If there is one ethical concept considered to be central to human social life it is the idea of justice. Although there are several competing principles of justice, the core concept of justice embodies the obligation to treat like cases alike, in relevant respects. Women may differ from men in some respects, but the fact that women get sick, become injured, and die from preventable causes renders them similar to men in the need to carry out biomedical research, develop therapies, (...) and attend to health problems specific to women. An ethical perspective on women’s health begins and ends with principles of justice. Although particular circumstances and conditions differ in developed and less developed countries, the ethical conclusions regarding justice are the same for women in all societies. (shrink)

Despite some significant advances in the creation and protection of rights affecting women's health, these do not always translate into actual health benefits for women. This collection asks: 'What is an effective law and what influences law's effectiveness or ineffectiveness? What dynamics, elements, and conditions come together to limit law's capacity to achieve instrumental goals for women's health and the advancement of women's health rights?' The book presents an integrated, co-referential and sustained critical discussion of the (...) normative and constitutive reasons for law's limited effectiveness in the field of women's health. It offers comprehensive and cohesive explanatory accounts of law's limits and for the first time in the field, introduces a distinction between formal and substantive effectiveness of laws. Its approach is trans-systemic, multi-jurisdictional and comparative, with a focus on six countries in North America, Europe, Asia, and Africa and international human rights case law based on matters arising from Hungary, Portugal, Spain, Slovakia, Czech Republic, Peru and Bolivia. The book will be a valuable resource for educators, students, lawyers, rights advocates, and policy-makers working in women's health, socio-legal studies, human rights, feminist legal studies, and legal philosophy more broadly. (shrink)

Dobbs v. Jackson Women’s Health continues a trajectory of U.S. Supreme Court jurisprudence that undermines the normative foundation of public health — the idea that the state is obligated to provide a robust set of supports for healthcare services and the underlying social determinants of health. Dobbs furthers a longstanding ideology of individual responsibility in public health, neglecting collective responsibility for better health outcomes. Such an ideology on individual responsibility not only enables a shrinking (...) of public health infrastructure for reproductive health, it facilitates the rise of reproductive coercion and a criminal legal response to pregnancy and abortion. This commentary situates Dobbs in the context of a long historical shift in public health that increasingly places burdens on individuals for their own reproductive health care, moving away from the possibility of a robust state public health infrastructure. (shrink)

Increasingly, research in women's health and healthcare foregrounds women's experience. Despite the contribution that explorations of women's ‘lived life’ makes to our understandings, the concern of these feminist authors is the absence of in‐depth analysis of the complexity of experience and the contexts in which women's experiences of health are constituted. In this paper, authors extend current understandings of the lived life by complicating notions of knowledge, experience, language and ideologies. These ideas challenge taken‐for‐granted assumptions that underlie current (...) women's healthcare practices, disrupting the reinscription of patriarchal ideologies and generating new possibilities for nursing practice. (shrink)

The problem of providing mandated medical care has become commonplace as correctional systems in the United States struggle to manage unprecedented increases in its aging prison population. This study explores older incarcerated women’s perceptions of prison health care policies and their day-to-day survival experiences. Aggregate data obtained from a sample of 327 older women residing in prison facilities in five Southern states were used to identify a baseline of health conditions and needs for this vulnerable group. With (...) an average of 4.2 chronic health conditions, frequently histories of victimization, and high rates of mental health issues, the women’s experiences of negotiating health care was particularly challenging. By incorporating the voices of older women, we expose the contradictions, dilemmas, and obstacles they experience in their attempts to obtain health care. It is clear from the personal accounts shared that, despite court mandates, penal harm practices such as delaying or denying medical treatment as well as occasional staff indifferences are common in women’s prisons. With older women having the greatest need for health care, an age- and gender-sensitive approach is recommended. (shrink)

As COVID-19 keeps impacting the world, its impact is felt differently by people of different sexes and genders. International guidelines and research on gender inequalities and women’s rights during the pandemic have been published. However, data from Taiwan is lacking. This study aims to fill the gap to increase our knowledge regarding this issue and provide policy recommendations. This study is part of a more extensive project in response to the fourth state report concerning the implementation of the Convention (...) on the Elimination of All Forms of Discrimination against Women in Taiwan in 2022. We have drawn on the guidelines and documents published by the United Nations human rights bodies, conducted interviews with advocacy and professional practitioners, and hosted a study group comprising students and teachers from the National Taiwan University College of Public Health to supplement the interview data. The data were analyzed thematically. The results include five themes: (1) particular health risks to carers (primarily women); (2) COVID-related measures’ impact on women’s health and health behaviors; (3) highly gendered psychological maladjustment; (4) increase in gender-based violence and domestic violence; and (5) mental health inequities and intersectionality. The study has global implications for societies of similar sociopolitical contexts and developmental statuses. To truly live up to the standard of CEDAW and other international human rights principles, we ask that central and local government be more aware of these lived experiences and adjust their policies accordingly, accounting for gender sensitivity. (shrink)

PONIC P, REID C and FRISBY W.Nursing Inquiry2010;17: 324–335 Cultivating the power of partnerships in feminist participatory action research in women’s healthFeminist participatory action research integrates feminist theories and participatory action research methods, often with the explicit intention of building community–academic partnerships to create new forms of knowledge to inform women's health. Despite the current pro‐partnership agenda in health research and policy settings, a lack of attention has been paid to how to cultivate effective partnerships given limited (...) resources, competing agendas, and inherent power differences. Based on our 10+ years individually and collectively conducting women's health and feminist participatory action research, we suggest that it is imperative to intentionally developpower‐withstrategies in order to avoid replicating the power imbalances that such projects seek to redress. By drawing on examples from three of our recent feminist participatory action projects we reflect on some of the tensions and complexities of attempting to cultivate power‐with research partnerships. We then offer skills and resources needed by academic researchers to effectively harness the collective resources, agendas, and knowledge that each partner brings to the table. We suggest that investing in the process of cultivating power‐with research partnerships ultimately improves our collective ability to understand and address women's health issues. (shrink)

_New research on broader determinants of health has culminated into the new paradigm of social determinants of health. The fundamental view that underlies this new paradigm is that socioeconomic and political contexts in which people live have significant bearing upon their health and well-being. Unlike a wealth of research on socioeconomic determinants, few studies have focused on the role of political factors. Some of these studies examine the role of political determinants on health through their mediation (...) with the labour environments and systems of welfare state. A few others study the relationship between polity regimes and population health more directly. However, none of them has a focus on women's health. This study explores the interactions, both direct and indirect, between democracy and women's health. In doing so, it identifies some of the main health vulnerabilities for women and explains, through a conceptual model, how democracy and respect for human rights interacts with women's health._. (shrink)

A major challenge in neuroscience is to understand what happens to a brain as it ages. Such insights could make it possible to distinguish between individuals who will undergo typical aging and those at risk for neurodegenerative disease. Over the last quarter century, thousands of human brain imaging studies have probed the neural basis of age-related cognitive decline. “Aging” studies generally enroll adults over the age of 65, a historical precedent rooted in the average retirement age of U.S. wage-earners. A (...) consequence of this research tradition is that it overlooks one of the most significant neuroendocrine changes in a woman’s life: the transition to menopause. The menopausal transition is marked by an overall decline in ovarian sex steroid production – up to 90% in the case of estradiol – a dramatic endocrine change that impacts multiple biological systems, including the brain. Despite sex differences in the risk for dementia, the influence that biological sex and sex hormones have on the aging brain is historically understudied, leaving a critical gap in our understanding of the aging process. In this Perspective, we highlight the influence that endocrine factors have on the aging brain. We devote particular attention to the neural and cognitive changes that unfold in the middle decade of life, as a function of reproductive aging. Next, we consider emerging evidence from animal and human studies that other endocrine factors occurring earlier in life (e.g. pregnancy, hormonal birth control use) also shape the aging process. Applying a women’s health lens to. (shrink)

Karen L. Baird, Beyond reproduction: Women’s health, activism, and public policy, Madison, NJ: Fairleigh Dickinson University Press, 2009, reviewed by Amanda R. Clarke.

The aim of this study was to investigate the effects of Islam as a religion and culture on Turkish women’s health. The study included 138 household members residing in the territory of three primary health care centers in Turkey: Güzelbahçe, Fahrettin Altay and Esentepe. Data were collected by means of a questionnaire prepared by a multidisciplinary team that included specialists from the departments of public health, psychiatric nursing and sociology. We found that the women’s (...) class='Hi'>health behavior changed from traditional to rational as education levels increased, and that religious and traditional attitudes and behaviors were predominant in the countryside, especially practices related to pregnancy, delivery, the postpartum period, induced abortion and family planning. One of the most important prerequisites for the improvement of women’s health is that nurses should know the religious practices and culture of the society for which they provide care, so that their efforts to protect and improve women’s health will be effective. (shrink)

Significant improvements in human rights and democracy have been made since the adoption of the Universal Declaration of Human Rights by the United Nations in 1948. Yet, human rights, especially women's rights, are still being violated in many parts of the developing world. The adverse effects of such violations on women's and children's health are well known, but they are rarely measured. This study uses cross-national data from over 145 countries to estimate the impact of democracy and respect for (...) human rights on various measures of women's health while controlling for confounding socio-economic factors such as income, education, fertility and healthcare. It finds that democracy and regards for human rights contribute positively to women's health outcomes, as do socio-economic variables. (shrink)

Client-provider relationships have significant effects on how individuals comprehend their life situation during chronic disease and illness. Yet, little is known about how frontline health care providers (HCPs) influence client’s identity formation through meaning-making with clients such as HIV-positive women living in poverty. This requires ethical consideration of the meanings made between clients and providers about client’s health and well-being, both individually and in the larger society. Health care providers (N = 15) and married women living with (...) HIV (N = 33) in north-central India engaged in separate intensive interviews providing narrative data which were analysed using a conceptual framework crossing Lipsky’s street-level bureaucracy theory (Lipsky 2010) with meaning-making processes. HCPs and women construct meanings of women’s role as caregivers that impact women’s sense of identity, health, and well-being. Findings indicate that despite being well-intentioned, HCPs inadvertently reinforce rigid gender norms and convey that women’s worth is tied to their familial caregiving role. HCPs’ discretionary advocacy may also reinforce societal images of women as incapable and needy, thereby harming them more generally. Attention to the gender-sensitive training of HIV health care providers may assure that discretion is ethically interrogated to promote gender equity and enhance women’s access to social welfare services. (shrink)

A careful observation of the phenomenon of human life allows us to understand that from the beginning of the human life cycle until its destruction, the existence of each subject is deeply marked b...

Prenatal ultrasound use is skyrocketing despite limited evidence of improved outcomes. One factor driving this trend is the widely recognized psychological appeal of real-time fetal imaging. Meanwhile, considering imperfect safety evidence, U.S. professional guidelines dictate that prenatal ultrasound—a screening test—should be governed by expected clinical benefits—an opportunity for intervention. However, when women’s healthcare professionals themselves are pregnant, their access to ultrasound technology permits informal, personal use that may deviate from standard-of-care, e.g., for reassurance. Highlighting a poignant case wherein a (...) pregnant obstetrician’s personal ultrasound use had unforeseen negative consequences, we explore this issue within context of professional ethics and informal medical care. We discuss how women’s health professionals’ self-care may influence and inform prenatal care at large. We advocate curtailing informal prenatal ultrasound use, but also potentially broadening accepted indications for or relaxing proscriptions against ultrasounds for patients. Further research and updated, evidence-based, ethically-sound guidelines are needed. (shrink)

Concerns have been raised in Africa to address women’s construction health and safety needs adequately. These concerns include less participation of women in the sector, low income and less benefits being given to women, lack of adequate protective construction clothing suited for women, unfavourable employment conditions for women, and lack of construction site security and other facilities for women. This research article provides an overview of the suggested solutions to address the concerns raised. In addition, practical interventions being (...) implemented by the Durban University of Technology and Makerere University research collaboration project team to address women’s needs in construction health and safety through women empowerment and involvement in construction research, education and practice in Africa are outlined. The main approaches applied in this research study are as follows: use of relevant publications on women’s construction health and safety needs in Africa and analysis of data obtained from reliable construction professional bodies in South Africa and Uganda to demonstrate gender imbalances.Contribution: The main contribution of this study was to emphasise the significance of including and involving women in construction research, education and practice as a major solution to address women’s health and safety needs in Africa in the future as women are in a much better position to understand their own needs than men. (shrink)

Numerous issues confront women's healthcare today, among them the medicalization of women's bodies, cosmetic genital surgery, violence against women, HIV, perinatal mental health disorders. This volume uniquely explores such difficult topics and others at the intersection of clinical practice, policy, and bioethics in women's health care through a feminist ethics lens. With in-depth discussions of issues in women's reproductive health, it also broadens scholarship by responding to a wider array of ethical challenges that many women experience in (...) accessing health care. Contributions touch on many themes previously tackled by feminist ethics, but in new, contemporary ways. Some chapters expand into new fields in the bioethics literature, such as the ethical issues related to the care of Indigenous women, uninsured refugees and immigrants, women engaged in sex work, and those with HIV at different life stages and perinatal mental health disorders. Authors seek to connect theory and practice with users of the health system by including women's voices in their research. Bringing to bear their experience in active clinical practice in medicine, nursing, and ethics, the authors contemplate new conceptual approaches to important issues in women's healthcare, and make ethical practice recommendations for those grappling with these issues. Topical and up-to-date, this book provides a valuable resource for physicians, nurses, clinical ethicists, and researchers working in some of the most critical areas of women's health and applied ethics today. (shrink)

In this article the authors examine the ways in which the definition of work as paid employment has affected women's health research, the knowledge and understanding of the relationships between women's work and health, and health and social policies. The authors argue for research and public policy based on an expanded definition of women's work, a redefinition that goes beyond employment to reflect the multiple contexts and dimensions of women's work as well as the diversity and differences (...) among women. (shrink)

This article provides a critical analysis of the evolution and impact of hospital-sponsored women's health centers. Using original data gathered from interviews, participant observation, and content analysis of documents and brochures, the authors describe the development of four models of hospital-sponsored women's health centers and illustrate three specific mechanisms of the co-optation process. They show how many elements of feminist health care were used for the purpose of marketing and revenue production rather than for empowering women and (...) transforming the delivery of care. Following Stratigaki's notion of negative countereffect, the authors show how the key feminist concepts of women-centered care and empowerment ended up contradicting their original meaning and purpose. Rather than being the subject of care, women became the object of treatment and revenue production. (shrink)

Recent decades have witnessed a growing number of states around the world relying on border control measures, such as immigration detention, to govern human mobility and control the movements of those classified as “unauthorised non-citizens.” In response to this, an increasing number of scholars from several disciplines, including psychologists, have begun to examine this phenomenon. In spite of the widespread concerns raised, few studies have been conducted inside immigration detention sites, primarily due to difficulties in gaining access. This body of (...) research becomes even scanter when it comes to the experiences of detained women. This study is the first of its kind to have surveyed 93 women confined in an Italian immigration detention facility. A partial mediation model with latent variables was tested through partial least structural equation modelling (PLS-SEM). The findings revealed the negative impact that unfair immigration procedures have on detained women’s human dignity, which in turn negatively affects their self-rated physical and mental health. Overall, our study sheds light on the dehumanisation and damage to human dignity that immigration detention entails, as well as its negative impact on the health of those affected. This evidence reinforces the image of these institutions as sites of persistent injustice, while stressing the need to envision alternative justice-oriented forms to address human mobility. (shrink)

This essay aims to clarify the value of developing systematic studies of ignorance as a component of any robust theory of knowledge. The author employs feminist efforts to recover and create knowledge of women's bodies in the contemporary women's health movement as a case study for cataloging different types of ignorance and shedding light on the nature of their production. She also helps us understand the ways resistance movements can be a helpful site for understanding how to identify, critique, (...) and transform ignorance. (shrink)

Womanist Bioethics introduces a practical framework to address health disparities and inequities, arguing that doing justice to Black women's bodies entails understanding health and vulnerability as cultural productions, thus implicating medical, policy-making, economic and religious institutions in the Black women's health crisis.

Empirical evidence confirms the existence of health inequalities between women and men in developing countries, with women experiencing poorer health status than men, as well as less access to vital health services. These disparities have different sources and take different forms, some of which result from cultural factors, others from discriminatory laws and practices, and still others from the biological fact that only women undergo pregnancy and childbirth, a major cause of maternal mortality. The injustice lies in (...) the fact that many of these disparities result from socially controllable factors, while others could be remedied, especially in cases of violations of human rights. Past and recent policies and practices of the United States Government can be faulted for both actions and omissions that have contributed to such inequalities. Different conceptions of global justice are explored, with implications for who owes what to whom regarding these disparities. (shrink)

In this paper, I will examine the Supreme Court of the United States’ (SCOTUS) arguments in the majority decision in Dobbs v. Jackson Women’s Health Organization, and I will show how some of those arguments are flawed. Primarily, I will show that the right to bodily autonomy is a well-established right, both in the courts and in societal practices, and that the right to an abortion should be understood as an example of the right to bodily autonomy or (...) bodily integrity. Second, I will examine the justices’ arguments that viability is not a reasonable place to restrict abortion access, in contrast to both Roe v. Wade and Planned Parenthood v. Casey, and will offer arguments that defend viability as a valid point to limit abortion access. Third, I will highlight some politicians’ goals to enact a federal ban on abortion, and show how the attempt to pass Personhood Amendments is a pathway for doing so. The upshot of this essay to is show how the SCOTUS decision is flawed, and how granting personhood to “potential life” has consequences that extend beyond abortion access. (shrink)

In this paper I argue that a global bioethicsis possible. Specifically, I present the viewthat there are within feminist approaches tobioethics some conceptual and methodologicaltools necessary to forge a bioethics thatembraces the health-related concerns of bothdeveloping and developed nations equally. Tosupport my argument I discuss some of thechallenges that have historically confrontedfeminists. If feminists accept the idea thatwomen are entirely the same, then feministspresent as fact the fiction of the essential``Woman.'' Not only does ``Woman'' not exist,``she'' obscures important racial, (...) ethnic,cultural, and class differences among women. However, if feminists stress women'sdifferences too much, feminists lose the powerto speak coherently and cogently about genderjustice, women's rights, and sexual equality ingeneral. Analyzing the ways in which the ideaof difference as well as the idea of samenesshave led feminists astray, I ask whether it ispossible to avoid the Scylla of absolutism(imperialism, colonialism, hegemony) on the onehand and the Charybdis of relativism(postmodernism, fragmentation, Balkanization)on the other. Finally, after reflecting uponthe work of Uma Narayan, Susan Muller Okin, andMartha Nussbaum, I conclude that there is a wayout of this ethical bind. By focusing onwomen's, children's, and men's common humanneeds, it is possible to lay thefoundation for a just and caring globalbioethics. (shrink)

Non-Invasive Prenatal Testing is a technology which provides information about fetal genetic characteristics very early in pregnancy by examining fetal DNA obtained from a sample of maternal blood. NIPT is a morally complex technology that has advanced quickly to market with a strong push from industry developers, leaving many areas of uncertainty still to be resolved, and creating a strong need for health policy that reflects women’s social and ethical values. We approach the need for ethical policy-making by (...) studying the use of NIPT and emerging policy in the province of Ontario, Canada. Using an adapted version of constructivist grounded theory, we conducted interviews with 38 women who have had personal experiences with NIPT. We used an iterative process of data collection and analysis and a staged coding strategy to conduct a descriptive analysis of ethics issues identified implicitly and explicitly by women who have been affected by this technology. The findings of this paper focus on current ethical issues for women seeking NIPT, including place in the prenatal pathway, health care provider counselling about the test, industry influence on the diffusion of NIPT, consequences of availability of test results. Other issues gain relevance in the context of future policy decisions regarding NIPT, including funding of NIPT and principles that may govern the expansion of the scope of NIPT. These findings are not an exhaustive list of all the potential ethical issues related to NIPT, but rather a representation of the issues which concern women who have personal experience with this test. Women who have had personal experience with NIPT have concerns and priorities which sometimes contrast dramatically with the theoretical ethics literature. These findings suggest the importance of engaging patients in ethical deliberation about morally complex technologies, and point to the need for more deliberative patient engagement work in this area. (shrink)

Dissociative Identity Disorder is an uncommon disorder that has long been associated with exposure to traumatic stressors exceeding manageable levels commonly encompassing physical, psychological and sexual abuse in childhood that is prolonged and severe in nature. In DID, dissociation continues after the traumatic experience and produces a disruption in identity where distinct personality states develop. These personalities are accompanied by variations in behaviour, emotions, memory, perception and cognition. The use of literature in psychiatry can enrich comprehension over the subjective experience (...) of a disorder, and the utilisation of 'illness narratives' in nursing research have been considered a way of improving knowledge about nursing care and theory development. This research explores experiences of DID through close textual reading and thematic analysis of five biographical and autobiographical texts, discussing the lived experience of the disorder. This narrative approach aims to inform empathetic understanding and support the facilitation of therapeutic alliances in mental healthcare for those experiencing the potentially debilitating and distressing symptoms of DID. Although controversies surrounding the biomedical diagnosis of DID are important to consider, the lived experiences of those who mental health nurses encounter should be priority. (shrink)

At the Inserm Ethics Committee's annual conference in October 2021, the "Gender and Health Research" working group presented a study comparing the impact of the COVID-19 crisis in France and the United States. This comparison highlights the dysfunction of public policies in the United States regarding equitable access to healthcare for women and minorities, in contrast to France where the public authorities have taken exceptional measures, notably to guarantee access to abortion and care for victims of violence.In France, during (...) the first lockdown, statistics from the national toll-free number "Sexualities, Contraception, Abortion" revealed that reports of difficulties related to abortion or contraception access... (shrink)

Clinicians and policy makers the world over are embracing evidence-based medicine. The promise of EBM is to use summaries of research evidence to determine which healthcare interventions are effective and which are not, so that patients may benefit from effective interventions and be protected from useless or harmful ones. EBM provides an ostensibly rational and objective means of deciding whether or not an intervention should be provided on the basis of its effectiveness, in theory leading to fair and effective healthcare (...) for all. In this paper I closely examine these claims from the perspective of healthcare for women, using relevant examples. I argue that the current processes of evidence-based medicine contain a number of biases against women. These biases occur in the production of the research that informs evidence-based medicine, in the methods used to analyse and synthesise the evidence, and in the application of EBM through the use of guidelines. Finally, the biomedical model of health that underpins most of the medical research used by EBM ignores the social and political context which contributes so much to the ill-health of women. (shrink)

Federal law often avoids setting minimum standards for women’s health and reproductive rights issues, leaving legislative and regulatory gaps for the states to fill as they see fit. This has mixed results. It can lead to state innovation that improves state-level health outcomes, informs federal health reform, and provides data on best practices for other states. On the other hand, some states may use the absence of a federal floor to impose draconian policies that pose risks (...) to women’s and maternal health. Health reforms at the federal level must trod carefully to enable state innovation, while imposing foundational safeguards for promoting women’s health nationwide. (shrink)