ABSTRACT: Since the invention of hormonal contraceptives, there has been disagreement between users and providers about the existence of side effects and their implications for care. The lack of consideration for cisgender women, and other people who may become pregnant, has often been explained by sexist bias in the philosophy of medicine. My goal is to contribute additional elements to this discussion. I will argue that there are structurally embedded assumptions about the responsibilities and goals of medicine that open the (...) door to this sexism in the first place. While we tend to accept that contraception is part of medicine for pragmatic reasons, we do not exhibit the same form of pragmatism when it comes to dealing with side effects. This is an unjustified double standard that fails to recognize the goals of contraception and the fact that it relies on medical expertise to achieve them. (shrink)

It can be assumed that value judgements, which are needed to judge what is ‘good’ or ‘better’ and what is ‘bad’ or ‘worse’, are involved in every decision-making process. The theoretical understanding and analysis of value judgements is, therefore, important in the context of bioethics, for example, to be able to ethically assess real decision-making processes in biomedical practice and make recommendations for improvements. However, real decision-making processes and the value judgements inherent in them must first be investigated empirically (‘empirical (...) bioethics’). For this to succeed, what exactly a ‘value judgement’ is and of what components it might consist must initially be theoretically clarified. A corresponding conceptual model can then support or even enable empirical data collection and analysis and, above all, subsequent ethical analysis and evaluation. This paper, therefore, presents a value judgement model with its theoretical derivation. It also illustrates its application in an interview study of decision-making between animal experimentation and alternative methods in the context of biomedical research. Though the model itself can be theoretically deepened and extended, the application of the model works in general and helps to uncover what value judgements can enter into decision-making. However, the empirical methods, for example, qualitative interviews, can also be better oriented towards eliciting value judgements (as understood according to the model). Further applications of the model to other topics or by means of other empirical methods are conceivable. (shrink)

Medicalization has become a key topic in contemporary philosophy of medicine. Discussions about what should be medicalized, what kinds of medicalization are desirable, and how specific cases ought to be evaluated increasingly shape debates about the boundaries and responsibilities of medicine. The medicalization debate is increasingly shaped by pragmatic considerations that draw attention to the complex interactions between mind and body and to the role of social and environmental conditions in shaping health. From this perspective, the value of medical interventions (...) and resources lies in their capacity to contribute to broader goals such as alleviating human suffering and promoting individual and collective well-being. While pragmatic approaches address several shortcomings of stricter, often essentialist frameworks, their existing analytical tools remain limited when it comes to evaluating controversial cases of medicalization. This paper examines these limitations and develops a refined pragmatic framework for distinguishing good from problematic medicalization. Using the case study of the pharmaceutical treatment of behavioral and mood-related symptoms associated with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), I propose a two-step approach. This two-step approach acknowledges the complexities of pragmatic medicalization and distinguishes between the potential usefulness of medicines to achieve pragmatic goals and the realization of this potential in actual practice. (shrink)