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In the Foundations of Bioethics and elsewhere,1 Engelhardt develops a contextual account of disease. As this essay illustrates, Engelhardt"s account can be employed in framing a feminist clinical epistemology. Feminists2 claim that medicine, with its authority to define what is normal and pathological and to command compliance to its norms, tends to strengthen patterns of stereotyping and reinforce existing unjustified power inequalities. As a consequence, ageism, gender bias, and racism occur as various ways of accounting for the structure of and procedural character of contexts in medicine. This essay focuses its attention on gender bias in clinical medicine and argues that a gender-neutral account of clinical reality (and the diagnosis and treatment of disease) is not the response one can or should give to current concerns regarding gender bias in clinical medicine. Rather, the essay establishes that a feminist clinical epistemology is worth considering in order explicitly to incorporate gender into our accounts of clinical reality. Moreover, a feminist clinical epistemology is what is needed if we are to develop scientific research projects, medical care, and public health policies that more accurately reflect biological and psychosocial gender differences. This analysis is to extend Engelhardt"s work in ways that carry special implications for our discussions concerning how we are to understand clinical reality, which in turn fuel our dialogues in biomedical ethics and public health policymaking.

DOI: 10.1007/978-94-011-5530-4_8

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