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Women in Clinical Studies: A Feminist View

Published online by Cambridge University Press:  29 July 2009

Susan Sherwin
Susan Sherwin
Affiliation:
Is Professor of Philosophy and Women's Studies in the Department of Philosophy at Dalhousie University in Halifax, Nova Scotia, Canada,
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Extract

There is significant evidence that the health needs of women and minorities have been neglected by a medical research community whose agendas and protocols tend to focus on more advantaged segments of society. In response, the National Institutes of Health (NIH) and Food and Drug Administration (FDA) in the United States have recently issued new policies aimed at increasing the utilization of women in clinical studies. As well, the U.S. Congress passed the NIH Revitalization Act of 1993, which specifically mandates increased inclusion of women and racial and ethnic groups in clinical studies. On the face of it, such gender and race-specific policies would appear to be morally problematic because traditionally ethics opposes the use of sex or race as legitimate criteria for distributions of benefits or burdens in social policies. Hence, these policies pose some significant moral questions. Feminist ethics provides us with a framework for evaluating such policies because of its readiness to recognize that socially and politically significant factors such as sex and race are morally relevant in setting public policy. Of course, feminist ethics does not simply endorse all appeals to sex and race but only the policies in which attention to such factors will contribute to social justice. In this essay, I Identify some of the Important ethical questions that a feminist ethics perspective raises about research policies devised to promote the Inclusion of women in clinical studies.

Type
Special Section: Research Ethics: Ethics at the Borders of Medical Research
Information
Cambridge Quarterly of Healthcare Ethics , Volume 3 , Issue 4 , Fall 1994 , pp. 533 - 538
Copyright
Copyright © Cambridge University Press 1994

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References

Notes

1. I do not provide any evidence for this belief because the literature is filled with detailed analysis of the systematic ways in which women are disadvantaged economically, socially, legally, politically, physically, and culturally. The account of oppression underlying my interpretation of the empirical data about women's disadvantaged status and choices as constituting oppression has been provided by Iris Marion Young in justice and the Politics of Difference. Princeton, New Jersey: Princeton University Press, 1990. Young identified five conditions as characterizing oppression, whether they appear singly or in combination: exploitation, marginalization, powerlessness, cultural imperialism, and violence.Google Scholar

2. See, for example, Ehrenreich, B, English, D. For Her Own Good: 150 Years of the Expert's Advice to Women. Garden City, New York; Anchor, 1979.Google ScholarFee, E, ed. Women and Health: The Politics of Sex in Medicine. Farmingdale, New York: Bay wood, 1983.Google ScholarFisher, S. In the Patient's Best Interest: Women and the Politics of Medical Decisions. New Brunswick, New Jersey; Rutgers University Press, 1986.Google ScholarPerales, CA, Young, LS, eds. Too Little Too Late: Dealing with the Health Needs of Women in Poverty. New York: Harrington Park, 1988.Google ScholarTodd, AD. Intimate Adversaries: Cultural Conflict between Doctors and Women Patients. Philadelphia: University of Pennsylvania Press, 1989.CrossRefGoogle ScholarWhite, EC, ed. The Black Women's Health Book: Speaking for Ourselves. Seattle: Seal, 1990.Google Scholar

3. See note 1. Young, . 1990.Google Scholar

4. This argument is spelled out in greater detail in Sherwin, S. No Longer Patient: Feminist Ethics and Health Care. Philadelphia: Temple University Press, 1992.Google Scholar

5. Several examples of such exclusions are provided by Dresser, R. Wanted: single white male for medical research. Hastings Center Report 1992;22(1):24–9.CrossRefGoogle ScholarPubMed

6. The Nazi studies on concentration camp residents and the Tuskegee syphilis study are two of the most notorious examples in this category.

7. See note 4. Sherwin, . 1992:159–65.Google Scholar

8. Corea, G. The Hidden Malpractice: How American Medicine Mistreats Women. Updated ed.New York: Harper Colophon, 1985:130–88.Google Scholar

9. Klien, RD. Infertility: Women Speak Out about Their Experiences of Reproductive Medicine. London: Pandora, 1989.Google Scholar

10. MacDonell, K, ed. Adverse Effects: Women and the Pharmaceutical Industry. Toronto: The Women's Press, 1986.Google Scholar

11. Jones, VL. Lupus and black women: managing a complex chronic disability. In: White, EC, ed. The Black Women's Health Book: Speaking for Ourselves. Seattle: Seal, 1990; 160–166.Google Scholar

12. Davis, AY. Sick and tired of being sick and tired: the politics of black women's health. In: White, EC, ed. The Black Women's Health Book: Speaking for Ourselves. Seattle: Seal, 1990:18–26.Google Scholar

13. See, for example, Harding, S. Whose Science? Whose Knowledge? Ithaca, New York: Cornell University Press, 1991.Google Scholar