Alice Dreger, Ellen Feder and Hilde Lindemann have published an update to their article, “Fetal Cosmetology,” in Bioethics Forum that comment on the “responses” to that article, including to my own contribution to the conversation. I am generally in agreement with Dreger et al., but I want to comment on how they respond to my concerns. In the article, “Prenatal Dex: Update and Omnibus Reply,” they state:
In the first published response to our Bioethics Forum essay, Emi Koyama castigated bioethicists in general for not acting to defend the rights of vulnerable persons, leaving us to wonder why our sustained and substantial action was seized as an opportunity to complain about non-action. While we share Ms. Koyama’s concerns about the medical-industrial complex’s take-over of women’s bodies, we rather doubt her postmodern feminist language would have moved the feds the way we have moved the feds. Pardon our pragmatism.
First of all, my essay was not a response to their piece in Bioethics Forum; it was a response to the “letter of concern from bioethicists” posted on Dreger’s site. In fact, I was not even aware of their Bioethics Forum piece until after I submitted the first draft of the essay, and reference to their article was added by the editor of Bioethics Forum to give readers further context.
I am castigating not just bioethicists’ inaction on behalf of vulnerable populations, but also the limitations bioethics as a field has imposed on itself on the scope of their philosophical and ethical inquiry, obsessing over policies and procedures rather than sociopolitical implication of the increasing role and authority of medicine. I did express my appreciation for the “action” of the bioethicists and other scholars responsible for the “letter of concern,” and at the same time I explained why it had the danger of backfiring, like it did on the controversy surrounding growth attenuation, because they continue to operate within the confines of the field of bioethics as it is today.
Further, I resent their dismissive characterisation of my essay as written in “postmodern feminist language” and the patronising statement, “Pardon our pragmatism.” I would concede that voices of concern from among disability rights and women’s health movements are often ineffective at changing the problematic medical practices by themselves, and we often need certain spokespersons and “experts” that transform these voices into pragmatic strategies, these spokespersons and “experts” must be held accountable to the movements which they represent. Thus, the need for pragmatic strategies is in no way an excuse for dismissing activists’ and impacted communities’ concerns as mere “postmodern” intellectual exercise.
Dreger herself has been labeled “postmodernist” by the critics of her work, and she resists this. On her website, she wrote: “Although I sometimes get labeled a ‘postmodernist’ because I write and speak about the social complexities of science and medicine, in fact I would have to label myself a raving modernist. I really believe in the power of science to improve our knowledge and our lives.” I also write and speak about the social complexities of science and medicine, including the field of bioethics, and somehow she finds it convenient to label me “postmodernist” in a dismissive way.
Finally, I find the suggestion that my “postmodern feminist language” is what prevents me from being able to “move the feds the way [Dreger et al.] have moved, as if we live in a society in which everyone’s opinions are equally respected and judged solely by their content, offensive. There is no question that their success (so far) has been made possible by the number of Ph.Ds and MDs on the “letter of concern” as well as by Dreger’s and others’ officially sanctioned academic and medical authority and connections that arose from these positions, which have been heavily influenced by their class backgrounds, educational and professional opportunities, and other social conditions. These factors inform our political sensibilities and sometimes open or close certain venues of social change.
I am a pragmatic person, and a pragmatic activist. As a pragmatist, I really don’t see any benefit from Dreger et al. and I continuing to communicate this way publicly. But I reject the idea that pragmatism is a justification for dismissing the sometimes inflexible and unpragmatic but principled work of the disability rights and women’s health movements; in fact, pragmatism and idealism are both essential elements of a successful social change movements, and even that of a successful activist.
Leave a Reply