Maternal mortality is still very high in Africa, despite progress in control efforts at the global level. One elemental link is the question of autonomy in maternal health, especially at the household level where intrinsic human rights are undermined. A rights-based consideration in bioethics is an approach that holds the centrality of the human person, with a compelling reference to the fundamental human rights of every person. A philosophical and sociological engagement of gender and the notion of autonomy within the (...) household reveals some fundamental rights-based perplexities for bioethical considerations in maternal health. The right to self-determination is undermined, and therefore women’s dignity, freedom and autonomy, capacities, and choices are easily defiled. This study applies a rights-based approach to maternal health and demonstrates how rights concerns are associated with negative outcomes in maternal health in Africa. The discussion is situated at the household level, which is the starting point in health care. The paper submits that beyond legal and political rights within the context of the state, rights-based issues manifest at the household level. Many of those rights issues, especially relating to women’s autonomy, are detrimental to maternal health in Africa. Therefore, a rights-based approach in the social construction of maternal health realities will contribute to alleviating the burden of maternal mortality in Africa. (shrink)

In contemporary liberal ethics patient autonomy is often interpreted as the right to self-determination: when it comes to treatment decisions, the patient is given the right to give or withhold informed consent. This paper joins in the philosophical and ethical criticism of the liberal interpretation as it does not regard patient autonomy as a right, rule or principle, but rather as a practice. Patient autonomy, or so I will argue, is realised in the concrete activities of day-to-day health care, in (...) the material and technological context of care, in arrangements of health care institutions, in the physical training of people with disabilities, as well as in the concrete activities of care-giving. This move from conversations in the consultation room to other sites and situations in the practice of care takes seriously the empirical reality of medical care and intends to show that patient autonomy is practically realised in a much richer and more creative way than most ethical theory seems to assume. (shrink)

This article is an expansion of comments I was honored to present at a celebration of the life and work of Anne Donchin at the June 2016 meeting of the International Network on Feminist Approaches to Bioethics in Edinburgh. It is obviously far from comprehensive, but I hope it gives readers a glimpse of an Anne of whose depths many of us were not fully aware. One of the most difficult parts of talking about someone who has died is highlighting (...) the positive without overdoing it to the extent that their friends and loved ones find themselves rolling their mental eyes a bit, since most of us—no matter how wonderful—are a little less than perfect. But my problem here is that the more I have found out... (shrink)

Mainstream breast cancer social movements such as that of Susan G. Komen have called on all women to race or fight for the cure for breast cancer. They suggest that the fight can be won by buying and wearing pink ribbons, taking part in races and walks, donating money, and participating in research. For some patients with breast cancer, research participation may involve non-diagnostic tumor biopsies. While this clinical research is performed in the hope of gaining new knowledge through the (...) removal and study of breast cancer tissue, these procedures have been heavily criticized because they offer little potential benefit to the patient providing the tissue (Helft and Daugherty 2006; Kimmelman et al. 2012;... (shrink)

This article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work.

This article seeks an improved understanding of nurse autonomy by looking at nursing through the lens of what recent feminist scholars have called ‘relational’ autonomy. A relational understanding of autonomy means a shift away from older views focused on individuals achieving independence, towards a view that seeks meaningful self-direction within a context of interdependency. The main claim made here is that nurse autonomy is, indeed, relational. The article begins with an explanation of the notion of relational autonomy. It then explains (...) both the collective and the individual application of the term ‘professional autonomy’. Finally, it argues that both senses of professional autonomy are best understood as relational, and suggests some implications of this conclusion. (shrink)

This paper will examine the concepts of integrity and moral residue as they relate to nursing practice in the current health care environment. I will begin with my definition and conception of ethical practice, and, based on that, will go on to argue for the importance of recognizing that nurses often find themselves in the position of compromising their moral integrity in order to maintain their self‐survival in the hospital or health care environment. I will argue that moral integrity is (...) necessary to a moral life, and is relational in nature. When integrity is threatened, the result is moral distress, moral residue, and in some cases, abandonment of the profession. The solution will require more than teaching bioethics to nursing students and nurses. It will require changes in the health care environment, organizational culture and the education of nurses, with an emphasis on building a moral community as an environment in which to practise ethically. (shrink)

Individualistic traditions of autonomy have long been critiqued by feminists for their atomistic and asocial presentation of human agents. Relational approaches to autonomy were developed as an alternative to these views. Relational accounts generally capture a more socially informed picture of human agents, and aim to differentiate between social phenomena that are conducive to our agency versus those that pose a hindrance to our agency. In this article, I explore the various relational conceptualizations of autonomy profferred to date. I critically (...) review some of the ongoing internal disputes within the relational autonomy literature, and conclude the article by taking stock of the value of relational autonomy despite these unresolved debates. (shrink)

Although consumers and physicians alike have long described the goal of aesthetic surgery as the production of an “improved” but still “natural-looking” body, interviews with women who had cosmetic surgery between 1990 and 2007 suggest that the “artificial” is becoming increasingly prevalent within consumers’ narratives of breast enlargement. This article explores that change in relation to processes of conspicuous consumption, the growing cultural emphasis on continual self-transformation, and the increasing normalization of cosmetic modification. Following Fraser, it treats consumers’ accounts not (...) as the reflection of “reality” or a “true self” but instead as indicators of the kinds of options, expressions, assumptions, and perspectives that are available for use in communication about cosmetic surgery. The analysis also draws on feminist writings about the social construction of “breastedness” in femininity. In so doing, it seeks to conceptualize the cultural significance of breasts that are “too good to be real.”. (shrink)

Justice is a key guiding ethical principle in bioethics. When justice is addressed in bioethics the focus is primarily on the fair distribution of resources, that is, distributive justice. In this thesis, I argue that a distributive conception of justice is unable to adequately address many of the relevant issues of justice within bioethics. These issues are better understood and addressed using a social conception of justice. Social justice is concerned with ensuring that the norms and rules of social structures (...) are fair and equitable. I argue that social and distributive justice are not only compatible, but also complementary. As a result, both conceptions of justice need to be applied to bioethical issues if we are to achieve a truly just outcome. As a case study, I apply this analysis to the controversial issue of the inclusion of pregnant women in clinical research trial. (shrink)