Ilvie Prince

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.

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.