No Choice but to Choose: The Technopolitics of Informed Consent

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Description
Informed Consent is a ubiquitous way of enshrining choice in the United States which regulates social relations in domains as varied as health, research, access to institutions, and prisons. Informed consent describes an imagined epistemic relationship between right knowledge and

Informed Consent is a ubiquitous way of enshrining choice in the United States which regulates social relations in domains as varied as health, research, access to institutions, and prisons. Informed consent describes an imagined epistemic relationship between right knowledge and legitimate choice, where judgements of capacitation determine whether a person is the right sort of person to take up knowledge which will render them agential under conditions of asymmetrical power. It has been developed over and over to solve problems of injustice, where the injustice in question is understood in terms of undue infringement on individual autonomy, and the logic of informed consent is re-invented to reframe the problem at hand as a rightful matter of individual choice. It is imagined to respect autonomy, and to perform a transformative "moral magic" that makes the forbidden quotidian. This dissertation develops this account of informed consent through a series of cases, each of which explicates different aspects of the technopolitics of informed consent. It begins with genetic counseling as a paradigm case in the logic of informed consent: a well-developed field that emerged to inform people about genetics and genomics in the interest not only of individual reproductive choice, but in opposition to eugenic shaping of populations through genetic knowledge. Next, pro- and anti- abortion deployments of informed consent illustrate an epistemology of information itself, which is understood to agentialize as well as to serve as a site for refusing choice to those deemed incapacitated. Third, liability waivers and requests for student informed consent on university campuses during the pandemic show informed consent to be a tool for the exercise of biopolitics and, in particular, for making responsible subjects. Finally, civil libertarian opposition to migrant genetic testing on the grounds that migrants weren’t asked for consent demonstrates a tight coupling between consent, imaginations of just state-subject relations, and what it means to be recognized as a person. Ultimately, this dissertation argues for a practice of attention that sees informed consent as an important site for the exercise of power and offers frameworks for analyzing it as such.
Date Created
2023
Agent

Cripping Trans Childhood: A Critical Examination into the Legislating of the Trans Child

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Description
2023 has been a record-breaking year for legislation aimed at restricting and even criminalizing access to gender affirming care for minors. In response to these legislative efforts, many advocates rely on invocations of medical authority to defend the right of

2023 has been a record-breaking year for legislation aimed at restricting and even criminalizing access to gender affirming care for minors. In response to these legislative efforts, many advocates rely on invocations of medical authority to defend the right of individuals to access gender affirming care. However, this reliance on the pathologization of transgender identity both reaffirms stigmatization of transgender identity as mental illness as well as forecloses on opportunities to affirm access to gender affirming care otherwise. The purpose of this research is to use disability justice scholarship, predominantly crip theory, to analyze these legislative efforts in-depth beyond the predominant critique offered by the medical-model. I demonstrate that these legislative moves to ban access to gender affirming care are part of a larger effort to prevent a trans future more broadly. Trans childhood has become a particularly fruitful site for this political action due to the ways in which normativities relating to time, biological plasticity, and capacity shape the way that their bodies are understood. I term those individual bodies which have such characteristics of non-normative temporalities, plasticity, and capacity/incapacity grafted onto them become “bodies of normative intervention” and explore how they become the laboratory sites for producing population-wide normative interventions. This legislative effort to restrict access to gender affirming care for minors represents a broader effort to legislate a trans future out of existence through the strategic targeting of trans children. This robs society of valuable trans knowledge and experience.
Date Created
2023
Agent

Factors with Conflicts in Medical Care Related to Religion that Affect the Physician’s Attitude in Patient Care

Description

The study investigated unconscious biases in physicians regarding conflicts in developing care plans for patients related to religious restrictions in medicine. Fourteen physicians were interviewed to discuss their experiences with these patients and find patterns and factors that could lead

The study investigated unconscious biases in physicians regarding conflicts in developing care plans for patients related to religious restrictions in medicine. Fourteen physicians were interviewed to discuss their experiences with these patients and find patterns and factors that could lead to more negative attitudes from the physicians in the patient’s care. It was found that the gender, religious background, and location of residency had various impacts on the attitude of the physician regarding a religious concern; however, there was no outstanding demographic that led to a comparatively negative attitude. Additionally, the type of reasoning a patient used related to a religious concern had an impact on the attitude of the physician, and this was due to the logic and duration of the concern as well as the attitude of the patient. These factors and patient cases were thoroughly analyzed and discussed throughout the paper to shed light on possible factors that could negatively affect the patient’s care.

Date Created
2023-05
Agent

Bioethical Considerations for the Medical Use of In Vitro Embryogenesis

Description

In vitro embryogenesis is a revolutionary technology were researchers are able to culture stem cells, currently from mice, and differentiate the culture into an embryo showing key developmental characteristics. This technology has extensive medical benefits through creating a collection of

In vitro embryogenesis is a revolutionary technology were researchers are able to culture stem cells, currently from mice, and differentiate the culture into an embryo showing key developmental characteristics. This technology has extensive medical benefits through creating a collection of genetically identical tissues and organs from which patients can receive treatment options. However, there are significant ethical objections to growing an embryo simply to destroy it and take its tissues and organs. Using ethical discussions of in vitro fertilization and abortion ethics, I was able to develop a framework to begin to solve these ethical discussions by identifying several physiologic reductions, which instead make a reservoir of tissue rather than a rational being.

Date Created
2023-05
Agent

Cis-men’s Perspectives on Male Birth Control

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Description
Birth control promised to curb growing human populations while liberating women individually and socially. Instead, these technologies reinforce a feedback loop associating only women’s bodies with family-planning responsibilities. As a result, many diverse female contraceptives have reached markets while few

Birth control promised to curb growing human populations while liberating women individually and socially. Instead, these technologies reinforce a feedback loop associating only women’s bodies with family-planning responsibilities. As a result, many diverse female contraceptives have reached markets while few male contraceptives have. Cis-men’s attitudes are commonly offered as explanation for why novel male contraceptives have not reached markets at the same pace, but little research has investigated this. I address this gap through thematic analysis of focus group interviews exploring cis-men’s attitudes on existing and novel male contraceptives. Focus group findings suggest cis-men experience less urgency to contracept due to differences in physiological burdens of pregnancy and childbirth. Decreased urgency does not mean that cis-men are uninterested in contracepting or in novel contraception options, but that cis-men express boundaries to what they will endure when contracepting. Knowing men’s articulated boundaries can help male contraceptive research and development (R&D) efforts moving forward. Additionally, these findings call into question current clinical risk assessment systems wherein risk of the medication is compared to how the individual experiences (unintended) pregnancy in a purely physical sense. Lastly, these data crucially demonstrate cis-men’s interest in contracepting and having a complete clinical risk assessment system for developing, novel male contraceptives is still not enough. Systemic changes must occur for male contraceptive technologies to be accessible and utilized by cis-male populations. Because interviews were conducted before the Supreme Court’s landmark 2022 decision that overturned federal abortion protections, I expanded my research to include a follow-up survey gauging how participants’ attitudes from the focus groups were impacted, if at all. The follow-up survey demonstrated increased urgency for novel male contraceptives as a result of the Dobbs decision, for example, can increase cis-men’s urgency/interest in trying the interventions regardless of their lack of familiarity with the method or its potential side effects. Follow-up survey findings also demonstrate how cis-men’s urgency/interest for novel male contraceptives is highly influenced by the current socio-political context surrounding reproductive justice issues. This finding affirms that the focus group data finding that the current FDA (Food and Drug Administration) clinical risk assessment is incomplete.
Date Created
2022
Agent

In Defense of Uncertainty: Challenging the “Regret Narrative” of Gender Transition

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Description
Mainstream discussions of trans issues often center around the invocation of transition regret to make overarching claims about its ethicality. In understanding this pervasive specter of regret as an expression of broad uncertainty, I explore the complex history of enduring

Mainstream discussions of trans issues often center around the invocation of transition regret to make overarching claims about its ethicality. In understanding this pervasive specter of regret as an expression of broad uncertainty, I explore the complex history of enduring gender concepts, current best-practices in trans medicine, and detransition narratives. I argue that the uncertainties therein are inherent and explore what it would mean to embrace uncertainty in trans medicine.
Date Created
2022-05
Agent

Overcoming a Cycle of Shame Through Menstrual Education: How Sources of Information Prepare Girls to Detect and Treat Abnormal Menstrual Bleeding

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Description
In the US, menstrual education, which provides key information about menstrual hygiene and health to both young girls and boys, historically lacks biologically accurate information about the menstrual cycle and perpetuates harmful perceptions about female reproductive health. When people are

In the US, menstrual education, which provides key information about menstrual hygiene and health to both young girls and boys, historically lacks biologically accurate information about the menstrual cycle and perpetuates harmful perceptions about female reproductive health. When people are unable to differentiate between normal and abnormal menstrual bleeding, based on a lack of quality menstrual education, common gynecological conditions often remain underreported. This raises a question as to how girls’ menstrual education experiences influence the ways in which they perceive normal menstrual bleeding and seek treatment for common abnormalities, such as heavy, painful, or irregular menstrual bleeding. A mixed methods approach allowed evaluation of girls’ abilities to recognize abnormal menstrual bleeding. A literature review established relevant historical and social context on the prevalence and quality of menstrual education in the US. Then, five focus groups, each including five to eight college-aged women, totaling thirty-three participants, allowed for macro-level analysis of current challenges and gaps in knowledge related to menstruation. To better examine the relationship between menstrual education and reproductive health outcomes, twelve semi-structured, one-on-one interviews allowed micro-level analysis. Those interviews consisted of women diagnosed with endometriosis and polycystic ovary syndrome, common gynecological conditions that include abnormal menstrual bleeding. Developing a codebook of definitions and exemplars of significant text segments and applying it to the collected data revealed several themes. For example, mothers, friends, teachers, the Internet, and social media are among the most common sources of information about menstrual hygiene and health. Yet, women reported that those sources of information often echoed stigmatized ideas about menstruation, eliciting feelings of shame and fear. That poor quality of information was instrumental to women’s abilities to detect and report abnormal menstrual bleeding. Women desire and need biologically accurate information about reproductive health, including menstruation and ovulation, fertility, and methods of birth control as treatments for abnormal menstrual bleeding. Unfortunately, menstrual education often leaves girls ill-equipped to identify and seek treatment for common gynecological conditions. Those findings may influence current menstrual education, incorporating biological information and actively dismissing common misconceptions about menstruation that influence stigma.
Date Created
2021
Agent

Misinformation and COVID-19: A Case Study on Hydroxychloroquine

Description

COVID-19 misinformation covers a wide range of topics such as fatality rate, mask effectiveness, potential cures, vaccine development, and the idea of a "plandemic". The spread of this misinformation happens at a rapid speed with the help of social media

COVID-19 misinformation covers a wide range of topics such as fatality rate, mask effectiveness, potential cures, vaccine development, and the idea of a "plandemic". The spread of this misinformation happens at a rapid speed with the help of social media and powerful influencers, including major political figures. This thesis is a focused case study on hydroxychloroquine, and builds a timeline of the misinformation surrounding the drug. From poorly conducted studies to the use of false experts, this study reveals how politicized misinformation garners more public attention than the actual science.

Date Created
2021-05
Agent

Science and Social Governance: Lessons from the Human Genome Editing Debate

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Description

This thesis responds to the question, "Can Science Make Sense of Life?" through a structural lens of the Human Germline Genetic Editing debate. I explore who is absent from the table, and how the ways of thinking that dominate marginalize

This thesis responds to the question, "Can Science Make Sense of Life?" through a structural lens of the Human Germline Genetic Editing debate. I explore who is absent from the table, and how the ways of thinking that dominate marginalize and exclude alternative frameworks and considerations. This analysis is centered around an examination of several perspectives from the disability community and an in-depth study of how the Orthodox Jewish community contends with genetic disease. These perspectives illuminate several lessons that prove to bring insight not merely to questions of permissibility on genetic editing, but also offer reflections on the larger relationship between science, technology, and society. I then return to the mainstream genetic editing debate to show how the culture it is born out of and the structures it has ingrained prevent lessons such as these from impacting the conversation. In light of such structures that continuously reproduce the assertion that it is science, not humanity, that is able to make sense of life, my final argument is that though science tends to gatekeep questions of emerging technologies by centering conversations on highly advanced and methodological considerations, public individuals need not feel as if they are irrelevant or unessential. Though science may offer one solution, it is the individuals and communities, not results from a lab, that are equipped to determine if it is the best solution.

Date Created
2021-05
Agent

The Correlation Between Prevention Levels and Health Status

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Description

There is a lot of variation in health outcomes when it comes to individual states in America. Some states, such as Hawaii, have the life expectancy equivalent to that of developed countries, whereas states like Mississippi have the life expectancy

There is a lot of variation in health outcomes when it comes to individual states in America. Some states, such as Hawaii, have the life expectancy equivalent to that of developed countries, whereas states like Mississippi have the life expectancy equivalent to that of third world countries. This raised the questions of which states are doing well in health and why, and if their health has to do with their performance in the primary, secondary, tertiary, and/or quaternary prevention levels. The purpose of this research was to investigate if there is a correlation between performance in any of the prevention levels and the overall health status of a state, and if there is, which prevention level would be most beneficial for states to prioritize. The hypothesis of this research was: states that prioritized primary and secondary levels of prevention would have better health than states that prioritized tertiary and quaternary levels of prevention, since basic health measures contribute more to health outcomes than advanced medicine. To investigate this question, indicators were chosen to derive the ranking of each state in health and each of the four prevention levels. Six states were then chosen to represent the high, average, and low health statuses respectively. The six states were ranked for all indicators, and the data was analyzed and compared to determine a potential relationship between the prevention level rankings and the overarching health ranking. It was found that there is a correlation between performance in the primary and secondary prevention levels and a state’s overall health status, whereas there was no such correlation for the tertiary and quaternary levels. A model for health was proposed for states looking to improve their health status, which was to invest in primary prevention, followed by secondary, tertiary, then quaternary prevention and only moving to the next prevention level once the previous level reached a satisfactory threshold.

Date Created
2021-05
Agent