In recent decades, the intertwining ideas of self-determination and well-being have received tremendous support in bioethics. Discussions regarding self-determination, or autonomy, often focus on two dimensions—the capacity of the patient and the freedom from external coercion. The practice of obtaining informed consent, for example, has become a standard procedure in therapeutic and research medicine. On the surface, it appears that patients now have more opportunities to exercise their self-determination than ever. Nonetheless, discussions of patient autonomy in the bioethics literature, which (...) focus on individual patients making particular decisions, neglect the social structure within which health-care decisions are made. Looking through the lens of disability and informed by the feminist conception of relational autonomy, this essay argues that the issue of autonomy is much more complex than the individualist model suggests. The social system and the ableist ideology impose various forms of pressure or oppressive power that can affect people’s ability to choose according to their value system. Even if such powers are not directly coercive, they influence potential parents’ decisions indirectly—they structure their alternatives in such a way that certain options are never considered as viable and other decisions must be made. This paper argues that, instead of only focusing on the individual act of decision-making, we need to pay attention to the social structure that frames people’s decision. (shrink)

Controversial and provocative, To Be Real is a blueprint for the creation of a new political force.

In this essay a selection of images of women Olympians who have opted to pose nude in calendars, in Playboy magazine and in mainstream men's magazines is critically analysed. It is argued that when women athletes pose nude, their talent and incredible skill are trivialised because they are sexually objectified. Based on Nussbaum's theory of objectification, a continuum is developed to analyse the said images. The analysis highlights theories of sexualisation, heteronormative culture, and homophobia which are entangled within the apparent (...) justifications for posing nude. These are rejected in favour of the objectification critique. (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)

Nurse practitioners (NPs) are increasingly called on to provide high‐quality health‐care particularly for people who face significant barriers to accessing services. Although discourses of social justice have become relatively common in nursing and health services literature, critical analyses of how NP roles articulate with social justice issues have received less attention. In this study, we examine the role of NPs from a critical social justice perspective. A critical social justice lens raises morally significant questions, for example, why certain individuals and (...) groups bear a disproportionate burden of illness and suffering; what social conditions contribute to disparities in health and social status; and what social mandate NPs ought to develop in response to these realities. In our analysis, we draw on lessons learned from the initial Canadian experience with the introduction of NPs in the 1970s to consider the renewed and burgeoning interest in NPs in Canada, Australia and elsewhere. As we argue, a critical social justice perspective (in addition to the biomedical foci of NP practice) will be essential to sustaining long‐term, socially responsive NP roles and achieving greater equity in health and health‐care. (shrink)