In this survey of feminist theory, Rosemarie Tong provides coverage of the psychoanalytic, existential and postmodern schools of feminism. The author guides the reader through the complexities of even the most notoriously difficult thinkers. Students will meet and become familiar with many of the essential figures in the feminist tradition, from Wollstonecraft and Engel, on through de Beauvoir, Dinnerstein, and Daly, and up to Mitchell and Cixous. The text treats all views with respect and encourages students to think critically and (...) sympathetically about a wide range of views that have a direct relevance to their own lives. (shrink)

No other cluster of medical issues affects the genders as differently as those related to procreationcontraception, sterilization, abortion, artificial insemination, in-vitro fertilization, surrogate motherhood, and genetic screening. Rosemarie Tong s approach to feminist bioethics serves as a catalyst to bring together different feminist voices in hope of actually doing something to make gender equity a present reality rather than a mere future possibility.".

In this paper I seek to distinguish a feminist virtue ethics of care from (1) justice ethics, (2) narrative ethics, (3) care ethics and (4) virtue ethics. I also connect this contemporary discussion of what makes a virtue ethics of care feminist to eighteenth and nineteenth century debates about male, female, and human virtue. I conclude that by focusing on issues related to gender - primarily those related to the systems, structures, and ideologies that create and sustain patterns of male (...) domination and female subordination - we can begin to appreciate that true care and bona-fide virtue can flourish only in societies that treat all persons with equal respect and consideration. (shrink)

In this article, I explain what makes a global bioethics “feminist” and why I think this development makes a better bioethics. Before defending this assertion explicitly, I engage in some preliminary work. First, I attempt to define global bioethics, showing why the so-called feminist sameness-difference debate [are men and women fundamentally the same or fundamentally different?] is of relevance to this attempt. I then discuss the difference between rights-based feminist approaches to global bioethics and care-based feminist approaches to global bioethics. (...) Next, I agree with a significant number of feminist bioethicists that care is a more fundamental moral value and practice than justice. Finally, I conclude that feminists’ insights about care, even more than rights, can bring us closer to achieving an inclusive, diverse, and fair feminist global bioethics. (shrink)

This collection brings together fourteen contributions by authors from around the globe. Each of the contributions engages with questions about how local and global bioethical issues are made to be comparable, in the hope of redressing basic needs and demands for justice. These works demonstrate the significant conceptual contributions that can be made through feminists' attention to debates in a range of interrelated fields, especially as they formulate appropriate responses to developments in medical technology, global economics, population shifts, and poverty.

Feminism was born in controversy and it continues to flourish in controversy. The distinguished contributors to this volume provide an array of perspectives on issues including: universal values, justice and care, a feminist philosophy of science, and the relationship of biology to social theory.

In this paper I examine the epistemology and ethics of consensus, focusing on the ways in which decision makers use/misuse ethical expertise. The major questions I raise and tentative answers I give are the following: First, are the ‘experts’ really experts? My tentative answer is that they are bona fide experts who often represent specific interest groups. Second, is the experts' authority merely epistemological or is it also ethical? My tentative answer is that the experts' authority consists not only in (...) their command over specific matters of fact and/or value, but also in their ability to achieve ‘consensus’ about what is ‘true’/‘false’, or ‘right’/‘wrong’. Third, should the authority of expertise be limited? My tentative answer is that it should be limited in the area of facts but especially in the area of values. Persons who are ethics ‘experts’ must be particularly careful to practice an ethics of persuasion rather than an ethics of compulsion . Their role is not to force their group consensus upon decision makers' individual moral perceptions and deliberations; rather it is to help decision makers come to their own conclusions about what they ought to do. Keywords: authority of expertise, consensus, ethics committees, ethics of persuasion, NIH consensus development conferences CiteULike Connotea Del.icio.us What's this? (shrink)

As human longevity increases, with people living well into their seventies and eighties, the need for long-term care for the elderly most certainly will grow. The longer people live, the more likely they fall prey to chronic disease, as well as to the standard toll the aging process takes on human bodies and psyches. In this article, I examine some of the concerns that a wide variety of governments, individuals, and families have expressed about meeting the long-term care needs of (...) large numbers of people over sixty-five. I then claim that each of these groups must do its share of long-term care for the elderly, depending on its ability to do so. Finally, I conclude that the more committed a country is to the deconstruction of ingrained notions about who should care and who should work, the more able it will be to meet the long-term care needs of the elderly and other vulnerable populations fairly. (shrink)

Hiring international migrant eldercare workers to work hard for little pay simply because this traveling workforce needs wages higher than those they would receive back home seems somehow “wrong.” The standard justification for hiring migrants seems more like an excuse than a justification. My purpose in this article, however, is not to condemn people who hire international migrant eldercare workers, but to suggest that these employers as well as their employees are caught in the same moral bind. Depending on how (...) uncaring a state is about meeting its people’s fundamental needs including adequate long-term care, it will create a hostile environment for the development of caring people. But a society without a sufficient number of caring people risks unraveling. People who avoid care work and who shun the practice of care are, in my estimation, “marginal” to society in that they are not contributing to the foundation that makes society possible. (shrink)

In this commentary on Eva Feder Kittay's Love's Labor: Essays on Women, Equality, and Dependency, I focus on Kittay's dependency theory. I apply this theory to an analysis of women's inadequate access to high-quality, cost-effective healthcare. I conclude that while quandaries remain unresolved, including getting men to do their share of dependency work, Kittay's book is an important and original contribution to feminist healthcare ethics and the development of a normative feminist ethic of care.

When the benefits of surgery do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery.

This essay discusses the history of the "futility debate" and the motives that sometimes prompt health care professionals, health care providers, patients, and surrogates to take different sides in it. Changes in the health care system, financial responsibility shifts, technical medical advances, and medical care rationing are analyzed as contributors to the futility debate. So too are variations in the definition of futility examined as part of the current controversy. The respective attitudes of professionals, providers, patients, and surrogates in accepting (...) the goals, capabilities, and limits of medicine are also explored. In particular, the lack of honest communication between health care professionals/health care providers on the one hand and patients/surrogates on the other is acknowledged as a major roadblock in the building of care-focused futility policies. Finally, various initial attempts of hospitals to create futility guidelines are evaluated in order to detect problem areas and to suggest lines of improvement. Keywords: medical futility, medical decision-making, virtues, resource allocation CiteULike Connotea Del.icio.us What's this? (shrink)

Teaching bioethics in the new millennium requires its practitioners to confront a wide area of methodological alternatives. This essay chronicles the author's journey from the principlism of Beauchamp and Childress, through narrative and postmodern bioethics, to a complex feminist critique of postmodern bioethics that emphasizes functional human capabilities and the creation of structures that can facilitate free discussion of those capabilities and how best to realize them. Teaching bioethics concerns not only the acknowledgement of differences but also reminding ourselves of (...) our samenesses. Sustained Habermasian democratic conversations might help us to escape the narrow confines of a postmodern bioethics of moral strangers for a richer world of moral friends. (shrink)

This article revisits the question of ectogenesis (out-of-body gestation) as our neonatal care and biogenetic technologies bring us closer to the possibility. In 1923, J.B.S. Haldane wrote approvingly of ectogenesis as a eugenic technique, using a science fiction format. In the 1970s and 1980s, feminists debated whether ectogenesis, if possible, would be liberating or oppressive for women. Given current legal and bioethical issues, we must now take seriously the possible costs of ectogenesis: the possibility of growing bodies for use as (...) spare parts, the erosion of the autonomy of women in the reproductive process, the denigration of the body through the loss of the physicality of pregnancy and childbirth. (Abstract prepared by Aaron Lee.). (shrink)

The essays in this book engage the original and controversial claims from Michael Boylan's A Just Society. Each essay discusses Boylan's claims from a particular chapter and offers a critical analysis of these claims. Boylan responds to the essays in his lengthy and philosophically rich reply.

: Although a wide variety of feminist approaches to bioethics presently share a common feminist methodology (sometimes referred to as "raising the woman question"), they do not all share the same feminist politics, ontology, epistemology, and ethics. As a result of their philosophical differences, feminist bioethicists do not always agree on which biomedical principles, practices, and policies are best suited to serving women's interests. In other words, some feminist bioethicists insist that so-called "assisted reproduction" enhances women's procreative liberty, while others (...) claim that it does nothing of the sort. Although such disagreement among feminist bioethicists reassures the general public that the feminist "program" for bioethics is not ideologically monolithic, it also confuses the public, especially women. In order to overcome this confusion, feminist bioethicists should work toward developing the kind of shared theoretical base that will foster frequent consensus on the biomedical principles, practices, and policies most likely to serve the interests of most women in the U.S. today. (shrink)

Entropy-based algorithms have been suggested as robust estimators of electroencephalography (EEG) predictability or regularity. This study aimed to examine possible disturbances in EEG complexity as a means to elucidate the pathophysiological mechanisms in chronic stroke, before and after a brain computer interface (BCI)-motor observation intervention. Eleven chronic stroke subjects and nine unimpaired subjects were recruited to examine the differences in their EEG complexity. The BCI-motor observation intervention was designed to promote functional recovery of the hand in stroke subjects. Fuzzy approximate (...) entropy (fApEn), a novel entropy-based algorithm designed to evaluate complexity in physiological systems, was applied to assess the EEG signals acquired from unimpaired subjects and stroke subjects, both before and after training. The results showed that stroke subjects had significantly lower EEG fApEn than unimpaired subjects (p < 0.05) in the motor cortex area of the brain (C3, C4, FC3, FC4, CP3, CP4) in both hemispheres before training. After training, motor function of the paretic upper limb, assessed by the Fugl-Meyer Assessment-Upper Limb (FMA-UL), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT) improved significantly (p < 0.05). Furthermore, the EEG fApEn in stroke subjects increased considerably in the central area of the contralesional hemisphere after training (p < 0.05). A significant correlation was noted between clinical scales (FMA-UL, ARAT, and WMFT) and EEG fApEn in C3/C4 in the contralesional hemisphere (p < 0.05). This finding suggests that the increase in EEG fApEn could be an estimator of the variance in upper limb motor function improvement. In summary, fApEn can be used to identify abnormal EEG complexity in chronic stroke, when used with BCI-motor observation training. Moreover, these findings based on the fApEn of EEG signals also expand the existing interpretation of training-induced functional improvement in stroke subjects. Entropy-based analysis might serve as a novel approach to understanding the abnormal cortical dynamics of stroke and the neurological changes induced by rehabilitation training. (shrink)

Worldwide populations are aging with economic development as a result of public health initiatives and advances in therapeutic discoveries. Since 1850, life expectancy has advanced by 1 year for every four. Accompanying this change is the rapid development of anti‐aging science. There are three schools of thought in the field of aging science. One perspective is the life course approach, which considers that aging is a good and natural process to be embraced as a necessary and positive aspect of life, (...) where the aim is to improve the quality of existing lifespan and “compress” morbidity. Another view is that aging is undesirable, and that rejuvenation and indeed immortality are possible since the biological basis of aging is understood, and therefore, strategies are possible for engineering negligible senescence. Finally, a hybrid approach is that life span can be extended by anti‐aging medicines but with uncertain effects on health. While these advances offer much promise, the ethical perspectives are seldom discussed in cross‐disciplinary settings. This article discusses some of the key ethical issues arising from recent advances in biogerontology. (shrink)

Feminist philosophy has had a powerful impact not just on philosophy but on other disciplines as well. This imaginatively edited anthology enables readers to sample this literature widely and to trace the breadth and the depth of its influence.

: Fins, Bacchetta, and Miller's clinical pragmatism has several appealing features: an emphasis on dialogue, a commitment to consensus, a focus on particular individuals rather than persons in general, and a strong interest in the process as well as the product of moral decision making. Nevertheless, for all its protests to the contrary, clinical pragmatism has a tendency to privilege medical facts over nonmedical values, to conflate appropriate medical decisions with right moral decisions, and to conceive problems at the bedside (...) in terms of "getting" patients and families to "go along" with the treatment plans of clinicians. In sum, there is within clinical pragmatism the potential for physicians to take back some of the power they ceded to patients during the height of the patients' rights and autonomy movement. Provided that clinicians guard against the temptation to use clinical pragmatism manipulatively, however, the method promises, more than most other methods of moral problem solving, to help increasingly diverse individuals make good moral decisions about patients' care under conditions of enormous uncertainty. (shrink)

This chapter contains sections titled: Moral Arguments against and for Surrogate Motherhood Legal Remedies for Surrogate Motherhood Perspectives of Health‐care Practitioners on Surrogate Motherhood Perspectives of Society on Surrogate Motherhood Conclusion.

Editors Wanda Teays, John-Stewart Gordon, and Alison Dundes Renteln have assembled the works of an interdisciplinary, international team of experts in bioethics into a comprehensive, innovative and accessible book. Topics covered range from torture and lethal injection to euthanasia, sex selection, vulnerable human subjects, to health equity, safety and public health, and environmental disasters like Bhopal, Fukushima, and more.

Hand function improvement in stroke survivors in the chronic stage usually plateaus by 6 months. Brain-computer interface (BCI)-guided robot-assisted training has been shown to be effective for facilitating upper-limb motor function recovery in chronic stroke. However, the underlying neuroplasticity change is not well understood. This study aimed to investigate the whole-brain neuroplasticity changes after 20-session BCI-guided robot hand training, and whether the changes could be maintained at the 6-month follow-up. Therefore, the clinical improvement and the neurological changes before, immediately after, (...) and 6 months after training were explored in 14 chronic stroke subjects. The upper-limb motor function was assessed by Action Research Arm Test (ARAT) and Fugl-Meyer Assessment for Upper-Limb (FMA), and the neurological changes were assessed using resting-state functional magnetic resonance imaging. Repeated-measure ANOVAs indicated that long-term motor improvement was found by both FMA (F[2,26]= 6.367,p= 0.006) and ARAT (F[2,26]= 7.230,p= 0.003). Seed-based functional connectivity analysis exhibited that significantly modulated FC was observed between ipsilesional motor regions (primary motor cortex and supplementary motor area) and contralesional areas (supplementary motor area, premotor cortex, and superior parietal lobule), and the effects were sustained after 6 months. The fALFF analysis showed that local neuronal activities significantly increased in central, frontal and parietal regions, and the effects were also sustained after 6 months. Consistent results in FC and fALFF analyses demonstrated the increase of neural activities in sensorimotor and fronto-parietal regions, which were highly involved in the BCI-guided training.Clinical Trial Registration:This study has been registered atClinicalTrials.govwith clinical trial registration number NCT02323061. (shrink)

There have been few feminist analyses of the abuse and neglect of elderly women per se. We think that most standard gerontological studies of the abuse and neglect of aging people have not disaggregated the group – elderly people – according to their differences in gender, race, ethnicity, social status, economic well-being, and so on. In contrast, feminist theory has certainly paid attention to gender differences, but many analyses have been surprisingly ageist. Feminists still focus on issues of concern to (...) younger women, giving short shrift to, or simply ignoring, the issues of many older women: chronic diseases, depression, loneliness, and confrontation with their mortality. In this chapter, we point out some of the ways that physical abuse and neglect differ for elderly women. We also argue that feminists, indeed everyone, should be especially concerned about the issues of elderly women as a matter of social justice. Because women still have much heavier caregiving roles and responsibilities than men, they generally reach old age poorer, sicker, and more stretched than men. Thought and efforts must be expanded in order to achieve the continually elusive goal of gender equity. (shrink)

The purpose of this commentary on James Nelson's article [1] is to advocate introducing the ethics of care into the arena of gestational conflict. Too often the debate gets stalled in a maternal versus fetal rights headlock. Interventionists stress fetal over maternal rights: they believe education, post-birth prosecution or pre-birth seizure of pregnant women may be permissible. In contrast to interventionists, other philosophers stress that favoring fetal rights treats women like fetal containers. I question whether we should really consider issues (...) of moral/parental obligations to children in terms of rights. Rather, the language of care should guide moral conduct vis-a-vis children/fetuses. The particularity of each woman's story — the particulars of her human relationships — inform her story. An individual's ability to care is largely a function of whether community cares for her. We must care for others to enable them to care for themselves and their loved ones — born or unborn. (shrink)