Scope Note 30: Feminist Perspectives on Bioethics

The literature of feminist bioethics has flourished in the last decade. Women’s health care, women’s role both as patient and health care professional, the many new reproductive technologies, the exclusion of women as research subjects, as well as the broader topic of feminist contributions to ethical theory itself, have all become topics of interest for feminist bioethical writers.

Although feminism is anything but a monolithic enterprise, Karen Lebacqz’ essay on feminism in the new, revised Encyclopedia of Bioethics (II A, 1995) says that “all feminists agree that women are oppressed and this oppression is wrong.” Rosemarie Tong refines this statement to include variations of feminism: “. . . feminist theory is not one, but many theories or perspectives and . . . each feminist theory or perspective attempts to describe women’s oppression, to explain its causes and consequences, and to prescribe strategies for women’s liberation” (VII, Tong 1989). She describes different feminist views in Feminine and Feminist Ethics (II A, 1993), labelling them liberal, Marxist, radical, psychoanalytic, socialist, existentialist, and postmodern. Alison Jaggar critiques these different forms of feminism in Feminist Politics and Human Nature, and Susan Sherwin applies these perspectives to the field of bioethics in No Longer Patient: Feminist Ethics and Health Care.

One of the central activities in current feminist bioethics is a revisitation of ethical theory itself. There is a distinction between “feminine” and “feminist” ethics in this field (II A, Tong 1993). “A feminine approach to ethics consists of observations of how the traditional approaches to ethics fail to fit the moral experiences and intuitions of women. In contrast, a feminist approach to ethics applies a specifically political perspective and offers suggestions of how ethics must be revised if it is to get at the patterns of dominance and oppression as they affect women” (IV, Sherwin 1992). Carol Gilligan’s two books, In a Different Voice and Mapping the Moral Domain, Nel Noddings’s Caring: A Feminine Approach to Ethics and Moral Education, and Virginia Held’s Feminist Morality: Transforming Culture, Society, and Politics can be thought of as feminine critiques of contemporary ethics.

Gilligan’s notion of the “ethics of care” has served as a point of departure for a discussion of a type of relational ethics that focuses on concrete experiences, pairs emotions with reason, and balances justice with care. This “ethics of care” has been both celebrated and criticized. The concept of “care” in ethics dates back to the “cura” tradition of care in ancient Rome and was further developed by philosophers Soren Kierkegaard and Martin Heidegger and psychologists Rollo May and Erik Erikson. Nursing theorists have built on this tradition both in theory and in practice (II A, Reich, Care, Encyclopedia of Bioethics, 1995). “Care” often is discussed in opposition to the liberal notion of “justice” (III, Sterba, Justice, Encyclopedia of Bioethics, 1995).

Gilligan’s theory was developed to provide a counter model to Lawrence Kohlberg’s six steps in the development of a human moral nature: (1) acting to avoid punishment, (2) acting to promote reciprocity, (3) conforming to get approbation, (4) respecting authority to maintain social order, (5) acting freely if others are not harmed, and (6) following self-legislated, self-imposed, universal principles of justice, reciprocity, and respect for the dignity of humans as individuals. In contrast, Gilligan holds that the moral self is an individual working with other individuals to identify mutually agreeable solutions to thorny human relations problems. Gilligan called Kohlberg’s the male moral point of view as an ethics of justice and hers the female moral view as an ethics of care. Her levels are (1) inward-directed care, (2) other-directed care subjugating personal wants and needs to others (eventually leading to anger), (3) a philosophy of care that balances egoism and altruism, recognizing the women’s connection to others and theirs to her.

According to Jocelyn Downie and Susan Sherwin (IV, 1993), oppression, as used by feminists, is understood as an interlocking series of restrictions and barriers that reduce the options available to members of a group defined by morally insignificant characteristics, here gender. The literature itself can be...