Research

A cover of Hypatia journal with illustration of diverse womenImposing Values and Enforcing Gender through Knowledge: Epistemic Oppression with the Morning-after Pill’s Drug Label

Hypatia 2022 [Email for Full Text]

This paper is about the harmful and unfair consequences of the US FDA’s outdated and misinformative labeling of LNG emergency contraceptive pills and its relation to dubious claims from antiabortionists of “right to conscience,” "conscientious objection,” and “religious freedom.” I explore the ethical problems of deception and injustice stemming from this alleged "Drug Fact" which is laden with antiabortion values, including how it limits the agency of patients as knowers and reinforces oppression through the paternalism and misogyny of provider refusals.

Abstract

Among feminist philosophers, there are two lines of argument that sexist values are illegitimate in science, focusing on epistemic or ethical problems. This article supports a third framework, elucidating how value-laden science can enable epistemic oppression. My analysis demonstrates how purported knowledge laden with sexist values can compromise epistemic autonomy and contribute to paternalism and misogyny.

I exemplify these epistemic wrongs with a case study of the morning-after pill (emergency contraception) during its 2006 switch to over-the-counter availability and its new drug label from the US Food and Drug Administration that it “may prevent implantation.” Antiabortion science advisers created this label to protect zygotes based on debated value judgments that were later concealed. This zygote-centric knowledge enabled them to shape potential users by instructing “good mothers” that they ought to protect zygotes and punishing “bad mothers” by refusing their requests for the drug. Therefore, I argue that the sexist values and gender norms of antiabortionists that prioritize zygotic health are illegitimate in this context because they cause epistemic injustices and perpetuate epistemic oppression. Furthermore, I advocate against blanket protections for the “right to conscience” and “religious freedom” of healthcare providers because they reinforce the epistemic oppression of women, especially those on the margins.

SHPS CoverStill No Pill for Men?
Double Standards & Demarcating Values in Biomedical Research

Studies in History and Philosophy of Science Part A 2022 [Full Text here]

Why is there still no highly effective, reversible contraceptive for cisgender men? The methodology of clinical trials has entrenched double standards, which ought to be changed on the grounds of equity.

*selected for Elsevier’s Special Issue for International Women’s Day 2022 (March 8). https://sdgresources.relx.com/articles/still-no-pill-men-double-standards-demarcating-values-biomedical-research

Abstract

Double standards are widespread throughout biomedicine, especially in research on reproductive health. One of the clearest cases of double standards involves the feminine gendering of reproductive responsibility for contraception and the continued lack of highly effective, reversible methods for cisgender men. While the biomedical establishment accepts diversity and inclusion as important social values for clinical trials, their continued use of inequitable standards undermines their ability to challenge unfair social hierarchies by developing male contraception.

Thus, the gender/sex bias present in contraceptive research raises the “New Demarcation Problem”: If we accept that values can and will play important roles in science, how can we nevertheless distinguish positive influences of values from more corrosive bias? I argue that biomedical researchers ought to aim their clinical trials at equity and utilize methodologies that actually achieve that aim. More specifically, I contend that we can avoid the problem of double standards by gender/sex in contraceptive research by utilizing more equitable standards. My demarcation strategy captures dynamic interplay between values and their effects, with direct policy implications for institutions conducting, funding, and evaluating clinical trials. For male contraceptive trials, this involves shifting risk assessment from an individual model to a shared model for sexual partners.

Contra CoverThe FDA Ought
to Change Plan B’s Label

Contraception 2021 [Email for full text*]

*Spanish translation available

The emergency-contraceptive pill Plan B has long been falsely equated with abortion because of allegations about its possible post-fertilization mechanism. This peer-reviewed commentary builds on my previous research about Plan B's FDA Drug Label, arguing that it ought to be changed to no longer mention the possibility of a post-fertilization effects.

Abstract

This commentary defends 3 arguments for changing the label of levonorgestrel-based emergency contraception (LNG EC) so that it no longer supports the possibility of a mechanism of action after fertilization. First, there is no direct scientific evidence confirming any postfertilization mechanisms. Second, despite the weight of evidence, there is still widespread public misunderstanding over the mechanism of LNG EC. Third, this FDA label is not a value-free claim, but instead it has functioned like a political tool for reducing contraceptive access. The label is laden with antiabortion values (even though EC is contraception, not abortion), and it imposes these values on potential users, resulting in barriers to access such as with Burwell v. Hobby Lobby. These 3 arguments together provide scientific, social, and ethical grounds for the FDA to take the initiate in changing Plan B's drug label.

Cover of Public Affairs Quarterly journalDrug Facts, Values, and
the Morning-After Pill

 

Public Affairs Quarterly 2021 [Full Text here]


In this paper, I explore how values can influence the creation of scientific facts, such as the FDA drug label for the emergency contraceptive Plan B & the debates over its alleged ability to cause abortion.  

Abstract

While the Value-Free Ideal of science has suffered compelling criticism, some advocates like Gregor Betz continue to argue that science policy advisors should avoid value judgments by hedging their hypotheses. This approach depends on a mistaken understanding of the relations between facts and values in regulatory science.

My case study involves the morning-after pill Plan B and the “Drug Fact” that it “may” prevent implantation. I analyze the operative values, which I call zygote-centrism, responsible for this hedged drug label. Then, I explain my twofold account of value-ladenness, involving the constitutive role of value judgments in science and the social function of facts as political tools. Because this drug fact is ineliminably value-laden in both senses, I conclude that hedged hypotheses are not necessarily value-free.

Image of the cover of Synthese magazine.

Broadening the Scope of Our Understanding of Mechanisms: Lessons from the History of the Morning-After Pill

Synthese 2019 [Full Text here]

This paper examines how mechanistic knowledge about how a drug works can involve ethics, morals, and politics, such as abortion, population control, and women's agency and access.

Abstract

Philosophers of science and medicine now aspire to provide useful, socially relevant accounts of mechanism. Yet, their primary focus has been on more proximate issues related to therapeutic effectiveness. To take the next step toward social relevance, we must investigate the challenges facing researchers, clinicians, and policy makers involving values and social context.

This paper uses debates over the controversial morning-after pill (emergency contraception) to gain insight into the deeper reasons for the production and use of mechanistic knowledge throughout biomedical research, clinical practice, and governmental regulation. To practice socially relevant philosophy of science, I argue that we need to account for mechanistic knowledge beyond immediate effectiveness, such as how it can also provide moral guidance, aid ethical categorization in the clinic, and function as a political instrument.

Cover Image of The Philosophy of Science publication.The Error Is in the Gap:
Synthesizing Accounts for Societal Values in Science

 

Philosophy of Science 2018 [Full Text here]

This paper examines the the different ways that philosophers have argued that ethical value judgments undermine value-freedom in science.

Abstract

Kevin Elliott and others separate two common arguments for the legitimacy of societal values in scientific reasoning as the gap and the error arguments (respectively, the arguments from underdetermination and from inductive risk). This article poses two questions: How are these two arguments related, and what can we learn from their interrelation?

I contend that we can better understand the error argument as nested within the gap because the error is a limited case of the gap with narrower features. Furthermore, this nestedness provides philosophers with conceptual tools for analyzing more robustly how values pervade science.

Cover Image of the Accountability in Research publication,Pesticides, Neurodevelopmental Disagreement, and
Bradford Hill’s Guidelines

Accountability in Research 2017,
with Kristin Shrader-Frechette [Full Text here]

This paper analyzes some of the methodological problems stemming from conflicts of interest (COIs) in industry-funded research, criticizing debatable studies on organophosphates funded by pesticide manufacturers.

Abstract

Neurodevelopmental disorders such as autism affect one-eighth of all U.S. newborns. Yet scientists, accessing the same data and using Bradford-Hill guidelines, draw different conclusions about the causes of these disorders. They disagree about the pesticide-harm hypothesis, that typical United States prenatal pesticide exposure can cause neurodevelopmental damage.

This article aims to discover whether apparent scientific disagreement about this hypothesis might be partly attributable to questionable interpretations of the Bradford-Hill causal guidelines. Key scientists, who claim to employ Bradford-Hill causal guidelines, yet fail to accept the pesticide-harm hypothesis, fall into errors of trimming the guidelines, requiring statistically-significant data, and ignoring semi-experimental evidence. However, the main scientists who accept the hypothesis appear to commit none of these errors. Although settling disagreement over the pesticide-harm hypothesis requires extensive analysis, this article suggests that at least some conflicts may arise because of questionable interpretations of the guidelines.

Read my papers on Academia.edu