IJFAB Blog | Official Blog of IJFAB: the International Journal of Feminist Approaches to Bioethics

“The Philosophical Treatments of Miscarriage and Pregnancy Loss”

Posted on March 26, 2015 by Patrick J. WelshMarch 26, 2015

The first-ever collection on philosophical treatments of miscarriage and pregnancy loss is also the first entirely Open Access issue of Journal of Social Philosophy. The creation of the Special Issue: Miscarriage, Reproductive Loss, and Fetal Death is motivated by the fact that miscarriage is widely experienced — yet the phenomenon of miscarriage remains shockingly under-theorized. Philosophers have written about abortion and about pregnancy, but until now we could count philosophical works on miscarriage on the fingers of one hand.

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Four reports from an afternoon on Thomas Piketty at the LSE, Part 4:
The local and the global

Posted on March 23, 2015 by Lynette ReidMarch 14, 2015

The LSE half-day discussing Piketty’s Capital in the Twenty-first Century and the implications of rising inequality for politics and policy closed with a focus on local social policy dimensions and global politics. This is the last of four blog posts describing the event—and I hope it will inspire you to take up some of the questions it raises.

Kitty Stewart, a researcher in early childhood development policy, took us from politics to social policy. Her general criticisms of Piketty were around his narrow focus on vertical inequality, ignoring the real if limited progress that has been made on horizontal inequalities (e.g. race and gender), and (joining the chorus, but in a different key) his focus on wealth. Her concern here was that Piketty limits himself to discussing wealth inequality without really asking what wealth is for, as Nancy Fraser would have us ask. I agree that this is a serious limitation in Piketty’s analysis. Continue reading →

Four reports from an afternoon on Thomas Piketty at the LSE, Part 3:
Piketty, politics, and policy

Posted on March 20, 2015 by Lynette ReidMarch 14, 2015

The Comparative and International Political Economy group at the LSE hosted a half-day discussion of Thomas Piketty, politics, and social policy, on the growing economic inequalities that Piketty and his collaborators document and what can be done about them, based on Piketty’s Capital in the Twenty-first Century. I had the good fortune to be in attendance just after signing off on edits on my review essay about Piketty and bioethics for IJFAB 8.2. This is the third of four blog posts describing the event.

One feature of this UK winter, apart from our enjoying an unusual allotment of sunshine, is that nothing can be accomplished—groceries sold, hair salon services offered, or intellectual phenomena critiqued—without reference to Fifty Shades of Grey. Robert Wade asked whether Capital’s sales figures will hold up, or drop off a cliff the way those of Fifty Shades did—asking, of course, not about retail strategy but about impact.

Wade traced Capital’s success to middle class anxiety about the changing prospects for their children and disbelief at the outcome of the financial crisis. The book is like a self-help book: it explains why you’re feeling anxious, and affirms that a lot of people like you are also feeling anxious. But will the interest endure, and will it shift public policy? The elites aren’t really afraid today, the way they were when the social state was built and public policy compressed income inequality in the 20th century. From his perspective in international development, Wade raised the whole story of the shift of production to the Asian workforce, the loss of economic power and disintegration of family life for the poor in the “west,” and the process of “financialization” in global markets and societies, with its soaring incomes for some in the financial sector. His criticisms are online here and here. Continue reading →

Lessons Great and Small

Posted on March 19, 2015 by Monique LanoixMarch 19, 2015

Oliver Sacks gave the Beatty lecture on the mysteries of the brain at McGill University in Montréal in October of 1997. I had the pleasure of being one of the many attending this exciting lecture. I write “exciting” as Sacks has a special gift for transmitting his love of neurology. In fact, to say that Sacks appreciates neurodiversity would be a gross understatement: he holds it in wonder. In this lecture, he explained that while in residency he was told by his supervisor to visit a patient who had dementia. The chief resident believed that Sacks only needed to spend a few minutes there and that he would be acquainted well enough with dementia. However, as Sacks recounts it, he was fascinated by this patient and the phenomenon of dementia and kept returning to visit with the patient. This struck me; many individuals consider people who have dementia as simply “out of it”. In my encounter with healthcare professionals in nursing homes, it has been the case that they usually consider those with dementia at times annoying, most of the time tolerable but certainly not fascinating. Yet, here was this neurologist, who knew how brains work optimally and who took the time to be in the presence of someone whose brain did not function in a regular way. For Sacks, it is a wonder that some brains have a different take on reality. In Sack’s perception, it does not need to be corrected necessarily; it is simply fascinating. He accepts diversity as one of those facts of life that so interesting. Sacks, in all his writings, and especially in person conveys his unwavering sense of wonder at other brains and other ways of apprehending the world. He truly appreciates diversity. This is a rare gift and luckily for us he also possesses another gift which is the capacity for sharing this sense of amazement. We can all thank him for the rigorous work he had undertaken in neurology but also for the manner in which he has never ceased to share his findings and most of all his sense of wonder and appreciation of diversity. To be able to accept this diversity and simply marvel at it, is a great lesson he has imparted to us; for this, I will always be grateful.

Continue reading →

Four reports from an afternoon on Thomas Piketty at the LSE, Part 2

Posted on March 18, 2015 by Lynette ReidMarch 14, 2015

A group of political science and social policy faculty gathered at the LSE on March 9 to foster the conversation around politics and social policy in an era of widening inequalities. As I wrote in my last post, I have a review essay on this question for bioethics coming out in IJFAB, and was able to go down to London from my sabbatical perch in Birmingham to be at the session. This second post takes us into some detail about economists’ critiques of Piketty. If it’s too much, wait for the next posts and we’ll be back to politics and policy.

The political economist David Soskice kicked off the day asking whether Piketty was setting the discussion of inequality off on the right foot: does Piketty’s focus on the 1% distract us from where our concern should lie—with the poor and their needs? Other participants defended Piketty on this point: economists have long studied the poor as the problem to be solved, rather than turning their attention to the rich as the problem to be solved (others are turning the discussion in that direction, for example Paul Piff). While the global absolute poverty rate may be falling (not a topic of discussion in the afternoon), the share that the poor enjoy in wealthy countries gets smaller and smaller. Studying poverty as the problem is blaming the victim, in essence. Continue reading →

Economic inequality, politics, and social policy:
Four reports from an afternoon on Thomas Piketty at the LSE, Part 1

Posted on March 16, 2015 by Lynette ReidMarch 14, 2015

What does the Occupy Wall Street slogan of the 99% and the 1% have to do with bioethics? I have just worked through edits with Kate Caras, our senior managing editor at IJFAB, of my review essay, “Piketty and the body” (forthcoming in the fall, issue 8.2).

Thomas Piketty, if you missed the excitement last year, is the French economist who, with many collaborators, is doing the rigorous economic analysis behind the OWS slogans. He and his collaborators have demonstrated not just the increasing concentration of income but also (more controversially) the increasing accumulation of wealth over the course of the last decades. In his Capital in the 21st Century—a surprisingly readable 700-page tome—he proposes the market mechanisms behind this, which he calls the fundamental laws of capital, the tendency of wealth (measured in ratio to income, called β) to accumulate when the rate of return on capital is greater than the rate of economic growth—or, as his famous formula has it, r > g. His conclusion, in its broadest terms, is that without the political will and appropriate policy—or the destruction of wealth brought about by the kinds of wars we saw in the 20th century—inequality will once again reach the dizzying heights of the 18th and 19th centuries. We’ll all be living in a world like that of Jane Austen or Honoré de Balzac, trying to marry into the right family, rather than focusing on the development of our own skills and talents. In short we’ll leave behind our meritocracy for a world dominated by questions of inheritance. (How real that meritocracy has been is open to debate, of course. See, for a recent example, Chris Bertram on Rawls and Piketty at Crooked Timber here.)

If you’re not ready to read 700 pages, you can read a reasonable summary at the New Republic by Robert Solow here, and the 4-page version of the data that Piketty and his Berkeley collaborator Emmanuel Saez wrote up for Science Magazine is here.

The idea that economic wellbeing has an influence on health is the most obvious relevance of Piketty to bioethics, of course. The connection (among others) is indicated by the idea of the “social determinants of health.” In my forthcoming review essay, I discuss a few more specific connections between rising inequality and accumulating wealth and health/healthcare. The issue that Piketty is trying to focus public debate on is around wealth accumulation. He challenges us to ask the question: what would a more egalitarian world look like when it comes to ownership of capital? Continue reading →

A Fictive Reality:
Science Fiction, Dystopia, and Assisted Reproduction

Posted on March 11, 2015 by Patrick J. WelshMarch 11, 2015

Guest post by Alana Cattapan (York University, Dalhousie University)

The use of science fiction to make sense of reproductive technologies is nothing new.

As new advances in assisted reproduction make headlines, journalists, politicians, and policymakers alike herald their trajectory “from sci-fi to reality,” lauding or lamenting their potential emergence in the mainstream.

In debates on assisted reproduction, mentioning these works seems to allow commentators to articulate their deep-rooted fears about the implications of unfamiliar technologies. There is something about changing the nature of human reproduction that many find unsettling, and literary works help people work through these issues and to use them as a kind of shorthand to describe a range of concerns. To this end, science writer Philip Ball recently wrote in The Guardian that stories about intervention in procreation—science fiction or otherwise— “do the universal job of myth, creating an ‘other’ not as a cautionary warning but in order more safely to examine ourselves.” However, the use of fiction in policy debates may also serve a more pernicious function.

In the long road to what would eventually become the Assisted Human Reproduction Act, stakeholders, parliamentarians, academics, and journalists made appeal after appeal to science fiction to evoke a sense of urgency and fear about what assisted reproductive technologies might bring. References to Brave New World, Frankenstein, The Island of Dr. Moreau, and The Handmaid’s Tale are found in policy documents, parliamentary debates, media reports, and responses from stakeholders, often with the intention of demonstrating science’s “temptation of going too far” or to evoke fear and abhorrence about the possibility of reproduction without women; “manipulating the most fundamental of all human relationships.” Continue reading →

Compounding the Harm of Normalizing Treatment of Intersex

Posted on March 6, 2015 by Ellen FederMarch 8, 2015

Update 3/8/14: Advocates for Informed Choice just posted an annotated video of the segment, and it is fantastic.

A recent Nightlight segment featured a promising story of the treatment of individuals born with atypical sex anatomies. It included the story of M.C., whose parents’ legal cases against the attending physicians and the state of South Carolina may be found here.

The most dramatic moment of the segment was the encounter between intersex activist Sean Saifa Wall and Terry Hensle, the Columbia University urologist who performed feminizing surgery when Wall was 13. (The reporter misleadingly recounts that this surgery “turned [Wall] biologically into a girl,” as if the removal of testes defined femaleness.) Wall, who had not felt like a girl as a child, transitioned in his mid-twenties.

When viewers are introduced to Hensle, he explains in response to the reporter’s question that parents are grateful for his work, and grants that as much as he might have enjoyed “playing God,” as the reporter suggested, “it was not,” he says, “the right thing to do.” He enthusiastically affirmed the value of hearing from former patients who had undergone normalizing interventions in the past, and readily agrees to a meeting with Wall, his former patient. Continue reading →

#LikeAGirl: Girl Power & The Persistence of Difference

Posted on March 6, 2015 by Ula KleinMarch 5, 2015

During this year’s Super Bowl, the feminine hygiene company Always released a commercial-cum-PSA that brought renewed interest to and awareness of the hashtag #LikeAGirl. The ad was by far one of the most moving spots that aired during the Super Bowl, as it featured boys and girls of various ages explaining both the negative meaning of the phrase as well as the ways in which the phrase might be reinvented.

At the heart of the campaign is the issue of girls’ self-esteem, which, studies have shown, drops dramatically for many young women during puberty. This is the same age at which girls traditionally become less interested in math and science. It is also an age commonly associated with school bullying, the start of dating and sexual exploration, and, in general, being pretty awful.

The ad suggests changing (rebranding?) the phrase “like a girl” to mean something else. Rather than meaning that something is weaker, inferior, sillier, or less skilled, “like a girl” could mean that something is done with strength, courage, skill, dedication, precision, accuracy, and passion. A search on Twitter reveals that #likeagirl is being used in various ways, most notably to draw attention to women who are making successful forays into male-dominated spheres.

While the effectiveness of hashtags is debatable when it comes to agitating for real change, what interests me more is the implicit and normative notion of sexual and gender difference in the campaign, as well as its problematic simplification of embodiment. Continue reading →

Innovative Techniques in Human Reproduction:
An ethical controversy

Posted on March 2, 2015 by Ruth MacklinFebruary 28, 2015

The Human Fertilisation and Embryology Authority (HFEA), a governmental regulatory agency in the United Kingdom, is ready to allow a technique that prevents women with mitochondrial DNA disease from transmitting the faulty DNA to their children. The HFEA position follows affirmative votes by both houses of the British Parliament (House of Commons and House of Lords), making the procedure legal in that country.

First, some background. Mitochondria are the cell’s chief source of energy. Mitochondrial disease is a group of disorders caused by dysfunctional mitochondria, the organelles that generate energy for the cell.

Two different procedures involve the use of healthy mitochondria from a donor egg, which means that genetic material from two women is used to create an embryo free of mitochondrial disease. As reported in the Guardian, “Both procedures have been tested in animals and resulted in healthy offspring. Good results have also been seen in human cells, but treated embryos have not been implanted into a woman to achieve a pregnancy.”

The approval of this innovative procedure means that its use will be the “first in humans,” a situation that understandably raises concerns about safety. As is true of any biomedical intervention, unknown risks may emerge in the future, even when scientific evidence so far indicates that risks are minimal or nonexistent. However, the HFEA is a cautious regulatory body that relies on robust scientific evidence before approving new techniques in medically assisted reproduction.

If safety concerns can be laid to rest, what other ethical objections have been raised about the use of this technique? And is any of those objections ethically persuasive? Continue reading →

Twenty Years of Bioethics at UNESCO

Posted on February 27, 2015 by Patrick J. WelshFebruary 27, 2015

In celebration of the 20th year of its Bioethics Programme, UNESCO has published an edited anthology, Global Bioethics: What For? It is freely available in its entirely online and features short essays by IJFAB advisory board member and one-time guest-contributor Daniel Callahan as well as our very own Mary C. Rawlinson. Follow the link above to access the volume in its entirety. There is sure to be something of interest to all readers!

As UNESCO puts it in their literature:

[Bioethics] is a democratic challenge, which must be shared by all members of a society, from the expert to the layman, because the resolution of ethical issues raised by scientific advances determines the way we live together. Societies’ choices affect our future and the future of coming generations.

And, elsewhere:

Since the 1970s, UNESCO’s involvement in the field of bioethics has reflected the international dimensions of this debate. Founded on the belief that there can be no peace without the intellectual and moral solidarity of humankind, UNESCO tries to involve all countries in this international and transcultural discussion.

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Posted on February 22, 2015 by Patrick J. WelshFebruary 22, 2015

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