Globalizing Feminist Bioethics: Crosscultural Perspectives (review)

Globalizing Feminist Bioethics: Crosscultural Perspectives is a collection created from the 1998 world congress of the International Network on Feminist Approaches to Bioethics, better known simply as FAB. This book builds on a previous anthology, Anne Donchin and Laura Purdy's edited collection of articles, Embodying Bioethics: Recent Feminist Advances (1999), which emerged from the 1996 FAB congress.

Globalizing Feminist Bioethics contains many excellent and interesting articles. It is an important and exciting new book, relevant to bioethicists, women's studies scholars, and philosophers interested in ethics or social and political philosophy.

The collection of articles is grouped very well, with clear connections between articles placed near one another. In addition to the useful introduction by Anne Donchin that points out the relationships between articles, the epilogue by Nancy M. Williams, and a helpful index, there are three sections to the book. The first section covers theoretical perspectives. The second section focuses on reproductive, genetic, and sexual health. The third and final section is about medical research and treatment.

The first section's first article, by Susan Sherwin, "Feminist Reflections on the Role of Theories in a Global Bioethics," contends that bioethical or ethical theories are best used as "lenses" that can be interchanged, akin to eyeglasses that can be picked up and taken off at will. More discussion of this different theoretical proposal is needed elsewhere, where potentially strong objections could be addressed. Perhaps a brief discussion of Norman Daniels' account of reflective equilibrium (1996) would have been an interesting addition to this article.

The second article, "Is a Global Bioethics Possible As Well As Desirable?" by Rosemarie Tong, nicely explains the difficulties that arose earlier due to an overzealous embracing by feminists of the ideal of difference. Because feminists feared imposing their moral views on other cultures, crucial health care needs of many women have not been addressed as well as possible. Tong presents a good discussion of the way in which the personal is political, and urges feminist bioethicists to help people become equally autonomous and equal recipients of just health care policies and practices.

The second section, on reproductive, genetic, and sexual health, is my favorite section because it abounds with articles on very interesting and current topics. In "Normalizing Reproductive Technologies and the Implications for Autonomy," Sherwin makes some good points that tie in with her valuable books, The Politics of Women's Health (1998) and No Longer Patient (1992). Her astute comments on relational autonomy are briefly reiterated here, and she further argues that in a political climate where the proliferation of reproductive technologies is the norm, women who face decisions about these technologies might exercise only a restricted autonomy. This article contains much thorough discussion of the negative aspects of in-vitro fertilization (IVF) and ultrasound, and little mention of anything positive. While it may be the case that "those who are involuntarily childless experience increased pressure to . . . do what is necessary to reproduce" (109), they also may find that reproductive technologies give them hope. Sherwin points out that routine ultrasound use offers no improvement in pregnancy outcome. She is right that because routine ultrasound has become "normalized," the burden of proof has shifted to those patients who might refuse the treatment, and it may be the case that by unquestioningly submitting to ultrasound, women are not exercising full autonomy. But routine use of this technology does allow women to exercise greater autonomy over whether to continue their pregnancies.

In "Cultural Differences and Sex Selection," Mary Mahowald takes an egalitarian feminist approach, arguing that sex selection is morally defensible if the intentions and consequences of the practice are not sexist and do not entail gender inequality. This clear and interesting article is similar to, but a revised version of, Chapter Six in Mahowald's Genes, Women, Equality (2000).

Loretta M. Kopelman's "Female Genital Circumcision and Conventionalist Ethical Relativism" discusses in good detail the practice of female genital cutting, laying out its context while simultaneously dealing with the issue of cultural relativism...