If personhood involves the construction of a narrative identity, then what are we to say of someone who is seriously ill or disabled? How can her life have any narrative when she is unable to write one?

Two rival paradigms permeate bioethics. One generally favors eugenics, euthanasia, assisted suicide and other methods for those with severely restricting physical and cognitive attributes. The other typically opposes these and favors instead ample support for "persons of difference" and their caring families or loved ones. In an attempt to understand the relation between these two paradigms, this article analyzes a publicly reported debate between proponents of both paradigms, bioethicist Peter Singer and lawyer Harriet McBryde Johnson. At issue, the article concludes, (...) are two distinct axiomatic sets of values resulting in not simply different styles of rhetoric but different vocabularies, in effect two different languages of ethics. (shrink)

For all its apparent debate bioethical discourse is in fact very narrow. The discussion that occurs is typically within limited parameters, rarely fundamental. Nor does it accommodate divergent perspectives with ease. The reason lies in its ideology and the political and economic perspectives that ideology promotes. Here the ideology of bioethics' fundamental axioms is critiqued as arbitrary and exclusive rather than necessary and inclusive. The result unpacks the ideological and political underpinnings of bioethical thinking and suggests new avenues for a (...) broader debate over fundamentals, and a different approach to bioethical debate. (shrink)

The term community in ethics and bioethics traditionally has been used to designate either a specific kind of moral relationship available to rational agents or, in contrast, the context in which any sense of rational agency can even be understood. I argue that bioethics is better served when both selves and community are expressed through a more processive language that highlights the functional character of such concepts. In particular, I see the turn to processive community in bioethics as a turn (...) towards method, contextualization, and narrative. In clinical practice, such a processive account demands that bioethics concentrate on methods of developing healthy dialogue and deeper understanding from within the problematic situation rather than trying to fix problems using ethical tools developed from outside the present situation. Community, I argue, is in and of the interactive processes of inquiry itself. Such inquiry, such communitying, requires that we engage individual patients in context; it demands more than simply gaining their permission or mere consent; it demands developing a supportive environment for participation. (shrink)

When a child is born with ambiguousgenitalia it is declared a psychosocialemergency, and the policy first proposed byJohn Money andadapted by the American Academy of Pediatrics requires determination ofunderlying condition, selection of gender,surgical intervention, and a commitment by allparties to accept the ``real sex'' of thepatient, all no later than 18–24 months,preferably earlier. Ethicists have recentlyquestioned this protocol on several grounds:lack of medical necessity, violation ofinformed consent, uncertainty of standards ofsuccess, among others. This suggests that thefaults in the protocol can (...) be addressed andimproved. Through a rhetorical approachinformed by Perelman/Olbrechts-Tyteca, thedisciplinary pathologization and reconstructionof the body are explored as incidents ofconstraining rhetoric that enact theirpersuasion upon the body of intersexedchildren. This essay shows that thepresumptions, judgments, values, andpresuppositions brought by the physician to theidentification, diagnosis, and curativeprocedures create a network of constraints thatexclude alternative possibilities. The resultis a situation wherein parents, physicians, andintersexed patients have ``no choice'' but toaccept the medical treatment guidelines. (shrink)

Theories of social justice are necessarily abstract, reaching beyond the particular and the immediate to the general and the timeless. Yet such theories, addressing the world and its problems, must respond to the real and changing dilemmas of the day. A brilliant work of practical philosophy, Frontiers of Justice is dedicated to this proposition. Taking up three urgent problems of social justice neglected by current theories and thus harder to tackle in practical terms and everyday life, Martha Nussbaum seeks a (...) theory of social justice that can guide us to a richer, more responsive approach to social cooperation. The idea of the social contract--especially as developed in the work of John Rawls--is one of the most powerful approaches to social justice in the Western tradition. But as Nussbaum demonstrates, even Rawls's theory, suggesting a contract for mutual advantage among approximate equals, cannot address questions of social justice posed by unequal parties. How, for instance, can we extend the equal rights of citizenship--education, health care, political rights and liberties--to those with physical and mental disabilities? How can we extend justice and dignified life conditions to all citizens of the world? And how, finally, can we bring our treatment of nonhuman animals into our notions of social justice? Exploring the limitations of the social contract in these three areas, Nussbaum devises an alternative theory based on the idea of capabilities. She helps us to think more clearly about the purposes of political cooperation and the nature of political principles--and to look to a future of greater justice for all. (shrink)

_Slow Cures and Bad Philosophers_ uses insights from the philosophy of Ludwig Wittgenstein to rethink bioethics. Although Wittgenstein produced little formal writing on ethics, this volume shows that, in fact, ethical issues permeate the entirety of his work. The scholars whom Carl Elliott has assembled in this volume pay particular attention to Wittgenstein’s concern with the thick context of moral problems, his suspicion of theory, and his belief in description as the real aim of philosophy. Their aim is not to (...) examine Wittgenstein’s personal moral convictions but rather to explore how a deep engagement with his work can illuminate some of the problems that medicine and biological science present. As Elliott explains in his introduction, Wittgenstein’s philosophy runs against the grain of most contemporary bioethics scholarship, which all too often ignores the context in which moral problems are situated and pays little attention to narrative, ethnography, and clinical case studies in rendering bioethical judgments. Such anonymous, impersonal, rule-writing directives in which health care workers are advised how to behave is what this volume intends to counteract. Instead, contributors stress the value of focusing on the concrete particulars of moral problems and write in the spirit of Wittgenstein’s belief that philosophy should be useful. Specific topics include the concept of “good dying,” the nature of clinical decision making, the treatment of neurologically damaged patients, the moral treatment of animals, and the challenges of moral particularism. Inspired by a philosopher who deplored “professional philosophy,” this work brings some startling insights and clarifications to contemporary ethical problems posed by the realities of modern medicine. _Contributors._ Larry Churchill, David DeGrazia, Cora Diamond, James Edwards, Carl Elliott, Grant Gillett, Paul Johnston, Margaret Olivia Little, James Lindemann Nelson, Knut Erik Tranoy. (shrink)

In ____Bodies That Matter,__ Judith Butler further develops her distinctive theory of gender by examining the workings of power at the most "material" dimensions of sex and sexuality. Deepening the inquiries she began in _Gender_ _Trouble,_ Butler offers an original reformulation of the materiality of bodies, examining how the power of heterosexual hegemony forms the "matter" of bodies, sex, and gender. Butler argues that power operates to constrain "sex" from the start, delimiting what counts as a viable sex. She offers (...) a clarification of the notion of "performativity" introduced in _Gender Trouble_ and explores the meaning of a citational politics. The text includes readings of Plato, Irigaray, Lacan, and Freud on the formation of materiality and bodily boundaries; "Paris is Burning," Nella Larsen's "Passing," and short stories by Willa Cather; along with a reconsideration of "performativity" and politics in feminist, queer, and radical democratic theory. (shrink)

"In these essays, health care professionals, scholars, and members of the disability community debate the implications of prenatal testing for people with disabilitties and for parent-child relationships generally."--Cover.

The book constitutes a reconsideration of her earlier view on gender performativity from Gender Trouble. In this work, the critique of gender norms is clearly situated within the framework of human persistence and survival.

In ____Bodies That Matter,__ Judith Butler further develops her distinctive theory of gender by examining the workings of power at the most "material" dimensions of sex and sexuality. Deepening the inquiries she began in _Gender_ _Trouble,_ Butler offers an original reformulation of the materiality of bodies, examining how the power of heterosexual hegemony forms the "matter" of bodies, sex, and gender. Butler argues that power operates to constrain "sex" from the start, delimiting what counts as a viable sex. She offers (...) a clarification of the notion of "performativity" introduced in _Gender Trouble_ and explores the meaning of a citational politics. The text includes readings of Plato, Irigaray, Lacan, and Freud on the formation of materiality and bodily boundaries; "Paris is Burning," Nella Larsen's "Passing," and short stories by Willa Cather; along with a reconsideration of "performativity" and politics in feminist, queer, and radical democratic theory. (shrink)