will the pediatrician, busy with "the really serious" cases, simply prescribe an antibiotic over the phone? Will she be told to bring the child to the office in the stormy weather? Then - as happened last time - will her child catch what's "going around?" Will she be asked to "wait and see" as if she isn't already doing that? Then, she meditates about the effects of childhood antibiotics and tonsillectomies on some of her friends - would "wait and see" indeed be better for her child? A poor, inner city mother paces the floor cuddling her sick toddler who screams from the pain of earache. Should she make her way to the clinic at the inner city teaching hospital? She knows friends who were indeed healed when they visited that clinic. But will some unskilled intern use her child to practice a tonsillectomy or eardrum puncture? She knows she'd have to wait on a snowy corer for the bus, to endure the clinic's waiting room while trying to comfort her child, and, finally, to bear a patronizing five minutes with the professional. Would borrowing a heater or some blankets from a neighbor be better for her child? Consider other women: the lesbian buddy of an AIDS victim deciding whether to call the ambulance for her friend, whose care has become too complicated for his circle of loving, supportive friends. Or the sixty-year-old caring for her mother with Alzheimers, exhausted from the physical care duties, who learns that at last a bed is available in a nursing home. Or the drug addict who wants to break her habit by attending the local methadone clinic,
In Setting Limits, Daniel Callahan advances the provocative thesis that age be a limiting factor in decisions to allocate certain kinds of health services to the elderly. However, when one looks at available data, one discovers that there are many more elderly women than there are elderly men, and these older women are poorer, more apt to live alone, and less likely to have informal social and personal supports than their male counterparts. Older women, therefore, will make the heaviest demand on health care resources. If age were to become a limiting factor, as Dr. Callahan sug-gests it should, the limits that will be set are limits that will affect women more dras” tically than they affect men. This review essay examines the implications of Callahan's thesis for elderly women.
Sara T. Fry maintains that care is a central concept for nursing ethics. This requires, among other things, that care is a virtue rather than a mode of being. But if care is a central virtue of ethics and medical ethics then the claim that care is a central concept for nursing ethics is trivial. Otherwise, it is implausible.
In this commentary on Eva Feder Kittay's Love's Labor: Essays on Women, Equality, and Dependency, I focus on Kittay's dependency theory. I apply this theory to an analysis of women's inadequate access to high-quality, cost-effective healthcare. I conclude that while quandaries remain unresolved, including getting men to do their share of dependency work, Kittay's book is an important and original contribution to feminist healthcare ethics and the development of a normative feminist ethic of care.
Our response to Sara Fry's paper focuses on the difficulty of understanding her insistence on the fundamental character of caring in a theory of nursing ethics. We discuss a number of problems her text throws in the way of making sense of this idea, and outline our own proposal for how caring's role may be reasonably understood: not as an alternative object of value, competing with autonomy or patient good, but rather as an alternative way of responding toward that which is of value. 1990 by Hypatia, Inc.
The development of nursing ethics as a field of inquiry has largely relied on theories of medical ethics that use autonomy, beneficence, and/or justice as foundational ethical principles. Such theories espouse a masculine approach to moral decision “making and ethical analysis. This paper challenges the presumption of medical ethics and its associated system of moral justification as an appropriate model for nursing ethics. It argues that the value foundations of nursing ethics are located within the existential phenomenon of human caring within the nurse/patient relationship instead of in models of patient good or rights-based notions of autonomy as articulated in prominent theories of medical ethics. Models of caring are analyzed and a moral-point-of-view (MPV) theory with caring as a fundamental value is proposed for the development of a theory of nursing ethics. This type of theory is supportive to feminist medical ethics because it focuses on the subscription to, and not merely the acceptance of, a particular view of morality.
Institutional ethics committees (IECs) in health care facilities now create moral policy, provide moral education, and consult with physicians and other health care workers. After sketching reasons for the development of IECs, this paper first examines the predominant moral standards it is often assumed IECs are now using, these standards being neo-Kantian principles of justice and utilitarian principles of the greatest good. Then, it is argued that a feminine ethics of care, as posited by Carol Gilligan and Nel Noddings, is an unacknowledged basis for IEC discussions and decisions. Further, it is suggested that feminine ethics of care can and should provide underlying theoretical tools and standards for IECs.
Feminist health activists and medical researchers frequently disagree on the adequacy of the informed consent processes in clinical trials. I argue for an informed consent process that reflects the central importance of patient-participant autonomy. Such a standard may raise concerns for medical researchers about their capacity to control the quantity and quality of the information they disclose to potential participants. These difficulties might be addressed by presenting potential participants with differently sized disclosure packages.
Problems with clinical research that create conflicts between doctors’ therapeutic and research obligations may be fueled by a rigid view of science as determiner of truth, a heavy reliance on statistics, and certain features of randomized clinical trials. 1 suggest some creative, feminist approaches to such research and explore ways to provide choice for patients and to use values in directing both therapy and science — to enhance the effectiveness of each.
Women wishing hospital admission for childbirth are asked to sign very general pre-admission consent forms. The use of such forms suggests that women in labor are considered incompetent to give informed consent. This paper explores some of the problems with advance directives and general consent, and argues that since women in labor are not generally incompetent, it is not appropriate to require this kind of consent of them.
This paper addresses the likely impact on women of being denied emergency contraception (EC) by pharmacists who conscientiously refuse to provide it. A common view-defended by Elizabeth Fenton and Loren Lomasky, among others-is that these refusals inconvenience rather than harm women so long as the women can easily get EC somewhere else close by. I argue from a feminist perspective that the refusals harm women even when they can easily get EC somewhere else close by.
This essay examines the possible systematic bias against the disabled in the structure and practice of genetic counseling. Finding that the profession's "nondirective" imperative remains problematic, the authors recommend that methodology developed by feminist standpoint epistemology be used to incorporate the perspective of disabled individuals in genetic counselors' education and practice, thereby reforming society's view of the disabled and preventing possible negative effects of genetic counseling on the self-concept and material circumstance of disabled individuals.
I explore some new directions—suggested by feminism—for medical ethics and for philosophical ethics generally. Moral philosophers need to confront two issues. The first is deciding which moral issues merit attention. Questions which incorporate the perspectives of women need to be posed—e. g., about the unequal treatment of women in health care, about the roles of physician and nurse, and about relationship issues other than power struggles. “Crisis issues” currently dominate medical ethics, to the neglect of what I call “housekeeping issues.” The second issue is how philosophical moral debates are conducted, especially how ulterior motives influence our beliefs and arguments. Both what we select—and neglect—to study as well as the “games” we play may be sending a message as loud as the words we do speak on ethics.
I argue that there is an important analogy between sex selection and selective abortion of fetuses diagnosed with Down syndrome. There are surprising parallels between the social construction of Down syndrome as a disability and the deeply entrenched institutionalization of sexual difference in many societies. Prevailing concepts of gender and mental retardation exert a powerful influence in constructing the sexual identities and life plans of people with Down syndrome, and also affect their families' lives.
