Retheorising Women’s Health: Shifting Paradigms and the Biomedical Body
Seminar 1
Governance
May 27 2009, University of Warwick. Ramphal Building Room 3.41
Arising Themes
Warm greetings to all!
The following represent a selection of arising themes from our first workshop. Please feel welcome and encouraged to make corrections and/or additions.
Many thanks again to the contributions of our three wonderful speakers: Mary Rawlinson, Sally Sheldon and Maya Goldenberg and to all the participants for a stimulating day of discussion. And very special thanks to Azrini Wahidin for the many organisational pieces she took on to support and facilitate the event.
The notes below are drawn both from the talks and from the themes emerging from our table and open discussions. I’ve organised them into several clusters including: 1. Critiques and questions pertaining to the discourse of rights; 2 the changing landscape of women’s health 3. Emergent questions for feminist health politics now and into the future
Prof. Deborah Lynn Steinberg
Department of Sociology
University of Warwick
1. Critique of Rights Discourse
Health politics generally and the Women’s Health movement have historically been driven by the discourse of rights. Key critiques of rights discourse include: that property is its foundational basis and paradigm and that, as such, it is intrinsically adversarial.
While rights discourse has been (in many cases) successfully mobilised to argue for more equitable health policy vis a vis women (e.g. rights of access, campaigns for more equitable distribution and management of health care resources and so on), the propertarian and adversarial character of liberal traditions of rights have also produced profound dilemmas for and obstacles to women’s health and feminist health politics.
a) problems with rights discourse
· adversarial orientation
· property as paradigm
· abstraction
c) Neoliberal values and governance
· neoliberal ethics (serving the values of capital, affirmative of dominant institutions; advocacy of consent while repudiating the value of dissent; invested in productivity and competition; investment in normotic [control/mastery] phantasy)
· neoliberal body ethics (bodies both at the nexus of and as objects of neoliberal values and modes of governmentality)
· how have both neoliberalism and religious/authoritarian forms of biopower shaped current struggles facing women in the health context?
Evidence Based Medicine as a paradigmatic instance
· The application of clinical epidemiology [population based/public health ‘norms’] to individual patient care
· Aggregate/abstracted statistical medicine [vs localised, ontologically orientated]
· Presumptions of parity and lack of nuance or error in aggregated trials
· Reductionism (limited variables considered; denial of specificity of individuals vis a vis health and health care)
· Universalism (normative/symbolic patient; normative/symbolic treatment protocols)
· ‘Standard of Care’ reinterpreted (from a notion of minimum standards required in the interest of public health, justice and equity; to application of singular treatment protocols to individuals)
b) problematic rights based concepts/ideals historically taken up to frame and support the feminist/women’s health movement
· autonomy
· bodily integrity
· choice
c) alternative concepts?
· Mobility (as liberty)
· Self-governance (vs governmentality)
· Agency [‘maternal agency’ as a new paradigm?]
2. The current context: transformations in the biopolitical field (i.e. the convergence of science, bodies and juridic power) surrounding and shaping women’s health politics
· transformations in the political economy of health care (both within national borders and internationally)
· transformations in informatics and knowledge
· transformations in technology and embodiment:
- bioconvergence: new forms of technological-embodied integration (in and outside the immediate context of medical/health care); between bodies and between bodies and technology
- bio-divergences and re-integrations: new forms of bodily dissection and disassociation (eg. transplants, reproductive processes, stem cells)
- emergent discourses of regeneration (restoration of damaged bodies), of re-genesis (engineering of novel bodies), and of reciprocity and replaceability
· transformations in projective/imaginative understandings of identity, difference, kinship, health and illness
· the counterpoint of neoliberal ethics and governance on the one hand, and conservative religious/authoritarian ethics and governance on the other
3. Women’s Health Movement
Key questions
a) How has the discourse of rights shaped the women’s health movement; and to what effect?
b) Do we need an alternative foundation/paradigm?
c) Are earlier critical perspectives, values and goals of the women’s health movement still viable?
d) By what indices should we evaluate transformations in the technological, political, economic and cultural landscape of health?
e) Can we continue to speak in generalisations/strategic universals such as ‘women’s health’?
f) What is the health field shaped not only by capillary dispersals of power – but also capillary convergences?
g) What is ‘the project of medicine’? (as a normative institution?; as a transformative institution? as a critical locus for justice politics?)
h) what is a feminist paradigm of health?
i) what is ‘health’?
· is health about obligation? [what are the obligations of health?]
· Is health a ‘right’ (or is it ‘health care’ that is a right?)
· Is health a ‘choice’?
· Is health a quality of life? A quality of life?
· Is health a depoliticising discourse; a legitimising discourse?
· Is health a heroic act, or imperative of action?
· What are the indicators of health?
· Is health a market?
· Is health about ‘voice’?
· Is health a discourse about contagion and cure? about care? about failed or redeemed bodies? about public or personal welfare? about abstract values or intersubjective relations?
· What is the place of death in health discourse?
Additional themes
Reproductive and Sexual Health Issues
Discourses of ‘risk’
Gender convergence/blurred boundaries
1