Self-Trust and Reproductive Autonomy

Abstract

A study of the importance of self-trust for women's autonomy in reproductive health. The power of new medical technologies, the cultural authority of physicians, and the gendered power dynamics of many patient-physician relationships can all inhibit women's reproductive freedom. Often these factors interfere with women's ability to trust themselves to choose and act in ways that are consistent with their own goals and values. In this book Carolyn McLeod introduces to the reproductive ethics literature the idea that in reproductive health care women's self-trust can be undermined in ways that threaten their autonomy. Understanding the importance of self-trust for autonomy, McLeod argues, is crucial to understanding the limits on women's reproductive freedom. McLeod brings feminist insights in philosophical moral psychology to reproductive ethics, and to health-care ethics more broadly. She identifies the social environments in which self-trust is formed and encouraged. She also shows how women's experiences of reproductive health care can enrich our understanding of self-trust and autonomy as philosophical concepts. The book's theoretical components are grounded in women's concrete experiences. The cases discussed, which involve miscarriage, infertility treatment, and prenatal diagnosis, show that what many women feel toward themselves in reproductive contexts is analogous to what we feel toward others when we trust or distrust them. McLeod also discusses what health-care providers can do to minimize the barriers to women's self-trust in reproductive health care, and why they have a duty to do so as part of their larger duty to respect patient autonomy.

The Business of Being Made: Exploring the Production of Temporalities in Assisted Reproductive Technologies

“…Despite the clear and obvious similarities of ART procedures to the dynamics of sexual abuse, I found only a small handful of studies that even mention sexual abuse (McLeod, 2002;Katz, 2008) and neither explore it. I feel hard pressed to imagine a more perfect repetition of sexual trauma in the medical field.…”

“…Although men can also be negatively impacted by ART treatments they are less apt to lose trust in themselves (McLeod, 2002). Additionally, because women are given the sole blame for infertility they may most willingly defer to medical advice and control in hopes of an answer (Browner & Press, 1995).…”

The Individualist Model of Autonomy and the Challenge of Disability

“…Many other social influences and systemic factors can also significantly distort a person's ability to freely form and make reproductive decisions according to his/ her value system. Feminists such as Anne Donchin, Susan Sherwin, Carolyn McLeod, and Rosemarie Tong have all expressed concerns of the long history of powerful social and medical control over the lives of women and marginalized groups [3,4,22,23].…”

Civic Friendship

“…Yet failure to share secrets and other intimate information about ourselves indicates a lack of trust in the friend which can itself be damaging to the relationship and can prevent trust from developing (Helm 2005). It should also be born in mind that the more we monitor another's activities to reduce the risk of betrayal, the less we are deemed to be trusting of them (McLeod 2006).…”