New study on hormonal birth control risks

A new study from Oxford University finds that the slightly elevated risk of breast cancer due to use of hormonal birth control pills extends across all forms of hormonal birth control. While earlier findings showing a similar increased risk were based in the study of combination pills containing both estrogen and progestin–the kind of pill dominant in the 1990s–these more recent results take into account progestin-only “mini pills” and intrauterine devices (IUDs), showing that elevated risk remains consistent across all forms of hormonal birth control. Although the absolute elevation of risk is small (+.15% for women under 40 and +.5% for women under 50 years old), the results are significant given that the population of hormonal birth control users in their 20s and 30s have a lower background risk for the disease, and that progestin-only therapies were previously assumed to carry less risk than combination pills. The results are interesting, moreover, given the significant differences in functioning between hormonal birth control therapies.

Mini pills and IUD

Source: “Study finds same small rise in breast cancer risk in many forms of hormonal birth control,” STATNews (statnews.com)

These findings raise familiar feminist bioethical questions concerning our relative lack of knowledge about hormonal birth control and the predominant focus on modes of contraception that intervene in the reproductive capacities of people with uteruses rather than exploring alternative methods like the “male pill.” Of course, the risks with hormonal birth control methods should be considered alongside their demonstrated benefits. Gillian Reeves, director of cancer epidemiology at Oxford and researcher on the recent study underscored to StatNews that, especially in the context of elevated maternal morality rates in the United States, hormonal birth control is still less risky than childbirth.

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Feminist Approaches to Bioethics Works-In-Progress Session

On Monday, April 3rd at 12pm Pacific/3pm Eastern (find your local time zone here) the American Society for Bioethics and Humanities (ASBH) affinity group on Feminist Approaches to Bioethics is hosting a virtual works-in-progress session for scholars to get feedback on news works in feminist approaches to bioethics. Anyone working on feminist approaches to bioethics broadly construed is welcome to join, learn about emerging work in feminist bioethics, and provide feedback. No need to be a member of ASBH or the FAB Affinity Group. Registration link here to join.

April 3rd via Zoom: Virtual Works-in-Progress Session Hosted by the ASBH Feminist Approaches to Bioethics (FAB) affinity group

2 New Works In Progress

Hannah Carpenter from The University of Texas Medical Branch will present on “Affording Access to Contraception” arguing that although the US Affordable Care Act has generally improved access and affordability of contraception, in the context of limited abortion access greater contraception access is imperative, including full coverage of contraception without restrictions in order to achieve reproductive autonomy.

Darcy Metcalfe from the University of Findlay will present on “Race-ing the Future’: Ending the Use of Racial Categories in Biotechnology,” a project that aims to end the use of racialized categories in the research, funding, and marketing of genetic biotechnologies in order for new and burgeoning genetic technologies to be free of the racialized harms of medical history.

Come learn about these project, provide collaborative and constructive feedback, and network with others working within feminist approaches to bioethics.

Register Here for April 3rd Event

Complete this link to attend the virtual works-in-progress session on April 3rd at 3pm Eastern Daylight Time.

The FAB Affinity Group

The ASBH Feminist Approaches to Bioethics Affinity Group (FAB) is currently co-chaired by Georgina Campelia (Department of Bioethics and Humanities, UW Medicine) and Elizabeth Lanphier (Ethics Center, Cincinnati Children’s Hospital Medical Center) and is seeking new leadership to co-chair the affinity group for a three year term from 2024 through 2026.

Reach out to Georgina or Elizabeth with any questions about the group and its activities including periodic virtual workshops, panels, and networking sessions in addition to the in-person meeting at the annual ASBH conference each October.

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FAB Gab Episode 30: Karen Davis on women’s pain and breaking through isolation

This month, on FAB Gab, Karen Davis speaks about her paper in the new Spring 2023 issue of IJFAB, which is about women’s experiences of pain and how dialogue with sympathetic others can break isolation. Karen’s work stems from her own experience with chronic pain and her background in philosophical hermeneutics.

Here’s a quote from the discussion:

[Gadamer’s] idea is self mastery, that like the physicians role is just to help you to control your own self in a way that you already can. And, you know, the image of the midwife is meaningful to philosophers in many ways. But that, that felt like a certain kind of abandonment to me, that wasn’t what I needed, in sort of a recovery or healing relationship. It wasn’t that midwife guidance, it was something a little different, that it wasn’t something within me that needed to be brought out. It was actually my connections with the world that needed to be reinstated, or reinvigorated. Right, that the pain had sort of cut me off.

Karen Davis, in discussion on FAB Gab

Check out this episode, and all other episodes of FAB Gab, on Spotify, Apple Podcasts, or Radio Public. You can subscribe so that you never miss an episode!

FAB Gab is hosted and produced by Kathryn MacKay.

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“Effectively the biggest prison in the world”

This is how Zahra Nader a freelance journalist describes Afghanistan under current Taliban rule to Amy Goodman on Democracy Now this week. In a week that saw many protests across the world tied to International Women’s Day, a small group of women in Afghanistan bravely sat outside the University they are now barred from entering to protest their exclusion from higher education.

The Taliban, who have now been in power for a little under two years, have been described as creating the most repressive country for women in the world by the U.N. Women are effectively trapped in their homes under new rules of movement, work, and education. This to the detriment of women and the country as a whole which is consequently suffering a humanitarian and economic crisis.

Source: Afghan Girls’ Education: ‘I Don’t Think I Have a Future’ | Human Rights Watch (hrw.org)

Access to education is also under threat in Iran where 1000 girls have been poisoned attending school. This follows large scale protests and arrests that began in September 2022 after the death of Mahsa Amini at the hands of the morality police. While international attention may have waned, resistance in Iran has continued with ongoing acts of defiance in the face of the repressive regime and subsequent arrests of journalists, athletes, people who dare dance in the street.

Shirin Ebadi, the first Iranian to win the Nobel Peace Prize, said:

“It’s not just about hope and ideas but action”

Action gains greater power through collective force. Feminists have always understood that solidarity is strength. All of us wherever we may be can do something. Find what actions you can take, they will vary by person and place, to stand together with those facing utter hopelessness.

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Online workshop on epistemic injustice in psychiatry and mental health

Just passing on this announcement relevant to folks working in feminist bioethics:

The Canada Research Chair on Epistemic Injustice and Agency is pleased to host an online workshop on Epistemic Injustice and Agency in Psychiatry and Mental Health, on 10 March 2023.

La Chaire de recherche du Canada sur l’injustice et l’agentivité épistémiques est heureuse d’organiser un atelier en ligne sur le thème Injustice et agentivité épistémiques en psychiatrie et en santé mentale, le 10 mars 2023.

Program – Programme:

https://crc-iae.com/events/?lang=en

Registration – Inscription:

https://forms.gle/47Zt4pDkJ8pnsjhD6

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FAB Gab Episode 29: Maya Goldenberg on Vaccine Hesitancy, pre- and mid-pandemic

The latest episode of FAB Gab is out now, and this time, Prof. Maya Goldenberg discusses her ‘author meets critics’ feature in the last issue of IJFAB. Goldenberg and two critics, Miriam Solomon and Inmaculada de Melo-Martin, discussed Goldenberg’s recent book, Vaccine Hesitancy: Public Trust, Expertise, and the War on Science (2021).

Goldberg and critics discuss vaccine hesitancy in the context of childhood vaccination, which is the book’s focus, as well as what might be extrapolated and applied to the public discussions around COVID-19 vaccines.

You can subscribe to FAB Gab on Spotify and Apple Podcasts, or listen to new episodes here!

FAB Gab is hosted and produced by Kathryn MacKay

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Urgent Care and Systemic Damage: Health Issues in the Wake of the earthquake affecting Syria and Turkey
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Hi, folks. IJFAB Blog Editors, here, with a quick roundup of links about the health and ethical issues that arise in the wake of any natural disaster, and specifically last week’s earthquake affecting Syria and Turkey. The death toll is presently well over 33,000, and expected to continue climbing as we see increased exposure to winter storms from lack of warm shelter, combined with disruption of social supports and access to health care, along with continued efforts for search and rescue and identification of the deceased. Pre-existing problems are worsened in such situations.

The Guardian has been doing some excellent English-language reporting. This link stopped updating on February 12, but has handy bullet points on major issues from Guardian reporting, and provides a timeline of events. It also discusses some of the reasons that the death toll will continue to rise, and the health and safety issues facing those who survived the event. https://www.theguardian.com/world/live/2023/feb/12/turkey-syria-earthquake-latest-news-updates-death-toll

This link, from Doctors Without Borders / Medecins Sans Frontieres (MSF), addresses their rescue and health efforts: https://www.doctorswithoutborders.org/latest/msf-responds-overwhelming-medical-needs-following-earthquakes-turkey-and-syria. Go to the link for details, but here’s their bullet-point summary of the situation on the ground as they are involved.

  • MSF-supported hospitals in northwestern Syria have seen more than 3,500 injured patients.
  • MSF has donated emergency kits, trauma kits, medical supplies, and blankets to 30 hospitals and health facilities in Idlib and Aleppo governorates.
  • We are running mobile clinics in five reception centers in Idlib governorate for people displaced by the earthquake and we will ramp up these services in the coming days.
  • We have sent our ambulances and dispatched extra medical staff—including surgeons—to hard-hit health care facilities in northwestern Syria
  • Teams are distributing blankets, hygiene kits, food items, and more supplies to families in Aleppo and Idlib governorates
  • Emergency teams are assessing the needs in southern Türkiye and stand ready to provide assistance

Al Jazeera reports on a well-known feature of natural disasters: not only do they introduce new health risks, but they can worsen pre-existing ones, especially when it comes to epidemics. Whether we’re talking about respiratory viruses that spread more virulently in packed warming centers and camps for displaced persons, or water-borne illnesses that worsen as water treatment and sewage systems are damaged by natural disaster, exacerbation of pre-existing health issues is common during and after natural disasters. The pre-existing health issue highlighted in the link at the beginning of this paragraph? Cholera.

Across war-torn Syria, where the UN has estimated that 5.3 million people have been left homeless by the disaster, “there was a perfect storm brewing before the earthquake – of increasing food insecurity, collapsing healthcare systems, the lack of access to safe water and poor sanitation”, said Eva Hines, chief of communications for the United Nations Children’s Fund (UNICEF) in the Syrian capital, Damascus.

“More than half of people in Syria depend on unsafe alternative water sources when it comes to their water needs. And that, of course, increases vulnerability to fast-spreading waterborne diseases such as cholera,” Hines told Al Jazeera.

To this editor’s surprise, Women’s Health magazine had a decent little article on why women are often at the pointy end of natural disasters. One issue is one we have seen throughout social upheavals that increase social stress and/or trap people at home, unable to move in society as they usually do: increases in domestic violence that fall overwhelmingly on women. In addition, already-heavy caregiving loads for children and elderly family members, as well as spouses, still tend to be borne disproportionately by women. These increase dramatically as food, clean water, and warm shelter become harder to find, and as family members may be injured or become ill.

While this editor cannot find good articles on mental health issues with respect to this particular earthquake, we can expect these to develop in coming months as survivors deal with loss, trauma, and even guilt. Mental health services are woefully inadequate in most of the world. And are common in the wake of natural disasters.

These are just some of the public health and individual health access issues that are present now in Syria and Turkey.

Another thing to consider is the role that social systems play in preventing or reducing death tolls, injuries, and illness. When we’re talking about earth quakes and flooding, this includes whether governments hold construction companies to good building standards. Yet, in Turkey, this has not happened. In fact, Turkish government leaders have proudly forgiven the fines and penalties of construction companies for not building to code. Here are a few links on this issue:

Natural disasters present not only emergent care needs and longer-term care needs for both physical and mental health, but also worsen existing health crises and highlight systemic problems (building codes; disproportionate caregiving loads; domestic violence) that could be otherwise.

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FAB Gab Episode 28: feeling ashamed about c-section shame, with Michelle Meagher and Kiera Keglowitsch

It’s the first FAB Gab episode of 2023, and we’re hitting the ground running and talking about shame. In this episode, Michelle Meagher and Kiera Keglowitsch discuss their paper that explores the idea of cesarean shame shame – that is, the shame that women feel about being ashamed of having to have an emergency c-section. We discuss birth plans, neoliberalism, and the social reality of affect.

You can check it out here, or wherever you listen to your podcasts of quality.

FAB Gab is hosted and produced by Kathryn MacKay

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FAB Gab Episode 27: Clock time or Stomach time? Megan Dean on the temporality of eating

The latest episode of FAB Gab, and the last for 2022, is now out! In this episode, Megan Dean discusses her recent paper on the temporality of eating, and how understanding time impacts how we understand food and our own subjectivity.

Check out the episode on Spotify, Apple Podcasts, or here.

FAB Gab is hosted and produced by Kathryn MacKay

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FAB Gab Episode 26: Floor Cuijpers and Petra Verdonk on an intersectional analysis of self-silencing in clinical trials

The latest episode of FAB Gab is out now! In this episode, Floor Cuijpers and Petra Verdonk present their work on the ways in which different kinds of marginalisation intersect to influence self-silencing behaviours among clinical trial participants. The trial that Cuijpers and Verdonk look at involves neuromuscular disorders, so they are particularly interested in the ways that disablement intersects with gender and class in different ways.

Here’s a sneak peak:

in this specific trial, these power dynamics manifested in actually participants at times silencing themselves. And this actually led them to or manifested in them overstepping their physical and emotional boundaries at times. And these aspects, we argue, are quite difficult, difficult to capture in more traditional ethical procedures and guidelines.

Floor Cuijpers, in conversation

Check out the episode, and all our other episodes, on Spotify, Apple Podcasts, or here.

FAB Gab is hosted and produced by Kathryn MacKay

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FAB Gab Episode 25: Claire Moore on capabilities and conscientious objection

The latest episode of FAB Gab is out now! In this episode, Claire Moore discusses her recent paper, which puts Sen’s capabilities approach to use in addressing conscientious objection to providing emergency contraception in the U.S. Claire’s approach takes reproductive autonomy and religious expression as two important capabilities.

Here’s a sneak peek at the conversation:

…many bioethicists agree and argue that we have a right to things like bodily autonomy or to reproductive choice. And those are really important to a lot of different arguments in bioethics. But similarly, a lot of bioethicists also agree that we have a right to enjoy religious expression and freedom from religious persecution. So seemingly, these sort of two things, what Sen would call a capability, these two different capabilities are at odds, which is, of course, very familiar in many debates about reproductive health care. So essentially, I try and argue that conscientious refusal to emergency contraception can create a very burdensome inequality for people wishing to prevent pregnancy, given the sort of background of historical and justices that are so apparent in the US with respect to reproductive health care access.

Claire Moore, in conversation

You can listen to the episode here, and access a transcript and the paper. Check out some of our other episodes, while you’re at it!

FAB Gab is hosted and produced by Kathryn MacKay

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FAB Gab Episode 24: Serene Ong on a pluralistic account of the family

The latest episode of FAB Gab is out now! This time, Serene Ong of the National University of Singapore discusses definitions of the family, and how we need a broader account than just a biological model to capture the complexity of family life, even in the context of genetic testing and screening.

Here’s a sneak peak:

“Within the context of genetic information, who counts as family? So at first pass, the answer seems obvious, biologically related family members, right? However, from an ethical point of view, the answer becomes more nuanced. In this paper, I propose that we should take a pluralistic view of who counts as family.”

Serene Ong, in conversation

To hear more about a pluralistic account of the family, you can check out the episode here! You can find all our episodes on your favourite podcasting platform.

FAB Gab is hosted and produced by Kathryn MacKay

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