In lieu of an abstract, here is a brief excerpt of the content:Hypatia 16.3 (2001) 172-176 [Access article in PDF] Book Review Diagnosis: Difference: The Moral Authority of Medicine Diagnosis: Difference: The Moral Authority of Medicine. By Abby L. Wilkerson. Ithaca: Cornell University Press, 1998. In this compact volume, Abby Wilkerson makes several important contributions to the burgeoning literature of feminist (bio)ethics by providing substantive arguments in support of some of the key intuitive beliefs that are central to much feminist (...) bioethics thinking. Most centrally, she carefully fleshes out a feminist case for re-framing traditional bioethics approaches to the relation between health and justice. Particularly valuable is her richly detailed argument establishing the importance of bringing to the realm of health and health care Iris Marion Young's (1990) important insight that justice involves far more than questions of distribution.At the same time, Wilkerson demonstrates another major feminist tenet: that ethics and epistemology are intimately related. This connection is developed [End Page 172] through a second major theme in which she systematically tracks medicine's tendency to extend its accepted epistemic authority over physical ailments into a general authority over many other aspects of life. She documents examples of medicine's success in leveraging its scientific knowledge about certain aspects of the body into a broader ideological vision through which it claims epistemic authority in the personal and moral realm. By making explicit the gaps between medical knowledge and moral knowledge, she is able to challenge the moral authority and social power that are now granted to medical experts.While these arguments are important, they are not the whole story of the book, for its message is as much about process in bioethics as it is about conclusions. Wilkerson insists that the specific perspective of the theorist affects her/his reasoning. She demonstrates the importance of this fact by using her own distinct position as a bisexual woman to make visible the implicit acceptance and perpetuation of several ideological norms by those in dominant positions in both medicine and bioethics. The central method of the book is what she calls "material-semiotic." It involves the assumption that all human experience is mediated by culture, and the body (specifically the medicalized body) must be recognized as a political site subject to a variety of social values. We must, therefore, attend to the cultural meanings of health and illness and explore the ways that society labels and responds to these conditions. This requires investigation of the specific bodily (material) effects of these meanings in both individual and social experience.The book begins with the epistemological frame of the argument in which Wilkerson claims that medicine is deeply infected by the values and biases of the dominant culture, including its tendencies towards sexist, racist, classist, homophobic, and ablist attitudes. She explores ways in which medical theory and practice stigmatize bodily experiences common to women (in gynecology, obstetrics, and the treatment of victims of sexual or domestic violence). Medicalizing so many aspects of women's experience has the effect of obscuring women's subjective experiences and replacing them with medicine's normative perspectives of appropriate psychological norms. Moreover, the norm of femaleness promoted is a heterosexual, middle class, white variety such that other forms of social difference (e.g., non-white, non-heterosexual) must then also be medicalized and stigmatized; that is, the medical model requires explanations of difference that render pathological most variations on the privileged norm. Hence, alternative sexualities, like differences in class, abilities, race, and gender are interpreted through a medical lens that is thoroughly value-laden. In such ways, the epistemological authority granted to medicine is conflated into an unjustified form of moral authority. Although similar biases are common to every powerful social institution in the United States, they are especially pernicious within medicine because of the enormous influence it exerts in shaping knowledge about the nature of difference between social [End Page 173] groups. This immense social power may be directed towards reducing inequalities and promoting social justice, but, all too often, it is used to convey beliefs and norms that serve the interests of the privileged.Wilkerson's criticism is not reserved... (shrink)

There is significant evidence that the health needs of women and minorities have been neglected by a medical research community whose agendas and protocols tend to focus on more advantaged segments of society. In response, the National Institutes of Health and Food and Drug Administration in the United States have recently issued new policies aimed at increasing the utilization of women in clinical studies. As well, the U.S. Congress passed the NIH Revitalization Act of 1993, which specifically mandates increased inclusion (...) of women and racial and ethnic groups in clinical studies. On the face of it, such gender and race-specific policies would appear to be morally problematic because traditionally ethics opposes the use of sex or race as legitimate criteria for distributions of benefits or burdens in social policies. Hence, these policies pose some significant moral questions. Feminist ethics provides us with a framework for evaluating such policies because of its readiness to recognize that socially and politically significant factors such as sex and race are morally relevant in setting public policy. Of course, feminist ethics does not simply endorse all appeals to sex and race but only the policies in which attention to such factors will contribute to social justice. In this essay, I Identify some of the Important ethical questions that a feminist ethics perspective raises about research policies devised to promote the Inclusion of women in clinical studies. (shrink)

The paper investigates the significance of the question of the fetus's status as a person for resolving the moral issues of abortion. It considers and evaluates several proposed solutions to this question. It also attempts to explain how different questions about the permissibility of abortion are appropriate to discussions at different levels of decision-making: the pregnant woman, the health professional, and the social policy level. The author's own conclusions to all these questions are offered along with other popular views.

"A collection of essays in feminist philosophy.

I discuss the characters Don Quixote and Sancho Panza and their relationship in order to understand better the place of idealistictheory and realistic practice in business ethics. The realism of Sancho Panza is required to make the idealism of Don Quixote effective.Indeed, the interaction and development of these characters can serve as a model for both the effective communication between andblending of the idealistic moral theoretician and the practical businessperson. Specifically, I argue that a quixotified Sancho Panza,as a combination of (...) theoretical idealism and practical realism, is necessary for managerial statesmanship. I first consider the positionthat this concept is unrealistic. In the final section, however, I show that a number of leadership and business theorists believe thatmanagerial statesmanship requires a quixotified Sancho Panza. I also consider the question, what helps to make a quixotic vision forbusiness ethical, and what is its content? (shrink)

In Section I, I criticize the view, implied by the concept of rational economic man, that feelings are inherently opposed to rationality. I attempt to show that emotions or feelings are essential to the proper functioning of reason, rational objectivity, and practical rationality or rational decision making. In addition, I argue that emotions can help to resolve certain ethical dilemmas. In Section II, I consider business writers who criticize business for overemphasizing the head at the expense of feelings or the (...) heart. In Section III, I discuss the connection between material self-interest (as manifested in trade) – a concept of rational economic man – and business virtues. (shrink)

When we think of theories that attempt to root capitalism in nature, the one that comes most readily to mind is Social Darwinism. In this theory, nature - driven by Darwinian natural selection (the struggle for existence and the survival of the fittest) - is interpreted to imply, when applied to human activities, that extreme competition will allow the most "fit" competitors to rise to the top and to survive in this "struggle for existence," and this process of dog-eat-dog competition (...) leads to both material and social progress. Not only has this theory been shown to be seriously flawed, the putative social implications of Darwinian natural selection do not accord with the findings of contemporary neoDarwinists who maintain, for example, that the behavior of monkeys and apes reveals a blend of competition and cooperation and, generally, a close connection to human moral behavior. Adam Smith provides a more helpful view of the connection between nature and capitalism. He maintains that nature's wisdom, as seen in its harmony and balance, is displayed in economics and human nature. Competitive free enterprise, as a vehicle for exchange, functions within a cooperative context and exhibits virtues and values such as mutual help and benefit, trust, harmony, and friendship. I shall show that neoDarwinists agree with Smith's view that nature supports a connection between competition and cooperation, and they maintain that moral activity, rather than destructive dog-eat-dog competition, is necessary to achieve the goals of natural selection. (shrink)

The evidence is overwhelming that members of particularly wealthy and industry-owning segments of Western societies have much larger carbon footprints than most other humans, and thereby contribute far more than their “fair share” to the enormous problem of climate change. Nonetheless, in this paper we shall counsel against a strategy focused primarily on blaming and shaming and propose, instead, a change in the ethical conversation about climate change. We recommend a shift in the ethical framework from a focus on the (...) role of individual agents and a conversation about guilt; in its place, we propose a relational approach to public health ethics that is centered around the idea of relational solidarity. We begin by briefly reviewing the most common—and woefully inadequate—approach in the West to reducing emissions and responding to the health-related impacts of climate change. We then go on to propose a relational approach to public health ethics as an alternative ethical framework that better fits the moral problems associated with climate change and holds promise for a more meaningful response. (shrink)

Her careful building of positions, her unique approaches to analyzing problems, and her excellent insights make this an important work for feminists, those ...

In part 1 of the paper, I develop a Platonic business ethic, emphasizing Plato’s Republic. I approach business ethics from a virtue ethics position, and I attempt to show that a Platonic craftsmanship model infuses a corporation with a type of managerial wisdom and justice, molds temperate and courageous corporate characters, and entails a morally fine type of self-interest. I also show that it is basic to two influential management theories.In part 2, I use Amartya Sen’s Development as Freedom to (...) show that the craftsmanship model is central to the concept of development. This concept is important in ethical discussions of both globalization and transnational corporations. Thus, I attempt to globalize Platonic business ethics using a craftsmanship model.In my concluding remarks, I attempt to show that the Plato/Sen position on development can be illustrated by both American and non-American capitalist firms functioning in our globalized world. (shrink)

This article reflects on the work of feminist bioethicists over the past ten years, reviewing how effective feminists have been in using relational theory to reorient bioethics and where we hope it will go from here. Feminist bioethicists have made significant achievements using relational theory to shape the notion of autonomy, bringing to light the relevance of patients' social circumstances and where they are situated within systems of privilege and oppression. But there is much work to be done to reorient (...) bioethics so that it is capable of addressing some current public health challenges. We argue that relational theory holds promise for beginning this work. (shrink)

Abortion has long been a central issue in the arena of applied ethics, but, the distinctive analysis of feminist ethics is generally overlooked in most philosophic discussions. Authors and readers commonly presume a familiarity with the feminist position and equate it with liberal defences of women's right to choose abortion, but, in fact, feminist ethics yields a different analysis of the moral questions surrounding abortion than that usually offered by the more familiar liberal defenders of abortion rights. Most feminists can (...) agree with some of the conclusions that arise from certain non-feminist arguments on abortion, but they often disagree about the way the issues are formulated and the sorts of reasons that are invoked in the mainstream literature. (shrink)

This paper argues that the various approaches to ethics that bioethicists rely on are not adequate to provide effective moral guidance in how to avoid a series of looming human catastrophes (associated with such threats as environmental degradation, war, extreme poverty, and pandemics). It proposes development of a new approach to ethics, dubbed public ethics, that simultaneously investigates moral responsibilities at multiple levels of human organization from the individual to international bodies. It argues that feminist relational theory can provide guidance (...) to development of this new type of ethics, and it warns against obstacles bioethicists face in its pursuit. (shrink)

Book reviewed in this article: How We Die. By Sherwin B. Nuland. New York: Alfred A. Knopf.

Demystifying Legal Reasoning defends the proposition that there are no special forms of reasoning peculiar to law. Legal decision makers engage in the same modes of reasoning that all actors use in deciding what to do: open-ended moral reasoning, empirical reasoning, and deduction from authoritative rules. This book addresses common law reasoning when prior judicial decisions determine the law, and interpretation of texts. In both areas, the popular view that legal decision makers practise special forms of reasoning is false.

The purpose of this dissertation is to develop and defend a method of elimination for determining justifiable basic normative ethical principles. The method is developed by considering Books I and X of Aristotle's Nicomachean Ethics and Plato's Meno. The method requires consideration on two different "levels." Aristotle and Plato use regulative endoxic premises as the evaluative criteria of the method. Such premises, which ideally are based upon universal agreement, guide an inquiry of our sort, i.e., determine the elimination or nonelimination (...) of the alternatives. Concerning the second "level," an adequate list of alternative possible solutions should be presented, and some principle or technique should be provided for determining such an adequate list. On the basis of the above premises, alternatives are evaluated in such a way that lack of accordance with any one of the relevant premises--assuming that there is more than one--is sufficient for the elimination of an alternative. The only alternative that is not eliminated by any of the premises provides the solution to the problem. The Aristotle chapter shows how regulative endoxic premises can be used, in an "ideal" sense, for choosing between two or more alternatives that generally accord with the premises. ;Our discussion of Aristotle and Plato shows that they do use this method and illustrates, in some detail, both how the method is used and specific variations of it. Our philosophers use different principles or techniques for determining the plausible alternatives. Aristotle chooses alternatives which are endoxic opinions. Plato uses the opinions of interlocutors, which are often endoxic, but he basically relies on a type of shared or cooperative rational inquiry to determine increasingly more adequate opinions, and, consequently, the plausible opinions that ought to be considered. On this "level," we attempt to show that the Platonic technique is more adequate than the Aristotelian procedure. ;Probably the most controversial feature of our method is the employment of regulative endoxic premises. Our final chapter is concerned with further clarification and defense of these premises. We attempt to show that regulative endoxic premises are different from and more adequate than the more objectionable opinions called conventionally moral opinions. We, then, attempt to provide a justifiable account of the differential value, in our method, in the evidential force of regulative endoxic premises and substantive endoxic opinions, and attempt to determine how adequate regulative endoxic premises relative to a specific inquiry can be identified. We argue that these premises provide the conditions necessary for the possibility of successful inquiry within, what I call, the ordinary ethical standpoint, and that the basic presupposition of this standpoint is an acceptable assumption. ;Two alternatives to our position concerning the defense of regulative endoxic premises are considered: They are intuitively self-evident. They are analytic truths based upon an appeal to ordinary usage. is readily seen to be objectionable. is, apparently, the position of Hare. We argue that Hare's position, which maintains that the probative force of regulative endoxic premises is based upon their analytic nature, is quite debatable, and does not, therefore, provide a viable alternative to our position. We also object to Hare's view of his regulative endoxa, viz., universalizability and prescriptivity. (shrink)

Sex selection technologies have become increasingly prevalent and accessible. We can find them advertised widely across the Internet and discussed in the popular media—an entry for “sex selection services” on Google generated 859,000 sites in April 2004. The available services fall into three main types: preconception sperm sorting followed either by intrauterine insemination of selected sperm or by in vitro fertilization ; preimplantation genetic diagnosis, by which embryos created by IVF are tested and only those of the desired sex are (...) transferred to the woman's uterus; and prenatal testing of fetuses through ultrasound or chromosomal analysis, followed by selective abortion of fetuses detected to be of the undesired sex. (shrink)

Book reviewed in this article: No Longer Patient: Feminist Ethics & Health Care. By Susan Sherwin Feminist Perspectives in Medical Ethics. Edited by Helen Bequaert Holmes and Laura M. Purdy.

I reflect on the past, present, and future of the field of bioethics. In so doing, I offer a very situated overview of where bioethics has been, where it now is, where it seems to be going, where I think we could do better, and where I dearly hope the field will be heading. I also propose three ways of re‐orienting our theoretic tools to guide us in a new direction: (1) adopt an ethics of responsibility; (2) explore the responsibilities (...) of various kinds of actors and relationships among them; (3) expand the types of participants engaged in bioethics. (shrink)

In this paper, I argue that an Aristotelian approach to business ethics would place theory and practice in business ethics in proper balance. I attempt to show this in two parts. In part one, I suggest that Aristotle’s balanced view of the relation between theory and practice in political philosophy can be applied to corporate life;Aristotle’s sophisticated ethical and political inquiries should help advocates of corporate culture to construct theories that are theoretically, practically, and ethically sound. In part two, I (...) argue that theory and practice are kept in proper balance in Aristotle’s discussion of phronesis or practical wisdom; therefore, Aristotelian phronesis should help to illuminate morally intelligent business conduct. (shrink)