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The Prophetic Role of Feminist Bioethics

Published online by Cambridge University Press:  09 September 2014

Marie J. Giblin
Marie J. Giblin*
Affiliation:
Xavier University
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Abstract

Feminist bioethics, in both its Christian and secular forms, can play a prophetic role by bringing a much-needed social ethics perspective to Christian health care ethics. Six characteristics of feminist bioethics are highlighted: focus on oppression of women and its concrete forms in the health care system; epistemological critique; call for a more diverse community of ethical reflection; critique of the standard principles of bioethics; criticism of liberal individualism in mainstream bioethics; and a critical perspective on the discipline's loyalties and social location. The author highlights two important tasks for feminist bioethics: analysis of the current metamorphosis of health care in the marketplace and the more explicit use of stories to ground ethical reflection in the concrete struggles of women in meeting health care challenges.

Type
Articles
Information
Horizons , Volume 24 , Issue 1 , Spring 1997 , pp. 37 - 49
Copyright
Copyright © The College Theology Society 1997

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References

1 Brueggeman, Walter, The Prophetic Imagination (Philadelphia: Fortress, 1978), 49–50.Google Scholar

2 Among these Christian feminists part of whose writing is in bioethics are: Lisa Sowie Cahill, Margaret A. Farley, Christine E. Gudorf, Beverly Wildung Harrison, and Karen Lebacqz.

3 For a specific example of the diversity of these perspectives, see Tong, Rosemarie, “Feminist Bioethics: Developing a ‘Feminist’ Answer to the Surrogate Motherhood Question,” Kennedy Institute of Ethics Journal 6/1 (1996): 37–52.CrossRefGoogle ScholarPubMed

4 See Gilligan, Carol, In a Different Voice: Psychological Theory and Women's Development (Cambridge: Harvard University Press, 1982);Google Scholar and Noddings, Nel, Caring: A Feminine Approach to Ethics and Moral Education (Berkeley: University of California Press, 1984).Google Scholar

5 See Okin, Susan Moller, Justice, Gender, and the Family (New York: Basic Books, 1989);Google ScholarHarrison, Beverly Wildung, Making the Connections: Essays in Feminist Social Ethics, ed. Robb, Carol S. (Boston: Beacon, 1985)Google Scholar, and Lebacqz, Karen, Six Theories of Justice (Minneapolis, MN: Augsburg, 1986).Google Scholar

6 Holmes, Helen Bequaert and Purdy, Laura M., eds., Feminist Perspectives in Medical Ethics (Bloomington: Indiana University Press, 1992).Google Scholar

7 For bibliographies of feminist bioethics see Lebacqz, Karen, “Feminism” in Reich, Warren T., ed., Encyclopedia of Bioethics, vol. 2 (New York: Simon and Schuster Macmillan, 1995), 808–18;Google ScholarMcCarrick, Pat Milmoe and Darragh, Martina, “Feminist Perspectives on Bioethics” (Scope Note 30), Kennedy Institute of Ethics Journal 6/1 (1996): 85–103;CrossRefGoogle ScholarPubMed and McCarrick, Pat Milmoe, “Gender Issues in Health Care” (Scope Note 27), Kennedy Institute of Ethics Journal 5/1 (1995): 61–82.CrossRefGoogle ScholarPubMed

8 Wolf, Susan M., “Introduction: Gender and Feminism in Bioethics” in Wolf, Susan M., ed., Feminism and Bioethics: Beyond Reproduction (New York: Oxford University Press, 1996), 8.Google Scholar I am indebted to Susan Wolf for her delineation of many of the issues discussed here.

9 Ibid., 21.

10 Ibid., 23.

11 See Lebacqz, , “Feminism,” 812;Google ScholarPubMedChesler, Phyllis, Women and Madness (New York: Harcourt Brace Jovanovich, 1972);Google Scholar and Ehrenreich, Barbara and English, Deirdre, The Sexual Politics of Sickness (Old Westbury, NY: Feminist Press, 1973).Google Scholar

12 Sherwin, Susan, “Feminist and Medical Ethics: Two Different Approaches to Contextual Ethics” in Holmes, and Purdy, , eds., Feminist Perspectives, 28.Google Scholar

13 Haraway, Donna J., Simians, Cyborgs, and Women: The Reinvention of Nature (New York: Routledge, 1991), 189;Google Scholar also see Mahowald, Mary B., “On Treatment of Myopia: Feminist Standpoint Theory and Bioethics” in Wolf, , ed., Feminism and Bioethics, 95–101.Google Scholar

14 See ibid., 99; Haraway, , Simians, Cyborgs, and Women, 180ff.;Google Scholar and Robb, Carol S., “Introduction” in Robb, , ed., Mating the Connections, xv.Google Scholar

15 Mahowald, , “On Treatment of Myopia,” 101.Google Scholar Haraway notes that there is a danger in romanticizing the vision of the less powerful and in considering their standpoints as “innocent” positions without critical interpretation. However she sees their standpoints as preferred because they seem to promise more adequate, transforming accounts of the world (see Haraway, , Simians, Cyborgs, and Women, 181).Google Scholar

16 Ibid.

17 Mahowald, , “On Treatment of Myopia,” 99.Google Scholar

18 Sherwin, Susan, No Longer Patient: Feminist Ethics and Health Care (Philadelphia: Temple University Press, 1992), 59.Google Scholar

19 Ibid., 75. Sherwin uses Marilyn Frye's definition of oppression as “an interlocking series of restrictions and barriers that reduce the options available to people on the basis of their membership in a group” (13).

20 Wolf, , “Introduction,” 25.Google ScholarPubMed Wolf notes the work of Helen Longino as distinct from standpoint theory but also indicating a need for a diverse community and a process of dialogue rather than exclusion. See Longino, Helen, “Subjects, Power, and Knowledge: Description and Prescription in Feminist Philosophies of Science” in Alcoff, Linda and Potter, Elizabeth, eds., Feminist Epistemologies (New York: Routledge, 1993), 101–20.Google Scholar

21 Wolf, “Introduction,” 25Google ScholarPubMed, and Robb, , “Introduction,” xv.Google ScholarPubMed

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23 The classical text outlining these principles is Beauchamp, Tom L. and Childress, James F., Principles of Biomedical Ethics, 4th ed. (New York: Oxford University Press, 1994).Google ScholarPubMed Feminist ethicists are not the only critics, as can be seen in DuBose, Edwin R., Hamel, Ronald P., and O'Connell, Laurence J., eds., A Matter of Principles? Ferment in U.S. Bioethics (Valley Forge, PA: Trinity Press International, 1994).Google Scholar In that book a number of different perspectives (European, Latin American, Buddhist, African American, feminist, religious) and a number of different ethical methodological approaches (phenomenological, narrative, hermeneutical, as well as virtue and casuistry approaches) take a critical view of what they call “principlism.”

24 See Wolf, , “Introduction,” 15Google ScholarPubMed, and Wolf, Susan M., “Gender, Feminism, and Death: Physician Assisted Suicide and Euthanasia” in Wolf, , ed., Feminism and Bioethics, 296–97; 282.Google ScholarPubMed

25 See Purdy, Laura M., “A Call to Heal Ethics” in Holmes, and Purdy, , eds., Feminist Perspectives, 10–11;Google ScholarWolf, , “Introduction,” 8–9;Google ScholarPubMed Sherwin, No Longer Patient, chap. 2; and Gudorf, Christine, “A Feminist Critique of Biomedical Principlism” in Dubose, Hamel and O'Connell, , eds., A Matter of Principles?, 168.Google Scholar

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27 Gudorf, , “A Feminist Critique,” 175.Google Scholar

28 Ibid., 175-76.

29 Wolf, , “Introduction,” 28Google ScholarPubMed, and Gudorf, , “A Feminist Critique,” 168.Google Scholar

30 Wolf, , “Introduction,” 28.Google ScholarPubMed

31 Gudorf, , “A Feminist Critique,” 171.Google Scholar

32 Ibid., 177.

33 Ibid., 172.

34 Ibid., 177.

35 Wolf, , “Gender, Feminism, and Death,” 307.Google Scholar

36 Ibid., 304; 306-7.

37 Beauchamp, and Childress, , Principles of Biomedical Ethics, 121;Google ScholarPubMed on allegiance to Kant and Mill, see Wolf, , “Introduction,” 16.Google ScholarPubMed

38 Fox, Renee C., “The Evolution of American Bioethics: A Sociological Perspective” in Weisz, George, ed., Social Science Perspectives on Medical Ethics (Philadelphia: University of Pennsylvania Press, 1990), 206.Google Scholar

39 Ibid., 206.

40 Ibid., 208.

41 Sherwin, , “Feminism and Bioethics,” 52.Google Scholar

42 Wolf, , “Introduction,” 18.Google ScholarPubMed

43 Sherwin, , “Feminism and Bioethics,” 52, 53.Google Scholar

44 Fox, , “The Evolution of American Bioethics,” 207.Google Scholar

45 Wolf, , “Introduction,” 18.Google ScholarPubMed

46 Ibid 19.

47 A few male bioethicists have already worried publicly that bioethics has stopped asking the larger questions. See Callahan, Daniel, What Kind of Life (New York: Simon and Schuster, 1990)Google Scholar, and Kass, Leon R., “Practicing Ethics: Where's the Action,” Hastings Center Report 20 (January–February 1990): 5–12.CrossRefGoogle ScholarPubMed However, they do not link the narrowing of the questions to the social location of the discipline.

48 Sherwin, , “Feminism and Bioethics,” 55.Google Scholar

49 Nelson, Hilde Lindemann and Nelson, James Lindemann, “Justice in the Allocation of Health Care Resources: A Feminist Account” in Wolf, , ed., Feminism and Bioethics, 364.Google ScholarPubMed

50 Sherwin, , “Feminism and Bioethics,” 56.Google Scholar

51 Ibid.

52 The Kennedy-Kassebaum Act, while positive, does little to make insurance affordable, even if it makes it available to those changing jobs. The difference between having a policy offered and having it offered and affordable has to be kept in mind regarding discussions of “health care access.” An example of government acquiesence to managed care organizations is the July 1996 shelving of rules issued in March 1996 that restricted the ability of health maintenance organizations to pay bonuses and other financial rewards to doctors as inducements to limit services provided to elderly and poor patients under Medicare and Medicaid (Pear, Robert, “Federal Rules Seek to Keep H.M.O.'s from Putting Profits Ahead of Patient Needs,” New York Times [National Edition], March 27, 1996, A11Google Scholar, and Pear, Robert, “U.S. Shelves Plan to Limit Rewards to H.M.O. Doctors,” New York Times, July 8, 1996, A1).Google Scholar

53 See Mariner, Wendy K., “Business vs. Medical Ethics: Conflicting Standards for Managed Care,” Journal of Law, Medicine & Ethics 23 (1995): 236–46.CrossRefGoogle ScholarPubMed

54 Good examples of case stories can be found in Second Opinion, a journal from the Parkridge Center, that, since 1995, has been replaced by Making the Rounds in Health, Faith, and Ethics. Christian feminist ethicist Karen Lebacqz effectively uses stories that she obtained from other published sources in two articles: “Feminism and Bioethics: An Overview,” Second Opinion 17/2 (October 1991): 11–25;Google Scholar and “The ‘Fridge’: Health Care and the Disembodiment of Women” in Cahill, Lisa Sowie and Farley, Margaret A., eds., Embodiment, Morality, and Medicine (Boston: Kluwer Academic Publishers, 1995), 155–67.CrossRefGoogle Scholar

55 Ward, Debbie, “Women and the Work of Caring,” Second Opinion 19/2 (October 1993): 11–25.Google Scholar

56 Wolf, , “Introduction,” 27;Google Scholar for a perspective that appreciates the richness of stories yet points to their limitations, see Hunter, Kathryn Montgomery, “Overview: ‘The Whole Story,’“ Second Opinion 19/2 (October 1993): 97–103.Google Scholar