This installment of the Feminist Bioethics Scholar Spotlight series features Supriya Subramani, a lecturer at the University of Sydney in Australia who engages ethnographic and phenomenological methods to questions of morality, behavior, and attitudes in healthcare contexts. Dr. Subramani has a book forthcoming this month with Routledge entitled Passive Patient Culture in India: Disrespect in Law and Medicine. Read on to learn more about Dr. Subramani as she responds to our questions about how she relates to the field of bioethics, what she is currently working on and is excited about in her research, and what she does outside of her research, teaching, and scholarship. Her interview unpacks serious tensions internal to bioethics and those of us working within and sometimes against it, showing the value of feminist approaches to bioethics, but also the need for ongoing and critical reflection as we undertake feminist and bioethics related work, projects, and activism.

What drew you to bioethics?

I sit with this question, not as an easy point of arrival but as an ongoing reckoning now, especially when one imposes (or not) the labels as social scientist, bioethicist or philosopher. So, I will try to do a little of both here.

My journey into this disciplinary space began when I was hired as a project associate – a “data collector” – for a Wellcome Trust-funded research project: Medical Ideas, Tools, Ethics, and Pluralism in South India. Under the sub-project Patient Welfare and Patient Autonomy: Reflections on Biomedical Ethics in the Indian Context, I was introduced to discipline of bioethics by my Project Investigator, who was keen on the idea of “Indian Bioethics” with training in Western Philosophy (which I would find problematic given the romanticization which happens with upper-caste-class academics and distancing from everyday realities within Indian political context). As part of this project I encountered conversations with healthcare professionals, mostly doctors and surgeons, who confidently declared, “we value patient autonomy because we practice informed consent.” It was a claim wrapped in certainty, an ethical pronouncement that assumed its own completeness.

But I was not convinced, and when I got a five year University Grant Commission fellowship my doctoral work, I wanted to explore: what did they mean? What was at stake in these pronouncements? How is informed consent understood within law and healthcare spaces? I wanted to go beyond the professionals, beyond the formal language of ethics, and into the spaces where autonomy (or not) is not simply asserted or disregarded but lived–where patients and their families navigate hospitals, along with healthcare professional in both public and private, with varying degrees of lack of power and precarity. And as I listened, I began to see that informed consent or real/valid consent, a concept so readily taken for granted in law and medicine, was not just a procedural step but situated within a site of tension and struggle for respect, self-respect and recognition.

Over time, I let go of the idea that informed consent was the central problem to “solve.” It took me a while to find a language and vocabulary, to unlearn, due to my own educational training, lack of social capital and exposure. I refused to join the well-rehearsed conversation that treats it as a technical and ethics issue outside social and political context, an “old problem” for the North and a new one for the South to “catch up” on. Resisting the dominant trope of “data” vs. “theory” or “descriptive” vs “normative,” especially the notion that people who are not well-versed or trained in certain dominant ways, can only produce “data” and that our work cannot be conceptually, philosophically, or theoretically rich. Instead, I turned toward what was sustaining the very conditions in which respecting a person (patient), becomes an impossibility–the archetype of passive patient, the everyday indignities, the larger oppressive structures, the deeply hierarchical norms that shape Indian healthcare, and yet what agency means, and how true dignity can be a possibility. What does it mean to talk about self-respect, respect, and dignity when entire institutional cultures are built on disrespect and humiliation?

And so, I now sit with working and teaching within so-called bio/public health/global health ethics differently, I think. I resist its disciplinary parochialism, its gatekeeping practices, its desire to make ethics a bounded field rather than a lived, messy, contested practice. I think my own trajectory, spanning science, management, social work, youth work, training in critical qualitative inquiry, and marked by my shifting identities and experiences, has influenced my refusal to stay within boundaries, by an insistence on unlearning, by a need to center the voices of marginalized. With years of my life and work spent in India, having worked in Zurich and my ongoing working in Australia, I see beautifully and sadly the cracks within the system, again and again the same privilege and power, with different flavours, colors, and shades depending on historical, political and social context one lives in.

I think my lack of training to core disciplines or bioethics and openness to explore the concepts and ideas beyond discipline, meeting many liked-minded people who centre value commitments with integrity and openness to engage with questions, ideas and concepts, has opened me up to amazing unlearning spaces and approaches. Also, this distance from conventional bioethics, from its rigid disciplinary training, from its tools and methods that often obscure more than they reveal, has allowed me in the process of finding my own voice. With its own anxieties.

I remain skeptical of bioethics as an institution, as a discipline that polices its own boundaries and for those who continue to work for its legitimacy. And yet, within that skepticism, I find something worth holding onto–a space to engage in discourse that matters to us, to society, in a way that refuses abstraction, that refuses neutrality, that refuses to erase the realities of those who bear the weight of injustice.

Are there any particular problematic tropes in bioethics that you’d like to call out?

One of the most troubling tropes in bioethics, and increasingly in feminist and decolonial spaces, is the tendency to claim a commitment to justice while reproducing the very hierarchies these spaces critique. I have become particularly wary of institutions and individuals who invoke the language of decolonization and critical theory, rarely cite minoritized scholars if at all, and often actively take ideas from them without proper acknowledgment or citation (a pattern I have experienced personally and have heard echoed in countless stories from India and elsewhere). These same institutions and individuals assume that diversity alone accomplishes the work of anti-racism or decolonization, without working on structures which creates and sustain these conditions.

There is a growing pattern where a narrow tick box exercise of diversity, even though now it has been increasingly targeted (which is a topic demanding its own attention!), including through positionality statements in conferences and journal articles, or bringing diverse scholars on projects, serves as a performative nod to decoloniality, rather than a substantive engagement with its radical demands. Especially when we think of settler colonial contexts, like Australia, the conversation then becomes a reckoning with ongoing colonial and imperial legacies and how as settlers we need to reflect on our complicity and ask what does mean for us to do “bioethics” in these spaces where land is fundamental for self-determination and sovereignty becomes central.

What concerns me most is how these decolonial claims often gain legitimacy through individuals who are closer to whiteness and power. This proximity allows us/them to survive and thrive in academic spaces sometimes, while more marginalized scholars remain on the periphery, our voices co-opted (or we co-opt) but not meaningfully engaged with. The question we need to ask is whether these practices genuinely contribute to dismantling colonial structures, or whether they merely perpetuate coloniality and imperial ways of producing knowledge. And how much of us, who categorize as minoritized, are also playing this game to survive and without thinking about the cost it takes.

As I’ve briefly argued in my recent work on reflexivity, we must take a hard look at our disciplines and the ways we ride new waves to retain money, power, and privilege under the guise of theorization and knowledge production. We need to scrutinize how our disciplines function under the guise of priority setting – particularly how funding is distributed, which topics are deemed important, and who gets to lead these conversations. The answer is not simply funneling more resources to a select few in the South or funding a handful of Black and Brown scholars in elite institutions, without engaging with complicity with each other and discomfort this work demands, for politics of feeling good for our privileged/often white souls. Instead, it requires addressing the deep, systemic injustices that shape whose knowledge is valued and whose struggles are rendered invisible. We cannot naively assume that placing a few marginalized scholars in positions of visibility will work like magic. Real change demands that we interrogate our own privilege, complicity, and power in the survival games of academia–and that we hold ourselves accountable beyond moments of convenience.

As a mid-career scholar (just five months short of being eligible for early-career status under the institution’s criteria) still navigating my voice and space within this community, I long for more genuine conversations and for scholars, peers, and leadership who are willing to take a stand when it truly matters–not selectively, not only when the broader climate makes it safe to do so. Not to practice Time-lagged Solidarity! The ongoing genocide and dehumanization of Palestinians have made this even more apparent. The silence–or worse, the deliberate distancing and disciplining–of many bioethicists and academics, and institutional silence, in this moment is deeply disheartening. It raises fundamental questions about the moral compass of a field that claims to be concerned with justice.

Bioethics, like many other disciplines, needs to reckon with the uncomfortable truth that it is not exempt from the structures of power and exclusion it critiques. If it fails to do so, it risks becoming yet another space where critical language is co-opted, stripped of its radical potential, and used to sustain the very inequities it claims to resist. My hope is to be part of a community and collective within these academic spaces, where we can flourish and create spaces that allow us to find our voices–voices that can free us all and lead to liberation in ways that stay true to our values. This is especially important for those who are willing to sit with discomfort, work through challenges to find meaning, and engage in work that truly matters for communities whose voices are often unheard and oneself. I feel privileged to be in this moment and to have the opportunity to write this, which is not perfect or easy often, and certainly costs sometimes. I hope to continue being part and search for this academic community, the so-called discipline of bioethics and elsewhere as I sit at margins of different fields, where I can practice alongside those who show ways to subvert and transform these academic spaces.

What next directions in your research are you most excited about?

I am excited to continue exploring reflexivity – not just as a concept, but as a practice of unlearning and relearning. My current book project, Practicing Reflexivity, is where I’m trying to work through some of these ideas, drawing from my own experiences of questioning methods, disciplines, and the ways we engage with knowing and politics of it.

My ongoing work on othering and belonging, particularly within migrant health ethics discourse, has been a way to connect the dots across my earlier projects. Recently, building on my work on the ethics of belonging, I’ve been experimenting with ways to move beyond traditional academic outputs and translate the theorization of it to practice. One approach has been through Theatre of the Oppressed, where theory is not just written about but enacted in everyday conversations within diverse communities. This process has made me reflect more on why we do research, who it is for, and why we often limit knowledge to journal articles when there are many other ways to create impact.

Another project I’m particularly excited about is my ethnographic research on chronic pain among rural women in India, which I’m finally able to start. This has been something I’ve wanted to do for a long time, and now that it’s coming together, I feel both excitement and a sense of lifetime responsibility, which any research should be. While I have been preparing for this, I also know that much of what I will learn will come from being in there, from listening, and from allowing myself to be challenged and resist in ways I can’t yet predict.

For now, excited to the uncertainties that come with these works. I expect to be surprised, to unlearn, and to rethink some of my own assumptions. And that, in itself, is something I look forward to.

What’s your favorite thing to do when you’re NOT doing bioethics, that you feel comfortable sharing?

These days, when I am not rage writing, and working through with some exhaustion at the site of violence and hypocrisy, I’m usually unwinding with a good thriller, fantasy, or drama – because nothing says relaxation like morally complex characters making questionable life choices. I also love reading black feminist scholarship and Kannada literature (working on it still), going for walks with my partner, and dancing. Fun fact: I used to be a mini-celebrity thanks to a reality TV show stint and several state and national dance competitions. Now, my dance floor is mostly my living room, where I am both the performer and the audience, and sometimes my partner!

Beyond that, I enjoy long hikes, one-on-one conversations, and hosting people at home. Moving across countries has been both a privilege and a logistical and emotional workout–it takes effort to keep up with the things I love. During much of my childhood, especially at my grandparents’ place, I loved walking up the hills and playing in rivers and streams with my cousins and aunties, and I still miss it. My love for hiking grew when I was in Zurich – being surrounded by mountains, breathing in fresh air, and gazing at the open sky brought me pure joy. The freedom to take solo trips without constantly watching for snakes or worrying about safety gave me a sense of independence, something I missed in India.

Since moving to Sydney, I’ve channeled some of my energy into inviting people over, cooking, and having long, and sometimes looking for ways connect and belong in a community. And when I’m not doing that, you’ll probably find me wandering along waterfronts, nearby beach or sometimes near national parks.

Thanks so much for sharing so much of yourself, your work, and your other interests with us, Supriya!