This paper presents a relational account of autonomy showing that a technological imperative impedes autonomy through undermining women’s capacity to resist use of technology in the context of labor and birth. A technological imperative encourages dependence on technology for reassurance whenever possible through creating a (i) separation of maternal and fetal interests; and (ii) perceived need to use technology whenever possible. In response I offer an account of how women might promote autonomy through cultivating self-trust and self-confidence. Autonomy is not (...) simply a matter of choosing freely and acting on our choices, it is also a matter of possessing the ability to resist social contexts undermining choice and action. An important implication of this view is that respecting autonomy requires more than simply respecting persons’ ability to make and act on choices. Respecting patient autonomy requires a recognition of patients’ need to resist factors impeding autonomy and support for that resistance. (shrink)

In this article, we discuss decision making during labor and delivery, specifically focusing on decision making around offering women a trial of labor after cesarean section. Many have discussed how humans are notoriously bad at assessing risks and how we often distort the nature of various risks surrounding childbirth. We will build on this discussion by showing that physicians make decisions around TOLAC not only based on distortions of risk, but also based on personal values rather than medical data. As (...) a result of this, we will further suggest that the party who is best epistemically situated to make decisions about TOLAC is the woman herself. (shrink)

Breastfeeding has become a subject of moral concern as its benefits have become well known. Encouraging mothers to breastfeed has been the goal of extensive public health promotion efforts. Emmanuel Levinas makes absolute responsibility to the Other central to his ethics, with giving food to the Other the paradigmatic ethical act. However, Levinas also provides an important critique of the autonomous individual who is taken for granted by breastfeeding promotion efforts. I argue that the ethical obligation to feed the hungry (...) child must be recognized as coextensive with meeting the needs of women, especially given the current absence of important social and economic supports for breastfeeding. Under a Levinasian framework, each of us is ethically responsible for feeding children; this responsibility is not limited to mothers. This ethical responsibility needs to be expressed through improving social and economic supports necessary for those individuals who wish to breastfeed, instead of attempting to convince women to breastfeed. This ethical responsibility must also be understood in a broader context of a politics of hunger, which provides access to quality food for all, and goes beyond mere nutrition to include the importance of culture, touch, and intimacy in the enjoyment of food—what Levinas calls “good soup.”. (shrink)

This paper explores how law might conceive of the injury or harm of endocrine disruption as it applies to an aboriginal community experiencing chronic chemical pollution. The effect of the pollution in this case is not only gendered, but gendering: it seems to be causing the ‘production’ of two girl babies for every boy born on the reserve. This presents an opening to interrogate how law is implicated in the constitution of not just gender but sex. The analysis takes an (...) embodied turn, attempting to validate the real and material consequences of synthetic chemicals acting on bodies—but uncovers that finding a harm in a declining sex ratio depends on a static conception of the human form, based on unfounded assumptions of ‘naturalness’ and ‘normalcy’. Elizabeth Grosz’s theory of ‘becoming’ offers a compelling challenge, essentially pointing to the conclusion that we should find harm where we find illness and suffering and not simply where we find difference. At the same time, we cannot discount the political economy of the pollution: the paper concludes by returning the focus to the role of power, colonialism and the state in the perpetuation of the pollution on the landscape. (shrink)

Subpart B of 45 Code of Federal Regulations Part 46 (CFR) identifies the criteria according to which research involving pregnant women, human fetuses, and neonates can be conducted ethically in the United States. As such, pregnant women and fetuses fall into a category requiring “additional protections,” often referred to as “vulnerable populations.” The CFR does not define vulnerability, but merely gives examples of vulnerable groups by pointing to different categories of potential research subjects needing additional protections. In this paper, I (...) assess critically the role of this categorization of pregnant women involved in research as “vulnerable,” both as separate entities and in combination with the fetuses they carry. In particular, I do three things: (1) demonstrate that pregnant women qua pregnancy are either not “vulnerable” according to any meaningful definition of that term or that such vulnerability is irrelevant to her status as a research participant; (2) argue that while a fetus may be vulnerable in terms of dependency, this categorization does not equate to the vulnerability of the pregnant woman; and (3) suggest that any vulnerability that appends to women is precisely the result of federal regulations and dubious public perceptions about pregnant women. I conclude by demonstrating how this erroneous characterization of pregnant women as “vulnerable” and its associated protections have not only impeded vital research for pregnant women and their fetuses, but have also negatively affected the inclusion of all women in clinical research. (shrink)

To mitigate animal suffering under industrial farming conditions, biotechnology companies are pursuing the development of genetically disenhanced animals. Recent advances in gene editing biotechnology have brought this to reality. In one of the first discussions of the ethics of disenhancement, Thompson argued that it is hard to find compelling reasons to oppose it. We offer an argument against disenhancement that draws upon parallels with human disenhancement, ecofeminism’s concern with the “logic of domination,” and a relational ethic that seeks to preserve (...) a meaningful relationship between farmers and their animals. In addition, we respond to two arguments in favor of animal disenhancement—one grounded in the non-identity problem and one that argues disenhancement is the best we can do to protect animal well-being right now. We argue that animal disenhancement does not address the fundamental issue of oppression of animals in the context of contemporary animal agriculture. Therefore, we conclude that animal disenhancement is not nearly as valuable as it might appear initially. (shrink)

This paper demonstrates how the problematic kinds of epistemic power that physicians have can diminish the epistemic privilege that pregnant women have over their bodies and can put them in a state of epistemic powerlessness. This result, I argue, constitutes an epistemic injustice for many pregnant women. A reconsideration of how we understand and care for pregnant women and of the physician–patient relationship can provide us with a valuable context and starting point for helping to alleviate the knowledge/power problems that (...) are symptomatic of the current system and structure of medicine. I suggest that we can begin to confront this kind of injustice if medicine adopts a more phenomenological understanding of bodies and if physicians and patients—in this case, pregnant women—become what I call “epistemic peers.”. (shrink)

Going through reproductive experiences (especially pregnancy and childbirth) in contemporary Western societies almost inevitably involves interaction with medical practitioners and various medical technologies in institutional context. This has important consequences for women as embodied subjects. A critical appraisal of these consequences—coming dominantly from feminist scholarship—relied on a problematic theory of both technology and the subject, which are in contemporary approaches no longer considered as given, coherent and well individualized wholes, but as complex constellations that are locally situated and that can (...) only be described empirically. In this study, we will be relying on the developments in phenomenological theory to reconceptualize women as technologically mediated embodied subjects and on the new paradigms in philosophy of technology and STS to reconstruct medical technology as situated—with the aim of reconceptualizing their relationship and exploring different possibilities for the mediating role of medical technology. It will be argued that technologization of female reproductive processes and alienating consequences for women are not necessary or directly interrelated. The role of technology varies from case to case and depends mainly on the nontechnological and relational aspects of institutional context, in which medical practitioners play a decisive role. (shrink)