Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

Informed consent is a central topic in contemporary biomedical ethics. Yet attempts to set defensible and feasible standards for consenting have led to persistent difficulties. In Rethinking Informed Consent in Bioethics Neil Manson and Onora O'Neill set debates about informed consent in medicine and research in a fresh light. They show why informed consent cannot be fully specific or fully explicit, and why more specific consent is not always ethically better. They argue that consent needs distinctive communicative transactions, by which (...) other obligations, prohibitions, and rights can be waived or set aside in controlled and specific ways. Their book offers a coherent, wide-ranging and practical account of the role of consent in biomedicine which will be valuable to readers working in a range of areas in bioethics, medicine and law. (shrink)

Feminism is the movement to end women’s oppression. One possible way to understand ‘woman’ in this claim is to take it as a sex term: ‘woman’ picks out human females and being a human female depends on various anatomical features (like genitalia). Historically many feminists have understood ‘woman’ differently: not as a sex term, but as a gender term that depends on social and cultural factors (like social position). In so doing, they distinguished sex (being female or male) from gender (...) (being a woman or a man), although most ordinary language users appear to treat the two interchangeably. More recently this distinction has come under sustained attack and many view it nowadays with (at least some) suspicion. This entry (around 12 000 words in length) outlines and discusses distinctly feminist debates on sex and gender. (shrink)

Trust is taken to be one of the foundational values in the doctor-patient relationship, facilitating access to the benefits of health care and providing a guarantee against possible harms. Despite this foundational role, some doctors betray the trust of their patients. Trusting involves granting discretionary powers and makes the truster vulnerable to the trustee. Patients trust medical practitioners to act with goodwill and to act competently. Some patients carry pre-existing vulnerabilities, for reasons such as gender, poverty, age, ethnicity, or disability, (...) and these vulnerabilities can be exacerbated when such patients extend their trust to a doctor. Gender stereotypes reduce women's ability to challenge and thereby assess their doctor's competency. In addition, women are more likely to be distrusted by their doctors and have their experiences of medical symptoms discounted. In this paper, we analyze two extreme examples of breaches of medical trust that exploited the vulnerability of women in the health care system: the "unfortunate experiment" at the National Women's Hospital in New Zealand and the Harold Shipman murders of elderly patients in the United Kingdom, examining the potential role of gender in the outcomes with regard to trust. Major breaches of medical trust such as these typically lead to government inquiries, revisions of ethical guidelines, and substantive policy change in an effort to re-establish public and patient trust. We argue that the medical profession has an ethical obligation to put mechanisms in place to protect vulnerable patients from abuses of trust, to monitor colleagues' competence, and to be prepared to blow the whistle to protect patients who are not in a position to recognize misplaced trust. Such mechanisms will act disprosportionately to reduce harm to women as patients. (shrink)

Approximately 47 percent of women ages fifteen to forty‐four are currently without children, and slightly more than 20 percent of white women in America will never bear children, the highest percentage in modern history. Many fertile women who are childless are voluntarily so. Although any competent person twenty‐one years or older is legally eligible for voluntary sterilization, many doctors refuse to sterilize childfree women. This essay explores various reasons a woman would want to continue in her childfree lifestyle, evaluates the (...) accessibility of sterilization for women who are childfree by examining the reported reasons for denial of sterilization—both from the woman's and the physician's perspective—and assesses the legal status of voluntary sterilization for nonparous women. The essay also urges physicians to follow recommended guidelines for counseling women who, regardless of parity, desire sterilization and to provide this contraception if, after careful consideration, there are no outstanding health or other reasons that the procedure should not be performed. (shrink)

Philosophers who have written about implicit bias have claimed or implied that individuals are not responsible, and therefore not blameworthy, for their implicit biases, and that this is a function of the nature of implicit bias as implicit: below the radar of conscious reflection, out of the control of the deliberating agent, and not rationally revisable in the way many of our reflective beliefs are. I argue that close attention to the findings of empirical psychology, and to the conditions for (...) blameworthiness, does not support these claims. I suggest that the arguments for the claim that individuals are not liable for blame are invalid, and that there is some reason to suppose that individuals are, at least sometimes, liable to blame for the extent to which they are influenced in behaviour and judgment by implicit biases. I also argue against the claim that it is counter-productive to see bias as something for which individuals are blameworthy; rather, understanding implicit bias as something for which we are liable to blame could be constructive. (shrink)

Research programs in empirical psychology from the past two decades have revealed implicit biases. Although implicit processes are pervasive, unavoidable, and often useful aspects of our cognitions, they may also lead us into error. The most problematic forms of implicit cognition are those which target social groups, encoding stereotypes or reflecting prejudicial evaluative hierarchies. Despite intentions to the contrary, implicit biases can influence our behaviours and judgements, contributing to patterns of discriminatory behaviour. These patterns of discrimination are obviously wrong and (...) unjust. But in remedying such wrongs, one question to be addressed concerns responsibility for implicit bias. Unlike some paradigmatic forms of wrongdoing, such discrimination is often unintentional, unendorsed, and perpetrated without awareness; and the harms are particularly damaging because they are cumulative and collectively perpetrated. So, what are we to make of questions of responsibility? In this article, we outline some of the main lines of recent philosophical thought, which address questions of responsibility for implicit bias. We focus on (a) the kind of responsibility at issue; (b) revisionist versus nonrevisionist conceptions of responsibility as applied to implicit bias; and (c) individual, institutional, and collective responsibility for implicit bias. (shrink)

The roles of women and of feminine identity have been historically and traditionally constructed around motherhood. However, recent years have seen a growing trend among women to remain childless/ childfree. Drawing on interviews with 25 voluntarily childless women, this article considers the extent to which this trend results from the appeal or pull of the perceived advantages of a childfree lifestyle as well as the ways childfree women might represent a more fundamental and radical rejection of motherhood and the activities (...) associated with it. The article concludes by considering how to recast understandings of feminine identity away from a mother-centered focus. (shrink)

Forthcoming, Journal of Philosophy [pdf manuscript].

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

In her long-awaited Responsibility for Justice, Young discusses our responsibilities to address "structural" injustices in which we among many are implicated, often by virtue of participating in a market, such as buying goods produced in sweatshops, or participating in booming housing markets that leave many homeless.