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Despite the fact that the requirement to obtain informed consent for medical procedures is deeply enshrined in both U.S. moral and legal doctrine, empirical studies and anecdotal accounts show that women's rights to informed consent and refusal of treatment are routinely undermined and ignored during childbirth. For example, citing the most recent Listening to Mothers survey, Marianne Nieuwenhuijze and Lisa Kane Low state that "a significant number of women said they felt pressure from a caregiver to agree to having an (...) intervention that they did not want during birth". Specifically, Nieuwenhuijze and Low cite that "19% of women who did not have epidural analgesia felt... (shrink)

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In 2018, at least 12 adults and 3 children died in U.S. detention facilities. In 2017, 12 people died in U.S. detention facilities and at least 10 women filed complaints against ICE for mistreatment that led them to miscarry. At the time of this writing, 26 people have died in US Custody during the Trump Administration and 74 people have died in U.S. detention facilities between 2010 and 2018, including Raul Ernesto Morales-Ramos, Augustina Ramirez-Arreola, Moises Tino-Lopez, Jose Azurdia, and Roxana (...) Hernandez. I am not going to argue that these deaths are wrong – I take that as obvious. Instead, I will suggest that nonideal theory shows why bioethicists have special obligations for condemning these deaths and getting involved to make them stop. When we heed nonideal theory’s demand to consider empirical realities, we will see that the role of the bioethicist extends wherever health care does. Moreover, when bioethicists expressly embrace nonideal rather than ideal theories to ground our work, we will see that there are plenty such theories available to us. Shelly Wilcox’s nonideal theory of immigration justice is especially well suited for bioethicists to use in relation to detainee health care and enter the conversation where they are so desperately needed. (shrink)

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Feminists have highlighted various ways in which medicalized childbirth is connected to violence. For example, the literature is replete with examples of court-ordered Cesarean sections, intimidation in the delivery room, women diagnosed with post-traumatic stress disorder as a result of their childbirth experiences. The most common approach to the accusations about the connections between medicalized childbirth and violence has been to investigate the degree to which the evidence bears out their accuracy. In this essay, the author takes a different course; (...) instead of trying to confirm or refute reports of violence in childbirth, she posits that understanding the ways in which violence is connected to medicalized childbirth requires us to note the existence of another form of violence that has not been recognized or discussed up to this point – metaphysical violence. The primary focus of this essay is to define that other form of violence as well as to suggest places where the routine practices of medicalized childbirth perpetuate it and possible ways to resist it. (shrink)

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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)

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The last fifteen years have seen an increasing social science scholarship into the nature and pervasiveness of hooking up amongst college students,1 but research on the philosophical and ethical issues within hookup culture and practice has not kept pace. To the extent that hooking up has been taken up by philosophers, it has been as part of a larger conversation about the ethics of casual sex, broadly construed; a conversation which is dominated by questions of objectification. As such, investigations into (...) the ethics of hookup sex have been limited to questions of whether someone was used in the encounter.2 This essay aims to change this by utilizing Ann Cahill’s recent book, Overcoming Objectification, to argue that the ethical problems with hookup sex in Guyland are not rooted in women’s objectification but rather their derivatization. (shrink)

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In September 2020, Project South, along with numerous other organizations, released a report detailing abuses in a Georgia Detention Center – including forced hysterectomies. Whatever other factors are at play, one of them is an intrinsic connection between obstetric violence against pregnant migrants and immigration injustice. It is not incidental that these acts – in US detention centers, along the US‐Mexico border, in Colombian hospitals and clinics – are being perpetrated on immigrant bodies. And it is not accidental or random (...) which immigrant bodies are vulnerable to these violations. Understanding and confronting obstetric violence directed at pregnant migrants, though, requires reconceptualizing the nature of obstetric violence itself. In particular, we must recognize that obstetric violence against pregnant Latin American migrants in the United States and Colombia is a type of immigration injustice, a means to perpetrate immigration injustice, and a product of immigration injustice. As such, bioethicists need to collaborate with immigration scholars to resist it.After providing some background on the nature of obstetric violence and some ways it is perpetuated against pregnant migrants in the United States and Colombia, I will give a brief overview of how I conceptualize immigration justice. From there, I explain how this type of obstetric violence constitutes a type of immigration injustice, a means to perpetrate immigration injustice, and a product of immigration injustice. My hope is that this analysis motivates bioethicists throughout the Americas to engage with immigration scholars and activists to confront the issue more forcefully. (shrink)

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Este artículo problematiza la forma en la que el feminismo ha interpretado al escepticismo como una amenaza para su proyecto epistemológico, ético y político, y plantea que, a pesar de dicha interpretación, el escepticismo es inherente a la filosofía feminista y un aliado útil para su proyecto. El problema ha estado en cómo el feminismo ha reducido su comprensión del escepticismo a una versión cartesiana extrema y ha pasado por alto otras corrientes de la tradición —como la de David Hume— (...) que podrían ser fructíferas para promover una actitud crítica y emancipatoria. Muestra así como una alianza entre una comprensión moderada del escepticismo y el feminismo puede brindar las herramientas necesarias para cuestionar formas de dominación patriarcal y poner en marcha investigaciones que combatan la opresión de género. (shrink)

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At this point, I think it is fair to say that most of us know someone—a family member, a coworker, a friend, a student—who is resisting getting a vaccine against COVID-19. Frankly, this amazes me. I was recently discussing this with a friend—"Rebecca"—when to my utter shock, she confessed to me that she "does not trust the vaccine" and is not planning to get one until there is more certainty of its efficacy and safety. While there are many things that (...) stood out to be in this conversation, what stood out to me was a particular comment she made; she said to me: "The thing is, I'm a skeptic, and you're not."I admit, this comment threw me for a loop. How could I, a feminist bioethicist who has dedicated a good chunk of... (shrink)

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In this article, I investigate actions that the United States took against Costa Rica during the 1980s in order to argue that current discussions about global justice and its foundations are flawed in three ways. First, it misidentifies the parties of global justice as individual citizens. Second, it conceptualizes global justice as exclusively a distributive justice concern and, as a result, it misidentifies what constitutes a global injustice as being the adverse fate of individuals who live in a poor nation. (...) Finally, the current debate provides no guidance in what must be considered to identify the specific obligations one nation may have to another nation. Given these three problems, I maintain that we conceptualize global injustice as an issue of social justice rather than one exclusively of distributive justice. This will require identifying nations as the parties to global justice, at least in certain cases, and realizing that our goal is to remedy oppressive global structures of power. Utilizing the social justice I propose will put us on the road toward achieving justice across the Americas. (shrink)

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In A Good Birth, obstetrician and bioethicist Anne Drapkin Lyerly aims to improve women’s experiences of childbirth in the United States by cutting through the vitriolic, shame-inducing, and blame-assigning language of what she terms “the birth wars”—the “polarized debate over where birth should be undertaken and how, who is the presumptive attendant, which professionals need to be supervised, and which way the money should flow”. Too often, women like Lyerly’s friend Erin, whom Lyerly interviewed for the book, are the casualties (...) of the birth wars, as they feel ashamed, distraught, and guilty for not giving birth according to the dictates of a particular ideology. According to Lyerly, Erin planned to... (shrink)

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Florencia Luna begins her essay, “Challenges for Assisted Reproduction and Secondary Infertility in Latin America,” by saying: “I want to explore a new way to think about Assisted Reproductive Technologies (ARTs) in the Latin American context.” I think she clearly achieves that objective. I want to suggest that she does more than this, however. In addition to revealing how traditional depictions of infertility in the United States and Europe are anachronistic for Latin America, her analysis offers feminist bioethicists in the (...) United States the opportunity to revisit our own assumptions about infertility and improve our work as a result.Luna states early in her essay that her analysis will center on secondary .. (shrink)

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Alison Bailey has recently explored the nature of what she calls privilege‐evasive epistemic pushback or “the variety of willful ignorance that many members of dominant groups engage in when they are asked to consider both the lived experience and structural injustices that members of marginalized groups experience daily.” In this article, I want to use Bailey's argument to demonstrate how privilege‐evasive epistemic pushback is facilitated and obscured by the disciplinary tools of traditional Western philosophy. Specifically, through exploring philosophical cultures of (...) justification and case studies, this work will reveal how students engage in privilege‐evasive epistemic pushback by deploying the reason/emotion divide and various philosophical norms and practices it underlies to protect their epistemic home turf. Then, I offer three emotion‐enhancing critical philosophical practices aimed at disrupting the ignorance‐promoting moves of privilege‐evasive epistemic pushback and, instead, engage emotion as epistemically significant. (shrink)

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In 2010, Taffy Brodesser-Akner published an article entitled, “How Childbirth Caused my PTSD,” on Salon.com. Much to my surprise, her claims that she was seriously traumatized by childbirth encountered strong resistance and disbelief. In trying to understand the source of this resistance, I discovered a type of violence, which I refer to as “metaphysical violence,” that is often overlooked, yet prevalent, in what many people in the United States understand as normal childbirth practices and protocols. In this essay, I will (...) use María Lugones’s Pilgramages/Peregrinajes to offer a detailed account of what constitutes metaphysical violence, how it functions, and why it is so damaging to at least 9% of post-partum women who meet the criteria for PTSD and the 18% of post-partum women who show some sign of the disorder. Then, I will offer suggestions for how we can help women who may be victims of metaphysical violence during birth avoid some of the trauma it so often induces. (shrink)

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