Ethical Issues in Women’s Healthcare addresses feminist topics typically left out of standard bioethics discourse, like female genital cosmetic surgery, access to healthcare for rural women, and the moral agency of abortion providers, to name a few. Written from a Canadian perspective, the book also highlights North American clinicians currently making major contributions to women’s healthcare. Intended to provide guidance for bioethicists, clinicians, and researchers, every chapter is written separately by clinicians or bioethicists working in the area described. The 14-chapter book is divided into three sections: (I) Locations, Migrations, and Access to Healthcare, (II) New and Emerging Themes, and (III) Reproductive Healthcare.
Each chapter within Ethical Issues in Women’s Healthcare is completely stand-alone. Some chapters are excellent—“Rural Women: Place, Community, and Accessing Healthcare” does a fantastic job framing some of the health challenges specific to rural women given their role and position in their communities. Meanwhile, “Sex Work, Ethics, and Healthcare” simply repeats the findings of a previous study conducted by the authors of that chapter.
As this example helps demonstrate, the book suffers from a lack of cohesion between chapters. Different chapters employ different ethical frameworks, and some do not cite an ethical framework at all. While some chapters utilize an ethical case-based approach, others simply report a literature review. Terminology used in one chapter often contradicts guidelines provided by another. Ironically, Chapter 9 emphasizes the importance of using non-gendered phrases like “pregnant people” in lieu of “pregnant women,” while Chapter 14 is entitled “Research with Pregnant Women.” Similarly, Chapter 5 is entitled “Drivers and Dilemmas of Female Genital Cosmetic Surgery” and discusses “female genitalia”—labia, clitoris, vagina—in spite of Chapter 9 explaining that body parts are not inherently gendered (i.e., a man may have labia, either due to an intersex variation or his transgender identity).
This book provides a grab-bag of feminist ethical topics; however, it fails to highlight their interconnectedness. We now live in an era of intersectionality theory—the theory that different elements of one’s identity are not merely additive, but interact to create unique challenges or privileges. In other words, the bioethical challenges relevant to a rural migrant woman may not be covered in the chapters on rural women or on migrant women, because these separate issues intersect with each other to create unique barriers to quality healthcare. Given the disparate nature of each chapter, Ethical Issues never really covers the interactions between issues or categories presented. Ethical Issues in Women’s Healthcare highlights important feminist issues in North America today, but in the era of intersectionality theory, this book may not be doing enough.