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May 18, 1994

Women and Children in Health Care: An Unequal Majority

Author Affiliations

Wells College Aurora, NY

JAMA. 1994;271(19):1548-1549. doi:10.1001/jama.1994.03510430104050

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Women and Children in Health Care should be required reading, along with Susan Sherwin's No Longer Patient, for those who are uneasy about the moral environment of contemporary medical practice. Both books show how serious inequality permeates the health care establishment, and both authors encourage their readers to do something about the problem.

Mahowald's book ranges from the theoretical to the practical. She starts with a useful critique of contemporary ethical theory and lays out a model for an egalitarian approach to moral problem solving. Although her initial discussion of the seven guidelines she proposes is schematic, her subsequent treatment of specific issues develops them more fully. Mahowald pays special attention to the sex-role stereotypes and power differentials that permeate medical practice. Her remedy is what she calls a "parentalist" model of relationships that empowers others by promoting both autonomy and health needs. Parentalism requires collaborative decision making and awareness

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