Bioethics has paid surprisingly little attention to the special problems faced by women and to feminist analyses of current health care issues other than ...

Fifteen original essays open up a novel area of inquiry: the distinctively ethical dimensions of women's experiences of and in aging. Contributors distinguished in the fields of feminist ethics and the ethics of aging explore assumptions, experiences, practices, and public policies that affect women's well-being and dignity in later life. The book brings to the study of women's aging a reflective dimension missing from the empirical work that has predominated to date. Ethical studies of aging have so far failed to (...) emphasize gender. And feminist ethics has neglected older women, even when emphasizing other dimensions of 'difference.' Finally work on aging in all fields has focused on the elderly, while this volume sees aging as an extended process of negotiating personal and social change. (shrink)

The use of aggregated quality of life estimatesin the formation of public policy and practiceguidelines raises concerns about the moralrelevance of variability in values inpreferences for health care. This variabilitymay reflect unique and deeply held beliefs thatmay be lost when averaged with the preferencesof other individuals. Feminist moral theorieswhich argue for attention to context andparticularity underline the importance ofascertaining the extent to which differences inpreferences for health states revealinformation which is morally relevant toclinicians and policymakers. To facilitatethese considerations, we present (...) an empiricalstudy of preferences for the timing andoccurrence of health states associated withhormone replacement therapy (HRT). Sixteenwomen between the ages of 45 and 55 wereenrolled in this pilot study. Theirpreferences regarding five health statesassociated with HRT (menopausal symptoms, sideeffects of HRT, breast cancer, myocardialinfarction, and osteoporosis) were assessed inquantitative terms known as utilities. Twostandard methods, the visual analog scale (VAS) and the standard gamble (SG), were used toassess utility and time preference (calculatedas a discount rate). The wide variability ofresponses underlines the importance oftailoring health care to individual women'spreferences. Policy guidelines whichincorporate utility analysis must recognize thenormative limitations of aggregatedpreferences, and the moral relevance ofindividual conceptions of health. (shrink)