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  • Rethinking "Normal"
  • Kathy Davis (bio)

For many years, I have wracked my brains trying to find the best way to discuss the cultural and ethical aspects of new developments in medicine and biotechnology. My favorite example is the cosmetic surgery "boom" and the endless proliferation of new techniques for surgically altering the appearance of the body. I have discovered that my audiences (students, colleagues, the general public) tend to respond to the expansion of cosmetic surgery in one of two ways. One group, while expressing some uneasiness about the cultural aspects of surgically reshaping the human body, tends to frame the ethics of cosmetic surgery as a matter of choice and informed consent. As long as the individual has sufficient information, she should be free to make her own decision. A second group takes a much less sanguine approach, arguing that cosmetic surgery is dangerous, costly, and demeaning to the individual and reflects a pernicious transformation of ordinary bodies into objects for medical intervention. For this group, the only ethical response to cosmetic surgery is to "just say no."

While I see the merits of both approaches, I am also constantly frustrated by what I see as a stubborn desire to settle the issue of cosmetic surgery once and for all. Not only does cosmetic surgery seem far too complex for easy solutions, but-and more importantly-I suspect that part of this desire for a speedy resolution is born of our discomfort and unease with some of the troubling normative issues that it evokes. This is why I welcomed the opportunity to review three recent books that attempt to initiate a broader discussion of the cultural and ethical aspects of medical developments intended to enhance the appearance and capacities of the human body.

All three books contain essays written by experts from different fields (medicine, philosophy, social sciences, humanities, law), as well as policy-makers, community activists, and patients. They deal with controversial medical interventions: psychotropic drugs for children suffering from depression or hyperactivity (ADHD) and surgeries for normalizing bodies, particularly the bodies of children (for example, conjoined twins, individuals with dwarfism, and children with ambiguous genitals or craniofacial deformities). Each book argues against viewing these interventions in strictly medical terms-as when we ask whether they achieve the desired outcome with a minimum of harm. Instead, these books raise questions concerning what constitutes a "normal" body, as well as the social pressures to eliminate physical and mental markers of difference. They explore the unintended consequences of medical technologies for normalizing different bodies. And they ask how we might engage in ethical discussions about embodied difference and the role of medicine in normalizing the human body.

No Child Left Different takes a critical look at the ubiquitous drugging of children in the United States today. Prescriptions for psychotropic drugs for children have skyrocketed in the past fifteen years. Currently one in ten white, middle-class, school-age U.S. boys takes the stimulant Ritalin for attention deficit disorders (ADHD), and antidepressants (Prozac, Paxil, Zoloft, and others) are being prescribed to 2.4 percent of all U.S. children, making them more frequently prescribed than any other pediatric medication, including antibiotics. These statistics are alarming, and the authors of this volume-most of whom are child psychologists, psychiatrists, or pediatricians-are unanimously concerned that drugs that were formerly a treatment of last resort are now becoming the treatment of preference.

No Child Left Different. Ed. Sharon Olfman. Praeger Publishers, 2006. 256 pages. Hardcover, $39.95.

Cutting to the Core: Exploring the Ethics of Contested Surgeries. Ed. David Benatar. Rowman & Littlefield, 2006. 246 pages. Paperback, $24.95.

Surgically Shaping Children: Technology, Ethics, and the Pursuit of Normality. Ed. Erik Parens. Johns Hopkins University Press, 2006. 274 pages. Hardcover, $50.00.

The desire for a "quick fix" for children's behavioral problems not only leaves the social context in which the problems emerged unaddressed, but it underplays the side effects of the drugs, including children's increased susceptibility to substance abuse later in life. The use of psychotropic drugs also attests to a widespread wish within the United States to eliminate quirky or eccentric behaviors in children, homogenize different kinds of minds...

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