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Mass Hysteria: Medicine, Culture, and Mothers' Bodies
Rowman & Littlefield Publishers (2005)
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This paper demonstrates how the problematic kinds of epistemic power that physicians have can diminish the epistemic privilege that pregnant women have over their bodies and can put them in a state of epistemic powerlessness. This result, I argue, constitutes an epistemic injustice for many pregnant women. A reconsideration of how we understand and care for pregnant women and of the physician–patient relationship can provide us with a valuable context and starting point for helping to alleviate the knowledge/power problems that (...) are symptomatic of the current system and structure of medicine. I suggest that we can begin to confront this kind of injustice if medicine adopts a more phenomenological understanding of bodies and if physicians and patients—in this case, pregnant women—become what I call “epistemic peers.”. (shrink) | |
As a culture, we have a tendency to measure motherhood in terms of a set of signal moments that have become the focus of special social attention and anxiety; we interpret these as emblematic summations of women's mothering abilities. Women's performances during these moments can seem to exhaust the story of mothering, and mothers often internalize these measures and evaluate their own mothering in terms of them. "Good" mothers are those who pass a series of tests—they bond properly during their (...) routine ultrasound screening, they do not let a sip of alcohol cross their lips during pregnancy, they give birth vaginally without pain medication, they do not offer their child an artificial nipple during the first six months, they feed their children maximally nutritious meals with every bite, and so on. This reductive understanding of mothering has had counterproductive effects upon health care practice and policy, encouraging measures that penalize mothers who do not live up to cultural norms during signal moments, while failing to promote extended narratives of healthy mothering. (shrink) | |
Subpart B of 45 Code of Federal Regulations Part 46 (CFR) identifies the criteria according to which research involving pregnant women, human fetuses, and neonates can be conducted ethically in the United States. As such, pregnant women and fetuses fall into a category requiring “additional protections,” often referred to as “vulnerable populations.” The CFR does not define vulnerability, but merely gives examples of vulnerable groups by pointing to different categories of potential research subjects needing additional protections. In this paper, I (...) assess critically the role of this categorization of pregnant women involved in research as “vulnerable,” both as separate entities and in combination with the fetuses they carry. In particular, I do three things: (1) demonstrate that pregnant women qua pregnancy are either not “vulnerable” according to any meaningful definition of that term or that such vulnerability is irrelevant to her status as a research participant; (2) argue that while a fetus may be vulnerable in terms of dependency, this categorization does not equate to the vulnerability of the pregnant woman; and (3) suggest that any vulnerability that appends to women is precisely the result of federal regulations and dubious public perceptions about pregnant women. I conclude by demonstrating how this erroneous characterization of pregnant women as “vulnerable” and its associated protections have not only impeded vital research for pregnant women and their fetuses, but have also negatively affected the inclusion of all women in clinical research. (shrink) | |
To mitigate animal suffering under industrial farming conditions, biotechnology companies are pursuing the development of genetically disenhanced animals. Recent advances in gene editing biotechnology have brought this to reality. In one of the first discussions of the ethics of disenhancement, Thompson argued that it is hard to find compelling reasons to oppose it. We offer an argument against disenhancement that draws upon parallels with human disenhancement, ecofeminism’s concern with the “logic of domination,” and a relational ethic that seeks to preserve (...) a meaningful relationship between farmers and their animals. In addition, we respond to two arguments in favor of animal disenhancement—one grounded in the non-identity problem and one that argues disenhancement is the best we can do to protect animal well-being right now. We argue that animal disenhancement does not address the fundamental issue of oppression of animals in the context of contemporary animal agriculture. Therefore, we conclude that animal disenhancement is not nearly as valuable as it might appear initially. (shrink) | |
This paper addresses and challenges the pronatalist marginalization and oppression of voluntarily childless women in the Global North. These conditions call for philosophical analyses and for sociopolitical responses that would make possible the necessary moral spaces for resistance. Focusing on the relatively privileged subgroups of women who are the targets of pronatalist campaigns, the paper explores the reasons behind their choices, the nature and methods of Western pronatalism, and distinguishes three specific sources of some of the more lasting, and stigmatizing (...) attacks: popular culture, law and policy, and medicine itself. I then argue that because they are construed by motherhood-essentializing, and increasingly popular, pronatalist narratives as, among other things, “failed” or “selfish,” voluntarily childless women are subsequently burdened with damaged identities that can leave them personally othered and uniquely liminal in ways that are destructive to moral agency. Finally, I conclude with a challenge to the pronatalist master narratives by suggesting the possibility of counter narratives to the voluntarily childless woman's liminality that might serve as the ground of moral and political solidarity among differently situated women, regardless of their motherhood status. (shrink) | |
Discussions of reproductive responsibility generally draw heavily upon the principles of nonmaleficence and beneficence. However, these principles are typically only applied to women due to the incorrect belief that only women can cause fetal harm. The cultural perception that women are likely to cause fetal and child harm is reflected in numerous social norms, policies, and laws. Conversely, there is little public discussion of men and fetal and child harm, which implies that men do not (or cannot) cause such harm. (...) My goal in this paper is to begin to fill the void in the academic literature about men’s reproductive responsibility by highlighting the health-related, economic, and social harms men can cause to potential fetuses and children and then examining what it would mean to hold them responsible for preventing these harms. Applying the principles of nonmaleficence and beneficence to men, I conclude that men have a moral duty to use contraception if their behavior—past, current, or future—could harm the potential fetuses and children who result from their unprotected sexual behavior. (shrink) | |
Starting from the intuition, shared by many women, that the legal right to an abortion must be defended but that they themselves could never undergo one, I offer an account of why pregnancy is morally valuable and why, nevertheless, it is often permissible to end one. Developing the idea that human pregnancy centrally involves the activity of calling a fetus into personhood, I argue that the permissibility of stopping this activity hinges on the goodness or badness of one's moral luck. | |
This paper presents a relational account of autonomy showing that a technological imperative impedes autonomy through undermining women’s capacity to resist use of technology in the context of labor and birth. A technological imperative encourages dependence on technology for reassurance whenever possible through creating a (i) separation of maternal and fetal interests; and (ii) perceived need to use technology whenever possible. In response I offer an account of how women might promote autonomy through cultivating self-trust and self-confidence. Autonomy is not (...) simply a matter of choosing freely and acting on our choices, it is also a matter of possessing the ability to resist social contexts undermining choice and action. An important implication of this view is that respecting autonomy requires more than simply respecting persons’ ability to make and act on choices. Respecting patient autonomy requires a recognition of patients’ need to resist factors impeding autonomy and support for that resistance. (shrink) | |
Drawing on sociological and anthropological studies, the aim of this article is to reconstruct how obstetric technologies contribute to a moral conception of pregnancy and motherhood, and to evaluate that conception from a normative point of view. Obstetrics and midwifery, so the assumption, are value-laden, value-producing and value-reproducing practices, values that shape the social perception of what it means to be a “good” pregnant woman and to be a “good” mother. Activities in the medical field of reproduction contribute to “kinning”, (...) that is the making of particular social relationships marked by closeness and special moral obligations. Three technologies, which belong to standard procedures in prenatal care in postmodern societies, are presently investigated: informed consent in prenatal care, obstetric sonogram, and birth plan. Their widespread application issupposed to serve the moral goal of effecting patient autonomy. A reconstruction of the actual moral implications of these technologies, however, reveals that this goal is missed in multiple ways. Informed consent situations are marked by involuntariness and blindness to social dimensions of decision-making; obstetric sonograms construct moral subjectivity and agency in a way that attribute inconsistent and unreasonable moral responsibilities to the pregnant woman; and birth plans obscure the need for a healthcare environment that reflects a shared-decision-making model, rather than a rational-choice-framework. (shrink) | |
Based on in-depth interviews, this article examines a sample of 48 Canadian women’s feelings about their changed postpartum bodies, their sense of self, and the factors that affect both. Our findings suggest that understanding women’s postpartum feelings requires contextualizing them in the work of infant care and women’s life circumstances, as well as ideologies about mothering and feminine appearance. Motherhood afforded the women in this study a new appreciation of their bodies, and a positive embodied sense of themselves, but only (...) if they felt their bodies performed maternal functions well. Concerns about appearance persisted and became especially salient when women faced the return to paid work. Moreover, varied life circumstances influenced women’s overall feelings about their changed bodies as insecurities were displaced onto women’s body images. (shrink) No categories | |
Images abound of women throughout the ages engaging in various activities. But why are there so few representations of childbirth in visual art? Feminist artist Judy Chicago once suggested that depictions of women giving birth do not commonly occur in Western culture but can be found in other contexts such as pre-Columbian art or societies previously considered "primitive." Chicago's own exploration of the theme resulted in the creation of The Birth Project (1980-85): an unprecedented series of eighty handcrafted works of (...) art created in a variety of needlework techniques by more than 130 artisans that celebrate the experience of birth and a woman's transformation into motherhood. But why is The Birth Project an aberration from today's norm? What are the reasons that childbirth remains a taboo subject in our visual culture? Why is the birthing experience--so pervasive for women--so infrequently celebrated, even by female artists? (shrink) | |
In this article, we discuss decision making during labor and delivery, specifically focusing on decision making around offering women a trial of labor after cesarean section. Many have discussed how humans are notoriously bad at assessing risks and how we often distort the nature of various risks surrounding childbirth. We will build on this discussion by showing that physicians make decisions around TOLAC not only based on distortions of risk, but also based on personal values rather than medical data. As (...) a result of this, we will further suggest that the party who is best epistemically situated to make decisions about TOLAC is the woman herself. (shrink) | |
The US Food and Drug Administration (FDA) is fraught with controversies over the role of values and politics in regulatory science, especially with drugs in the realm of reproductive health. Philosophers and science studies scholars have investigated the ways in which social context shapes medical knowledge through value judgments, and feminist scholars and activists have criticized sexism and injustice in reproductive medicine. Nonetheless, there has been no systematic study of values and gender norms in FDA drug regulation. I focus on (...) three questions about values in regulatory science. First, how have societal values and gender norms shaped the way that the FDA regulates drugs in the realm of reproductive health, specifically with drug labels? Second, what are the ethical, epistemic, and social consequences of these influences on regulation for women and other marginalized groups? Third, which societal values and gender norms ought to influence drug regulation about reproductive health, and how ought this happen? Integrating philosophical analysis with historical archival research and in-depth interviews, I conduct three case studies of drug labeling about reproductive health: (1) the “drug fact” about the mechanism of the morning-after pill; (2) the package inserts for patients about the health risks of oral contraceptives; and (3) the special physician labels made for prescribing drugs to pregnant women. I identify three challenges for the FDA and suggest ways to reduce the influence of sexist values and facilitate feminist alternatives. First, across these cases, I have found that there are many ways in which other concerns in reproductive medicine (such as zygotic life, fetal health, and population control) have devalued women’s health. Second, both knowledge and ignorance xvi about their reproductive health have contributed to women’s oppression, especially poor women and women of color. Finally, by avoiding the epistemic dimensions of ethics, powerful, mostly male parties in medicine (such as doctors, pharmaceutical companies, and religious institutions) have misused “informed consent,” “religious freedom,” and “paternalism” for unethical purposes. For improvement, I suggest extracting sexist values and gender norms from regulatory science that cause epistemic injustices, and I point to success stories for reforming sexism with feminism at the FDA. (shrink) | |
This dissertation offers a robust philosophical examination of a phenomenon that is morally, socially, and politically significant – microaggressions. Microaggressions are understood to be brief and routine verbal, behavioral, or environmental indignities that, whether intentional or unintentional, convey hostility toward or bias against members of marginalized groups. Microaggressions are rooted in stereotypes and/or bias (whether implicit or explicit) and are connected to broader systems of oppression. Microaggressions are philosophically interesting, since they involve significant ambiguity, questions about speech and communication, and (...) the ability for our speech to encode and transmit bits of meaning. Microaggressions prompt reflection about the nature of blameworthiness and responsibility, especially for unintended acts and harms. They involve questions about how we perceive and treat one another, and whether or not people are treated as true equals in our social and political worlds. For all of these reasons, microaggressions are a critical area in need of philosophical reflection, specifically reflection in feminist philosophy, philosophy of language, moral philosophy, and social and political philosophy. This dissertation seeks to advance the philosophy of microaggressions through three distinct aims: a conceptual aim (chapters 2 and 3), an epistemological aim (chapters 1 and 2), and a moral aim (chapters 4 and 5). The conceptual aim involves clarifying how we should understand and categorize microaggressions. The epistemological aim involves identifying some of the epistemological assumptions undergirding discussions of microaggressions in the literature, including assumptions made by critics of microaggression theory, and arguing for an alternative epistemological framework for theorizing about microaggressions. The moral aim involves better understanding the harms of microaggressions, including their role in reinforcing structures of oppression and unjust social hierarchy. Taken together, these chapters make some progress on the conceptual, epistemological, and moral questions that microaggressions generate, and which philosophers have not yet adequately analyzed. It thus offers a meaningful contribution to the conversations philosophers are beginning to have about the morally and politically salient phenomenon of microaggressions. (shrink) No categories | |
No categories | |
Nossa seleção de verbetes parte do interesse de cada pesquisador e os dispomos de maneira histórico-cronológica e, ao mesmo tempo, temática. O verbete de Melissa Lane, “Filosofia Política Antiga” vai da abrangência da política entre os gregos até a república e o império, às portas da cristianização. A “Filosofia Política Medieval”, de John Kilcullen e Jonathan Robinson, é o tópico que mais demanda espaço na nossa seleção em virtude das disputas intrínsecas ao período, da recepção de Aristóteles pelo medievo e (...) da tensão entre poder Papal e Civil. No verbete “Liberalismo”, de Gerald Gaus, Shane Courtland e David Schmidtz, vemos as fontes fundantes da Filosofia Política da modernidade. As ideias de liberdade negativa e positiva se coadunam com a Ética Liberal e sua influência sobre a abrangência do valor fundamental da liberdade individual diante das políticas públicas. O texto de Ian Carter, “Liberdade Positiva e Liberdade Negativa”, expõe o paradoxo da liberdade em suas concepções valorativas e neutra, muito úteis para compreender os problemas políticos que enfrentamos hoje. Por fim, Bas Van Der Vossen no texto “Libertarianismo” trata das noções tensas entre Estado e indivíduos. A concepção de “liberdade de si”, genuinamente negativa, ganha destaque justificatório. Jackie Scully, no verbete Bioética Feminista, exemplifica o valor da influência dessas correntes no âmago de todos os contemporâneos. Sua escrita homenageia postumamente Anne Donchin com um apanhado histórico da luta de inserção de políticas feministas na pesquisa acadêmica global. No verbete “Democracia”, os professores brasileiros Gustavo Dalaqua e Alberto Ribeiro Barros acrescentaram tópicos importantes ao tema geral, respectivamente: “Construtivismo Representativo vs. Representação Descritiva” e “Democracia Contestatória de Philip Pettit”. O texto de Thomas Christiano perpassa os principais argumentos de justificação política contra e a favor da democracia ocidental, com foco central nas concepções de liberdade e igualdade. Os verbetes dispostos nessa seleção de textos são tendenciosos na medida que expressam o interesse genuíno de cada pesquisador com os assuntos relevantes em suas pesquisas. Em virtude disso, a escolha “adota um lado” em detrimento de outros – mais especificamente: de outro que poderia ser mais “progressista”. Por si só, o livro já nasce reclamando um segundo volume, que será providenciado. Colocamos de lado qualquer exigência de “imparcialidade”, algo que não existe na Filosofia, muito menos na Filosofia Política. Sobressai, nesse aspecto, o caráter reflexivo que o assunto exige e a importância do assunto, sem o qual não teríamos a modernas concepções de representatividade, as teorias da justiça ou mesmo as ciências sociais. Um outro volume, portanto, se faz imperativo, por conta da abrangência da própria SEP e do respeito a seu projeto inicial, genuinamente um plano plural. (shrink) | |
The article examines the writings of one of the most influential political philosophers, Hannah Arendt, and specifically focuses on her views regarding the distinction between the private and the public and the transformation of the public to the social by modernity. Arendt’s theory of human activity and critique of modernity are explored to critically evaluate the social contributions and implications of reproductive technologies especially where the use of such technologies is most dominant within Western societies. Focusing on empirical studies on (...) new reproductive technologies in Israel, it is argued, powerfully demonstrates Arendt’s theory, and broadens the perspectives through which society should evaluate these new technologies towards a more reflective understanding of its current laws and policies and their affect on women more generally. (shrink) | |
This paper explores how law might conceive of the injury or harm of endocrine disruption as it applies to an aboriginal community experiencing chronic chemical pollution. The effect of the pollution in this case is not only gendered, but gendering: it seems to be causing the ‘production’ of two girl babies for every boy born on the reserve. This presents an opening to interrogate how law is implicated in the constitution of not just gender but sex. The analysis takes an (...) embodied turn, attempting to validate the real and material consequences of synthetic chemicals acting on bodies—but uncovers that finding a harm in a declining sex ratio depends on a static conception of the human form, based on unfounded assumptions of ‘naturalness’ and ‘normalcy’. Elizabeth Grosz’s theory of ‘becoming’ offers a compelling challenge, essentially pointing to the conclusion that we should find harm where we find illness and suffering and not simply where we find difference. At the same time, we cannot discount the political economy of the pollution: the paper concludes by returning the focus to the role of power, colonialism and the state in the perpetuation of the pollution on the landscape. (shrink) |
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