In this paper, I offer a prolegomenon to the philosophy of harm reduction. I begin with an overview of the philosophical literature on both harm and harm reduction, and a brief summary of harm reduction scholarship outside of philosophy in order to make the case that philosophers have something to contribute to understanding harm reduction, and moreover that engagement with harm reduction would improve philosophical scholarship. I then proceed to survey and assess the nascent and still modest philosophy of harm (...) reduction literature that has begun to emerge. I pay particular attention to two Canadian philosophers who have called for the expansion of harm reduction beyond the realm of so-called “vice”. Finally, I sketch some of the most interesting and important philosophical issues that I think the philosophy of harm reduction must grapple with going forward. (shrink)

Among feminist philosophers, there are two lines of argument that sexist values are illegitimate in science, focusing on epistemic or ethical problems. This article supports a third framework, elucidating how value-laden science can enable epistemic oppression. My analysis demonstrates how purported knowledge laden with sexist values can compromise epistemic autonomy and contribute to paternalism and misogyny. I exemplify these epistemic wrongs with a case study of the morning-after pill during its 2006 switch to over-the-counter availability and its new drug label (...) from the US Food and Drug Administration that it “may prevent implantation.” Antiabortion science advisers created this label to protect zygotes based on debated value judgments that were later concealed. This zygote-centric knowledge enabled them to shape potential users by instructing “good mothers” that they ought to protect zygotes and punishing “bad mothers” by refusing their requests for the drug. Therefore, I argue that the sexist values and gender norms of antiabortionists that prioritize zygotic health are illegitimate in this context because they cause epistemic injustices and perpetuate epistemic oppression. Furthermore, I advocate against blanket protections for the “right to conscience” and “religious freedom” of healthcare providers because they reinforce the epistemic oppression of women, especially those on the margins.Content Warning: This article discusses sexual assault and refusals to provide contraception to patients, including survivors. (shrink)

In any given society, rights are said to co-exist. When rights, however, begin to conflict, a balance must be sought. In few fields has the ability of governments to accommodate two conflicting sets of rights been so controversial as it has in the case of conscientious objection in reproductive health care. Today, states have an obligation under international law to protect the right to the freedom of thought, conscience, and religion of medical providers. They also, however, have an obligation to (...) protect right to the highest attainable standard of health and other fundamental rights of women. Considering the extent to which CO has been invoked in the context of reproductive health care, international law recognizes limits to its use. Over the years, human rights bodies have sought to develop guidelines around CO in order to ensure the protection of women’s basic rights. While some state practices have shown to be consistent with guidelines established at the international level, some countries have struggled to provide an effective balance so as to protect women’s fundamental rights. Taking the example of countries in Latin America and Europe, this article provides an overview of the different ways states have sought to regulate CO in the medical context and the various difficulties ensued. (shrink)

The conscientious refusal to dispense emergency contraception is legally protected in fourteen states. While the ethical dimensions of these objections have been explored within moral and feminist philosophy, conscientious refusal to the over-the-counter sale of EC has not been significantly studied through an egalitarian lens, especially with attention to the existing reproductive healthcare landscape in which these refusals occur. This article argues, through Amartya Sen’s capability approach, that conscientious refusal to EC creates a burdensome inequality for people wishing to prevent (...) pregnancy that manifests within a background of historical injustices, elevating its importance in our weighing of capabilities. (shrink)

This paper comes out of a panel honoring the work of Anne Donchin (1940-2014), which took place at the 2016 Congress of the International Network on Feminist Approaches to Bioethics (FAB) in Edinburgh. My general aim is to highlight the contributions Anne made to feminist bioethics, and to feminist reproductive ethics in particular. My more specific aim, however, is to have a kind of conversation with Anne, through her work, about whether reproductive justice could demand insurance coverage for in vitro (...) fertilization. I quote liberally from Anne’s work for this purpose, but also to shower the reader with her words, reminding those of us who knew her well what a wonderful colleague she was. (shrink)

In this paper I discuss the interrelated topics of stereotype threat and attributional ambiguity as they relate to gender and gender identity. The former has become an emerging topic in feminist philosophy and has spawned a tremendous amount of research in social psychology and elsewhere. But the discussion, at least in how it connects to gender, is incomplete: the focus is only on cisgender women and their experiences. By considering trans women's experiences of stereotype threat and attributional ambiguity, we gain (...) a deeper understanding of the phenomena and their problematic effects. (shrink)

A recent focus of the debate on conscientious objection in healthcare is the question of whether practitioners should have to justify their refusal to perform certain functions. A recent article by Cowley addresses a practical aspect of this controversy, namely the question of whether doctors claiming conscientious objector status in relation to abortion should be required, like their counterparts claiming exemption from military conscription, to defend their claim before a tribunal. Cowley argues against the use of tribunals in the medical (...) case, on the grounds that there are likely to be fewer unjustified claims to conscientious objection in this context than in the military, and that in any case tribunals will not be an effective way of distinguishing genuine and false cases. I reject these arguments and propose a different conception of the role of a medical conscientious objection tribunal. (shrink)

This dissertation offers a robust philosophical examination of a phenomenon that is morally, socially, and politically significant – microaggressions. Microaggressions are understood to be brief and routine verbal, behavioral, or environmental indignities that, whether intentional or unintentional, convey hostility toward or bias against members of marginalized groups. Microaggressions are rooted in stereotypes and/or bias (whether implicit or explicit) and are connected to broader systems of oppression. Microaggressions are philosophically interesting, since they involve significant ambiguity, questions about speech and communication, and (...) the ability for our speech to encode and transmit bits of meaning. Microaggressions prompt reflection about the nature of blameworthiness and responsibility, especially for unintended acts and harms. They involve questions about how we perceive and treat one another, and whether or not people are treated as true equals in our social and political worlds. For all of these reasons, microaggressions are a critical area in need of philosophical reflection, specifically reflection in feminist philosophy, philosophy of language, moral philosophy, and social and political philosophy. This dissertation seeks to advance the philosophy of microaggressions through three distinct aims: a conceptual aim (chapters 2 and 3), an epistemological aim (chapters 1 and 2), and a moral aim (chapters 4 and 5). The conceptual aim involves clarifying how we should understand and categorize microaggressions. The epistemological aim involves identifying some of the epistemological assumptions undergirding discussions of microaggressions in the literature, including assumptions made by critics of microaggression theory, and arguing for an alternative epistemological framework for theorizing about microaggressions. The moral aim involves better understanding the harms of microaggressions, including their role in reinforcing structures of oppression and unjust social hierarchy. Taken together, these chapters make some progress on the conceptual, epistemological, and moral questions that microaggressions generate, and which philosophers have not yet adequately analyzed. It thus offers a meaningful contribution to the conversations philosophers are beginning to have about the morally and politically salient phenomenon of microaggressions. (shrink)

The US Food and Drug Administration (FDA) is fraught with controversies over the role of values and politics in regulatory science, especially with drugs in the realm of reproductive health. Philosophers and science studies scholars have investigated the ways in which social context shapes medical knowledge through value judgments, and feminist scholars and activists have criticized sexism and injustice in reproductive medicine. Nonetheless, there has been no systematic study of values and gender norms in FDA drug regulation. I focus on (...) three questions about values in regulatory science. First, how have societal values and gender norms shaped the way that the FDA regulates drugs in the realm of reproductive health, specifically with drug labels? Second, what are the ethical, epistemic, and social consequences of these influences on regulation for women and other marginalized groups? Third, which societal values and gender norms ought to influence drug regulation about reproductive health, and how ought this happen? Integrating philosophical analysis with historical archival research and in-depth interviews, I conduct three case studies of drug labeling about reproductive health: (1) the “drug fact” about the mechanism of the morning-after pill; (2) the package inserts for patients about the health risks of oral contraceptives; and (3) the special physician labels made for prescribing drugs to pregnant women. I identify three challenges for the FDA and suggest ways to reduce the influence of sexist values and facilitate feminist alternatives. First, across these cases, I have found that there are many ways in which other concerns in reproductive medicine (such as zygotic life, fetal health, and population control) have devalued women’s health. Second, both knowledge and ignorance xvi about their reproductive health have contributed to women’s oppression, especially poor women and women of color. Finally, by avoiding the epistemic dimensions of ethics, powerful, mostly male parties in medicine (such as doctors, pharmaceutical companies, and religious institutions) have misused “informed consent,” “religious freedom,” and “paternalism” for unethical purposes. For improvement, I suggest extracting sexist values and gender norms from regulatory science that cause epistemic injustices, and I point to success stories for reforming sexism with feminism at the FDA. (shrink)