Women were expected to demonstrate a more relational sense of autonomy and more relational self-construal, as well as a stronger tendency towards an ethic of care. Women scored significantly higher than men on the Relational Interdependent Self-Construal Scale, indicating a more relational self-construal in women.
INTRODUCTION
HIV/AIDS and Clinical Research in Developing Countries
In South Africa, not only is the rate of HIV infection particularly high, it is consistent with the wider rate of infection in Africa by falling disproportionately on the shoulders of some of the most vulnerable citizens: poor, illiterate, unhealthy Black women and children . The gender-based physical, emotional and psychological violence, as well as the social and economic deprivation to which women are regularly subjected, are symptomatic of the wider gender inequality that further increases women's lack of personal autonomy, as is the case in many of the African societies in Sub-Saharan Africa (Jackson, . 2002).
Gender and the Limits of Conventional Approaches to Autonomy in Ethics and
For these reasons and in this context, the current study attempts to present a reconceptualization of women's autonomy within the real-life experiences of women most affected by HIV, who are likely to be the targets of much clinical research conducted in developing countries such as South Africa. Essentially, the critique of these concepts involves a critique of individualism, which emphasizes the current notions of autonomy used in mainstream bioethics.
LITERATURE REVIEW
Conventional Approaches to Autonomy in Philosophy, Ethics and Bioethics
- The “Four-Principles” Approach and the Principle of Autonomy
- Informed Consent and the Principle of Autonomy
- Components of informed consent
- Barriers to obtaining informed consent
- Challenges to autonomy in informed consent: paternalism versus “mandatory
- The Principle of Autonomy: Conceptual Challenges
- The Principle of Autonomy: Challenges Posed by Contemporary Ethical Issues
- An Alternative Approach: Challenges from Virtue Ethics
Informed consent is one of the critical issues in the ongoing debates about the ethical conduct of medical practice and biomedical research. Here again the principles of beneficence and non-maleficence pose a significant challenge to the apparent dominance of the principle of autonomy.
Feminist Critiques of Traditional Bioethics and the Principlist Approach to Autonomy .40
- Feminist Critiques of Conventional Autonomy
- Principled autonomy and (the neglect of) gender
- Principled autonomy and (the neglect of) context and relationships
- Principled autonomy, patriarchy and power
- Autonomy in context
Because standard concepts of autonomy seem to suggest that decision-making takes place in isolation from the relationships in which women are embedded, according to Goldberg. Accounts of autonomy must be aware of people's dependence, of their embeddedness in relationships, and of the relevance of both to ethical decision-making (Adshead, 2001).
Justice versus Care: An Ethic of Individualism versus an Ethic of Connectedness, Men
- The Problem with Conventional Ethics: Individualism and Androcentrism
- Justice versus Care Perspectives: Men (Kohlberg) versus Women (Gilligan)
- An ethic of justice: Critique
- An ethic of care
- Value of care ethics
- Problems with care ethics
- Integration of justice and care
In contrast, the values of care and connection, prominent in women's experience, offer a view of the self as interdependent on others, and of relationships as networks of affiliation (Gilligan, 1986). The rehabilitation of the feminist ethics of care is an important step towards constructing a conception of autonomy compatible with a. The emphasis on the relational nature of the moral agent in zooethics recognizes the importance of relationships in the development of autonomy.
Feminist (Re)-Conceptions of the (Gendered) Self
- Gender and Self
- Models of Self Development
- The Self in Ethical Context
- Feminist (Re)Conceptions of the Self
The connection between gender and notions of self, however, has only recently begun to receive attention. These findings add weight to the need to develop more relational notions of self that will be applicable to both men and women. It is this relational view of the self that underlies many of the feminist alternatives to traditional (individualistic) notions of autonomy that have been developed.
Feminist Alternatives to Principled Autonomy: Relational Models
- Relational Autonomy: Feminist Models
- Relational Autonomy in Context: Power and Relationship
Another alternative to the traditionally individualistic views of autonomy in the ethical mainstream has been proposed by Hoagland (1988). However, this alternative does not eliminate the importance of autonomy in the caring individual's self-concept. Competitive values of power takeover are traditionally associated with notions of autonomy; changing the.
Situating Relational Autonomy in Research Ethics in HIV Vaccine Trials in Developing
Fisher thus builds on the conceptual foundations of feminist ethics to develop a more relational ethics for science and research, which incorporates and enhances the interpersonal nature of and the obligations inherent in the relationship between scientist and participant. Ironically, the scientific goal of the study was to strengthen the role of women in the fight to reduce sex workers' vulnerability to HIV. This section has attempted to demonstrate connections between the theoretical concepts discussed in the previous sections and the research context, and has shown how relational autonomy models are practically applicable in the ethical conduct of research.
Summary
This does not mean that (ethical) principles are relativistic...moral arguments take place in context and therefore depend at least implicitly on...beliefs about human nature and social processes...arguments begin where we are , and appeals to where we live now. Subsequent sections have demonstrated how this individualistic approach has given rise to the individualistic conceptions of the self that underlie dominant conceptions of autonomy, and to the ethics of justice that have tended to dominate bioethical thinking. In the course of the above discussion, it has become clear that the alternative approaches.
METHODOLOGY
Aims and Hypotheses
Moral orientation: Men will show a greater tendency toward a justice orientation than women, while women will show a greater tendency toward a caring orientation than men. Black men would be expected to show a greater tendency toward a justice orientation than White women, while White women would show a greater tendency toward a justice orientation than Black women. White women will have a greater tendency toward a caregiving orientation than black men, who will have a greater tendency toward a caregiving orientation than white men.
Research Design & Methodology
- Feminist Critiques of Quantitative Methodology
- Value of Quantitative Methodology in Feminist Research
Qualitative methods, believed to be untainted by quantitative shortcomings, have been presented in feminist research as a suitable ameliorative alternative. A number of writers have recently begun to advocate and defend the use of quantitative techniques in feminist research, arguing that, when used critically, these methods can actually be more appropriate—indeed, essential—in some cases (Dunn & Waller, 2000; Griffin ). & Phoenix, 1994; Reinharz, 1993; Risman, 1993; Sprague & Zimmerman, 1989). Quantitative research has been shown to be equally valuable in highlighting the unequal treatment of women and men through the use of quantification techniques while avoiding the methodological pitfalls evident in traditionally "masculine" research (Sprague & Zimmerman, 1989).
Sample
- Gender
- Race
- Other Demographics
The main research hypothesis is that men will show higher levels of independence in their experience of both autonomy and self-constructiveness, and, accordingly, will show a greater tendency towards an ethic of justice; women will show higher degrees of interdependence in their experience of their autonomy and their self-constructions, and greater tendencies towards an ethic of care in their moral orientations.
Instruments
- Pilot Instruments
- Relational Being Scale
- Description
- Reliability and validity coefficients
- Administration and scoring
- Relational-Interdependent Self-Construal Scale
- Description
- Reliability and validity coefficients
- Administration and scoring
- Moral Orientation Scale
- Description
- Reliability and validity coefficients
- Administration and scoring
- Demographic Questionnaire
Of these, the following were chosen to measure autonomy – Bekker (1993), Boughn (1995) – the following to measure relational/independent aspects of the self – Cross et al. See Appendix A for a comparison of these scales). Items were generated from concepts related to relational forms of the interdependent self-construal as defined in the literature, as well as from. Two of the eleven items are negatively worded and their scoring is reversed in the data analysis.
Procedure
- Pilot Study
- Main Study
Based on these results, it was decided that the final survey should include the RBS, the RISC scale and the MOS. The researcher requested that time be given for a brief explanation of the nature and purpose of the study (Appendix B), as well as confirmation of. It was also emphasized that completing the questionnaires was not related to course requirements or assessment and some students chose not to take questionnaires to complete.
Analysis of Data
- Assumption Testing
- Reliability Testing
- Descriptive Statistics
- The Relational Being Subscales
- The Relational-Interdependent Self-Construal Scale
- The Moral Orientation Subscales
- The Relationship between Gender, Race, and the RBS, RISC and MOS Subscales
- Correlations
A multivariate analysis of variance (MANOVA) was used to test for significant differences in mean values between men and women on the RBS subscales. Significant differences between males and females on the MOS subscales were tested using MANOVA. MANOVA was used to test for significant differences on the RBS subscales between Black men, White men, Black women, and White women.
Ethical Considerations
RESULTS
Mean Subscale Scores
- The Relational Being Scale
- The Relational-Interdependent Self-Construal Scale
- The Moral Orientation Scale
In the present study, women's mean scores were consistently higher than men's. The mean RISC scores of the White group were higher than the mean RISC scores of the Black group (see Appendix E for table of RISC by race). Interestingly, the mean scores of white men were higher than the scores of black women and black men.
The Association between Autonomy and Gender (and Race)
- Autonomy and Gender
- Autonomy and Race
In contrast, white women scored highest on the relationship subscale, followed by black men, black women, and finally white men. Results across all four groups indicated that there were no significant differences between Black men, White men, Black women, and White women on the autonomy subscale. On the Relation subscale, black men, black women, and white women all scored significantly higher than white men.
The Association between Self-Construal and Gender (and Race)
- Self and Gender
- Self and Race
The results of analyzes by gender and race using MANOVA and Bonferroni pairwise comparisons of RISC scores are summarized in Table 4.12 and Table 4.13, respectively, below. Mean RISC scores for white women were significantly higher than for black women, black men, and white men. Interestingly, mean RISC scores were higher for white men than for black women and black men, although not significantly different.
The Association between Moral Orientation and Gender (and Race)
- Moral Orientation and Gender
- Moral Orientation and Race
White men scored higher on Justice than White women, while White women scored higher on Care than White men. The scores of White men on the Justice subscale were significantly higher than the scores of Black men, but there were no other significant gender by race differences on this subscale. White men > White women > Black women > Black men; Care: Black men > Black women >.
Correlations between Scores by Gender (and Race)
- Correlations between RBS, RISC and MOS Scores by Gender
- Correlations between RBS, RISC and MOS Scores by Race
Since constructs measuring components of autonomy and of the relational interdependent self are expected to be negatively correlated, this overlap is unexpected and points to the potential validity problems with the subscales of the Relational Being Scale. Correlations between the autonomy and relationship subscales of the RBS, the justice and caring subscales of the MOS, and the global scores of the RISC scale were calculated separately for Black women, White women, Black men, and White men. Contrary to expectations, there were no significant positive correlations between scores on the justice and caring subscales and the scores on any of the other subscales for either group.
Summary of Results
Analyzed by race and gender, results in all four groups showed that the mean autonomy subscale scores of Black men, White men, and Black women were significantly higher than the mean scores of White women. Black men unexpectedly scored higher than Black women on the RISC scale, but this was not a significant difference. Whites' scores on the fairness subscale were significantly higher than Blacks' scores.
DISCUSSION
The Association between Autonomy and Gender (and Race)
- Autonomy and Gender
- Autonomy and Race
- Gender differences within race groups
- Gender differences between race groups
However, the lack of significant differences between men and women on the Autonomy subscale of the RBS, as discussed below, suggests that women have a greater tendency to. The difference between men and women was in the expected direction (men higher than women), but was not statistically significant. That the men and women in the present study did not differ significantly on the Autonomy subscale may also be a reflection of the changing times, and of changing gender roles.
The Association between Self-Construal and Gender (and Race)
- Self-Construal and Gender
- Self-Construal and Race
- Gender differences within race groups
- Gender differences between race groups
One of the explanations offered for why men's and women's self-construals might differ in this way has to do with their differential socialization experiences. Important to understanding variations in men's and women's sense of self is recognition of variations in men's and women's positions in society in relation to the distribution of power rather than biology (Lykes, 1985). However, a closer examination of men's and women's perceptions of the nature of self-relationships may have attenuated the apparent gender differences in their self-concepts that were found in this study.
The Association between Moral Orientation and Gender (and Race)
- Moral Orientation and Gender
- Moral Orientation and Race
- Gender differences within race groups
- Gender differences between race groups
Correlations between Autonomy, Self and Ethical Orientation and Gender (and Race) 225
- Correlations by Race
Summary, Limitations and Implications
- Summary
- Limitations of this Study
- Implications of this Study
CONCLUSION & RECOMMENDATIONS
Key Conclusions
Recommendations for Future Research
