Feminism and Healthcare: Toward a Feminist Pragmatist Model of Healthcare Provision
This chapter covers a range of topics pertaining to the ontological, epistemological, and ethical intricacies, complications, and possibilities of providing quality healthcare to women patients regardless of disability, race, ethnicity, and class by using empirical examples of certain diseases. Methodological concepts through reflections on subjectivity and objectivity are presented as contested issues, and radical objectivity, a concept comprising subjectivity, objectivity, and intersubjectivity, is proposed as a knowledge paradigm that allows healthcare personnel and patients to make knowledge claims that are mutually recognized as valid. Three models of healthcare, paternalistic, person-centered, and feminist pragmatist, are presented, outlining the specific problems inherent in each model of healthcare provision. The paternalistic model allows for no agency on the patients’ part, elevating healthcare personnel, specifically doctors, to authoritative knowers. The person-centered model of healthcare grants some shared responsibility between healthcare personnel and patients, and some concessions are made toward patients as knowers. In the feminist pragmatist model, healthcare personnel and patients commit to equal relationships. Gender equality and gender equity are identified as insufficient tools for organizational change, and theories of professions are drawn on to deliberate about change at the systemic level.
KeywordsFeminism Methodology Ontology Epistemology Paternalism Pragmatism
- Andrist L. A feminist model for women’s health care. Nurs Inq. 1997;4:268–74. https://doi.org/10.1111/j.1440-1800.1997.tb00113.x.CrossRefGoogle Scholar
- Bosely S, Glenza J, Davidson H. Endometriosis: the hidden suffering of millions of women revealed. The Guardian. 2015. https://www.theguardian.com/society/2015/sep/28/endometriosis-hidden-suffering-millions-women. Accessed 15 Oct 2017.
- Brown L. Endometriosis treatment ‘unacceptable’ and women aren’t diagnosed quickly enough. BBC Newsbeat. 2017. http://www.bbc.co.uk/newsbeat/article/39364958/endometriosis-treatment-unacceptable-and-women-arent-diagnosed-quickly-enough. Accessed 27 Sept 2017.
- Duffy S. A fair society? How the cuts target disabled people. Resource document, The Centre for Welfare Reform. 2013. http://www.centreforwelfarereform.org/uploads/attachment/354/a-fair-society.pdf Accessed 20 Sept 2017.
- Epstein S. Impure science: AIDS, activism, and the politics of knowledge. San Diego: University of California Press; 1996.Google Scholar
- Evans T, Mafubelu D. Women and health. Today’s evidence tomorrow’s agenda. Report. World Health Organisation. 2009. http://www.who.int/gender/women_health_report/full_report_20091104_en.pdf. Accessed 15 Nov 2017.
- Fenton S. How sexist stereotypes mean doctors ignore women’s pain. The Independent. 2016a. http://www.independent.co.uk/life-style/health-and-families/health-news/how-sexist-stereotypes-mean-doctors-ignore-womens-pain-a7157931.html. Accessed 27 Oct 2017.
- Fenton S. Period pain is officially as bad as a heart attack – so why have doctors ignored it? The answer is simple. Online article, The Independent. 2016b. http://www.independent.co.uk/voices/period-pain-is-officially-as-bad-as-a-heart-attack-so-why-have-doctors-ignored-it-the-answer-is-a6883831.html. Accessed 25 Oct 2017.
- Freidson E. How dominant are the professions? In: Hafferty FW, McKinlay JB, editors. The changing medical profession: an international perspective. New York: Oxford University Press; 1993. p. 54–66.Google Scholar
- Fricker M, Hornsby J. The Cambridge companion to feminism in philosophy. Cambridge: Cambridge University Press; 2000.Google Scholar
- Gillberg G. A methodological interpretation of feminist pragmatism. In: Hamington M, Bardwell-Jones C, editors. Contemporary feminist pragmatism. New York: Routledge; 2012. p. 217–37.Google Scholar
- Goldin R. PACE: the research that sparked a patient rebellion and challenged medicine. Sense about Science USA. 2016. http://senseaboutscienceusa.org/pace-research-sparked-patient-rebellion-challenged-medicine/. Accessed 10 Nov 2017.
- Govender V, Penn-Kekana L. Gender biases and discrimination: a review of health care interpersonal interactions. Women and Gender Equity Knowledge Network. 2007. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.493.104&rep=rep1&type=pdf. Accessed 25 Oct 2017.
- Hsu J. The relative efficiency of public and private service delivery. World Health Report. World Health Organisation. 2010. http://www.who.int/healthsystems/topics/financing/healthreport/P-P_HSUNo39.pdf. Accessed 15 Oct 2017.
- Kennedy A. Authors of our own misfortune? The problems with psychogenic explanations for physical illnesses. South Willingham: The Village Digital Press; 2012.Google Scholar
- Light DW. The medical profession and organizational change: from professional dominance to countervailing power. In: Bird C, Conrad P, Fremont AM, editors. Handbook of medical sociology. Prentice Hall: Upper Saddle River; 2000. p. 201–16.Google Scholar
- Mickle K. Why are so many women being misdiagnosed? Glamour. 2017. https://www.glamour.com/story/why-are-so-many-women-being-misdiagnosed. Accessed 18 Oct 2017.
- Minnich EK. Transforming knowledge. Philadelphia: Temple University Press; 2005.Google Scholar
- Nott SM. Body beautiful? Feminist perspectives on the World Health Organisation. In: Morris A, Nott S, editors. Well women. The gendered nature of health care provision. Aldershot: Ashgate Publishing Limited; 2002. p. 145–64.Google Scholar
- Nott SM, Morris A. All in the mind: feminism and health care. In: Morris A, Nott S, editors. Well women. The gendered nature of health care provision. Aldershot: Ashgate Publishing Limited; 2002. p. 1–20.Google Scholar
- Payton M. Doctors are failing to spot heart attacks in women – these are the symptoms. The Independent. 2016. http://www.independent.co.uk/life-style/health-and-families/health-news/women-heart-attacks-misdiagnosis-men-statistics-study-says-a7216661.html. Accessed 25 Oct 2017.
- Racaniello V. No ‘recovery’ in PACE trial, new analysis finds. Virology blog. 2016. http://www.virology.ws/2016/09/21/no-recovery-in-pace-trial-new-analysis-finds/. Accessed 30 Sept 2017.
- Reid C, Gillberg C. Feminist participatory action research. In: Brydon-Miller M, Coghlan D, editors. The SAGE encyclopaedia of action research. New York: SAGE; 2014. p. 343–6.Google Scholar
- Sherwin S. No longer patient. Feminist ethics & health care. Philadelphia: Temple University Press; 1992.Google Scholar
- Shotwell A. Against purity. Living ethically in compromised times. Minnesota: University of Minnesota Press; 2016.Google Scholar
- Staples S. During ME awareness week we revisit the toxic legacy of McEvedy and Beard. Online article. The ME Association. 2017. http://www.meassociation.org.uk/2017/05/during-me-awareness-week-we-revisit-the-toxic-legacy-of-mcevedy-and-beard-10-may-2017/. Accessed 03 Nov 2017.
- Steen L. The wilderness of the medically unexplained. Resource document. theBMJopinion. 2016. http://blogs.bmj.com/bmj/2016/08/25/lisa-steen-the-wilderness-of-the-medically-unexplained/. Accessed 19 Nov 2017.
- Stewart M. Cash not care, the planned demolition of the UK welfare state. London: New Generation Publishing; 2017.Google Scholar
- Webster R. Why Freud was wrong: sin, science and psychoanalysis. London: Harper Collins; 1996.Google Scholar
- Webster R. Freud. London: Weidenfeld & Nicolson; 2003.Google Scholar
- Wendell S. The rejected body. Feminist philosophical reflections on disability. New York: Routledge; 1996.Google Scholar
- WHO. Road Map for Action (2014–2019). Integrating Equity, Gender, Human Rights, and Social Determinants into the Work of WHO. Report. World Health Organisation. 2015. http://www.who.int/gender-equity-rights/knowledge/web-roadmap.pdf?ua=1. Accessed 28 Sept 2017.