Genes, Women, Equality ebook download

Genes, Women, Equality. Mary Briody Mahowald

Genes, Women, Equality

Download Genes, Women, Equality

Genes, Women, Equality Mary Briody Mahowald. pdf ebook
Publisher:
Language: English
Page: 314
ISBN: 0195121104, 9780195121100

From The New England Journal of Medicine

Since the advent of the Human Genome Project in 1990, ethicists, geneticists, physicians, and commentators have explored the implications of this government-sponsored effort to map and sequence the human genome. The past decade has also witnessed an increase in explorations of science and scientific methods by feminist theorists. Mary Briody Mahowald, a well-known contributor to the literature of feminist bioethics, bridges these two fields in Genes, Women, Equality, a study of "gender equality in genetics." The result should be of interest to bioethicists, feminist theorists, and practitioners in the field of medical genetics.

The book covers a broad range of issues, including genetic testing, behavioral genetics, cloning, fertility treatments, and the availability of genetic counseling services and health insurance. The broad net Mahowald casts is both a strength and a weakness: though she raises numerous provocative questions, readers might find that the book's 16 chapters, each with its own numerous subheadings, often resemble a series of short essays rather than a coherent text.

Several sections of the book stand out. Mahowald's examination of the vagaries of gene therapy, particularly the ethical implications of the use of these techniques to enhance a feature, as opposed to curing or preventing a problem, are engaging and informative. Her discussion of approaches such as preimplantation genetic diagnosis during fertility treatments offers the reader an entree into the ethical territory opened by new methods of reproductive technology.

Throughout the book, Mahowald's ethical compass points to an "egalitarian feminist standpoint theory." She constantly invokes and places great value on the perspectives of "nondominant" groups -- here defined as women, the poor, racial and ethnic minorities, and the disabled. White men, it is assumed, have a discrete worldview that, according to feminist theory, is often inimical to the well-being of women.

Drawing on the work of feminist theorists such as Nancy Hartsock and Donna Haraway, Mahowald rejects objectivity in bioethics as a pretense and chides bioethicists and geneticists for failing to recognize that their dominant position in society has fostered myopia about the experiences of nondominant groups. For Mahowald, critique and correction of this nearsightedness are the first steps on the path to "gender justice" in genetics.

But Mahowald's egalitarian feminist standpoint rests on several questionable assumptions. For example, the notion that nondominant groups in society have a superior perspective simply because of their nondominant position -- and thus that geneticists and bioethicists should ascribe to them a "privileged status" -- is presented uncritically, as is her claim that biologic differences between the sexes are necessarily disadvantageous to women and thus require social policies to reduce their harmful effect.

Weaknesses in the feminist-standpoint theory also emerge when Mahowald tackles difficult questions about women's autonomy with regard to forms of genetic technology. Mahowald suggests, for example, that genetic enhancement in utero -- that is, strategies to improve a child's ultimate physical and intellectual endowments -- could create a new form of discrimination against women, as they face "overt and covert" pressure to alter potential children genetically. Although it is worthwhile to question what influence social expectations might have on a person's decision to seek genetic therapy, Mahowald feels that the pressure is solely on women. In the process she misses far more provocative questions, such as how feminist-standpoint theorists reconcile the fact that there are many women who, if given the opportunity, would eagerly engage in genetic manipulation to engineer perfect children for themselves.

The conclusions Mahowald draws from some of her case studies are also less than compelling, such as the story of Julia, a pregnant 27-year-old woman with the metabolic disorder phenylketonuria who refused to follow dietary restrictions during her pregnancy and who gave birth to a severely retarded child as a result. Invoking feminist-standpoint theory, Mahowald defends Julia's behavior by arguing that her interests -- as the person "most affected" -- were paramount. Though the story is rife with possibilities for further examination, particularly the ethical implications of the interests of the potential child, Mahowald relegates these issues to a footnote, where she avers that the interests of the child, as a nonautonomous being, are not at issue.

Mahowald's feminist orientation sometimes leads her to accept claims uncritically. For example, she states that women have been underrepresented in clinical trials. This is a myth that is entrenched in the women's health literature. Her outlook prompts her to see potential victims around every corner. For example, she worries that genetic researchers may try to "coopt" poor or uninsured women as unpaid test subjects in clinical studies of no demonstrable benefit to the women.

Mahowald's use of feminist-standpoint theory is not without its strengths. Her dedication to "collaborative inquiry" in genetics is surely worthy, and questions about the public's access to and understanding of genetic technology are issues of which all medical geneticists should be aware. Mahowald's argument for a more inclusive bioethics is fully in keeping with the emphasis feminist bioethicists place on marginalized social groups, and when it serves as a reminder to medical geneticists to consider the different experiences of their patients, it is useful. But in looking constantly at the margins, Mahowald often misses the solid center -- the questions about moral agency and ethics that apply to all persons, regardless of group identification.

Despite the difficulties with Mahowald's use of feminist-standpoint theory, the book offers readers a good introduction to the range of questions feminist bioethicists are posing. Although we may not reach a state of complete ethical certainty on many of these issues, Mahowald's work serves as an excellent reminder that genetics requires of its practitioners a continuing commitment to their exploration.

Review

"...an important perspective on current and future genetic practices and policies. This book is an essential read for feminists and nonfeminists alike who are scholars and practitioners of genetic technologies."--Hypatia

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