Self-Trust and Reproductive Autonomy (Basic Bioethics)

2003.10.08
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The power of new medical technologies, the cultural authority of physicians, and the gendered power dynamics of many patient-physician relationships can all inhibit women's reproductive freedom.

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Often these factors interfere with women's ability to trust themselves to choose and act in ways that are consistent with their own goals and values. In this book Carolyn McLeod introduces to the reproductive ethics literature the idea that in reproductive health care women's self-trust can be undermined in ways that threaten their autonomy.

Understanding the importance of self-trust for autonomy, McLeod argues, is crucial to understanding the limits on women's reproductive freedom.

McLeod brings feminist insights in philosophical moral psychology to reproductive ethics, and to health-care ethics more broadly. She identifies the social environments in which self-trust is formed and encouraged.

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She also shows how women's experiences of reproductive health care can enrich our understanding of self-trust and autonomy as philosophical concepts. The book's theoretical components are grounded in women's concrete experiences.

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The cases discussed, which involve miscarriage, infertility treatment, and prenatal diagnosis, show that what many women feel toward themselves in reproductive contexts is analogous to what we feel toward others when we trust or distrust them. McLeod also discusses what health-care providers can do to minimize the barriers to women's self-trust in reproductive health care, and why they have a duty to do so as part of their larger duty to respect patient autonomy.

Self-Trust and Reproductive Autonomy (Basic Bioethics)

I enjoyed this book for its elegant and systematic argumentation, sensitively presented case studies, and treatment of philosophical subtleties. Self-Trust and Reproductive Autonomy is highly original and very readable. All too rarely does a bioethicist manage not only to develop a new theoretical concept but also to apply it successfully in the realm of health care. Carolyn McLeod provides a brilliant feminist analysis of the novel concept of self-trust and its relationship to women's sense of reproductive autonomy.

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Self-Trust and Reproductive Autonomy (Basic Bioethics): Medicine & Health Science Books @ verrumemill.cf Self-Trust and Reproductive Autonomy (Basic Bioethics) [Carolyn McLeod] on verrumemill.cf *FREE* shipping on qualifying offers. A study of the importance of.

McLeod's book will help health care practitioners in the field of obstetrics to work with pregnant women in a manner that leaves women in confident charge of their bodies. Moreover, McLeod's book will help the general reader understand important moral issues surrounding miscarriage, infertility treatment, and prenatal diagnosis. This book makes an impressive and significant contribution to the philosophical literatures on trust and autonomy.

Feminist Bioethics

It also shows why bioethicists and health care practitioners must develop a more complex understanding of autonomy in order to promote the autonomy of patients who are subject to oppressive social conditions. McLeod's exploration of the connection between self-trust and autonomy in the context of reproductive choice makes an important contribution to the feminist project of reconceiving autonomy as relational. Has the philosophical emphasis on the importance of individual autonomy, centrally in medical ethics but in bioethics more widely, offered a philosophical rationale for a reduction in the extent to which people are prepared to trust?

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Are we, collectively, facing a trade-off between these two important values? There is certainly a concept of autonomy, as a desirable feature of people identified reductively as their capacity for independence, that is inimical to relations of trust, in the sense that such individuals require a self-sufficient space of action which renders trusting relations with others largely redundant.

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She argues that the idea of autonomy can hardly be intelligibly stated, let alone defended, without a context of choice and trust playing an important role in any such context. As she points out, the practical focus of this concern has been to increase the scope and demands of informed consent, with the philosophical rationale for this practice very much in the background. People who are ill, who want treatment that will enable them to recover and who are choosing from a limited range of possible treatments described to them by those in charge of their treatment certainly do not seem to be exercising a Millian autonomous experiment in living.

They are, rather, at the sharp end no pun intended of a medical system that increasingly presents itself to its consumers as an industrial process.

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Once again, however, faithfulness to the facts of different cases and sensitivity to different concepts going under the same name leads her to doubt whether the important concept of negative liberty that protects the private sphere of the individual, and a far more ethically ambitious notion of autonomy as akin to free self-expression, really ought to be classed together. She concedes that the former is an important notion, and protects such taken for granted but hard won freedom as that which people now enjoy when they plan the timing of having children.

Basically happy with the regulatory regime that structures these discussions in the United Kingdom she is, nonetheless, troubled by the combination of effective public regulation with a collapse in public trust. I suspect that this conclusion will be endorsed by those academics in the United Kingdom who have been on the receiving end of this particular trend in public administration applied to institutions of higher education.

Her criticism of the openness agenda is more indirect: it has, in her view, increased the trustworthiness of those in public life, but that is not the same as ensuring that they are in fact more trusted. The opposite has been the case, ironically very often in those areas of biomedical ethics that are most closely politically regulated such as animal testing.