This page intentionally left blank Naturalized Bioethics Naturalized Bioethics represents a revolutionary change in how health care ethics is practiced It calls for bioethicists to give up their dependence on utilitarianism and other ideal moral theories and instead to move toward a self-reflexive, socially inquisitive, politically critical, and inclusive ethics Wary of idealizations that bypass social realities, the naturalism in ethics that is developed in this volume is empirically nourished and acutely aware that ethical theory is the practice of particular people in particular times, places, cultures, and professional environments The essays in this collection examine the variety of embodied experiences of individual people They situate the bioethicist within the clinical or research context, take seriously the web of relationships in which all human beings are nested, and explore a number of the many different kinds of power relations that inform health care encounters Naturalized Bioethics aims to help bioethicists, doctors, nurses, allied health professionals, disability studies scholars, medical researchers, and other health professionals address the ethical issues surrounding health care Hilde Lindemann is Professor of Philosophy at Michigan State University A former editor of Hypatia and the Hastings Center Report, she is the author of a number of books, including An Invitation to Feminist Ethics and Damaged Identities, Narrative Repair Marian Verkerk is Professor of the Ethics of Care at the University Medical Center, Groningen, in the Netherlands, where she is also Head of the Department of Medical Ethics, Health Law, and Medical Humanities and Director of the Center for the Ethics of Care Margaret Urban Walker is Lincoln Professor of Ethics and Professor of Philosophy at Arizona State University Her work on moral epistemology and moral psychology includes Moral Repair: Reconstructing Moral Relations after Wrongdoing; Moral Contexts; and Moral Understandings: A Feminist Study in Ethics, now in its second edition Naturalized Bioethics Toward Responsible Knowing and Practice Edited by HILDE LINDEMANN Michigan State University MARIAN VERKERK University of Groningen MARGARET URBAN WALKER Arizona State University CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521895248 © Cambridge University Press 2009 This publication is in copyright Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press First published in print format 2008 ISBN-13 978-0-511-43732-8 eBook (EBL) ISBN-13 978-0-521-89524-8 hardback Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate Contents Contributors Acknowledgments Introduction: Groningen Naturalism in Bioethics Margaret Urban Walker I re s p on s i b le kn ow i n g Moral Bodies: Epistemologies of Embodiment Jackie Leach Scully Choosing Surgical Birth: Desire and the Nature of Bioethical Advice Raymond G De Vries, Lisa Kane Low, and Elizabeth (Libby) Bogdan-Lovis Holding on to Edmund: The Relational Work of Identity Hilde Lindemann Caring, Minimal Autonomy, and the Limits of Liberalism Agnieszka Jaworska Narrative, Complexity, and Context: Autonomy as an Epistemic Value Naomi Scheman Toward a Naturalized Narrative Bioethics Tod Chambers page vii xiii 23 42 65 80 106 125 v vi r e s p o ns i bl e p ct i c e Motivating Health: Empathy and the Normative Activity of Coping Jodi Halpern and Margaret Olivia Little Contents II Economies of Hope in a Period of Transition: Parents in the Time Leading Up to Their Child’s Liver Transplantation Mare Knibbe and Marian Verkerk Consent as a Grant of Authority: A Care Ethics Reading of Informed Consent Joan C Tronto 10 Professional Loving Care and the Bearable Heaviness of Being Annelies van Heijst 11 Ideal Theory Bioethics and the Exclusion of People with Severe Cognitive Disabilities Eva Feder Kittay 12 Epilogue: Naturalized Bioethics in Practice Marian Verkerk and Hilde Lindemann 143 162 182 199 218 238 Bibliography 249 Index 267 Contributors Elizabeth (Libby) Bogdan-Lovis is Assistant Director of the Center for Ethics and Humanities in the Life Sciences and Co-director of the Bioethics, Humanities, and Society Program at Michigan State University She precepts ethics modules in the College of Human Medicine Her master’s thesis adopted a critical social science perspective focusing on the political economy of childbirth management This same approach, which examines the distribution of power and wealth and its effects on health and healing, aptly characterizes her ongoing scholarship Her most recent work includes a coedited issue of Social Science and Medicine devoted to a social analysis of evidencebased medicine Tod Chambers is Associate Professor of Bioethics and Medical Humanities and of Medicine at Northwestern University’s Feinberg School of Medicine His areas of research include the rhetoric of bioethics and cross-cultural issues in clinical medicine He is the author of The Fiction of Bioethics (Routledge, 1999) and, with Carl Elliott, is coeditor of Prozac as a Way of Life (University of North Carolina Press, 2003) He is presently working on a second monograph on the rhetoric of bioethics Raymond G De Vries is a member of the Bioethics Program, the Department of Obstetrics and Gynecology, and the Department of Medical Education at the Medical School, University of Michigan He is the author of A Pleasing Birth: Midwifery and Maternity Care in vii viii Contributors the Netherlands (Temple University Press, 2005) and coeditor of The View from Here: Bioethics and the Social Sciences (Blackwell, 2007) He is working on a critical social history of bioethics and is studying the regulation of science; clinical trials of genetic therapies and deep brain stimulation; international research ethics; informed consent and the “problem” of therapeutic misconception; and the social, ethical, and policy issues associated with nonmedically indicated surgical birth Jodi Halpern is Associate Professor of Bioethics and Medical Humanities at the University of California, Berkeley She was in the Medical Scientist Training Program at Yale University and received her M.D in 1989 and her Ph.D in Philosophy in 1994, winning Yale’s Porter Prize for outstanding dissertation across all disciplines She completed her internship and residency in psychiatry at UCLA in 1993 and a Robert Wood Johnson Clinical Scholar Fellowship at UCLA in 1996 During 1997–98 she was a Rockefeller Fellow at Princeton University The author of From Detached Concern to Empathy: Humanizing Medical Practice (Oxford University Press, 2001), she has a Greenwall Faculty Fellowship to study the role of emotional predictions in health care decisions about unfamiliar future health states Agnieszka Jaworska is Associate Professor of Philosophy at the University of California, Riverside Her research lies at the intersection of ethical theory, medical ethics, and moral psychology Her current project, entitled “Ethical Dilemmas at the Margins of Agency,” concerns the ethics of treatment of individuals whose status as persons is thought to be compromised or uncertain, such as Alzheimer’s patients, addicts, psychopaths, and young children It is part of a larger investigation of the nature of caring as an attitude Professor Jaworska received her B.S.E from Princeton University and her Ph.D from Harvard University She was trained in clinical bioethics in the Department of Bioethics at the National Institutes of Health She has published in Ethics, Philosophy and Public Affairs, and Philosophy and Phenomenological Research Eva Feder Kittay is Professor of Philosophy at SUNY, Stony Brook She publishes on care ethics, feminist philosophy, and disability theory Major publications include Love’s Labor: Essays on Women, 268 autonomy (cont.) patient, 69, 71, 105, 182–4, 201 and consent, 182 contradicting values, 81 perceptual, defined, 113 physician, 49 precedent (Dworkin), 76 professional, 49–51 relational, 187 and contextual, 108, 115 respect for, 108, 110 and self-governance, 93 avoidance, 152 Bacon, Francis, 209 bad news, delivering, 153 Baier, Annette, 191 Balance and Refinement (DePaul), 244 Baumann, Richard, 138 Beauchamp, Tom, 6–9, 11–12, 182 Beauvoir, Simone de, 205 Becket, Thomas, 133 behavior, neonatal, 52 behavioral change, motivating, 144–5 belief, 165, 169 Belmont Report, 183 beneficence, 8, 27, 43, 60, 62 Benjamin, Walter, 138 bioethics and change, 238 engineering model of (Caplan), 11 ethics of care approach to, defined, 183 and exclusion of viewpoints, 23 moral principles essential to (Beauchamp and Childress), 8–9, 11 resocializing (Farmer and Campos), role of, in ethics education, 243 routinization of deliberation in, 43 shaped by desire, 62 and social context, 63 stages of, 240 standard versus naturalized, 69 Index bioethics, naturalized approaches to, 10 of disability, 25 and ethical theories, 23 and ethics of care, 216 and moral authority of local claims, 40 and moral intuitions, 28 in practice, 238–47 and reflexivity, 10, 246–7 and specificity of the social situation, 37 skepticism of, 23 biography, 133–5 and medical ethics, 130 birth breech position, 49, 53, 56 home versus hospital, 52 increasing technology around, 56 nurse characterizations of, 57 surgical and desire, 47 MSNBC e-discussion on, 58 obstetrician preference for, 47 statistics for, 45 vaginal intervention in, 50 and pelvic floor damage, 45, 46 blood pH, umbilical cord, 52 Bodies in Revolt (O’Brien), 206 Bogdan-Lovis, Elizabeth, 16, 19 Bourdieu, Pierre, 15, 34–7, 38–40 breast cancer, 102 Brody, Howard, 132, 186, 192 Brown, Wendy, 189 Callahan, Daniel, 69–71 Campos, Nicole Gastineau, Caplan, Arthur, 11 care necessary, power imbalance in, 18 professional, final goal of, 200 care, ethics of defined, 204 feminist roots of, 204 and naturalism, 205 Index and naturalized bioethics, 199 caring, 89, 91, 102, 104, 153 and autonomy, 81 practice of, 234, 235 carnality, 204, 206, 207 cultural ideas of, 208 Cassell, Eric, 73 casuistry, 239 Catcher in the Rye, The (Salinger), 136 CDMR (cesarean delivery on maternal request), 44–8, 224–5 meta questions of, 44 risks and benefits of, 49 statistics for, 45–7 Chambers, Ross, 128, 138 Chambers, Tod, 15, 16, 19 Childress, James, 8–10, 11 choice, 58 Cinderella, 127 commonality, 23 competence, moral, requirements of, 243 consent as autonomous authorization (Epstein), 187 as autonomy, 182–4, 189, 191, 192 versus consent as surrender, 189 and beneficence, 194 clinical, 18 elements of traditional, 182 as grant of authority, 189, 191 informed, 17, 64, 121, 184 and paternalism, 64 and power imbalance, 185 institutional arrangement of, 182 and justice, 195, 197 legitimizing power, 189 mandatory informed, 59 as shared decision making (Schneider), 184 as surrender, 187–9 as trade-off, 188 consenting, ritual of, 19 context, morally relevant, 10 conversation, power-sensitive (Haraway), 11 269 coping, 15, 151–4 defined, 144, 151 normative, 15 counterstories, 130 CSMR (congenital severe mental retardation), 221, 224, 225, 229, 233 culture, Deaf, 30–2 curiosity, 7, 11 and empathy, 155 d’Haese, Roel, 209 De Jong, P A., 53 De Vries, Raymond, 16, 19 death tame (Arie`s), 69 by technological attenuation (Callahan), 70 wild (Arie`s), 69–71 DeBruin, Debra, 120 decision, minimal conditions of an autonomous, 88 Declaration of a Desire for a Natural Death, 67 definitions, stipulative, 234 deliberation, moral, 238–9 dynamic, 239 denial, 151, 160 DePaul, Michael, 244 designer babies, Deaf, 27, 33 desirability, 168 desire attributes of, 47 birthing mother, 57 influencing science, 54 nurse, 57 physician, 55, 57 professional, 48, 50, 54, 60, 64 shaping bioethics, 62 Dewey, John, diabetes, 207 direction of fit, 149 disability, 24, 33, 37, 38 defined, 24 epistemology of, 25 moral character of, 24 naturalized bioethics of, 25 Index 270 disclosure, full, 196 discourse, situated, disease, 162 defined, 207 disenfranchisement, epistemic, 117 doptone, 56 Doris, John, 2, 71 Drabble, Margaret, 107 Dresser, Rebecca, 76, 77 Duchesneau, Sharon, 27–30, 37, 40 Dworkin, Ronald, 75, 76 dying, shifting definition of, 70 emotional episodes, 89 empathy, 144, 155–9 clinical, 155 defined, 155 and dilemma, 156, 157, 158, 160 enterprise, existential, 151 Epe´e, Abbe´ de l’, 30 Epstein, M., 184, 187, 189 equilibrium, reflective (Rawls), 11–14, 232, 239 Eternal Sunshine of the Spotless Mind, 125, 126 ethics applied, 11 best practices of, 227–34 disability (Scully), 25 empirically informed (Doris), feminist, 23, 25 and naturalism, potent theme of, 17 naturalism in, 1, 4–5 common denominator of, minimally defined, participatory, 239 principlist model of, 11 reflective equilibrium theory construction in, 11, 12 as storytelling, 131 Ethics of Killing, The (McMahan), 221, 224, 229 ethnography, 135 exclusion, 24 fabula, 126, 127, 131–3 defined, 126 Faden, Ruth, 182 Farmer, Paul, feminism, and naturalism in ethics, fetoscope, 56 Fludernik, Monika, 134, 135 Forster, E M., 135 Foucault, Michel, 216 Frank, Arthur, 137 Frankfurt, Harry, 88 friendship, unequal, 203 futurity, 168 Gawande, Atul, 80, 81–2, 85, 101, 103 Geller, Robert, 57 Gilligan, Carol, 205 Glover, Jonathan, Goffman, Irving, 138, 216 Groopman, Jerome, 166 Habiba, M., 56 habitus (Bourdieu), 15, 34–7 bioethicist, 38–40 changing, 39 Deaf, 35, 36, 38 defined, 34 ethical relevance of, 36 Halpern, Jodi, 15, 18, 19, 96 Hamlet, Prince of Denmark, Tragedy of (Shakespeare), 126 Hannah, Mary, 49, 50, 54 Haraway, Donna, 11 Harer, W Benson, Jr., 49, 50 health behaviors, barriers to changing, 145 contextual, 146, 147 educator, clinician as, 145 health care objectification in, 202 and social inequality, 197–8 Western paradigms of, 200 Index Healthy at Every Size (HAES), 154 helplessness, learned, 147 Henry II, 133 hermeneutics, 239 hexis (Bourdieu), 34 hierarchy, motivational, 94, 96 Higgins, Paul, 35 Hobbes, Thomas, 188, 189 holding, in identity, 72–4, 77–9 hope, 163, 164–6 activities involved in, 167 and agency, 163, 166, 167 belief-and-desire conception of, 166 defined, 165, 168 economy of, 170, 172, 177 defined, 170 efficacy of, 169 evaluating, 170 features of, 168, 173–5 futurity of, 173, 174 and goals, 167 and healing, 166 phenomena of (Walker), 168 social character of, 173, 178 as state of mind, 167 hoping space, 163 Hull, Margaret, 131–3, 139 Hume, David, humility, 16, 227, 230, 234, 235 idealization, 218, 219 problematic use of, 222 identity Deaf world, 31 defined, 72 as life story (Montgomery), 132 maintaining, 72 and narrative, 72, 73 and trauma, 73 idiosyncrasy, locus of (Scheman), 113–14 Ignatieff, Michael, 203 illness, as a call for stories (Frank), 137 271 imagination, 8, 11 embodied, 176 impairment, 25, 38, 206–7 cognitive, 219 defined, 24, 37 hearing prediscursive features of, 33 as sociolinguistics, 29, 30, 33 profound cognitive, defined, 228 incompetence, epistemic, presumption of, 117 insurance, malpractice, 56 integrity, defined, 114 interests, 47–8 critical (Dworkin), 76 experiential (Dresser), 76 experiential (Dworkin), 75 internality, models of, 88 International Federation of Gynecologists and Obstetricians (FIGO), 61 International Urogynecology Journal, 54 Internet Movie Database, 125 intervention, incremental and realistic, 147 intuitions, 8, 12, 218 moral, 232 Irigaray, Luce, 208–11 Jaggar, Alison, Jaworska, Agnieszka, 14, 19 Journal of Perinatal Medicine, 53 judgment, moral, justice, 8, 43, 60, 62, 195, 220 workplace, 206 Kant, Immanuel, 188 kasai, 164 Kitcher, Philip, Kittay, Eva, 14, 16, 19–20, 185 Knibbe, Mare, 17, 19 knowledge indigenous, 118 patient, 118, 120 Knowles, Dom David, 133 272 Kolata, Gina, 197 Kuhse, Helga, 221 L’oubli de l’air (The Forgetting of Air, Irigaray), 208 Labov, William, 134 language, sign, 29–31, 33–4 marginalization of, 32 Leeman, L M., 55 Leeuw, F De, 54 Lerner, Barron, 139 Liaschenko, Joan, 57, 120 liberalism, strict, 84 Lievaart, M., 52–4 life story, 132, 134, 135, 136–7, 138 Life’s Dominion (Dworkin), 75 Lindemann, Hilde, 13, 14, 18, 112, 115, 129–31, 133 Little, Margaret, 15, 18, 19 “Living Related Donation,” 164 Locke, John, 188, 190 Low, Lisa Kane, 16, 19 MacIntyre, Alasdair, 128, 132, 133, 136 marginality, 24 Martin, Wallace, 126 McCullough, Candace, 27–8, 29–30, 37, 40 McLeod, Carolyn, 187, 195 McMahan, Jeff, 16, 220–2, 224, 226, 228–30, 231, 232–4 meaning, prereflexive, 34 memento mori, 210 memoirs, 134, 137 Deaf, 30–2 disability, 26 mereological perspective, defined, 107 midwives, 56, 57 Dutch, 51, 53 Milan Congress, 30 Miles, Steven, 131, 132, 139 Mill, John Stuart, 83 Mills, Charles, Index Mink, Louis O., 133 modesty, epistemic, 16, 227, 230 Mol, Annemarie, 207–9 Montgomery, Kathryn, 131 moral theory, as situated discourse, Moral Understandings (Walker), 205 morality de facto, defined, 246–7 models of, 239 origin of, process model of, 239 product model of, 239 Morskieft, Marja, 210 motivation, fear, 153 Myerhoff, Barbara, 135 Narayan, Uma, 118 narrative, 15 autonomous, 113 coherence, 131 defined, 113 endings, 133 ethics, 132 and coherence, 131 naturalized, 138, 139 in ethics, 128 as fundamental observable quality of life (Brody), 132 master, 130 natural, three genres of (Fludernik), 134 and perceptual autonomy, 113 point of a, 128, 138 repair (Lindemann), 130 role of, 112 salient, 113 self-repair, 137 and shared conventions, 131 unified, 129 Narrative Versions, Narrative Theories (Smith), 127 National Institution for Deaf-Mutes, 30 Index naturalism in ethics, 2–3 and ethics of care, 205 feminist, 3–5 and relativism, pragmatic (Kitcher), Nazi experimentation, 109 Nelson, James Lindemann, 11 Netherlands Organization for Scientific Research, 13 Neurath, Otto, NMISB (nonmedically indicated surgical birth), 48, 55, 60, 64 deep lesson of, 64 professional opinions about, 61 Noddings, Nel, 205 nonmaleficence, 8, 43, 60, 62 Nozick, Robert, 226 Nuremberg Trials, 227 273 philosopher, moral, versus medical ethicist, 130 philosophy, experimental, Plante, L A., 55 Plato, 185 PLC (Professional Loving Care), 16, 19, 203 defined, 18, 203 manifestations of, 203 professional training in, 214 qualities of, 213 pluralism, reasonable value, 235 possibility, nonzero, 169 power imbalance, in medical care, 183, 185, 186–8, 211, 238 Pratt, Mary Louis, 135 precautionary principle, defined, 59 precepts, ethical, learned, 10 Preston, P., 35 principlism (Beauchamp and Childress), 8–10, 43, 60 proxy, medical considerations of, 71 dilemma of, 65–9, 74, 77, 115 maintaining patient identity, 72, 74, 77–8 O’Brien, Ruth, 206, 208 O’Neill, Onora, 185, 218, 219 obstetrics, in the Netherlands, 51 Ollivier, J M., 212 Onfray, Marie-Claude, 209, 212, 213 Onfray, Michael, 209, 212, 213 Ong, Walter, 135 ownership, 88 questions, reidentification and characterization (Scechtman), 74 Parfit, Derek, 224 particularism, 40 paternalism, 64, 81, 82, 84 as disrespect for minimally autonomous choices, 103 pathways (Snyder), 167 patient, as consumer, limitation of the model of, 192 Patient’s Bill of Rights, 186, 191 Payer, L., 50 pelvic floor, 45, 46, 54 perception, risk, psychology of, 146 perceptions and sensations, patient, 118–20 perfectionism, liberal, 85, 103 Rabinowitz, Paul, 130 race, philosophy of, and naturalism in ethics, Racial Contract, The (Mills), Rawls, John, 12 realism, moral, reality, and the social world, 35 reason, practical, versus theoretical, 149 reflection square, 240–4 reflection, first-order, 97 reflexivity, Regan, M., 57 Regan, Tom, 226 relationship, 204 274 relativism cultural, 148 value, 235 Republic, The (Plato), 185 research community-based participatory, 121 ethical rules concerning humans in, 109 and respect for subject autonomy, 108 respect, 183 responsibility, 234 epistemic, 16, 227, 234 mapping the geography of (Walker, M.), 240 Rethinking Life and Death (Singer), 223 risk, communicating, 15 and coping, 144, 154 defined, 144 dominance model of, 159 and emotion, 147 and fear, 159–60 and integration, 154 limitations of, 148 mental noise model of, 159 Rosencrantz and Guildenstern Are Dead (Stoppard), 126 Rousseau, Jean Jacques, 188 Ruddick, Sara, 205 Sacks, Oliver, 132 Salinger, J D., 136 Schechtman, Marya, 74 Scheman, Naomi, 16, 17 Schiavo, Terry, 78, 139 schools, residential, for hearing impaired, 29–31 Schultz, Paul, 110, 114 Scully, Jackie, 14, 15, 16, 18, 19 Sea Lady, The (Drabble), 107 Second Opinion, 131 seeing, moral (DePaul), 244 self moral, philosophy’s standard model for, 24 punctual (C Taylor), 129 Index self-governance, normative, 93, 94 selfhood, holding, 69, 71, 77–9, 112 Shakespeare, William, 126 Sherwin, Susan, 187, 195 Should the Baby Live? (McMahan), 221 Singer, Peter, 16, 220, 221, 222–4, 228, 231 thought experiment of, 227 situated observer, 10 sjuzet, 126 defined, 126 smartness pyramid (Schultz), 114 Smith, Adam, Smith, Barbara Herrstein, 126–9 Snow, C P., 107 Snyder, C R., 167, 173 social contract, and racial ideology, societies, structured by inequalities, Socrates, 235 Song of Evil (d’Haese), 209 special institution (Singer), 222–4 speciesism, 222 Stoppard, Tom, 126 Stories of Sickness (Brody), 132 story, basic, 126–9 storytelling in eastern Texas, 138 event (Bauman), 138 nonspontanous, three genres of (Fludernik), 134 spontaneous conversational (Fludernik), 134 structure, deep, 127 suffering, as identity disintegration (Cassell), 73 Taylor, Charles, 129 teleology, Aristotelian, theorizing, bioethical, maxims of good (Kittay), 16 theory, ideal, distinguishing characteristic of, 218 therapy, genetic, ethical problems associated with, 43 Index thinking agentic, 167 magical, 152 Thomas Saga, 133 Tolstoy, Leo, 228 transition, 162–4, 180 challenges prior to transplantation, 165 and incremental statements, 153 transplantation, liver, 162, 164, 165, 171 treatment, physician’s role-bias toward, 70 Treffers, Pieter, 52–4 Tronto, Joan, 17, 18 Troubled Dream of Life, The (Callahan), 69 trust, 193 defined, 191 scientific and public, 109, 122 turn constructional units (TCU), 135 Turner, Victor, 133 Tuskegee syphilitic study, 109 275 University Medical Center Groningen, 164, 199 urogynecology, 54 defined, 45, 54 utilitarianism, 220 van der Burg, Wibren, 239 van Heijst, Annelies, 15, 18, 19 variation, physical, 24 Veatch, Robert, 70 Velleman, David, 93 Verhoeven, A., 54 Verkerk, Marian, 13, 17, 19, 199 vulnerability, 204 Walker, Lou Ann, 34 Walker, Margaret Urban, 13, 23, 129, 163, 168, 180, 205 Watson, Gary, 88, 97 When Illness Goes Public (Lerner), 139 Woese, Carl R., 112 Wounded Storyteller, The (Frank), 137 writing, and memory, 135 Yeats, William Butler, 112 understanding, moral, generalized, 37 Zion, Libby, 139 ... Naturalized Bioethics Toward Responsible Knowing and Practice Edited by HILDE LINDEMANN Michigan State University MARIAN VERKERK University of Groningen MARGARET URBAN WALKER Arizona State University CAMBRIDGE. .. United States of America by Cambridge University Press, New York www .cambridge. org Information on this title: www .cambridge. org/9780521895248 © Cambridge University Press 2009 This publication... State University CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK Published