18 December 2011

Bioethics

University of Pennsylvania bioethicists Lance Wahlert & Autumn Fiester have argued for a queer bioethics, noting claims that bioethics has to be reconceptualised to challenge the status quo, include the disadvantaged and encourage self-reflection among practitioners.

Their 'Queer Bioethics: Why Its Time Has Come' in 26(1) Bioethics (2011) calls for a bioethical analysis that accommodates LGBTQI (lesbian, gay, bisexual, transgender, queer, and intersex) people -
Queer bioethics requires us to take a two-fold approach: (1) We must pay greater attention to the topics, identities, and issues that are blatantly queer, for the service of queer persons; and, (2) We must examine the most common, the most pedestrian, and the most germane of universal health issues (those we wouldn't even instinctively think of as 'queer') and imagine how they might be complicated or rendered troubling by the injection of queer personhood."
Unfortunately the call does not feature a coherent agenda ... it would be useful to move beyond exhortations that "The time for queer bioethics is now". The authors state that -
LGBTQI bioethics, what we call ‘queer bioethics,’ meets all of the demands made by the discipline’s critics. It places the ‘less powerful’ center-stage; it chal- lenges the status quo and the presumptive legitimacy of the normative; it employs powerful intellectual resources from neighboring fields (queer theory, disability studies, medical humanities, and the history of medicine); and, it challenges our complacency in the face of injustice and discrimination in medical encounters, systems, and policies. Given a parallel urgency to the other topics that critics press us to address, the time for queer bioethics is now.
They comment that -
to address and to redress the topics that speak to queer bioethics is to do more than just highlight and collate a list of LGBTQI issues that need attention. This is certainly an indispensable aim of a queering of bioeth- ics; but it does not go far enough. A far loftier goal is to outline how doing queer bioethics constitutes more than expanding the canon of bioethical topics to include queer ones. Rather, queer bioethics mandates a change in both the topical and the methodological approaches to queer identity. To address the former, we maintain, of course, that we must make bioethicists pay greater attention to the ‘queer’ (as a noun) – the persons, identities, and LGBTQI health care matters central to the population in question. But we must also be mindful of the latter by encouraging bioethics to ‘queer’ itself (as a verb) – whereby otherwise non-queer subjects are considered for their sexual variations, are distorted to envision an appre- ciation that is not hetero-normative, and are re-imagined such that conventional notions and readings of patient selfhood (especially sexual- and gender-related ones) face directly the perils of marginalization and stigmatization.
They conclude that -
When it comes to gay, bi, trans, and intersex persons and patients, then, we have to ask multiple questions that might explain the field’s silence – or maybe even its avoid- ance of these persons altogether. Are queer patients being deemed ‘less sympathetic’ or perhaps ‘guilty’ in some unspoken way? Are they somehow read as distasteful and even culpable within the bioethical gaze for their indi- vidual gayness, seropositivity, gender nonconformity, or non-traditional family structures? Have we conflated, in particular in the wake of AIDS, a cultural notion of contagion with the very idea of queerness? In other words, is there an unacknowledged concern that, by showing an interest in queer matters, bioethicists are apprehensive to ‘out’ themselves – not just as queer, but also, more broadly, as queer-invested?