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A study of the importance of self-trust for women's autonomy in reproductive health. The power of new medical technologies, the cultural authority of physicians, and the gendered power dynamics of many patient-physician relationships can all inhibit women's reproductive freedom. Often these factors interfere with women's ability to trust themselves to choose and act in ways that are consistent with their own goals and values. In this book Carolyn McLeod introduces to the reproductive ethics literature the idea that in reproductive health care women's self-trust can be undermined in ways that threaten their autonomy. Understanding the importance of self-trust for autonomy, McLeod argues, is crucial to understanding the limits on women's reproductive freedom. McLeod brings feminist insights in philosophical moral psychology to reproductive ethics, and to health-care ethics more broadly. She identifies the social environments in which self-trust is formed and encouraged. She also shows how women's experiences of reproductive health care can enrich our understanding of self-trust and autonomy as philosophical concepts. The book's theoretical components are grounded in women's concrete experiences. The cases discussed, which involve miscarriage, infertility treatment, and prenatal diagnosis, show that what many women feel toward themselves in reproductive contexts is analogous to what we feel toward others when we trust or distrust them. McLeod also discusses what health-care providers can do to minimize the barriers to women's self-trust in reproductive health care, and why they have a duty to do so as part of their larger duty to respect patient autonomy.
New parents suddenly come face to face with myriad issues that demand careful attention but appear in a context unlikely to provide opportunities for extended or clear-headed critical reflection, whether at home with a new baby or in the neonatal intensive care unit. As such, their capacity for autonomy may be compromised. Attending to new parental autonomy as an extension of reproductive autonomy, and as a complicated phenomenon in its own right rather than simply as a matter to be balanced against other autonomy rights, can help us to see how new parents might be aided in their quest for competency and good decision making. In this paper I show how a relational view of autonomy attentive to the coercive effects of oppressive social norms and to the importance of developing autonomy competency, especially as related to self-trust can improve our understanding of the situation of new parents and signal ways to cultivate and to better respect their autonomy.
In Conscience in Reproductive Health Care, Carolyn McLeod responds to a growing worldwide trend of health care professionals conscientiously refusing to provide abortions and similar reproductive health services in countries where these services are legal and professionally accepted. She argues that conscientious objectors in health care should have to prioritize the interests of patients in receiving care over their own interest in acting on their conscience. McLeod defends this 'prioritizing approach' to conscientious objection over the more popular 'compromise approach' in bioethics-without downplaying the importance of health care professionals having a conscience or the moral complexity of their conscientious refusals. She begins with a description of what is at stake for the main parties to the conflicts generated by conscientious refusals in reproductive health care: the objector and the patient. Her central argument for the prioritizing approach is that health care professionals who are charged with gatekeeping access to services such as abortions are fiduciaries for their patients and for the public they are licensed to serve. As such, they have a duty of loyalty to these beneficiaries and must give primacy to their interests in gaining access to care. McLeod provides insights into ethical issues extending beyond the question of conscientious refusal, including the value of conscience and the fundamental moral nature of the relationships health care professionals have with current and prospective patients.
Argues against the conceptions of individual autonomy which are widely relied on in bioethics.
This collection of original essays explores the social and relational dimensions of individual autonomy. Rejecting the feminist charge that autonomy is inherently masculinist, the contributors draw on feminist critiques of autonomy to challenge and enrich contemporary philosophical debates about agency, identity, and moral responsibility. The essays analyze the complex ways in which oppression can impair an agent's capacity for autonomy, and investigate connections, neglected by standard accounts, between autonomy and other aspects of the agent, including self-conception, self-worth, memory, and the imagination.
"The average woman concerned about pregnancy spends approximately thirty years trying to prevent conception. She largely does so alone using prescription birth control, a phenomenon often taken for granted as natural and beneficial in the United States. In Just Get on the Pill, Littlejohn draws on interviews to show how young women come to take responsibility for prescription birth control as the "woman's method" and relinquish control of external condoms as the "man's method." She uncovers how gendered compulsory birth control-in which women are held accountable for preventing and resolving pregnancies in gender-constrained ways-encroaches on women's reproductive autonomy and erodes their ability to protect themselves from disease. In tracing the gendered politics of pregnancy prevention, Littlejohn argues that the gender division of labor in birth control is not natural. It is unjust"--
This collection of new essays examines philosophical issues at the intersection of feminism and autonomy studies. Are autonomy and independence useful goals for women and subordinate persons? Is autonomy possible in contexts of social subordination? Is the pursuit of desires that issue from patriarchal norms consistent with autonomous agency? How do emotions and caring relate to autonomous deliberation? Contributors to this collection answer these questions and others, advancing central debates in autonomy theory by examining basic components, normative commitments, and applications of conceptions of autonomy. Several chapters look at the conditions necessary for autonomous agency and at the role that values and norms - such as independence, equality, inclusivity, self-respect, care and femininity - play in feminist theories of autonomy. Whereas some contributing authors focus on dimensions of autonomy that are internal to the mind - such as deliberative reflection, desires, cares, emotions, self-identities and feelings of self-worth - several authors address social conditions and practices that support or stifle autonomous agency, often answering questions of practical import. These include such questions as: What type of gender socialization best supports autonomous agency and feminist goals? When does adapting to severely oppressive circumstances, such as those in human trafficking, turn into a loss of autonomy? How are ideals of autonomy affected by capitalism? and How do conceptions of autonomy inform issues in bioethics, such as end-of-life decisions, or rights to bodily self-determination?
As women’s reproductive rights are increasingly under attack, a minister and ethicist weighs in on the abortion debate—offering a stirring argument that “the best arbiter of a woman’s reproductive destiny is herself” (Cecile Richards, former President of the Planned Parenthood Federation of America) Here’s a fact that we often ignore: unplanned pregnancy and abortion are a normal part of women’s reproductive lives. Roughly one-third of US women will have an abortion by age forty-five, and fifty to sixty percent of the women who have abortions were using birth control during the month they got pregnant. Yet women who have abortions are routinely shamed and judged, and safe and affordable access to abortion is under relentless assault, with the most devastating impact on poor women and women of color. Rebecca Todd Peters, a Presbyterian minister and social ethicist, argues that this shaming and judging reflects deep, often unspoken patriarchal and racist assumptions about women and women’s sexual activity. These assumptions are at the heart of what she calls the justification framework, which governs our public debate about abortion, and disrupts our ability to have authentic public discussions about the health and well-being of women and their families. Abortion, then, isn’t the social problem we should be focusing on. The problem is our inability to trust women to act as rational, capable, responsible moral agents who must weigh the concrete moral question of what to do when they are pregnant or when there are problems during a pregnancy. Ambitious in method and scope, Trust Women skillfully interweaves political analysis, sociology, ancient and modern philosophy, Christian tradition, and medical history, and grounds its analysis in the material reality of women’s lives and their decisions about sexuality, abortion, and child-bearing. It ends with a powerful re-imagining of the moral contours of pre-natal life and suggests we recognize pregnancy as a time when a woman must assent, again and again, to an ethical relationship with the prenate.