Biographical Information. Rosemarie Tong is Distinguished Professor of Health Care Ethics at the University of North Carolina. She taught at Williams College from to and was Olmstead Visiting Professor of Philosophy and Women's Studies at Lafayette College in The WWW Ethics Center for Engineering and Science is an extensive web site for feminist practical and professional ethics. You can access this site here. There is a website for Feminist Medical Ethics, here. A further milestone in the development of feminist bioethics was the publication of Rosemary Tong’s Feminist Approaches to Bioethics: Theoretical Reflections and Practical Applications (). Gradually, mainstream bioethics journals and organizations began to recognize feminist approaches. Rose marie tong feminist and feminist ethics essay Rose marie tong feminist and feminist ethics essay essay about me myself and my future essay on being a group member essay websites for teachers essays, rachel getting married movie analysis essay year old tattooed mummy essay launchbar alfred comparison essay voittaa rahaa unessay lakme. Notre Dame Philosophical Reviews is an electronic, Wendy Rogers, and Susan Dodds (eds.), Vulnerability: New Essays in Ethics and Feminist Philosophy, Oxford University Press, , pp., $ (pbk), and the collection ends with an essay by Rosemarie Tong on the needs of aging people from the standpoint of vulnerability. Each of.
Over the decades since then bioethics has blossomed into an interdisciplinary field that borrows from a cluster of interrelated areas of scholarship including philosophy, theology, law, medicine, and the social and biological sciences, and that in the United States in particular has become highly professionalized.
Bioethics has generated a massive literature ranging over a broad array of moral problems that arise within biomedical and life science research, the healthcare professions, and the institutions and bodies that deliver healthcare services.
Increasingly, its remit goes beyond what are traditionally deemed medical topics to include public health issues and areas of social care that interact with medical and life sciences. Its reach extends from the beginning to the end of human life, to areas of biology and genetics on which medicine draws, to research that seeks to expand the knowledge base of medicine; and many contemporary bioethicists are also interested in the societal impacts of the life sciences in general.
In some countries bioethicists now also enjoy considerable professional prestige. Some serve on public policy panels and in medical school faculties, and others have been engaged as consultants to industry. Conferences introduce newcomers to the field and disseminate recent bioethical scholarship. Many professional medical and allied health organizations require bioethics training for certification, while regulations in the United States and other countries now expect medical schools to include research ethics in their curricula.
A few bioethicists have even become media celebrities. And as the field of bioethics has professionalized and diversified, questions have arisen about its direction and focus. Notwithstanding its early attention to instances of exploitation and abuse, some critics have discerned an increasing conservatism in bioethics that neglects the concerns of marginalized groups. These critics argue that with institutionalization, bioethics is losing sight of its radical origins Holmes ; Purdy ; Eckenwiler and Cohn Bioethicists are tending to frame issues and formulate theory from the vantage point of privileged social and professional groups, even in the developing regions of the world as local bioethicists there seek a share in the prestige of high technology medicine Salles and Bertomeu ; Luna During the s, feminists in particular argued that bioethics was developing in a way that gave too little attention to gender-specific disparities in healthcare research and therapy, or to the effects of other power disparities, such as class and ethnicity, on quality of healthcare.
These critiques evolved out of several lines of influence. Public notice of the widespread and, it has to be said, continuing under-representation of women in clinical trials increased that momentum Baylis, Downie and Sherwin Engaging with these activist concerns, feminists drew on late twentieth century scholarship in feminist moral and social theory that utilizes sex, gender, and other marginalizing characteristics as categories of analysis that are bound up with power relations across public and private life.
This research called attention to the need for theoretical grounding to provide a framework for practical strategies to curtail oppressive practices in medicine and healthcare. It is within this context of attention to practical issues combined with the drive to provide a conceptual underpinning for analysis and, ultimately, reform, that the emergence of feminist bioethics should be understood. Feminists working in bioethics today speak in many different voices, reflecting their disparate social positioning and academic backgrounds, and the new global reach of the field.
Nonetheless, they share significant commonalities, both in their criticisms of dominant structures and in their efforts to build a more adequate framework that is responsive to the diversity of the circumstances of women and other groups. In doing so they call attention to neglected voices that are seldom represented within mainstream bioethics.
Notably, feminist discourse highlights the way in which hierarchical rankings that categorize people by sex, race, ethnicity, age, disability, or susceptibility to genetic disease, can perpetuate unjust practices in health and social care, research, and public health.
Feminist critique also addresses the fundamental theory of mainstream bioethics.
Feminist-friendly bioethicists have noted systemic weaknesses in the explanatory framework that grounds the bioethical analysis of research and clinical practices and increasingly also of public health measures. Critics fault both the abstract character of much bioethical theory and inattention to such key components of morality as the contexts that frame health care and the relational networks that inform patient decision making.
The tendency to ground theory in a set of abstract principles that are only subsequently applied to practical problems makes it easy to ignore bio ethically relevant particulars such as the unequal burden borne by women by virtue of their conventional reproductive and nurturing roles, or inequities between social and economic groups. Finally, some feminist theorists are developing alternative methodologies to remedy the epistemological shortcomings of the dominant bioethical model of reasoning.
Essays by feminists in the leading texts were limited primarily to treatment of reproductive issues such as abortion and maternal-fetal relations.
Less initial attention was given to interconnections between these issues and more pervasive bioethical concerns such as the limits of physician authority, conflicts between commercial interests and patient wellbeing, or the conflation of moral and medical values.
In these early days, feminist commentary on innovative reproductive interventions was also beginning to appear e. In a collection of articles previously published in the journal Hypatia was brought out as Feminist Perspectives in Medical Ethics Holmes and Purdy Susan Sherwin published No Longer Patient: Feminist Ethics and Health Care, the first book-length treatment of feminist bioethical theory To bring attention to disregard of feminist perspectives, Susan Wolf undertook a project at the Hastings Center which led to the anthology Feminism and Bioethics: This collection incorporates feminist perspectives on many issues that had seldom been discussed in standard course texts, including the under-representation of women subjects in medical research, the pervasive influence of the abstract individualistic conception of personal autonomy, and stigmatizing portrayals of HIV-positive women.
Theoretical Reflections and Practical Applications Gradually, mainstream bioethics journals and organizations began to recognize feminist approaches.
Several journals featured special issues by feminist scholars spanning a cluster of topics including AIDS, reconfiguration of the principle of autonomy, gender issues in psychiatry, and the global dimensions of feminist bioethics. Bioethics conferences in a number of countries began to schedule sessions that explicitly addressed feminist approaches and topics, and more feminists were included on the general program, while the market for more feminist-friendly teaching texts has expanded and publishers have been responsive see e.
These and similar efforts resulted in feminist writings on an increasing diversity of substantive topics beginning to appear in bioethics journals and anthologies. Thus the healthcare priorities of women and other underserved groups still received disproportionally little bioethical attention.
And despite these advances, concerns persisted that feminists were under-represented on governmental panels formulating public policy. The strategic importance of feminist involvement at the policy-making level to redress injustices and promote more equitable policy choices was emphasized by Sherwin and Baylis , while other feminists have highlighted the need to reframe public policy and the research that underpins it to include the social impact of gender and other biases Rogers ; Mahowald FAB aims to foster development of a more inclusive theory of bioethics at both the academic and grassroots levels.
Three goals have been central: The articulation of these objectives represents an effort to systematize prevailing commonalities among feminists working in the field and stimulate further collaborative work. FAB has held its own Congress every 2 years since , usually immediately before the World Congress of Bioethics WCB organized by the International Association of Bioethics, and taking themes which relate to the WCB theme but giving them a particularly feminist slant.
Papers presented at these Congresses have been published in four anthologies Donchin and Purdy ; Tong, Anderson and Santos ; Tong, Donchin and Dodds ; Scully, Baldwin-Ragaven and Fitzpatrick , while another volume focusing on postmodern approaches includes a selection of papers from the FAB conference Shildrick and Mykitiuk IJFAB has provided a new forum within bioethics for feminist thought and debate. IJFAB invites submissions approaching any problem or topic in bioethics from the resources of feminist scholarship for its open issues, and encourages proposals for special thematic issues that have covered topics such as research ethics, ethical issues in psychiatry, aging and long-term care, disability, vulnerability, transnational reproductive travel, food ethics, fitness, and climate change.
IJFAB also invites individual commentaries or conversations among groups of scholars on contemporary problems in bioethics, as well as personal narratives that illuminate topics in bioethics. From its beginning, IJFAB has been committed to expanding the field of bioethics beyond a narrow focus on science and technology to include attention to public health and the social determinants of health, as well as broader issues such as food, the environment, labor, or globalization, that are directly related to community health.
In the following sections this article turns to consider substantive issues addressed by feminist bioethics; feminist bioethical work on bioethical theory; and feminist contributions to bioethical methodology. Some Substantive Issues What follows is not intended to be an exhaustive list of substantive topics, past and present, in feminist bioethics, but rather an indication of some central and longstanding areas of interest, directions in which these might be going, and examples of areas where feminist bioethics has brought a fresh and, feminists would argue, valuable perspective.
A key insight of feminist bioethics is that, because women bear a disproportionate share of the associated risks and burdens, new reproductive technologies are not gender neutral, a fact frequently ignored in debates about the ethics of assisted reproduction. The assessment of the social and ethical implications of reproductive medical innovations persists, growing ever more complex with the proliferation of techniques to generate, test and manipulate embryos e.
Two concerns remain paramount: Authors voice concern that future development of enhancement techniques, whether genetic or other, will exacerbate these tendencies and pose even greater threats to social equality, alongside the health benefits they may offer.
Many of these issues overlap with others, such as the impact of caregiving responsibilities on the caregiver, and the effect of particular economic policies on socially marginalized groups.
Donna Dickenson in particular is noted here for her extensive work on property and ownership of the body and body parts, as is Cathy Waldby for her examination of the global economy of reproductive tissues Waldby and Mitchell ; Cooper and Waldby Feminist bioethicists have argued that there are legitimate questions to be asked about the scope of and justification for claims about the forms of care offered, and the balance between individual, familial, state and commercial suppliers of medical and social care.
These questions are being asked more widely in mainstream bioethics, prompted by longterm changes to the shape of family life across different societies and, as a result, the way families interact with medical and social care. At the same time, the demographic changes leading to aging populations are combining with economic and political forces to drive the retrenchment of health and welfare structures across many western countries.
As a result, care responsibilities are increasingly falling back onto families, and implicitly onto traditional family structures in which responsibility for the care of dependent members is assumed to lie with women members of the family.
Feminist critics have pressed for both empirical and normative consideration of familial versus societal responsibilities in the areas of health and other forms of care, asking critical questions about how these responsibilities come to exist and are enacted in a range of situations.
In a group of leading scholars, both feminist and others, established an international consortium, the Network of Ethics of Families, specifically to provide a more robust theoretical ethical framework in this area Verkerk et al. Feminist scholars have also called for greater clarity about the meaning of care or sometimes, dependency work and who it is done by, warning against the conflation of the types of care performed by nurse, nurse-aides, home helps, and family members, and equally against the invisibility of the unpaid care work provided by family members compared to the world of even relatively low- paid care work.
Noting the gendered nature of much longterm care work, a number of feminist bioethicists Tong ; Lanoix a,b have been examining the ethics of the national and international arrangements of care for children, elderly and chronically ill people, and the associated development of international migrant care work Weir ; Eckenwiler , In many ways, the central perspectives and current concerns of public health ethics were long anticipated by feminist health care movements and feminist bioethics.
Public health ethics is concerned with the multiple activities of public health, carried out by a range of health professionals and agents, and is necessarily concerned with health inequities both nationally and globally, how they operate and how they can be minimized or eradicated in public health, but also crucially bringing a broader perspective that includes an interest in how these inequities come about in the first place.
As Rogers notes, a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. Feminist bioethical scholarship has sometimes overlapped with the growing company of feminist disability scholars, many of whom write about disability as a form of embodied social exclusion that can intersect or synergize with gender.
This engagement has produced a body of work that problematizes the construal of the impaired body in bioethics as a problem to be solved by biomedical means and for which the key bioethical issues are to do with regulating the technologies that can be applied to prevent or cure disability Silvers, Wasserman and Mahowald ; Fine and Asch ; Parens and Asch ; Wong ; Tremain ; Scully ; Ho ; Hall There has also been rich theoretical work on the social and cultural expectations of normality, and the political choices that are made in the area of prevention of and support for disabled people, contributed through feminist discussion of the norms of dependency Kittay and vulnerability Scully A different slant on embodiment is provided by the existing and growing body of feminist work on medicalization, particularly the medicalization of non-standard embodiments or embodied states and their classification as pathologies, and the questions of autonomy and choice that such medicalization raises Purdy , ; Garry The pathologization of the obese body and its relationship to fat stigma and cultural beauty standards has been extensively discussed on the IJFAB blog, while other sites of attention are the medicalization of intersex M.
Holmes ; Feder and of altered states of consciousness Harbin Feminist bioethics has also generated a growing body of work on transgendered embodiment Draper and Evans ; J.
Nelson , 3. Revealingly, as early as the Journal of Medicine and Philosophy published a special issue devoted to feminist bioethics and containing some key papers on psychiatric issues volume 26, number 4. In a special issue of IJFAB volume 4, number1, several authors examined questions of mental health and illness. Again, this scrutiny is not unique to feminist bioethics; what is distinctive is the way these issues are refracted through a feminist lens that pays close attention to thorny questions of power, authority and the silencing of anomalous voices.
Their contributions are distinctive not least because of the foundational relationship of feminist scholarship to activism, which means that the scholarly treatment of these topics is grounded in a critique of the background norms and conditions that produce observable and persistent injustices in medicine and healthcare. This is one reason why feminist bioethical theory tends to have a practical orientation. Though some feminist criticism objects to any attempt to formulate universal principles at all, most is more circumscribed, directed principally against theoretical frameworks that presuppose a generic individual subject that is abstract, disembodied and socially disembedded, in a way that has enabled morally relevant particulars to be ignored, and that privileges the perspective of an elite, historically mostly male group Walker Feminist critics point out that this theoretical orientation generally has the consequence of justifying the prevailing status quo, thereby inhibiting any real consideration of social change.
The search for a more satisfactory moral grounding for bioethics has taken feminist scholars in several directions. A few favor dispensing with principles entirely and reconstituting bioethics through narrative case-specific interpretation along the lines pioneered by Nel Noddings and her followers. Others, without going this far, are nevertheless convinced that narrative approaches have useful applications in bioethics e.
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Yet others have criticized the abstract universal approach to theory construction from the perspective of European thought e. Other groups of feminists have ventured along the different routes of post-structuralist and postmodern theory on the one hand Shildrick ; Shildrick and Mykitiuk and particularism Little on the other, to challenge other kinds of claim to universality. And yet other feminists think a framework that incorporates universal principles can and should continue to constitute one dimension of an adequate bioethical theory, provided that these principles are formulated in non-exclusionary terms that reflect the relational context and empirical realities of individual lives.
Care ethics Originating in the work of feminist psychologist Carol Gilligan and the proliferation of scholarship stimulated by her insights, care theorists have emphasized patterns of moral reasoning that are allegedly characteristic of women—reasoning that prioritizes caring, relationships, and responsibilities—and contrasted them with modes of reasoning that privilege justice and rights, and which Gilligan and her followers have taken to be more characteristic of men.
It should be noted here, however, that the specifically gendered contours of care and justice in this work have been challenged by those who see the difference as more to do with the forms of moral reasoning mobilized by socially and politically marginalized groups, women being one of these: Care theorists distrust traditional moral principles and emphasize the necessity of values such as love, care, and responsibility to capture contextual subtleties and relational bonds that are overlooked within principle-oriented ethical frameworks.
Both feminists and others have voiced doubts about the capacity of an ethics based in care alone to address some of the concerns of feminist bioethics. The first anthology to consider this controversy, Women and Moral Theory, juxtaposed some of the leading care theorists with critics who question the significance of a gender-differentiated morality and its relevance to political and legal issues Kittay and Meyers In her work, No Longer Patient: