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Added by: Emma Holmes, David MacDonald, Yichi Zhang, and Samuel Dando-MoorePublisher’s Note:
Bartky draws on the experience of daily life to unmask the many disguises by which intimations of inferiority are visited upon women. She critiques both the male bias of current theory and the debilitating dominion held by notions of "proper femininity" over women and their bodies in patriarchal culture.Tilton, Emily, Jenkins Ichikawa, Jonathan. Not What I Agreed To: Content and Consent2021, Ethics, 132(1): 127-154.-
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Added by: Emma Holmes, David MacDonald, Yichi Zhang, and Samuel Dando-MooreAbstract:
Deception sometimes results in nonconsensual sex. A recent body of literature diagnoses such violations as invalidating consent: the agreement is not morally transformative, which is why the sexual contact is a rights violation. We pursue a different explanation for the wrongs in question: there is valid consent, but it is not consent to the sex act that happened. Semantic conventions play a key role in distinguishing deceptions that result in nonconsensual sex (like stealth condom removal) from those that don’t (like white lies). Our framework is also applicable to more controversial cases, like those implicated in so-called “gender fraud” complaints.Comment (from this Blueprint): Tilton and Ichikawa attempt to work out what goes wrong in certain deception cases but not in others. This is useful as a reply to Dougherty's argument that sex from deception is always morally serious and it engages with the issues Fischel raises around gender deception.
Jenkins Ichikawa, Jonathan. Presupposition and Consent2020, Feminist Philosophy Quarterly. 6(4).-
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Added by: Emma Holmes, David MacDonald, Yichi Zhang, and Samuel Dando-MooreAbstract:
I argue that “consent” language presupposes that the contemplated action is or would be at someone else’s behest. When one does something for another reason—for example, when one elects independently to do something, or when one accepts an invitation to do something—it is linguistically inappropriate to describe the actor as “consenting” to it; but it is also inappropriate to describe them as “not consenting” to it. A consequence of this idea is that “consent” is poorly suited to play its canonical central role in contemporary sexual ethics. But this does not mean that nonconsensual sex can be morally permissible. Consent language, I’ll suggest, carries the conventional presupposition that that which is or might be consented to is at someone else’s behest. One implication will be a new kind of support for feminist critiques of consent theory in sexual ethics.Comment (from this Blueprint): Here Ichikawa argues that the language of "consent" to sex presupposes that there is a 'requester' who asks for sex and a 'consenter' who then replies yes or no. Ichikawa argues that this reinforces sexist norms of how sex works.
Alexander, Larry, Hurd, Heidi, Westen, Peter. Consent Does Not Require Communication: A Reply to Dougherty2016, Law and Philosophy. 35: 655-660.-
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Added by: Emma Holmes, David MacDonald, Yichi Zhang, and Samuel Dando-MooreAbstract:
Tom Dougherty argues that consenting, like promising, requires both an appropriate mental attitude and a communication of that attitude.Thus, just as a promise is not a promise unless it is communicated to the promisee, consent is not consent unless it is communicated to the relevant party or parties. And those like us, who believe consent is just the attitude, and that it can exist without its being communicated, are in error. Or so Dougherty argues. We, however, are unpersuaded. We believe Dougherty is right about promises, but wrong about consent. Although each of us gives a slightly different account of the attitude that constitutes consent, we all agree that consent is constituted by that attitude and need not be communicated in order to alter the morality of another’s conduct.Comment (from this Blueprint): The authors argue that consent is an attitude, rather than an act of communication. They give two examples to support this view where the communication of consent doesn’t occur or goes wrong somehow, but nonetheless (they claim) it is intuitively a consensual interaction.
Priest, Maura. Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm2019, The American Journal of Bioethics. 19 (2): 45-59.-
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Added by: Chris Blake-TurnerAbstract:
In this article, I argue that (1) transgender adolescents should have the legal right to access puberty-blocking treatment (PBT) without parental approval, and (2) the state has a role to play in publicizing information about gender dysphoria. Not only are transgender children harmed psychologically and physically via lack of access to PBT, but PBT is the established standard of care. Given that we generally think that parental authority should not go so far as to (1) severally and permanently harm a child and (2) prevent a child from access to standard physical care, then it follows that parental authority should not encompass denying gender-dysphoric children access to PBT. Moreover, transgender children without supportive parents cannot be helped without access to health care clinics and counseling to facilitate the transition. Hence there is an additional duty of the state to help facilitate sharing this information with vulnerable teens.Comment (from this Blueprint): Priest argues that the state should provide puberty-blocking treatment (PBT) for trans youth, even if their parents are not supportive. Priest’s argument is important partly because it avoids the issue of whether adolescents and children can give properly informed consent. This is a point that some of Priest’s critics seem to have missed (see, for example, Laidlaw et al. 2019. “The Right to Best Care for Children Does Not Include the Right to Medical Transition”, and Harris et al. 2019. “Decision Making and the Long-Term Impact of Puberty Blockade in Transgender Children”). Priest’s conclusion is founded instead on a principle of harm avoidance.
Ashley, Florence. Gatekeeping Hormone Replacement Therapy for Transgender Patients is Dehumanising2019, The Journal of Medical Ethics. 45: 480-482.-
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Added by: Chris Blake-TurnerAbstract:
Although informed consent models for prescribing hormone replacement therapy are becoming increasingly prevalent, many physicians continue to require an assessment and referral letter from a mental health professional prior to prescription. Drawing on personal and communal experience, the author argues that assessment and referral requirements are dehumanising and unethical, foregrounding the ways in which these requirements evidence a mistrust of trans people, suppress the diversity of their experiences and sustain an unjustified double standard in contrast to other forms of clinical care. Physicians should abandon this unethical requirement in favour of an informed consent approach to transgender care.Comment (from this Blueprint): Ashley draws on their own experiences as a trans person, as well as that of the trans community more broadly, to argue against assessment and referral requirements for hormone-replacement therapy (HRT). Ashley argues instead for an informed consent model, on which providers of HRT are not gatekeepers of transness, but facilitators of thoughtful decision-making.
Stramondo, Joseph A.. Tragic Choices: Disability, Triage, and Equity Amidst a Global Pandemic2021, The Journal of Philosophy of Disability. 1: 201–210.-
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Added by: Chris Blake-TurnerAbstract:
In this paper, I make three arguments regarding Crisis Standards of Care developed during the COVID-19 pandemic. First, I argue against the consideration of third person quality of life judgments that deprioritize disabled or chronically ill people on a basis other than their survival, even if protocols use the language of health to justify maintaining the supposedly higher well-being of non-disabled people. Second, while it may be unavoidable that some disabled people are deprioritized by triage protocols that must consider the likelihood that someone will survive intensive treatment, Crisis Standards of Care should not consider the amount or duration of treatment someone may need to survive. Finally, I argue that, rather than parsing who should be denied treatment to maximize lives saved, professional bioethicists should have put our energy into reducing the need for such choices at all by resisting the systemic injustices that drive the need for triage.Comment (from this Blueprint): Stramondo critiques triage protocols that were put into place, or at least proposed, during the COVID-19 pandemic. Stramondo argues that protocols that prioritize quality of life involve ableist commitments. While chance-of-survival protocols might do better here, he argues that they are also vulnerable to creeping ableism. Stramondo’s paper is valuable not only for its perspective on triage protocols, but also for highlighting some crucial theoretical contributions by philosophers of disability and by bioethicists. Stramondo also argues not to cede too much ground to fatalism in thinking about triage protocols; bioethicists should also, and perhaps primarily, resist the framing of triage as inevitable, rather than a product of various privileged interests.
Taylor, Sunaura. Beasts of Burden: Animal and Disability Liberation2017, The New Press.-
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Added by: Chris Blake-TurnerPublisher’s Note:
How much of what we understand of ourselves as “human” depends on our physical and mental abilities—how we move (or cannot move) in and interact with the world? And how much of our definition of “human” depends on its difference from “animal”? Drawing on her own experiences as a disabled person, a disability activist, and an animal advocate, author Sunaura Taylor persuades us to think deeply, and sometimes uncomfortably, about what divides the human from the animal, the disabled from the nondisabled—and what it might mean to break down those divisions, to claim the animal and the vulnerable in ourselves, in a process she calls “cripping animal ethics.” Beasts of Burden suggests that issues of disability and animal justice—which have heretofore primarily been presented in opposition—are in fact deeply entangled. Fusing philosophy, memoir, science, and the radical truths these disciplines can bring—whether about factory farming, disability oppression, or our assumptions of human superiority over animals—Taylor draws attention to new worlds of experience and empathy that can open up important avenues of solidarity across species and ability. Beasts of Burden is a wonderfully engaging and elegantly written work, both philosophical and personal, by a brilliant new voice.Comment (from this Blueprint): In this excerpt from her book, Beasts of Burden, Taylor resists the way that animals and intellectual disabled people are often framed in terms of one another. She argues that this does a disservice to both groups. Animals are not voiceless, as they are often constructed. And their comparison to disabled people in the (in)famous argument from marginal cases should not be accepted. Perhaps most importantly, the argument opens for discussion the worth of disabled people’s lives. But this is not something that should be open for discussion, especially given the marginalization of disabled people.
Wilson, Yolonda, et al.. Intersectionality in Clinical Medicine: The Need for a Conceptual Framework2019, The American Journal of Bioethics. 19(2): 8–19.-
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Added by: Chris Blake-TurnerAbstract:
Intersectionality has become a significant intellectual approach for those thinking about the ways that race, gender, and other social identities converge in order to create unique forms of oppression. Although the initial work on intersectionality addressed the unique position of black women relative to both black men and white women, the concept has since been expanded to address a range of social identities. Here we consider how to apply some of the theoretical tools provided by intersectionality to the clinical context. We begin with a brief discussion of intersectionality and how it might be useful in a clinical context. We then discuss two clinical scenarios that highlight how we think considering intersectionality could lead to more successful patient–clinician interactions. Finally, we extrapolate general strategies for applying intersectionality to the clinical context before considering objections and replies.Comment (from this Blueprint): Wilson et al. argue that intersectionality is an important concept in clinical practice. They clarify the concept and distinguish their call for intersectionality from nearby claims. For instance, they argue that intersectionality goes beyond mere cultural competence that healthcare providers are already trained in, at least to some degree. Their paper is anchored around two fictionalized case studies, which they use to make vivid and explain their central claims. They end by responding to objections, including the very idea of intersectionality itself.
Ray, Keisha. It’s Time for a Black Bioethics2021, The American Journal of Bioethics. 21(2): 38–40.-
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Added by: Chris Blake-TurnerAbstract:
There are some long-standing social issues that imperil Black Americans' relationship with health and healthcare. These issues include racial disparities in health outcomes (Barr 2014), provider bias and racism lessening their access to quality care (Sabin et al. 2009), disproportionate police killings (DeGue, Fowler, and Calkins 2016), and white supremacy and racism which encourage poor health (Williams and Mohammed 2013). Bioethics, comprised of humanities, legal, science, and medical scholars committed to ethical reasoning is prima facie well suited to address these problems and influence solutions in the form of policy and education. Bioethics, however, so far has shown only a minimal commitment to Black racial justice.Comment (from this Blueprint): In this short, seminal piece, Keisha Ray argues that bioethics needs to address issues of health and well-being of Black individuals. She applies Beauchamp and Childress’s famous four principles of bioethics to a particular issue: the disproportionate maternal mortality rate of Black women in the United States. Ray argues bioethics must incorporate the lens of Black bioethics, if the discipline is to remain relevant.
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Bartky, Sandra Lee. Femininity and Domination
1990, Routledge.
Comment (from this Blueprint): Chapter 4 is about what a feminist should do when they have a sexual desire which is in tension with their feminist beliefs in a way that makes them feel ashamed. There are two natural choices: to give up the shame and continue to have the desire, or to give up the desire. Bartky examines both of these choices and finds us in a tricky situation: it is sometimes apt and understandable to feel shame about a sexual desire (when it really is in tension with your principles), but she is sceptical about the view that we can change our desires at will or with therapy.