I argue that “consent” language presupposes that the contemplated action is or would be at someone else’s behest. When one does something for another reason—for example, when one elects independently to do something, or when one accepts an invitation to do something—it is linguistically inappropriate to describe the actor as “consenting” to it; but it is also inappropriate to describe them as “not consenting” to it. A consequence of this idea is that “consent” is poorly suited to play its canonical central role in contemporary sexual ethics. But this does not mean that nonconsensual sex can be morally permissible. Consent language, I’ll suggest, carries the conventional presupposition that that which is or might be consented to is at someone else’s behest. One implication will be a new kind of support for feminist critiques of consent theory in sexual ethics.
Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm
In this article, I argue that (1) transgender adolescents should have the legal right to access puberty-blocking treatment (PBT) without parental approval, and (2) the state has a role to play in publicizing information about gender dysphoria. Not only are transgender children harmed psychologically and physically via lack of access to PBT, but PBT is the established standard of care. Given that we generally think that parental authority should not go so far as to (1) severally and permanently harm a child and (2) prevent a child from access to standard physical care, then it follows that parental authority should not encompass denying gender-dysphoric children access to PBT. Moreover, transgender children without supportive parents cannot be helped without access to health care clinics and counseling to facilitate the transition. Hence there is an additional duty of the state to help facilitate sharing this information with vulnerable teens.
Moral Distress Reexamined: A Feminist Interpretation of Nurses’ Identities, Relationships, and Responsibilites
Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values and responsibilities in situations of moral distress. We also discuss the importance of nurses creating “counterstories” of their work as knowledgeable and trustworthy professionals to repair their damaged moral identities, and, finally, we recommend that efforts toward shifting the goal of health care away from the prolongation of life at all costs to the relief of suffering to diminish the moral distress that is a common response to aggressive care at end-of-life.
Epistemic Oppression and Ableism in Bioethics
Disabled people face obstacles to participation in epistemic communities that would be beneficial for making sense of our experiences and are susceptible to epistemic oppression. Knowledge and skills grounded in disabled people’s experiences are treated as unintelligible within an ableist hermeneutic, specifically, the dominant conception of disability as lack. My discussion will focus on a few types of epistemic oppression—willful hermeneutical ignorance, epistemic exploitation, and epistemic imperialism—as they manifest in some bioethicists’ claims about and interactions with disabled people. One of the problems with the epistemic phenomena with which I am concerned is that they direct our skepticism regarding claims and justifications in the wrong direction. When we ought to be asking dominantly situated epistemic agents to justify their knowledge claims, our attention is instead directed toward skepticism regarding the accounts of marginally situated agents who are actually in a better position to know. I conclude by discussing disabled knowers’ responses to epistemic oppression, including articulating the epistemic harm they have undergone as well as ways of creating resistant ways of knowing.
Race Based Medicine, Colorblind Disease: How Racism in Medicine Harms Us All
The genome between socially constructed racial groups is 99.5%-99.9% identical; the 0.1%-0.5% variation between any two unrelated individuals is greatest between individuals in the same racial group; and there are no identifiable racial genomic clusters. Nevertheless, race continues to be used as a biological reality in health disparities research, medical guidelines, and standards of care reinforcing the notion that racial and ethnic minorities are inferior, while ignoring the health problems of Whites. This article discusses how the continued misuse of race in medicine and the identification of Whites as the control group, which reinforces this racial hierarchy, are examples of racism in medicine that harm all us. To address this problem, race should only be used as a factor in medicine when explicitly connected to racism or to fulfill diversity and inclusion efforts.
“Life Comes from it”: Navajo Justice Concepts
This paper offers a comparison between Navajo conceptions of law and justice based on the community’s experiences to those of Anglo-european law and justice.
Red Skin, White Masks: Rejecting the Colonial Politics of Recognition
Over the past forty years, recognition has become the dominant mode of negotiation and decolonization between the nation-state and Indigenous nations in North America. The term “recognition” shapes debates over Indigenous cultural distinctiveness, Indigenous rights to land and self-government, and Indigenous peoples’ right to benefit from the development of their lands and resources.
In a work of critically engaged political theory, Glen Sean Coulthard challenges recognition as a method of organizing difference and identity in liberal politics, questioning the assumption that contemporary difference and past histories of destructive colonialism between the state and Indigenous peoples can be reconciled through a process of acknowledgment. Beyond this, Coulthard examines an alternative politics—one that seeks to revalue, reconstruct, and redeploy Indigenous cultural practices based on self-recognition rather than on seeking appreciation from the very agents of colonialism.
Coulthard demonstrates how a “place-based” modification of Karl Marx’s theory of “primitive accumulation” throws light on Indigenous–state relations in settler-colonial contexts and how Frantz Fanon’s critique of colonial recognition shows that this relationship reproduces itself over time. This framework strengthens his exploration of the ways that the politics of recognition has come to serve the interests of settler-colonial power.
In addressing the core tenets of Indigenous resistance movements, like Red Power and Idle No More, Coulthard offers fresh insights into the politics of active decolonization.
Wasáse: Indigenous Pathways of Action and Freedom
The word Wasáse is the Kanienkeha (Mohawk) word for the ancient war dance ceremony of unity, strength, and commitment to action. The author notes, “This book traces the journey of those Indigenous people who have found a way to transcend the colonial identities which are the legacy of our history and live as Onkwehonwe, original people. It is dialogue and reflection on the process of transcending colonialism in a personal and collective sense: making meaningful change in our lives and transforming society by recreating our personalities, regenerating our cultures, and surging against forces that keep us bound to our colonial past.”
Understanding Tribal Sovereignty: Definitions, Conceptualizations, and Interpretations
Forty years have passed since the Midcontinent American Studies Journal published its landmark special issue, “The Indian Today.” Since that publication, the landscape of Indian country has changed dramatically. This change has come primarily from an amazing cultural resurgence among Native Peoples in the United States — a resurgence that has manifested itself in everything from the Red Power movement to the birth of American Indian studies in the academy; to the renaissance of contemporary Native art, literature, and film; to the creation of tribal colleges, museums, and cultural centers; to the unprecedented rise in economic development; to notable gains in power in political and legal arenas.
Working Together: Crossing Color Lines at Work
Amidst signs of declining social capital, the typical workplace is a hotbed of sociability and cooperation. And in a still-segregated society, the workplace is where adults are most likely to interact across color lines. The convergence of close interaction and some racial diversity makes the workplace a crucial institution within a diverse democratic society. Paradoxically, the involuntariness of workplace associations—the compulsion of economic necessity, of managerial authority, and of law—helps to facilitate constructive interaction among diverse co-workers. Where racial diversity is a fact of organizational life (and the law can help to make it so), then employers and workers have their own powerful reasons—psychological and economic—to make those relationships constructive, even amicable. I contend here that it is where we are compelled to get along, and not where we choose to do so, that we can best advance the project of racial integration.