No abstract

Philosophers working in bioethics often hope to identify abstract principles and universal values to guide professional practice, relying on ideals of objectivity and impartiality, and on the power of rational (individual, autonomous) deliberation. Such a focus has made it difficult to address issues arising from group‐based, sociohistorical differences like race and ethnicity. This essay offers a survey of some of the major issues concerning race in the field of bioethics. These issues include a long history of racialized abuse in medical and scientific research, reproductive injustice and abuse against women of color, and persistent racial and ethnic disparities in U.S. health and health care. The essay also argues that the field of bioethics as a whole would be improved by taking the experience of racial minorities into account in all its theorizing. Philosophers can aid in this task by expanding their theoretical focus beyond questions of individual rights to questions of social justice, beyond informed consent to community collaboration, and beyond cultural competency to both structural competency and cultural humility.

A thriving North American industry has emerged designed to help gay men become biological parents through surrogacy and egg donation. Taking as given that gay men have the same ethical right to pursue such reproductive technologies as heterosexual couples or individuals, this article asks whether access to egg donation and surrogacy for gay men specifically could be considered a matter not just of (consumer) rights, but of justice. The idea of shifting discourse about reproduction from the language of ‘rights’ to that of ‘justice’ is most notably articulated by women of colour. Their call for reproductive justice seeks to expand discussion beyond the narrow right to an abortion (as a negative privacy right) to encompass broader, positive rights, such as the rights to bear healthy children and to raise them in safe environments. What, if anything, might we learn from reproductive justice movements about how to frame gay men's desire/demand for access to surrogacy? While I find several productive connections between the two groups, two factors lead me to argue against understanding gay access to surrogacy as a matter of justice: first, the necessary reliance on women's reproductive labour; and second, the largely non-structural causes of gay couples' inability to reproduce. Nevertheless, by considering two driving forces behind gay male assisted reproduction – social norms favouring biological family formation and the need for family security – I ultimately conclude that a basis for solidarity exists between gay men and reproductive justice movements. That basis is a concept like ‘procreative liberty’.

In this article, I begin by describing what I call this Black Lives Matter moment in the US. I then offer three reasons for considering racism as a bioethical issue, the least discussed of which is the way in which racism acts as a barrier to the creation of better healthcare systems. Next, I argue that the concept of race itself constitutes a bioethical issue in a way that is not fully reducible to racism. Finally, I discuss how we, both bioethicists and health care professionals, might meet this moment by identifying individual points of responsibility (beyond liability) for structural injustice.

This paper explores the limitations of epistemic scientism for understanding the role the concept of race plays in assisted reproductive technology (ART) practices. Two major limitations centre around the desire to use scientific knowledge to bring about social improvement. In the first case, undue focus is placed on debunking the scientific reality of racial categories and characteristics. The alternative to this approach is to focus instead on the way the race idea functions in ART practices. Doing so reveals how the race idea (1) helps to define the reproductive "problems" different groups of women are experiencing and to dictate when and how they should be "helped"; (2) helps to resolve tensions about who should be considered the real parents of children produced by reproductive technologies; and (3) is used to limit ART use where that use threatens to denaturalize the very sociopolitical landscape the race idea has created. In the second case, scientific knowledge regarding reproduction is thought to call for technological control over that reproduction. This leads to an overemphasis on personal responsibility and a depoliticization of racialized social inequalities.