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Conclusion Lessons from Physicians Perhaps particularly in medicine, discussions of ethics today have become increasingly difficult to distinguish from discussions concerning “legality.” asking about what is right or good can too easily become a question of what is permissible or what constitutes culpability. returning to ancient and early modern sources of ethics, as i have proposed in the last two chapters, may serve to remind us that, while ethical concepts or frameworks figure prominently in the law, questions concerning what is ethical or moral are not identical with those concerning what is legal. So many practices in which we engage in our lives are matters of rich ethical reflection falling outside the realm of legal regulation. When i began researching the history of bioethics fifteen years ago, i was surprised by the incongruity between the conception of what was in medicine called “ethics” and the understanding of ethics that i had received in my training in philosophy. Many disciplines have been developed for—and are well suited to— crafting answers to questions. But philosophy is first and foremost a discipline developed to ask questions. if we do not ask why we think as we’ve been taught, or why we do as we’ve been trained or as we have become accustomed, we will take for granted that what we think is true and what we do is right. Just as important, as Socrates first demonstrated, is asking whether the questions we ask are the right questions. Do they move us to consider or investigate what is important, vital, true, consequential? are the questions informed questions, themselves grounded in knowledge that is reliable? and, we should ask, why do we ask the questions we ask? For what purpose, to what end, and for whose benefit do we ask them? What it means for philosophers to consider “the problem” of intersex—that is, to understand the ethical significance of the treatment, both medical and social , of those with atypical sex anatomies—is to consider both what questions are asked and what questions are not asked and why. in retrospect, i think it was my awareness that i didn’t know much at all about atypical sex or the experience of those who had been subjected to normalizing interventions that led me to think about how the tools of philosophy could be put to work to understand what has motivated treatment and to clarify the nature of the wrongs that have occurred. The point with which i continued to struggle, and that i had put aside, was the question of change. it was not so clear to me what role philosophy could play in changing the standard of care. 193 194 | Making Sense of intersex The series of conversations i had with the parents Sonja and elias directed me to return to the ethical tradition of the ancient greeks for guidance in thinking about how we might understand the possibilities for change in the care of children with atypical sex anatomies. Through this lens i began to return to some of the conversations i had had with physicians about their practices and began to see that perhaps i had been asking the wrong questions. When i sought out physicians to learn what was occurring in their clinics, the questions i would ask, as i had assured my university’s institutional review Board, would be limited to those concerning how parents of children with atypical sex anatomies were counseled in the clinics where they worked. it had not occurred to me that during those conversations any of the physicians would spontaneously offer what i came to recognize as a form of testimony. Their stories revealed awareness of their own fallibility, of the mistakes they had made, or in which they felt implicated as doing harm. But in these stories, too, was a recognition of what i came to understand as the dignity of vulnerability that was so important for understanding the problem of intersex. rather than ask how philosophy could play a role, then, perhaps the tools of philosophy could be most effective in identifying how ethical reasoning was at work in change that had already begun. Dr. Spruce’s Story During our conversation about the kind of counseling parents of children with atypical sex anatomies are given today, Dr. Spruce began to think out loud about why he thought change in the prevailing standard of care had proved so difficult. Physicians and medical researchers are not only committed to their work; they...

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